HNF 150 Exam #1 Body Basics, Digestion, Digestive Diseases, and Alcohol

12. Identify the differences between inflammation and chronic inflammation on health and disease.

Acute Inflammation Chronic Inflammation Onset Immediate Delayed Duration Days Weeks to months Inflammatory cells (FYI) Neutrophils Lymphocytes, monocytes Signs Prominent (visible) Not as prominent Outcome Resolution (healing), chronic inflammation Tissue destruction

4. Describe secretions of the digestive system including secretion, organ and role.

Secretions of the Digestive System Secretion Where it's made/Organ Role Saliva Mouth Begins starch digestion, lubrication, aids with swallowing Mucus Mouth, stomach, small intestine, large intestine Protects lining of the GI tract, lubrication Enzymes: amylases for starch proteases for protein lipases for lipids Mouth, stomach, small intestine, pancreas Break down carbs, fats and protein so body can absorb them Hydrochloric Acid Stomach Unwinds protein chains so enzymes can act, kills microorganisms, stops carb digestion Bile Liver (stored in gallbladder) Emulsifies fat, necessary for fat digestion Bicarbonate Pancreas, small intestine Neutralizes stomach acid in small intestine Hormones Stomach, small intestine, pancreas Regulates digestion and absorption

8. Recognize the fight- or-flight reaction or stress response and the body's response to stress by the: 1) nerves, 2) hormonal system,3) metabolism, 4) digestive system, 5) liver, and 6) fat cells. (Think of the overall purpose of fight- or-flight and what would be needed to facilitate the process)

a. (Combination of Hormonal and Nervous System) i. Another name for the fight or flight response = stress response b. When we detect danger... 1. Nerves release neurotransmitters 2. Glands release the hormones: Epinephrine and Norepinephrine 3. Every organ responds and Metabolism speeds up 4. Liver releases glucose from stores 5. Fat cells release fat 6. Heart races, pupils of eyes widen, muscles tense, digestion shuts down, breathing quickens, blood pressure rises.

16. Describe what counts as one alcoholic drink

a. 5 oz wine b. 1.5 oz liquor (80 proof) c. 12 oz beer (ice beers contain much higher alcohol-content than regular beer)

9. Understand the purpose of the immune system.

a. A complex network of tissues, cells and molecules that interacts and uses various mechanisms to achieve resistance or immunity to a variety of threats to the host.

15. Trace what happens when alcohol enters the body, including the time it takes for alcohol to reach the brain. Compare and contrast the effects of gender, body size, and food consumption on alcohol metabolism.

a. After Alcohol Enters the body i. What Happens to the Alcohol I Drink? 1. Alcohol is a toxin (FYI- oxidized to acetaldehyde in liver; excess aldehyde accumulation is toxic) 2. Alcohol metabolism takes priority over metabolism of other nutrients 3. Does not require digestion to be absorbed 4. Alcohol diffuses through the stomach wall and circulates in the blood (absorbed more quickly than it is metabolized) (only a tiny bit metabolized in stomach) ii. How Alcohol Contributes to the "Beer Belly" 1. Alcohol speeds up synthesis of fatty acids by liver 2. Alcohol interferes with liver metabolism 3. Alcohol contributes to excess calories (not nutrient dense) 4. Alcohol consumption may replace other foods otherwise consumed 5. Alcohol consumption may stimulate appetite iii. C. Liver deterioration: 1. Effects of Too Much Alcohol on the Liver a. Fatty liver -- the first stage of liver deterioration and interferes with the distribution of oxygen and nutrients to the liver's cells b. Fibrosis -- If the condition persists long enough, the liver cells will die, forming fibrous scar tissue, the second stage of liver deterioration c. Cirrhosis -- the final stage of liver damage and is virtually irreversible 2. Fatty liver: a. The first stage of liver deterioration and interferes with the distribution of oxygen and nutrients to the liver's cells b. Alcohol speeds up synthesis of fatty acids by liver c. Liver is overwhelmed by alcohol metabolism and cannot efficiently distribute the fatty acids into blood stream 3. Cirrhosis: a. characterized by widespread nodules in the liver b. complications of cirrhosis are jaundice, edema, bleeding esophageal varices, blood coagulation abnormalities, coma and death b. Alcohol Metabolism i. Social Considerations 1. A. Matching Drinks a. Everyone metabolizes alcohol differently ii. Everyone metabolizes alcohol differently because of (8): 1. Body weight ( lean muscle vs fat more muscle=less effect) 2. Speed of intake 3. Food in stomach 4. Gender 5. Age 6. Type of beverage 7. Drinking history 8. Physical and emotional state 9. Use of other drugs 1. Height, weight, and body composition (lean muscle vs fat) 2. Gender women get drunk faster - fat metabolizes differently, menstrual cycle, birth control, antibiotics, etc. 3. Genetics a. Linkage between genetics and addiction b. Get better high c. Pleasure and pain centers are closer in addiction d. May form a faster, more efficient connection 4. Medication - alcohol may max or min effects when it interacts with medication 5. Food a. Eat first b. Stomach gets irritated by alcohol c. Eat before, during, and after d. Can slow absorption of alcohol 6. Dehydration a. Alternate between alcohol and H2O b. Can drink longer 7. Sleep/fatigue is a bad combo when paired with alcohol 8. Mood a. Angry, aggravated, or depressed --> feeling doesn't go away while drinking 9. Environment a. Body works harder in an unknown environment -> symptoms of intoxication looks worse --> brain has to spend E to navigate iii. Sobering up: 1. Food slows alcohol's absorption 2. CHOs and fats are especially useful in keeping alcohol in the stomach longer 3. 1 drink takes 1½ hours to metabolize 4. Coffee and walking do NOT help 5. TIME is only means of "sobering up"

10. Identify primary and secondary lymphoid organs

a. Central/primary organs- where lymphocytes are made i. thymus- increases in size from fetal stage to puberty and then decreases ii. bone marrow b. Secondary- where adaptive immune responses are initiated and lymphocytes are maintained i. spleen, lymph nodes and some in the tonsils, appendix, the gut, etc.

5. Recall how nutrients are transported in the body and state the 3 requirements of healthy cardiovascular and lymph circulation systems.

a. Circulatory and Lymphatic System i. 2 Types of BODY FLUIDS: 1) Blood and 2) Lymph 1. Functions (2): a. Supply energy, oxygen, and nutrients b. Carry away waste materials b. Parts of Circulatory System i. Arteries = carry blood containing fresh oxygen from heart to tissues ii. Veins = carry blood with carbon dioxide from tissues to heart iii. Red Blood Cell = cell that transport oxygen in the cell c. Lymphatic system = has own separate vessels d. Extracellular fluid surrounding cells = derived from capillaries, some goes back into the blood stream through the capillaries and some becomes lymph fluid and flows through the lymph vessels e. Adequate circulation requires (3): i. Ample fluid intake ii. Cardiovascular fitness - keeps heart muscle strong iii. Good nutrition - blood is very sensitive to malnutrition

13. Describe causes and treatment for the following digestive diseases: constipation, diverticulosis/itis, diarrhea, heartburn and GERD, IBS, ulcers, ulcerative colitis, and Crohn's disease.

a. Constipation a. Difficult or infrequent bowel movements b. With extended time in colon increased fluid reabsorption and hardening of the feces c. Some causes: i. Not enough fiber in diet ii. Ignoring normal urges to defecate iii. Slow down of peristalsis, stress iv. Use of antacids, calcium and iron supplements d. Treatment i. Increase whole plant foods (dietary fiber) ii. Increase consumption of water and fluids b. Diverticul-"osis" and -"itis" i. Cause: Low whole plant food (fiber) diet ii. Treatment: high fiber diet, medical treatment if severe c. Diarrhea a. Loose watery stools occurring more than 3 times per day b. Major issue for children in developing countries (1 of 7 childhood deaths) c. Causes: i. Intestinal infection - rotavirus, bacteria or parasites ii. Food intolerances, medications, substances that are not easily absorbed iii. Intestinal tract secretes fluid instead of absorbing it iv. Toxins damage intestinal cells d. Treatment: i. Prevent dehydration -- increased fluid intake (water with some electrolytes and glucose) ii. Homemade recipe - 1 quart water, 2 TBS sugar, ½ tsp salt iii. Reduce intake of poorly absorbed substance (if that was the cause) d. Heartburn and GERD a. Also called Acid Reflux b. Gastroesophageal Reflux Disease (GERD) when more than 2x per week c. Other symptoms: hoarseness, trouble swallowing, coughing, gagging, nausea d. Can lead to anemia, bleeding, and cancer e. Treatment: i. Smaller meals ii. Avoid offending foods such as fatty meals iii. Stop smoking, limit alcohol intake iv. Do not lie down after eating v. Avoid heavy use of antacids - stomach needs acid to digest vi. food and kill microorganisms e. Irritable Bowel Syndrome (IBS) i. 10-15% of population, more common in women ii. Cause unknown, stress and diet may play a role iii. Fructose, HFCS, sugar alcohols, gas-forming foods, soy, wheat, fatty foods iv. Symptoms can be mild or severe 1. Irregular bowel function (diahrrea/constipation), abdominal pain, bloating v. Believed causes for symptoms: 1. abnormal GI tract motility, 2. lower pain threshold for bloating vi. Work with a doctor and dietitian to identify problem foods and plan a diet to minimize symptoms. f. Ulcers i. Weakening of the lining of esophagus, stomach or upper small intestine ii. Burning pain in stomach between meals or at night iii. Increases risk for cancer iv. Causes: 1. Bacteria: Helicobacter pylori weakens mucus coating 2. Heavy use of aspirin/ibuprofen reduces production of mucus v. Treatment: 1. Avoid foods that cause discomfort 2. Relaxation 3. Antibiotics if caused by bacteria g. Inflammatory Bowel Diseases i. 1 in every 500 people, usually diagnosed around age 20 ii. Genetic link, may have diet link, over-active immune/inflammatory response iii. Ulcerative Colitis 1. Inflammation in the large intestine iv. Crohn's disease 1. Inflammation of entire GI tract 2. Usually last part of colon v. Swelling, scar tissue formation narrowing of GI tract vi. Cellular damage nutritional deficiencies due to poor absorption vii. Anemia, osteoporosis, protein-calorie malnutrition viii. Need careful nutritional monitoring ix. Treatment: Work with doctor on diet, immune-suppressive drugs, antibiotics, surgery to remove damaged parts of intestine

14. List examples of prebiotics and probiotics, and explain how these three words (microbiome, prebiotic, probiotic) are related to one another

a. Gastrointestinal microbiome i. The human GI tract contains approximately 1014 bacteria; more diverse further in gut ii. These microbes are classically known to: 1. Digest molecules we can't digest: Cellulose and Some starches 2. Produce vitamins B12 and K 3. State of the art research has shown they also: a. Interact with our Immune systems b. Interact with our Brains c. Modulate our Metabolism d. Prevent infection iii. Factors that Change the GI Microbiota Host Diet/Supplement treatment Genetics Sex Age Immune system Gut motility Nondigestible carbohydrates Fat Prebiotics Probiotics Antibiotics Gastric bypass Other medications iv. The definition of "prebiotic" is hotly debated. 1. Definition of prebiotic: a nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and/ or activity of one or a limited number of bacteria in the colon, and thus improves host health Country Regulatory Agency Definition U.S.A. FDA Non-digestible food ingredients that beneficially affect the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon Europe EFSA Must change the microbiota AND have a beneficial physiological effect or outcome in a human intervention study Canada Canadian Food Inspection Agency Must have measurable health benefits in humans 2. Examples of Prebiotics a. inulin and oligofructose (produced from insulin) b. fructooligosaccharides (FOS) synthetically produced from sucrose c. galactose-containing and xylose-containing oligosaccharides d. resistant starch (RS) e. pectin f. milk oligosaccharides b. Probiotics are: i. living microbes that have the potential to confer a beneficial health effect ii. live microbes themselves iii. foods containing live microbes 1. some yogurts 2. fermented foods (kimchi, sauerkraut, and kombucha) 3. human milk c. Synbiotics definition: combine the prebiotics that feed specific probiotic bacteria into one product for consumption i. Examples: supplements, human milk, and most yogurts

17. Alcohol Metabolism Effects

a. Height, weight, and body composition (lean muscle vs fat) b. Gender women get drunk faster - fat metabolizes differently, menstrual cycle, birth control, antibiotics, etc. c. Genetics i. Linkage between genetics and addiction ii. Get better high iii. Pleasure and pain centers are closer in addiction iv. May form a faster, more efficient connection d. Medication - alcohol may max or min effects when it interacts with medication e. Food i. Eat first ii. Stomach gets irritated by alcohol iii. Eat before, during, and after iv. Can slow absorption of alcohol f. Dehydration i. Alternate between alcohol and H2O ii. Can drink longer g. Sleep/fatigue is a bad combo when paired with alcohol h. Mood i. Angry, aggravated, or depressed --> feeling doesn't go away while drinking i. Environment i. Body works harder in an unknown environment -> symptoms of intoxication looks worse --> brain has to spend E to navigate j. MSU students drink on average 0-3 drinks when they party (includes everyone) k. Alcohol is a depressant

3. Recall the basics of digestion and absorption for carbohydrates, protein, fat and water.

a. In the Mouth (less than a minute) i. Mechanical 1. Chewing and swallowing 2. Teeth/tongue crush and mash food, nutrients and fiber into smaller pieces 3. Mucus in saliva keeps things lubricated 4. Esophagus transports food to stomach (peristalsis) ii. Chemical 1. CARB digestion begins: salivary enzyme converts starch to sugar b. In the stomach (1-2 hours) i. Mechanical 1. Collecting and churning 2. Food is collected in upper storage area 3. Food enters digesting area of stomach 4. Mixing of food and liquid into CHYME 5. After 1-2 hours, pyloric sphincter releases chyme slowly into small intestine (1 tsp at a time) ii. Chemical 1. Parietal cells secrete ACID (HCl). Acidic environment: a. Stops CARB digestion b. Activates protein enzymes to uncoil PROTEINS in bread, PB, and seeds c. Kills harmful bacteria and viruses 2. Mucus prevents stomach from digesting itself 3. Secretion of enzymes to clip protein and lipids (primarily protein) 4. FAT forms a watery layer on top c. Small intestine (7-8 hours) i. Mechanical 1. Peristalsis and segmentation ii. Chemical and Absorption 1. Pancreas sends in sodium bicarbonate to neutralize stomach acid 2. SUGARS (type of CARB) from banana absorbed into small intestinal cells 3. Bile from liver (stored in gall bladder) arrives through the bile duct to blend with FAT from PB and seeds 4. Pancreas and intestinal cells send in digestive enzymes 5. CARBS, PROTEIN, FATS broken into smaller units by enzymes and absorbed by small intestinal cells 6. Small FATS and some VITAMINS absorbed by lymph, then to blood and liver 7. CARBS, PROTEINS, VIT, MINERALS, and large FATS absorbed by blood and go to liver d. Large Intestine (12-14 hours) i. Mechanical 1. Arrival of water, some minerals, undigested fiber and starches 2. Peristalsis and mass movement 3. Illeocecal valve prevents backflow to small intestine 4. Normal feces is 75% water and 25% solids 5. At the end of the digestive tract, remaining feces excreted through the rectum and anus ii. Chemical and absorption 1. Beneficial bacteria and some pathogens (change in response to diet and addition of PROBIOTICS 2. Over 400 species 3. 10 times as many bacterial cells here as cells in the human body! 4. FIBER and resistant starch (PREBIOTICS) in seeds, bread, PB, and banana is partly digested/fermented by bacteria 5. FIBER fragments, water, and some minerals (especially sodium and potassium) are absorbed

11. Understand the concept of innate and adaptive immunity (how are they different?)

a. Innate immune system i. Responds when threat breaks through the body's barrier defense (within hours) ii. Not antigen specific iii. Goal is to eliminate/control the threat and prepare the adaptive immune response iv. Not impacted by previous exposure v. NK Cell (lymphocytes) and Granulocytes and Myeloid cells b. Adaptive immune system- i. Responds when threat has broken through the body's barrier defense and overwhelms innate immune system ii. More or less creates an army of immune cells to attack the specific antigen iii. May respond due to past experiences (acquired immunity) iv. Goal is to eliminate/control the threat v. Impacted by previous exposure vi. B and T lymphocytes

7. Identify the 3 organs and general processes involved in excretion of wastes.

a. Lungs- release carbon dioxide b. Liver - filters blood and sends wastes to the small intestine through the bile duct to be excreted as feces, or to the kidneys to be excreted as urine c. Kidneys - Removes toxins from the body and need good supply of water, strong heat and cardiovascular system, sufficient energy, and adequate nutrition d. Skin - maintains body temp through excretion of water and salts

2. Compare the differences between mechanical digestion and chemical digestion and point out where these processes occur along the digestive tract.

a. Mechanical Digestion: physically breaking food down (begins in mouth); peristaltic wave (series of contractions and relaxations) i. Types of movement: 1. Chewing - crush and grind food with teeth (mouth) 2. Peristalsis - one way, rhythmic, longitudinal muscles (Esophagus and Intestines) 3. Segmentation - two way, mixing, circular muscles (Intestines) 4. Mass Movement - large intestine, short duration, 3-4 times/day 5. Stomach muscles - crisscrossed layers create churning and mixing motions 6. Sphincters/valves - between components of digestive tract, regulate flow of chyme, powerful squirts b. Chemical Digestion: breaking food down into simpler nutrients to be used by cells (begins in the mouth) i. Begins when see or smell food.... Brain triggers salivary glands to secrete saliva ii. Organs/areas involved: oral cavity with salivary glands, stomach, liver, gallbladder, bile duct, large intestine (colon)

1. List the order of the components of the digestive tract and the main digestive actions taking place in each (the main organs that hold the food and the accessory organs). Recall the order of the digestive tract.

a. Oral cavity/Mouth: Chews and mixes food with saliva i. Salivary Glands: Donate a starch-digesting enzyme; donate a trace of fat-digesting enzyme (important for infants) ii. Tongue: b. Esophagus: Passes food to stomach c. Stomach: Adds acid, enzymes, and fluid; churns, mixes, and grinds food to a liquid mass d. Small Intestine: secretes enzymes that digest carbohydrates, fat, and protein; cells lining intestine absorb nutrients into blood and lymph i. Liver: Manufactures bile, a detergent-like substance that facilitates digestion of fats ii. Gallbladder: stores bile until needed iii. Bile duct: conducts bile to small intestine iv. Pancreas: manufactures enzymes to digest all energy-yielding nutrients; releases bicarbonate to neutralize stomach acid that enters small intestine v. Pancreatic duct e. Large Intestine: Reabsorbs water and minerals; passes waste (fiber, bacteria, any unabsorbed nutrients) and some water to rectum f. Rectum: stores waste prior to elimination g. Anus: Holds rectum closed; opens to allow elimination

6. Identify the two organs involved in storage of carbohydrate and the type of tissue that stores fat within the body.

a. Organs i. Liver 1. Liver decides the fate of the glucose (5): a. Use it for energy b. Store as glycogen c. Store as fat d. Make non-essential amino acids e. Dump into blood ii. Pancreas 1. Causes absorption or release of glucose b. Tissue i. Adipose tissue stores fat ii. Muscle can also store glucose

d. Alcohol

e. 5% of students drink occasionally f. 70% of people have consumed alcohol in the past 30 days g. 1 in 4 students at MSU don't drink h. Tips: i. Stay hydrated ii. Stay in a group iii. Eat before, during, and after iv. Know your limits and count your drinks v. Take a cab vi. Pee vii. Sleep i. College Students are the largest population in drinking

k. What is one serving? (by volume)

i. 6 oz - wine ii. 12 oz - beer iii. 1.5 oz distilled liquor (80 proof) 1. % - % ethanol in alcohol 2. Proof - 2x the %

l. Alcohol iClicker Quections

i. Alcohol is an aphrodisiac --> MYTH 1. Lower inhibion, social lubricant 2. 90% of sexual assualt involves alcohol 3. Alcohol doesn't consent 4. Doesn't enhance sex a. Nerve endings are on fire i. Increased HR and blood flow 1. Men: can't get "hard", hard to orgasm, and ejaculate 2. Women: Deadens nerves -> don't feel; need hydration for lubrication ii. Having a drink then walking across campus (in the winter will keep you warmer) --> MYTH 1. Vasodilator - feel warm, but you aren't - unable to shiver iii. Alcohol will help you sleep at night --> MYTH 1. Alcohol has sedative effects 2. You will get bad sleep 3. Body goes through withdrawal 4. Prevents all stages of sleep/cycles or REM sleep 5. Pilot stimulator - significant deficiencies a. Critical thinking, complex problem solving, and multi-tasking deficiencies iv. You can sober up quickly if you have to --> MYTH 1. Can't metabolize any quicker 2. Takes 1-1.5 hrs to metabolize one drink v. Alcohol is a stimulant --> MYTH 1. Alcohol is a depressant 2. Biphasic a. Beginning: warm, buzzing, initial euphoria i. Pleasure neurotransmitter --> DA released DA is required to live a normal life 1. DA release increases, peaks, then decreases a. DA Max release- i. decreased every time you use a substance; when you reach a peak your brain shuts down your DA system ii. Brain: 100 ng/dL iii. Opiate: 950 iv. Alcohol: 875 v. Pot: 500 vi. Cocaine: 1000 vii. Meth: 1100 b. Substance abuse disorder: i. Altered basal levels of DA - 20 ng/dL b. BAC levels decrease and you come off the "high" c. .055 BAC best euphoria d. 0.06 BAC DA levels decrease i. Lose language (speech), judgment, concentration, memory, etc. vi. It is impossible to recall memories form a black out --> TRUE 1. Fragmented blackout - parts of memory intact 2. En bloc black out - total black out

j. Binge Drinking:

i. Consuming 4 or 5 drinks in a short period of time for women and 5 or more drinks in a short period of time for men (over 2 hours) 1. 0.8 BAC or above for binge drinking 2. Men should only drink 2-3 drinks in the first hour or two