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Feces 1. Composition a. water: 75% b. solid: 25% 1. roughage (30%) of solids a. insoluble fiber (e.g.

cellulose, lignin) - undigestible - acts as a bowel irritant - draws H2O out into lumen - cleans out lower GI -- correlated with cancer of colon b. soluble fiber (e.g. gums, pectins) - digestible - cholesterol concentration - binds bile salts - bile still needed to break-up fats - more cholesterol converted to bile salts - cholesterol pulled from bloodstream 2. dead bacteria (20%) 3. fat (10-20%) - steatorrhea = fat in stools 4. inorganic material (10-20%) 5. undigested proteins (10%) 2. Color - due to RBC breakdown products (e.g. bilirubin) 3. Odor - H2S (rotten egg smell) - mercaptans (sewer gas) 4. Flatus (gas) - produced by bacteria - beans - inhibit carbonic anhydrase - recall, CO2 + H2O H2CO3- HCO3- + H+ - increase in carbon dioxide and water Biochemistry and Metabolism - See figure 26.5, p. 858 1. Two sources of energy a. glucose - normally stored as glycogen 1. liver stores 85 g - glycogenolysis = glycogen catabolism yields glucose - glycogenesis = glucose anabolism yields glycogen 2. muscles store 400 g - reflects total muscle stores - allows for immediate source of energy with exercise

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- concentration is 80 mg/dL (70-100 mg/dL is normal) 1. post-prandial state - immediately after a meal - concentrations >140 mg/dL may indicate hyperglycemia - not necessarily diabetes 2. fasted individual - concentrations would be <115 mg/dL b. fat - 80-85% of available energy is found in fat 2. Deriving energy a. glycogen in liver - enzymes can crack out glucose 1. glycolysis
glucose (6 C) 2 pyruvic acid (3 C)

O2 absent lactic acid 2 ATP (net)

2. tricarboxcylic acid cycle (TCA) - also called the Krebs Cycle or the citric acid cycle - lactic acid can be oxidized -- funneled back into the pathway - acetyl-coenzyme A (from acetate) goes into Krebs cycle - yields reducing agents that go into electron transport chain 3. electron transport chain - yields 36-38 ATP * note: ATP yield - anaerobic exercise yields 2 ATP rapidly - aerobic exercise yields 36-38 ATP, but its slower b. protein - broken into amino acids - some can go into Krebs Cycle for energy - some can be interconverted with glucogenic molecules -- yields glucose for CNS - seen in starvation state - typically, go to ammonia / urea and are excreted in the urine - pyruvate can go back to glucose and back to glycogen - seen in sated individual - builds up glycogen stores in liver c. triglycerides - building blocks of fats 1. fatty acids - undergo -oxidation - cleaves acetate molecules (2 C) off of fatty acids (20 C) - acetate can go into the Krebs Cycle to yield ATP 2. glycerol backbone - possible for this to build new glucose -- this is a minor pathway

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Nutrition - See text p. 851-881 - Body preferentially uses the following as fuel: - see figure 26.10 1. Carbohydrates - used very rapidly 2. Fats (lipids) - this is the preferred fuel in a sedentary individual 3. Proteins - seen when individual does not get enough fuel for brain (protein wasting) - broken down to amino acids ATP can be generated - in starvation state, protein glucose for CNS - Physiologic states: - see text p. 867-869 and figure 26.11 and 26.12 1. Absorptive state - also called post-prandial - after a meal - glucose converted to glycogen, then stored - limited glycogen storage capacity -- 85 g in the liver, 300-400 g in muscle - excess glucose is stored as fat - amino acids - build new structural proteins - excess amino acids converted to fat 2. Post-absorptive state - several hours after a meal - decreased glucose concentrations initially - liver glycogen can be used to supply more glucose a. resting muscles - preferentially utilize fats - glucose sparing effect of fatty acids - glucose is the only source of energy for the CNS b. active muscles - preferentially utilize carbohydrates - glycogen in liver glucose glycolysis Krebs Cycle ATP - fat stores used as available glycogen is depleted 3. Exercise - initially muscles utilize carbohydrates - glycogen can be utilized - with much exercise, fat stores are eventually used 4. Prolonged fasting - interconversions between other substances to yield glucose (gluconeogenesis) - e.g. amino acids glucose 5. Starvation - glycogen stores are depleted, as are glucose stores - brain uses ketone bodies for energy - three types, one of them is acetone - manifests a fruity smelling breath - protein dramatically broken down Dr. Hutz Week 12 13

Fats - See text p. 864-867 and figure 26.9 and 26.10 1. Three types: a. saturated fats - solid at room temperature - all single bonds - all available sights on carbon are occupied by hydrogen - examples: 1. stearic acid found in lard 2. palmitic acid in palm oil - will increase body stores of cholesterol - LDL cholesterol - this is the bad cholesterol b. monounsaturated - liquid at room temperature - 1 double bond present - ex. oleic acid in olive oil - LDL cholesterol - no change in HDL cholesterol c. polyunsaturated - liquid at room temperature - 2 or more double bonds - ex. polyenoic acid found in safflower oil - LDL - HDL * note: its important to have a balance of these three 2. Essential fatty acids - body cannot synthesize them - must have an outside source for proper nutrition - extremely important molecules - used as precursors for other molecules - help with human cell membrane production - found in plant cell membranes - it is nearly impossible to avoid these in a normal diet - e.g. corn oil, cottonseed oil, and soybean oil a. linoleic acid b. linolenic acid - precursor of arachidonic acid 3. -oxidation - generates energy from fat stores - 2-carbon fragments cleaved off of long chain fatty acids - fragments can be shifted to the Krebs cycle to yield ATP

CourseNotes Week 12 14

Protein - See text p. 862-864 and figure 26.8 and 26.10 1. Essential amino acids - there are 8-9 that are essential - they cannot be synthesized by the body - an exogenous source is needed - most of these are neutral amino acids - e.g. corn - deficient in two of the essential amino acids - some cultures survive on corn as their major carbohydrate source - genetically engineered to contain all of the essential amino acids 2. Nitrogen balance - protein anabolism / catabolism a. zero nitrogen balance - protein synthesized = protein broken down b. positive nitrogen balance - protein synthesized > protein broken down - muscle mass will increase - seen in actively growing children, weight lifters and people taking anabolic steroids - nitrogen breakdown products in the urine - e.g. urea, ammonia - this can be used to asses nitrogen balance c. negative nitrogen balance - protein synthesized < protein broken down - nitrogen breakdown products in the urine - seen in starvation - not enough protein in diet - often accompanied by nutritional edema - protein wasting - body breaks down own protein for energy - plasma protein - plasma osmotic pressure (POP) - water leaves vascular supply and goes into the ISF - e.g. Kwashiorkor - adequate amount of calories, not the appropriate types however

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Calorie (c) - See text p. 869 - Labels on food products, etc. show kilocalories - kilocalorie (C) = 1,000 calorie (c) - calorie (c) = amount of energy required to raise 1 g of water by 1C - Bomb calorimeter - measures the amount of energy (calories) present in food - food sample placed inside apparatus - surrounded by water - food is ignited - temperature difference of the water is used to calculate the calories - examples: a. carbohydrate - liberates 4.1 kcal/g b. protein - liberates 5.3 kcal/g * note: in the body, protein isnt usually completely combusted c. fat - liberates 9.3 kcal/g * note: if not all burned, excess will be stored Caloric Requirements 1. Basal metabolic rate (BMR) - energy required to keep a person alive in a vegetative state - maintain BMR with moderate exercise - 80 kg male = 2800 kcal/day - values have fluctuated a lot in recent years a. 70 kg man - 2000-2200 kcal/day b. 55 kg woman - 1400 kcal/day * note: even with just a little exercise, it will be raised at least 300 kcal/day 2. Rule of thumb -- maintaining body weight - require 30-35 kcal per kilogram of body weight 3. Terms a. clinical obesity = 125%/130% (men/women) of the ideal body weight -- from actuarial weight b. morbid obesity = 160% of ideal body weight 4. Amounts may vary a. sedentary individual - 300 kcal + BMR b. pregnant - 300-500 kcal/day + BMR (esp. in third trimester) c. lactating - 500 kcal/day + BMR * Note: 1 lb. of body weight 3500 kcal

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Time Required to Deplete Body of Certain Reserves 1. Carbohydrates - 13 hours - glycogen is bodys only real reserve - present in muscle and liver 2. Fat - 20 to 40 days - young men - 20-25% of body mass is fat - fat deposited in belly - apple shaped - young women - closer to 30% - estrogen causes fat to be deposited differently - breasts, buttocks, hips - pear shaped 3. Protein - depleted in hours - functionally there isnt a reserve - body only breaks protein down for energy when absolutely necessary - i.e. starvation 4. Water - 3-4 days 5. Iron - 125/750 days (women/men) - found in liver, hemoglobin - RDA is 10-15 mg/day 6. Calcium - 7 years - found in bones and teeth - important in skeletal muscle contraction - osteoporosis = demineralization of bone - occurs over course of entire life - 800-1800 mg/day - depends on sex, age, period of life 7. Sodium - 2 to 3 days - found in many sources -- not easy to deplete this 8. Vitamins - not an actual source of energy, but needed - important as co-factors for enzymes - vitamin B12 - 7 years - animals are the main source - some yeasts have little B12 -- not adequate amounts - vegans need injections after seven years to avoid becoming anemic - need for healthy RBC development

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Dietary Composition 1. Calories - ideal percentage of calories from the following is 60:30:10 - energy is only derived from these three: a. carbohydrates - RDA is 60% - American diet is typically 40-50% b. fats - RDA is < 30% - American diet is 40% c. proteins - RDA is 10% - American diet is 20% 2. Minerals - see table 26.2, p. 876-877 - inorganic elements (non carbon-containing) * note: cant derive energy from minerals - they help derive energy from other compounds, however - normal, healthy diet usually provides plenty of minerals a. sodium ion - needed for nerve conduction and muscle contraction b. calcium ion - found in bones and teeth - needed for muscle contraction c. phosphorus ion - found in bones and teeth - component of ATP - require 800-1200 mg/day d. potassium ion - primary intracellular cation - important for resting membrane potential - nerve cells and muscle cells e. magnesium ion - acts as a co-factor (enzyme activator) - helps activate Na+ / K+ pump f. chloride - major extracellular anion - involved in chloride shift g. iron ion - helps form hemoglobin structure and content - carries oxygen h. fluoride - prevents dental caries (decay) i. iodide - important component of thyroid hormones - regulation of basal metabolic rate - low levels lead to formation of a goiter

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- trace amounts of following: a. cobalt - constituent of vitamin B12 b. zinc - extremely important in activating insulin - slows down breakdown of insulin c. selenium - 20-70 g/day 3. Vitamins - organic = made up of carbon, hydrogen, oxygen, nitrogen, phosphorus, or sulfur - cannot derive energy from vitamins - many serve as co-factors (activate enzymes) - important for metabolic function, growth and health maintenance a. fat soluble vitamins: - see table 26.1, p. 873 - stored in lipid droplets - examples are vitamins A, D, E and K - toxic effects can be seen by overdosing - e.g. hypervitaminosis A = headache, nausea and vomiting 1. A (retinol or retinoic acid) - RDA is 800-1000 g - derived from carotene - found in eggs, yellow vegetables, fortified milk - important for the production of rhodopsin (visual purple) - deficiency results in night blindness and corneal problems (opacity) 2. D (cholecalciferol) - RDA is 10 g - found in milk, dairy products, eggs - important in promoting bone growth - absorption of calcium and phosphorus - deficiency causes: a. rickets - seen in children - bones do not form properly b. osteomalacia - seen in adults 3. E (-tocopherol) - not much clinical evidence on its function... - anti-oxidant in vitro - prevents oxidation of cells - may serve to prevent cell aging - found in green leafy vegetables, meat - deficiency results in malabsorption at the GI tract -- malabsorption syndrome 4. K (menadione) - extremely important in blood clotting - found in green leafy vegetables - bacteria in GI tract can synthesize K - deficiency results in slow clotting Dr. Hutz Week 12 19

Saturations 1. Animal fat - all show 10-20% cholesterol - found in cell membranes of animals a. beef fat -- 50% saturated b. butter -- 50% saturated c. chicken fat -- 30-40% saturated, 11-21% polyunsaturated 2. Margarine - 18% saturated fat - 35% unsaturated fat - 0% cholesterol, unless its been added * Note: for every 10% drop in cholesterol concentration, there is about a 20% drop in CV risk General Dietary Recommendations 1. Calcium - maintain a good source of calcium in your diet - from dairy products, fish, antacids - particularly women that are predisposed to osteoporosis 2. Fat - keep low levels - less than 30% of calories from fat 3. Fiber - soluble -- binds bile acids - insoluble -- bowel irritant - try to increase levels of both (25-30g/day) 4. Four food groups a. dairy -- 2-3 servings of low fat dairy products/day b. meat -- 1-2 servings of meat/day (less is better) c. fruit / vegetables -- 5-9 servings of vegetables and fruits/day d. grains -- 6-11 servings of whole-grain products/day 5. Smoking - decrease or quit 6. Exercise - 3 times per week, 20 min. each time - this should be aerobic exercise 7. Aspirin - 1 aspirin/day for people that are at a particular risk of cardiovascular disease - keeps blood thinned 8. Alcohol - in moderation - if you drink on a regular basis, should reduce intake to 2 glasses of wine/day - will risk of cardiovascular disease - treat alcohol as you would fat - controversial issue: beneficial effects from consuming small amounts of alcohol

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Endocrine System - See text p. 548-575 - Endocrinology = study of hormones - Made up of several glands located throughout the body 1. Classical - hormones are released directly into the blood stream - hormones may be produced by one organ and travel through the body to effect another organ - typically travel great distances in body before having an effect 2. Non-classical a. paracrine messengers - have a local effect - do not typically travel far to have an effect - do not usually enter blood supply - e.g. prostaglandins - produced by the uterus, go to ovary and have an effect - never enter the general blood stream b. autocrine hormones - released from one cell and exert an effect on the same cell - very localized effect (e.g. estrogen) c. intracrine effect - regulation of changes within the cell are at the nuclear level - substance never leaves the cell 3. Endocrine system vs. nervous system - both are communicating systems a. endocrine system - works through blood - shows much slower effects - may take hours to days - effects are prolonged - substances found in the fluids of the body b. nervous system - works through neurotransmitters - shows very rapid communication - effects are seen within seconds - effects are very brief - substances found in nerves

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