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what are the alcohol recommendations?
- Males - max. 1-2 drinks/day
- Females - max. 1 drink/day
- Max 4 on any occasion with food
- Avoid if pregnant
what is 1 drink?
- 1 drink = 1/2 oz pure ethanol
- 5 oz wine
- 12 oz beer
- 10oz wine cooler
- 1 1/2 oz liquor (80 proof whiskey, gin, brandy, rum, vodka)
who is alcohol converted to acetyl CoA?
what is CoA?
- Co enzyme A
- Essential in the diet
- Vitamin B
- Using NAD (niacin) and generating acid (H+ ions)
what happens with high alchol consumption?
what are the metabolic effects?
- Less NAD+ - pyruvate produces lactate rather than acetyl cos
- More H+ - acidosis along with lactate
- Acetyl CoA produced produces fatty acids and ketones rather than entering TCA cycle - fatty liver
- With decreased gluconeogenesis -- ketosis
- Decreased protein synthesis
- Both cause liver damage: fibrosis then cirrhosis
what is the link between alcohol and malnutrition?
- Empty calories
- ↓ nutrient inatke
- Compromises vitamin status
- * Wernicke-Kprsakoff syndrome - thiamin destruction
- *Anemia - due to folate excretion
- *Decreased ↘ vitamin D activation in liver
- *B6 loss from binding protein
- Causes dehydration
- Increases Fatty Acid synthesis, AA catabolism
- Decreases Protein synthesis, gluconeogenesis
what is fetal alcohol syndrome (FAS)?
- Incidence 1 and 9 per 1000 live births
- Alcohol crosses the placenta freely and is directly toxic
- Drinking alcohol during pregnancy threatens the fetus with:
- *Irreversible brain damage
- *Growth restriction
- *Cognitive impairment
- *Facial abnormalities
- *Vision abnormalities
how does FAS damage occur?
- Direct - intoxication, teratogenic effects
- Indirect - Malnutrition
what is the french paradox?
France = ↓ CVD despite ↑ saturated fat intake
- Red wine consumption = very unclear
- alcohol or flavanoids or combination of both
- Resveratol protects against LDL oxidation
- Alcohol has ↑ HDL
what are the risks associated with alcohol consumption?
- cancer - oral, stomach, colon, breast, prostate
- drunk driving
what is cirrhosis?
- Irreversible liver damamge casused by alcohol, hepatitis B or C, due to iron toxicity (hemochromatosis)
- As liver constantly repairs, accumulation of fibrosis tissue, scars and nodules and connective tissue - impaired function
- Fatty accumulation = causes steatosis
- Inflammation - hepatitis
- Cirrosis is IRREVERSIBLE
what does cirrhosis lead to?
what are the functions of water?
- Nutrient absorption and transport
- Biochemical reactions
- Shock absorber
- Temperature regulation
- Excretion of wastes
what are the functions of electrolytes?
- Fluid compartments and balance
- Acid/base balance
- Muscle contractions
- Conduction of nerve impulses
what are the recommended water intakes?
- Average: 1-1.5ml/kcal/energy expenditure
- Women: 2.7L
- Men: 3.7L
who needs increased water intakes?
- Preganant and lactating women
- Diarrhea and vomiting
- Fever, heavy exercise
- Elderly, air travel
- Hot environment
how much is our daily water intake?
- - 2500ml
- Liquid: 1200 ml
- Food: 1000 ml
- Metabolic: 300ml
how much is our daily water output?
- Kidneys: 1200ml* (obligatory urine excretion is 500ml)
- Skin: 800ml
- Lungs: 350ml
- Feces: 150ml
what minerals are in charge of electrolyte balance?
Sodium (Na) and Potassium (K)
what is sodium?
- An extracellular cation
- Helps with blood volume regulation
- Na K ATPase
what is potassium?
- An intracellular cation
- High blood concentration (cardiac arrest)
how is fluid and electrolyte balance regulated in the body?
- GI tract: 10L/day ( secretion and reabsorption)
- Kidneys: Hormone regulate water and sodium excretion
how can fluid and electrolyte balance be disturbed in the body?
- By losses
- Sweating, bleeding, GI loss (vomitting, diarrhea)
- Diabetes - lose water and glucose
Replacement - oral rehydration therapy
what is the upper limit of normal blood pressure?
how does blood filtration work in the nephron?
- 1. Blood flows into the glomerulus and some fluid with dissolved substances is absorbed into the tubule
- 2. Fluid and substances that are needed by the body return to the blood vessels that are along side the tubules
- 3. The tubules passes the waste materials to the bladder
how do the kidneys respond to low blood flow?
- 1. Kidneys respond to low blood flow by releasing the enzyme RENIN to activate angiotensinigen
- 2. Angiotensinigen is converted to angiotensin
- 3. Angiotensin will signal the adrenal glands to secrete aldosterone
- 4. Angiotensin will cause the blood vessels to constrict and thus raising pressure
- ** Aldosterone and ADH signal the kidneys to keep the sodium and water thus increasing ↑ the blood volume
what are the recommended electrolyte intakes?
- AI: 1500mg/day
- UL: 2300mg/day
90% of men and 60% of women consume more than the UL
- AI: 4700mg/day
- UL: none
Most people consume less than 50% of the RDA
what is DASH?
Dietary Approaches to Stop Hypertension
what are the DASH recommendations?
- Consume a significant V and F intake
- Provide 30% of its calories from fat (nuts, fish, whole grains, low fat dairy products)
- Emphasizes vegetarian protein sources
- Restricts sodium together with an increase in potassium
what did the DASH studies show?
- DASH diet = greater reduction in BP
- Reducing Na reduces BP
what doe the DASH diet provide more than the american diet?
- Potassium (↑ K)
- Magnesium (↑ Mg)
- Calcium (↑ Ca)
- Red meat
- Sweet foods and beverages
what are the benefits of a DASH diet?
- Helps lower BP
- Helps lower cholesterol and LDL cholesterol
- Helps prevent/reduces hypertension when combined with a low sodium diet