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A 23 year old female is on a raw organic, vegan diet. Her appearance…

- - - - dietary requirements (O 1.2)
        
        130 g or 45 to 65% of total caloric intake
      - body uses
        
        glucose is the primary nutrients used by cells to produce ATP (energy)
        
        ATP is necessary to carry out physiological function
      - dietary sources
        
        simple sugars are found in fruits, honey, sugar cane and milk
        
        monosaccharides (glucose, galactose, fructose)
        
        disaccharides (sucrose, lactose, maltose)
        
        complex sugars (polysaccharides)
        
        starch is found in bread, cereal, flour, pasta, rice, potatoes (grains)
        
        cellulose (fiber) is found mostly in plant cell walls
        
        glycogen, the storage molecule for back-up glucose in the liver
      - deficit
        
        lack of energy
        
        protein & fat tissue wasting to get fuel for energy
    - - dietary sources
        
        eggs, milk, fish, and meat contain complete proteins that meet body's amino acid requirements for tissue metabolism
        
        legumes, nuts, and cereals contain incomplete proteins that have less essential amino acids
      - dietary requirements (O 1.2)
        
        0.8 g/kg of body weight daily
      - body uses
        
        8 amino acids are considered "essential" because they come from diet
        
        amino acids necessary for protein synthesis
        
        important for structural & functional materials
        
        collagen (most abundant protein fiber)
        
        found in skin, bones, and other connective tissues
        
        muscle proteins
        
        necessary for structure & function on contractions
        
        albumin
        
        maintain colloid osmotic pressure
        
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        globulins
        
        gamma-globulins
        
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        alpha & beta globulins
        
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        protein hormones
        
        parathyroid hormone
        
        antidiuretic hormone
        
        follicle-stimulating hormone
        
        thyroid-stimulating hormone
        
        energy source when carbohydrate or fat calories are not sufficient for ATP production
        
        enzymes that accelerate metabolic processes (O2.3)
      - Nitrogen Balance (O1.4)
        
        the rate of protein synthesis should equal the rate of protein breakdown in healthy adults
        
        negative nitrogen balance: more protein breakdown than synthesis, which occurs in physical stress, poor protein dietary intake, or starvation
        
        positive nitrogen balance: more protein synthesis than breakdown, which occurs in growing children, pregnancy, and tissue repair after injury
    - - dietary sources
        
        triglycerides
        
        animal fats from eggs, chicken, milk, meat, and lard
        
        plant fats in seeds, nuts, vegetable and olive oils
        
        cholesterol found in eggs, meats, shellfish, and milk
      - dietary requirements (O 1.2)
        
        65 g or 20-35% of total caloric intake
      - body uses
        
        triglycerides
        
        help absorb fat-soluble vitamins
        
        makes up adipose tissue, which protects organs and insulates the body
        
        fuel source for metabolic energy
        
        cholesterol is essential for cell membrane stabilization and steroid hormones (ie: sex hormones)
      - deficit
        
        adipose tissue and protein break down to provide energy
        
        weight loss
        
        poor heat insulation
    - - water-soluble vitamins are not stored and leave the body through urine (O1.1d)
        
        B-complex vitamins
        
        ie: vitamin B12 is only found in meats, eggs, and dairy (animal products). Vitamin B12 is necessary for proper red blood cell maturation. A vitamin B12 deficiency can lead to abnormally shaped red blood cells and anemia
        
        ie: vitamin B3 is found in lean meats and liver. This vitamin is crucial for biomolecule synthesis, energy release, and coenzyme formation for metabolism.
        
        Vitamin C
        
        acts as an antioxidant for detoxification and is found in citrus fruits and tomatoes
      - fat-soluble vitamins are stored in adipose tissue and the liver (O1.1d)
        
        Vitamin A
        
        component of visual function
        
        Vitamin D
        
        necessary for calcium absorption, promotes bone growth
        
        Vitamin E
        
        functions as an antioxidant
        
        Vitamin K
        
        important for clotting
    - - transports substances (ie: blood and lymph)
      - lubricates structures (ie: serous fluid)
      - cushions structures (ie: cerebrospinal fluid)
      - aids in elimination of wastes (ie: urine and sweat)
      - drives chemical reactions (ie: cellular respiration)
      - recommended daily intake is 2-3 L (O 1.2)
    - - major minerals (at least 100 mg daily intake)
        
        calcium
        
        green vegetables & dairy
        
        bone formation, clotting, intracellular signaling
        
        muscle weakness, bone loss, and depressed nerves
        
        potassium
        
        meats, fruits, grains, vegetables, & dairy
        
        muscle contraction & nerve function
        
        deficiency could cause muscle weakness
        
        sodium
        
        table salt & canned foods
        
        muscle contraction & nerve function
        
        deficiency could cause neuromuscular disturbances
        
        chlorine, cobalt, magnesium, phosphorus, manganese, sulfur
      - trace minerals (less than 100 mg daily intake)
        
        iron
        
        red meat, poultry, fish, leafy greens, nuts, whole grains
        
        component of hemoglobin where oxygen binds
        
        deficiency can cause anemia and weakness
        
        zinc
        
        meat & seeds
        
        protein synthesis and wound healing
        
        deficiency can cause hair loss, skin & hair changes
        
        copper, chromium, fluorine, iodine, & selenium
  - - - half of plate is vegetables and fruits while the other half is protein and grains
- - - - ie: dehydration synthesis & protein synthesis (O2.2)
    - - ie: hydrolysis & carbohydrate digestion (O2.2)
  - - - fatty acids absorbed in the small intestine are transported to the liver
        
        fatty acids in the liver are oxidized into acetyl CoA
        
        HMG-CoA (enzyme) converted acetyl CoA into cholesterol
        
        either released in blood as lipoproteins or synthesized into bile salts
        
        a low dietary intake of cholesterol results in low blood cholesterol, increasing cholesterol synthesis in liver
        
        a high dietary intake of cholesterol results in high blood cholesterol, decreasing cholesterol synthesis in liver
    - - the liver synthesizes lipoproteins since insoluble lipids cannot be transported alone in blood (O3.3f)
        
        very-low-density lipoproteins (VLDLs) and low-density lipoproteins (LDLs)
        
        transport lipids from liver to peripheral tissues
        
        high-density lipoproteins (HDLs)
        
        transport lipids from peripheral tissues to liver
    - - noncarbohydrates are converted to glucose by gluconeogenesis (O3.1e)
      - monosaccharides (ie: glucose) absorbed in small intestine are sent to the liver's hepatocytes
        
        glucose molecules bind to form glycogen via glycogenesis for extra energy storage (O3.1e)
        
        glycogen stored in liver and skeletal muscle
        
        glucose molecules released from glycogen via glycogenolysis when extra glucose is needed (O3.1e)
      - glucose is used in cellular respiration to generate ATP for cellular processes
        
        C6H12O6 + O2 > H2O + CO2 + ATP (glucose combined with oxygen makes water, carbon dioxide, and ATP) (O3.1a)
    - - fatty acids join with glycerol to form triglycerides via lipogenesis (O3.3b)
      - fatty acids and glycerol released from triglycerides via lipolysis (O3.3b)
        
        glycerol converted to glucose via gluconeogenesis (O3.3e)
        
        new glucose used in cellular respiration
        
        ATP production
        
        fatty acids broken down into acetyl CoA through beta oxidation (03.3d/e)
        
        acetyl CoA converted to ketone bodies
        
        released into blood & transported to cells to be oxidized in cellular respiration
        
        ATP production
        
        acetyl CoA used in cholesterol synthesis
    - - amino acids have amine group removed through deamination
        
        removed amine group is converted to urea, which enters blood and is eliminated by kidneys
        
        remaining amino acid components are oxidized in cellular respiration (O3.2d)
        
        ATP production
      - proteins synthesis occurs in every body cell except red blood cells (O3.2a)
        
        amino acids form a chain that is converted into a protein through folding and bonding
  - - - when body needs energy, adipose tissue will undergo lipolysis to release fatty acids and glycerol
        
        converted and used in cellular respiration for ATP
      - fats not being used by the body can be stored in adipose tissue through lipogenesis
  - - - absorptive state
        
        time you are eating, digesting, and absorbing nutrients
        
        lasts 4 hours after a meal (3 meals/day x 4 hours = 12 hours in absorptive state)
        
        concentration of glucose, triglycerides and amino acids in blood are increasing as they are absorbed from the GI tract
        
        insulin is released from the pancreas in response to increased blood glucose levels (normal range: 70-110 mg/dL) (O5.2)
        
        stimulates liver and skeletal muscle cells to store glucose through glycogenesis
        
        causes adipose tissue to increase uptake of triglycerides from blood through lipogenesis
        
        stimulates cells to increase amino acid uptake to accelerate rate of protein synthesis
      - post-absorptive state
        
        time between meals in which body is relying on stored nutrients since no absorption is taking place
        
        12 hours spent in post-absorptive state daily
        
        concentration of glucose, triglycerides, and amino acids in blood are decreasing
        
        glucagon is released from pancreas in response to low blood glucose levels (O5.2)
        
        stimulates liver cells to catabolize glycogen into glucose via glycogenolysis
        
        stimulates gluconeogenesis
        
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        causes adipose tissue to break down triglycerides via lipolysis
  - - - ie: if energy is not needed, glucose can be converted into acetyl CoA, synthesized into triglycerides, and stored as fat in adipose tissue
    - - body weight is maintained by a balance of calorie consumption in diet and calories expended through metabolism and physical activity (O5.5)
  - - - basal metabolic rate (BMR) is the amount of energy used when an individual is at rest and not eating
        
        resting conditions include
        
        not eaten for 12 hours
        
        reclined and relaxed
        
        exposed to room temperature between 20°C and 25°C
        
        varies from person to person based on (O5.7)
        
        sex
        
        males have a higher BMR than females
        
        age
        
        BMR decreases with age
        
        lean body mass
        
        greater lean body mass, the higher the BMR
        
        hormone levels
        
        thyroid hormone increases BMR and lipolysis of adipose tissue
        
        hypothyroidism has a decreased BMR (O7)
        
        tends to gain weight and have a cold intolerance due to less heat production
        
        hyperthyroidism has an increased BMR (O7)
        
        tends to lose weight and have a heat intolerance due to more heat production
        
        body surface area
        
        heat is lost through surface of skin
        
        greater the surface area, greater the heat loss
      - total metabolic rate (TMR) is the amount of energy used by the body, including energy needed for physical activity
        
        BMR + metabolism associated with physical activity
        
        varies from person to person based on (O5.7)
        
        food intake
        
        metabolism increases following a meal but decreases after absorption is complete (post-absorptive state)
        
        amount of skeletal muscle activity
        
        increased activity and exercise increases TMR
        
        changing environmental conditions
        
        metabolism increases when exposed to cold temperatures
      - as metabolic rate increases, more heat is produced
        
        homeostatic mechanisms keep body temperature near normal value of 98.6°F (O6)
        
        crucial for maintaining core body temperature
        
        temperature of vital portions of our body (head & torso) to ensure life sustenance (O5.8)
        
        neural control is mediated by the hypothalamus
        
        detects temperature of blood or nerve signals received from skin
        
        increased metabolic rate and body temperature
        
        hypothalamus stimulates sweat glands to release sweat to draw away heat
        
        hypothalamus stimulates vasodilation of peripheral vessels to bring heat to skin surface
        
        decreased metabolic rate and body temperature
        
        hypothalamus inhibits sweat gland activity
        
        hypothalamus stimulates vasoconstriction of peripheral vessels
        
        induces skeletal muscle contraction through shivering to generate heat
        
        hormonal control
        
        thyroid hormone (most significant)
        
        temperature decreases
        
        hypothalamus release thyroid-releasing hormone
        
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        epinephrine/norepinephrine
        
        growth hormone
        
        testosterone
- - - - fewer and larger red blood cells that die off faster than normal red blood cells
        
        less oxygen carrying capacity
        
        fatigue, bloodshot eyes, & feeling tired
        
        red blood cells die faster, resulting in increased bilirubin production from liver
        
        increased levels of bilirubin gives patient a yellow appearance
  - - - fatigue, bloodshot eyes, & feeling tired
  - - - low calcium
        
        decreased bone mass
        
        fragile, fractures, pain, osteopenia, & increased risk for osteoporosis
        
        low calcium increases permeability of cell membrane to sodium
        
        more sodium enters cells, causing hypopolarization of resting membrane potential
        
        shaky movements
- - - - insufficient nitrogen to synthesize protein molecules
        
        insufficient enzyme activity & decreased lean muscle mass
        
        decreased metabolic processes
        
        decreased heat production
        
        decreased core body temperature
        
        decreased temperature support for vital structures (head & torso)
        
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        decreased fever response to fight infection
        
        less amino acids for ATP production
        
        weight loss, thin, & fragile
        
        less collagen synthesis/supply
        
        impaired skin structure
        
        increased risk for skin injury and delayed wound healing
        
        less keratin synthesis
        
        impaired hair growth/hair loss
        
        decreased globulin synthesis
        
        decreased antibody production
        
        decreased immune response/function
        
        decrease amount of transporters for insoluble materials in blood (ie: fats)
        
        decreased distribution of certain nutrients
        
        decreased synthesis of protein hormones
        
        decreased synthesis of follicle-stimulating hormone
        
        menstrual abnormalities
        
        decreased synthesis of thyroid hormone
        
        decreased metabolism & body temperature
        
        decreased albumin synthesis
        
        decreased colloid osmotic pressure
        
        fluid shifts from vessels to tissue spaces
        
        swelling
- - - - fatigue, confusion, & neurological impairment
- - - - infection enters bloodstream
        
        mounts systemic inflammatory response
        
        widespread vasodilation
        
        severely low blood pressure
        
        severely inadequate tissue perfusion
        
        death from septic shock
    - - further malnutrition & fatigue
- - - - hair loss, skin changes
  - - - anemia, weakness, fatigue, pale skin, cold sensitivity
  - - - resting membrane potential is less positive (hyperpolarized)
        
        takes longer for cells to depolarize
        
        neuromuscular disturbance
        
        muscle weakness & fatigue
    - - decreased tissue perfusion
- - - - contains all essential amino acids for adequate protein synthesis
  - - - allows for more efficient mechanical and chemical digestion
      - makes nutrients more available for absorption
- - - - weight loss
        
        fragile
      - less heat production
        
        poor thermoregulation
        
        decreased core body temperature
- - - - fragile
  - - - decreased synthesis of estrogen & progesterone
        
        menstrual abnormalities
        
        decreased estrogen causes increased osteoclast activity
        
        weaker bones
        
        increased risk for osteopenia & osteopenia
- - - - dietary fiber (cellulose)
- - - - action potential travels through t-tubules and triggers voltage gated calcium channels on sarcoplasmic reticulum to release caclium into sarcoplasm
      - action potential occurs as a wave of depolarization and repolarization down sarcolemma
      - sodium potassium pumps quickly restore sodium and potassium gradients
      - release of potassium causes repolarization
      - slower voltage-gated potassium channels also open, releasing potassium
      - voltage gated sodium channels allow sodium influx which open more voltage gated sodium channels further down the membrane
    - - Hydrolysis of ATP places myosin back in its ready position to repeat power stroke
      - ATP binds to myosin, causing it to release actin
      - bending of myosin pulls actin toward M-line, called the power stroke
      - ADP and Pi are released, myosin head bends
      - myosin binds to actin forming cross-bridge
      - tropomyosin exposes active sites on actin
      - troponin changes shape, moving tropomyosin
      - calcium released into sarcoplasm binds to troponin
    - - additional sodium crosses sarcolemma
      - adjacent voltage gated sodium channels open
      - influx of sodium depolarizes motor end plate
    - - acetylcholinesterase breaks down acetylcholine for recycling
      - acetylcholine binds to chemically gated sodium channels and opens them
      - acetylcholine crosses synaptic cleft
      - influx of calcium triggers exocytosis of acetylcholine
      - action potential in axon opens calcium channels on terminal