• What is the cause of metabolic acidosis? Click all that apply.

___ Excess H+ generated within the body

___ Loss of base from the body

___ Deficit of H+ within the body

___ Gain of base in the body

• Metabolic acidosis can be caused by either a gain of acid or a loss of base from the body.

• Which of the following would be observed in simple, uncompensated metabolic acidosis?

___ CO₂ rises

___ CO₂ falls

___ HCO₃^- rises

___ HCO₃^- falls

• HCO₃^- levels fall due to loss of HCO₃^- from the body or increased acid reacting with HCO₃^-.

• What system will compensate for respiratory acidosis?

___ Respiratory system

___ Renal system

• Because the problem is metabolic in origin, the respiratory system compensates.

• As a result of compensation, which direction will this reaction go?

CO₂ + H₂O H₂CO₃ HCO₃^- + H⁺

Carbon dioxide Water Carbonic acid Bicarbonate Hydrogen ion

• The increased H⁺ causes the equilibrium reaction of this reaction to shift to the left.

• Will this individual hyperventilate or hypoventilate?

___ Hyperventilate

___ Hypoventilate

• The individual hyperventilates to blow off the excess carbon dioxide which is generated.

Metabolic Alkalosis

• What is the cause of metabolic alkalosis? Click all that apply.

___ Excess H+ generated within the body

___ Loss of base from the body

___ Deficit of H+ within the body

___ Gain of base in the body

• Metabolic alkalosis can be caused by either a loss of acid or a gain of base in the body

• Which of the following would be observed in simple, uncompensated metabolic alkalosis?

___ CO₂ rises

___ CO₂ falls

___ HCO₃^- rises

___ HCO₃^- falls

• HCO₃^- levels rise due to gain of HCO₃^- or decreased acid reacting with HCO₃^-.

• What system will compensate for metabolic alkalosis?

___ Respiratory system

___ Renal system

• Because the problem is metabolic in origin, the respiratory system compensates.

• As a result of compensation, which direction will this reaction go?

CO₂ + H₂O H₂CO₃ HCO₃^- + H⁺

Carbon dioxide Water Carbonic acid Bicarbonate Hydrogen ion

• The decreased H⁺ causes the equilibrium reaction of this reaction to shift to the right.

• Will this individual hyperventilate or hypoventilate?

___ Hyperventilate

___ Hypoventilate

• The individual hypoventilates to conserve CO₂.

• Notice that the equilibrium reaction illustrates how the respiratory system compensates for metabolic acidosis and alkalosis. The respiratory system is not the cause of the condition.

Respiratory Acidosis

• What is the cause of respiratory acidosis?

___ Excess H⁺ generated in the body

___ Loss of base from the body

___ Deficit of H⁺ from the body

___ Gain of base from the body

___ Increased H₂CO₃

___ Decreased H₂CO₃

• Respiratory acidosis occurs because CO₂ is not eliminated from the body.

• As a result of respiratory acidosis, which direction will this reaction go?

CO₂ + H₂O H₂CO₃ HCO₃^- + H⁺

Carbon dioxide Water Carbonic acid Bicarbonate Hydrogen ion

• Yes, the increased CO₂ in the blood will cause the reaction to shift to the right.

• Which of the following would be observed in simple, uncompensated respiratory acidosis?

___ CO₂ rises

___ CO₂ falls

___ HCO₃^- rises

___ HCO₃^- falls

• CO₂ rises because the individual is unable to blow off this gas.

• What system will compensate for respiratory acidosis?

___ Respiratory system

___ Renal system

• Over time, the renal system will compensate by generating or reabsorbing HCO₃, or excreting H+, but it may take hours or days for complete compensation to occur.

Respiratory Alkalosis

• What is the cause of respiratory alkalosis? Click all that apply.

___ Excess H⁺ generated in the body

___ Loss of H⁺ from the body

___ Loss of CO₂ from the body

___ Buildup of CO₂ in the body

• Respiratory alkalosis occurs when too much carbon dioxide is eliminated from the body because of hyperventilation.

• As a result of respiratory alkalosis, which direction will this reaction go?

CO₂ + H₂O H₂CO₃ HCO₃^- + H⁺

Carbon dioxide Water Carbonic acid Bicarbonate Hydrogen ion

• The equilibrium reaction shifts to the left as acid is used up.

• As acid is used up, which direction will the reaction go?

• Which of the following would be observed in simple, uncompensated respiratory alkalosis

___ CO₂ rises

___ CO₂ falls

___ HCO₃^- rises

___ HCO₃^- falls

• Yes, CO₂ falls due to hyperventilation.

• What system will compensate for respiratory alkalosis?

___ Respiratory system

___ Renal system

• Over time, the renal system will compensate by excreting excess base.

 do not dissolve in water, but dissolve in organic solvents

• triglycerides most commonly found in food and in the body (made up of glycerol and free fatty acids

• Fatty acids

• Saturated  animal fats

• Unsaturated  hydrogen missing from chain, and has a double bond. 1 double bond is monounsaturated (canola oil).

• Polyunsaturated  2 or more double bonds (corn oil)

• Omega 3 – if the first double bond is located 3 carbons from the omega end or methyl end then it is the omega 3. (some have positive effect on heart rhythm and can help in decreasing chances of blood clotting for MI)

  • Alpha linolenic acid – major omega -3 (from diet)

• Omega 6 – if the first double bond is located 6 carbons from the omega end

  • Linoleic acid – major omega 6 (from diet)

• Omega 9 – if the first double bond is located 9 carbons from the omega end

  • Oleic acid – major omega 9

• Eicosanoids  collectively they are referred to as local hormones (typically not carried to other sites and act locally) dietary factors can contribute to the effect or regulation of these hormones

  • Hormone – a chemical messenger

    • Prostaglandins – PG  involved in sleep reg., body temp, ovulation, endometrial lining produces many of these in the uterus (effect on uterus and muscles on head)

    • Prostacyclins – PGI  tend to inhibit TX and interfere with blood platelets

    • Thromboxanes – TX  effect on blood platelet function, can cause them to clot and release serotonin, which causes vasoconstriction

    • Lukotrienes – LT  more involved in causing contractions of smooth muscles in respiratory and GI contractions. Mainly in allergic reactions

    • Lipoxins – LX  same as LT

Aspirin  makes platelets less sticky

Triglycerides  fats and oils made up of these. These cannot cross cell membranes, but when we break off one of the fatty acids we get a di, then monoglycerides. Glycerol can cross a cell membrane.

• they are very energy dense too. They can store more energy than protein.

• Also the thin layer underneath your skin there is fat

• In females if there is no fat then the reproductive system shuts down and those people do not ovulate.

• Adipose  triglycerides are stored here. Each cell can get 50 X larger. Plus you can create more fat cells.

• Anorexia Nervosa  loose the fat. Subcutaneous fat is gone. The subcutaneous fat is about 20-25% of your body weight.

Fat soluble vitamins  A,D,E, and K

Phospholipids  involved in the formation of cell membranes and function as emulsifyiers (decreases surface area through mechanical process, allows fat to mix with water) Bile acids are the main emulsifiers

Bile Acids  composed of cholesterol, bilirubin (waste product of red cell degradation)

Sterols  steroids – there is no glycerol or fatty acid base. Do not dissolve in water either, so technically a fat

Cholesterol  acytel co-a

It is a component of many things. Testosterone, cell membranes, steroids, and many other things.

• we have the ability to make about 10% of our needed cholesterol

• Need 700 mg chol/day

• Cholesterol cannot come from plants

• stomach using lipase which is an enzyme that breaks down the tri glycerides to diglycerides

• Most absorption in SI.

• CCK is released and stimulates the release of bile from the gallbladder and the release of more lipase from the pancreas

• CCK levels can be lower with eating disorders (anorexia)

• Hydrolizes the tris to monos

• Phospholipase – helps to digest phospholipids in duodenum and jejunum (main place where fat is absorbed)

• After absorbed they are reformed into triglycerides and then into lipoproteins

• Lipoproteins are called chylomicrons  these are produced by the small intestine. Enter the blood through the lymphatic system. Once in the blood stream it is broken down into fatty acid and glycerol

• The enzyme in blood vessels breaks down the chylomicrons (lipoprotein lipase)

• TAG  FA + glycerol

• Takes upwards of 2 – 10 hours

Serum  coagulated blood

Plasma  not coagulated blood

VLDL  liver produces the most, liver will surround the lipid with a shell and that is the VLDL

Lipoprotein lipase will break down the TAG  fat + glycerol

The remaining part now is LDL  and this is mainly cholesterol

Most of the LDL is taken up by the cells of the liver. If you eat a diet that tends to be low in saturated fat and cholesterol it will encourage the liver to take up the LDL. If you do the opposite it inhibits the liver’s ability to take up LDL.

Scavenger Pathway for cholesterol uptake  it is designed to reduce the LDL that is in the blood stream. The cells can actually digest the LDL, but what they do after the digestion they tend to deposit it on the wall of blood vessels creating plaque. Tend to deposit the waste on damaged blood vessels. This is why high fat diets are contributing to plaque.

The damage is not sustained on the straight away vessels, but occurs at turns and junctions.

Fruits and vegetables will help decrease the LDL. Along with high anti-oxidant levels.

HDL  has the highest amount of protein (making it the denser than all of the rest)

• Picks up cholesterol from the blood and is carried back to the liver where it is excreted. High HDL levels is GOOD. Low HDL levels are correlated with increased risk of problems.

VLDL  mostly TAG

LDL  Mostly cholesterol

HDL  most protein, not cholesterol

• feeling full is caused by the GI tract being full

  • Proteins and fats remain in GI tract longer than carbs. Protein and fat stimulate this above peptide GIP.

• GIP slows the release of stomach contents into the duodenum. Therefore you feel full longer. Due to the stomach emptying slower. Fiber can also add to this feeling.

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Hydrogenation  bubbling the H+ ions into the oil

• Mono and poly saturated fatty acids are normally cis bonds (same side and keeps the chain from bending

• Trans fatty acid move hydrogen to opposite side (allows the fatty acid chain to bend) (Trans fatty acids have shown and increase with these increases the LDL and decreases the HDL

• No current intake limit or RDA recommendation for these

• Approx 4% of your energy intake should come from a plant oil.

• A person at risk of CVD, their fat intake should not exceed 20-30% of total energy intake and out of that only 7-10% should be from saturated fats.

Total cholesterol should be <>

LDL <>

HDL > 60 mg/dl

Triglycerides should be less than 150mg/dl

Hs-CRP test (this test is not recommended by the American Heart Association

C- reactive protein  is a protein associated with inflammation. The idea was if the blood vessels are inflamed the c-reactive protein will be elevated, however it will also be elevated if you have muscle damage somewhere.

This test tells you that the fire is on, but it will not tell you where.

Infarctions happen in the early morning hour. (4am – 6 am (65%))

Platelets are sticker in the morning, because 10,000 years ago you were most likely to forage for food in the morning.

• tons of substances in the body are made up of these and consists of 17% of your body weight and are crucial in body function

• hormones, enzymes, fluid balance,

• valued at 4kcal/G as an energy source

• Albumin is most osmotically active protein in serum – this is why osmotic activity decreases when there are liver problems

• We can create them too

20 AA

• Carbon bound to an amino group.

• 11 are non-essential (dispensable – body can make them)

• 9 essential amino acids (indispensable – must get them from the diet)

• Semiessential (conditionally dispensable) tyrosine and cystine. These are made from essential amino acid counterparts unless they are consumed.

• Essential and non-essential amino acids are present in foods

Transamination

• Metabolic process of synthesizing non-essential Amino Acids (co-enzyme vit B-6 needed)

Deamination

• removal of the amino group from the amino acid

• Amino group is converted to ammonia (by liver) and then to urea (by the liver and the kidney). Urea is excreted by the kidney.

• Bacteria in the environment  urease is the enzyme that breaks down urea to ammonia

• BUN  Blood urea nitrogen, this is a test to see if the kidneys are functioning correctly. If your BUN is high then you are having problems with your kidneys. Not eating protein will lower the BUN, however you will not have everything you need from proteins

The only portal of exit for creatine is the kidneys

Animal protein gives all 9 essential protein except gelatin

Plant protein  do not contain all 9 except the soy bean which does

Typically what happens with various foods when eating you are compensating for other foods that are deficient in another amino acid.

Protein digestion begins in the stomach and is degraded by pepsin

Pepsinogen  activated by HCL (released by parietal cells along with intrinsic factor)

Gastrin  controls pepsinogen (chief cells) and HCL

Chyme  this is created with enzymes and protein breaking down in stomach

CCK released in SI and triggers additional enzymes

Trypsin – reduces peptides into individual amino acids

Chymotrypsin

Carboxypeptidase

Absorption  peptides and AA are absorbed in the SI by ACTIVE absorption. As an adult we do not absorb whole proteins. However, infants can absorb a whole protein molecule. The small absorbed pepetides are digested to smaller peptides and are carried to the hepatic portal vein and are the stored or produced into glucose or fat,

• Collagen, Actin, Myosin  structural proteins

• Albumin, globulins (involved in carrying vitamins both fat and water soluble, carry hormones and anti bodies)

• Acid-base  buffers are, hemoglobin, in blood

• Hormones  Thyroid (tyrosine), insulin

• Immune function  immunoglobins

• Glucose formation (especially in starvation mode)

• Energy  do not supply the body with much energy unless there is an extreme situation (very costly source of energy)

Positive Balance in protein

• Pregnant, training, child  they all need the positive balance

• Ingesting more protein than you are utilizing

Negative Balance in protein

• fever, fasting, infections (bacteria mainly), some forms of kidney disease,  this is usually when people have this

Equilibrium in Protein

• Calculate nitrogen balance and values. Nitrogen is only found in protein. Across the board nitrogen makes up about 16% of the protein.

Nitrogen = 16% / WT of protein

A persons protein intake is determined by the gram so protein by 6.25 g. You then compare this with the nitrogen being lost. Usually lost in the form of urea. Some lost in nails, hair, skin, This is usually around 2g

N Balance = protein intake / 6.25g - urine urea - (0.2 X urine urea) - 2 g

Infants need N balance to = + 1.6 for balance

Adults need N balance to = + 0.8 for balance

RDA  male 56g – 155lbs

 female 44g – 120 lbs

High Protein diets  promote Ca 2++ in urine

Need calcium for nerve tissue and cardiac tissue 1200mg a day

Burden kidneys and can cause problems (hypertrophy)

2 reservoirs are bones and teeth

With increased CA ²⁺ you pull from the bones

Females at age of 15, 50% of them have osteoporosis

69% of our protein comes from an animal source

We normally eat 145 lbs of meat a year (beef, fish, poultry)

Magnesium and Fiber only come from plants. They also have lower cholesterol.

Protein Quality  Ability of the protein to maintain tissue growth and cellular activity

• we get concerned about the protein quality when the amount of protein consumed is equal too or less than the amount of protein required to meet essential amino acids intake

• When protein intake exceeds the amino acid intake amount the effectiveness of the protein is almost nothing. It does not matter how good the protein is. We have no way to store amino acids. Also it could be harming you if you are overly excessive.

• Biological Value  this is a measure of how efficiently and effectively a foods protein, once absorbed, can be utilized by the body

  • The food that has the highest is EGG WHITES. All of the nitrogen that you absorb is retained. The amino acid most closely resembles our own and is absorbed the most. (eating them raw)

• another way to measure the quality of a protein

• the protein efficiency ratio compares the amount of weight that is gained by a growing rat after 10 days of eating a standard amount of protein from one single source.

• PER = grams of weight gained / grams of protein consumed

• (amount of each essential amino acid that is provided by a gram of the foods protein) and that is divided by the (ideal amount for that essential amino acid per gram of food protein)

• Ideal amount

  • The minimal amount of each of the 9 essential acids per gram of food protein needed

  • The amino acid needs of children is the ideal

    • Score Basis is 0 – 1.0

• First determine the chemical score of the protein, then multiply the digestibility of the protein by the chemical score.

• Maximum digestibility is = 1.0 (milk, soy beans, raw egg are all 1.0)

• If the protein lacks any of the 9 essential AA then the chemical score will automatically be 0

• Wheat =

  • chemical score of .47

  • Digestibility score of .90

    • .47 X .90 = .423 is the PDCAAS

• 3 grams protein X .423 = 1.29g