OVERVIEW OF NUTRITION AND METABOLISM Nutrition refers to the food we eat-involves three basic nutrient type: Carbohydrates, fats

and proteins plus vitamins and minerals. Malnutrition - a deficiency in the consumption of foods, vitamins and minerals. Metabolism the use of nutrients-a process made up of two major other processes y Catabolism beaks food down into smaller molecular compounds and releases two forms of energy-heat and chemical. y Anabolism a synthesis process. Both processes take place inside of cells continuously and concurrently. Chemical energy releases by catabolism must be transferred to ATP, which supply energy directly to the energy using reactions of all cells. CARBOHYDRATES Dietary sources of carbohydrates Complex carbohydrates y Polysaccharides starches; found in vegetables and grains; glycogen is found in meat y Cellulose a component of most plant tissue; passes through the system without being broken down y Disaccharides found in refined sugar; must be broken down before they can be absorbed y Monosaccharides found in fruits; move directly into the internal environment without being processed directly *Glucose carbohydrate most useful to the human cell; can be converted from other monosaccharide Carbohydrate metabolism y human cells catabolize most of the carbohydrate absorbed and anabolize a small portion of it. Glucose transport and phosphorylation glucose reacts with ATP to form glucose-6-phosphate; this steps prepares glucose for further metabolic reactions. This step is irreversible except in the intestinal mucosa, liver, and kidney tubules Glycolysis the first process of carbohydrate catabolism; consists of a series of chemical reactions Glycolysis occurs in the cytoplasm of all human cells An anaerobic process that provide cells with energy under conditions of inadequate oxygen. It breaks down chemical bonds in glucose molecules and releases about 5%of the energy stored in them It prepares glucose for the second step of the in catabolism the citric acid cycle Citric acid cycle Two pyruvic acid molecules from glycolysis are converted to two acetyl molecules in the transition reaction, losing 1 CO2 per pyruvic acid molecule converted By end of transition reaction and citric acid cycle, two pyruvic acids have been broken down to 6 CO2 and 6H2O Citric acid cycle also called the tricarboxylic acid (TCA) cycle because citric acid is also called tricarboxylic acid Citric acid cycle once called krebs cycle after Sir Han Krebs who discovered this process Electron transport system high energy electrons removed during the citric acid cycle enter a chain of molecules that are embedded in the inner membrane of the mitochondria; as electrons move down the chain, they release small bursts of energy to pump protons between the inner and outer membrane of the mitochondrion Oxidative Phosphorylation the joining of phosphate group to ADP from ATP The anaerobic pathway a pathway for the catabolism of glucose; transfers energy to ATP using only glycolysis; ultimately ends wth the oxidative phophrylation of ATP (using oxygen debt) Glycogenesis a series of chemical reactions in which glucose molecules joined to form a strand of glucose beads; a process that operates when the blood glucose level increases above the midpoint of its normal range Glycogenolysis the reversal of glycogenesis; it means different things in different cells Gluconeogenesis the formation of new glucose, which occurs chiefly in the liver Control of glucose metabolism hormonal and neural devices maintain homeostasis of bloods glucose concentration Insulin secreted by beta cells to decrease blood glucose level Glucagon increases the blood glucose level by increasing the activity of the enzyme phosphorylase Epinephrine hormone secreted in time of stress; increases phosphorylase activity Adrenocorticotropic hormone stimulates the adrenal cortex to increase its secretion of glucocorticoids Glucocorticoids accelerate gluconeogenesis Growth hormone increases blood glucose level by shifting to carbohydrates to fat catabolism Thyroid stimulating hormone has complex effects on metabolism Hormones that causes the blood glucose level to rise are called hyperglymic Insulin is hyperglymic because it causes the blood glucose level decreases

LIPIDS Dietary Sources of lipids triglycerides the most common lipids composed of a glycerol sub unit that is attached in three fatty acids Phopholipids an important lipids found in all foods Cholesterol an important lipid found only in animal foods Dietary fats Saturated fats that contains fatty acid chains in whish there is no double bonds Unsaturated fats contain fatty acid chains in which there are some double bonds Transport of lipids they are transported in blood as chylomicrons, lipoproteins and fatty acids In the absorptive state, many chylomicrons are present in the blood Postabsorptive state 95% of lipids are in the form of lipoproteins Lipoproteins consist of lipids and proteins and are formed in the liver *Blood contains three types of lipoproteins: very low density,low density & high density Lipid metabolism Lipid catabolism triglycerides are hydrolyzed to yield fatty acids and glycerol; glycerol is converted to glceraldehyde-3-phophate, which enters the glcolysis pathway; fatty acids are broken down by beta oxidation and are then catabolized through the citric acid cycle Lipid anabolism consist of the synthesis of triglycerides, cholesterol, phospholipids, and prostaglandins Control of lipid metabolism is through the following hormones Insulin Growth Hormone ACTH Glucocorticoids

PROTEINS Sources of proteins Proteins are assembled from a pool of 20 different Amino Acids The body synthesizes amino acids from the other compounds in the body Only about half of the necessary types of amino acids can be produced by the body; the rest are supplied through diet they are found in both meat and vegetables Protein metabolism anabolism is primary and catabolism is secondary Protein anabolism - the process by which proteins are synthesized by the ribosomes of the cells Protein catabolism deamination takes place in the liver cells and forms an ammonia molecule, which is oxidized or converted to glucose or fats Protein balance -the rate of protein anabolism balance the rate of protein catabolism Nitrogen Balance the amount of nitrogen taken in equals in equals the nitrogen in the protein catabolic waste Two kinds of protein or nitrogen imbalance Negative nitrogen balance protein catabolism exceeds protein anabolism; more tissue protein are catabolized than are replaced by protein synthesis Positive nitrogen balance protein anabolism exceeds protein catabolism Control of protein metabolism achieved by hormones VITAMINS AND MINERALS Vitamins organic molecules necessary for normal metabolism; many attach to enzymes and help them work or have another important biochemical roles The body does not make most of the necessary vitamins; they must be obtained through diet The body stores fat soluble vitamins and does not store water soluble vitamins. Minerals reactions METABOLIC RATES Metabolic rate means the amount of energy released by catabolism Metabolic rates are expressed in two ways The number of kilocalories of heat energy expanded per hour or per day As normal or as percentage above or below normal Inorganic elements or salts found in earth; they attach toenzymes and help them work and function in chemical

Basal metabolic rate the rate of energy expanded under basal condition Factors: size, sex, age, thyroid hormones, body temperature, drugs, other factors Total metabolic rate the amount of energy used in a given time Main determinants The basal metabolic rate The energy used to do skeletal muscle work The thermic effects of foods Energy balance and weight the body maintains a state of energy balance The body maintains a weight when the total calories in the food ingested equals the total metabolic rate The body weight increases when energy input exceeds energy output Body weight decreases when energy outputs exceeds energy input MECHANISMS FOR REGULATING FOOD INTAKE The hypothalamus plays a part in food intake Appetite center cluster of neurons in the lateral hypothalamus that if stimulated brings about increased appetite Satiety center a group of neurons in the ventral medical nucleus of the hypothalamus that if stimulated brings about decrease appetite THE BIG PICTURE: NUTRITION METABOLISM AND THE WHOLE BODY Energy cell in the body needs the maintenance of the metabolic pathways to stay alive Anabolic pathways build the various structural and functional components of the cells Catabolic pathways convert energy to a usable form and degrade large molecules into sub units used in anabolic pathways Cells require appropriate amounts of vitamins and minerals produce structural and functional components necessary for cellular metabolism Other body mechanism operate to ensure that nutrient reach the cells

Gastrointestinal Physiology Gastrointestinal System Composed of the alimentary canal and associated glands that empty their secretions into the alimentary canal. Provides a physical and immunologic barrier that separates the external environment from the internal environment. Provides the body with continual supply of water, electrolytes and nutrients. Requires: 1. Movement of food through the alimentary tract 2. Secretion of digestive juices and digestion of food. 3. Absorption of digestive products, water, and electrolytes 4. Circulation of blood through the gastrointestinal organs to carry away the absorbed substances 5. Control of these functions by the nervous and hormonal systems General principles of gastrointestinal motility Characteristics of the Gastrointestinal Wall Layers from the outer surface inwards: y The serosa y The submucosa layer y A longitudinal muscle layer y The mucosa y Circular muscle layer y The GI smooth muscle Individual muscles are 200 and 500 micrometers in length 2 and 10 micrometers in diameter Arranged in bundles ~ 1000 parallel fibers Each bundles connected electrically with each other through gap junctions that allow low resistance movement of ions. Muscle layer functions as a syncytium Electrical Activity of theGastrointestinal smooth muscles Gastrointestinal Motility Unitary smooth muscle (syncytium) Exception: pharynx, upper 1/3rd of the esophagus, and the external anal sphincter ( striated muscles) y Phasic contractions y Rhythmic contractions y Tonic contractions y Occurs in waves y Slow waves y Not action potential Slow, undulating changes in the resting membrane potential of interstitial cells of Cajal (pacemaker for GI smooth muscles) Mechanism of slow wave production y Cyclic activation and deactivation of the cell membrane Na-K pump y Depolarization brings membrane potential to the smooth muscle cells (threshold)

Increases the probability that action potential will occur

Frequency of the slow waves y Varies along the GI tract y Sets the maximum frequency of contractions for each y But is constant and characteristic for each part of the GI part of the GIT tract y Slowest in the stomach (3 slow waves/ min) y Is not influenced by neural or hormonal input (is y Highest in the duodenum ( 12 slow waves/min) modified) y Spike potentials True action potentials Occur automatically when the RMP becomes more positive than -40Mv (NV -50 to -60 mv) It is the movement of large amount of calcium ions to the interior of the muscle fiber during the spike potentials Esophagus The upper 1/3 is striated muscle The middle 1/3 is mixed striated and smooth muscle gullet penetrates the diaphragm to the stomach 10 inches long/ 25 cm ANS Nerve Fibers submucosal nerve plaxus myenteric nerve plexus serosalsubserous plexus STOMACH C-shaped left side of abdominal cavity with sphincters cardioesophageal and pyloric REGIONS: y cardiac region y pylorus y fundus y stomach y body y rugae or folds contains a third OBLIQUELY arranged layer Mucosa simple columnar epithlium which produces a large amount of MUCUS Neural control of Gastrointestinal Function 1. Myenteric and submucosal plexuses 2. Extrinsic control by parasympathetic and sympathetic fibers 3. sensoryfibers passing from the luminal epithelium and gut wall to the enteric plexuses Comparison Between the Myenteric and Submucosal Plexuses Functional types of movements in the Gastrointestinal Tract 1. Propulsive movements 2. Mixing movements The Propulsive Movements--Peristalsis y The usual stimulus for stimulus is distension of the gut. y Does not occur in the absence of myenteric plexus ( myenteric reflex or peristaltic reflex) y Peristaltic reflex plus the analward direction of movement = y law of the gut The Mixing Movements y Processing of food in the mouth, pharynx, and esophagus y mastication/chewing y Lubricates food by mixing it with saliva. y Decrease the size of food particles to facilitate swallowing and to begin the digestive process. y mastication/chewing Teeth for chewing; the anterior teeth (incisors) provide a strong cutting action and the posterior teeth (molars) a grinding action. Chewing reflex y Food bolus initiates reflex inhibition of the muscles of mastication, which allows the lower jaw to drop. y This drop initiates a stretch reflex that leads to rebound contraction. y Which raises the jaw to cause closure of the teeth y Which compresses the bolus again against the linings of the mouth.

y y

greater and lesser curvature Muscular Layer

Chewing aids in the digestion of food : Digestive enzymes act only on the surfaces of food particles The rate of digestion is highly dependent on the total surface area exposed to the intestinal secretions Fine particulate prevents excoriation of the gastrointestinal tract and increases the ease of food emptied from the stomach into the small intestine. In general, swallowing can be divided into: 1. Voluntary stage 2. Pharyngeal stage 3. Esophageal stage Voluntary stage voluntarily squeezed or rolled posteriorly into the pharynx by pressure of the tongue upward and backward against the palate. Pharyngeal stage y Bolus of food enters the posterior mouth and pharynx stimulate swallowing receptor areas. y The soft palate is pulled upward to close the posterior nares y The palatopharyngeal folds on either side of the pharynx are pulled medially to each other. y The vocal cords of the larynx and larynx is pulled upward and anteriorly by the neck muscles. y Both affects prevent passage of food into the trachea y Upper esophageal sphincter relaxes allowing food to move easily and freely from posterior pharynx into upper esophagus y Sequence of events in swallowing y Nasopharynx is close, breathing is inhibited y Laryngeal muscle contract to close the glottis and elevate the larynx y Peristalsis begins in the pharynx y Upper esophageal sphincter relaxes to permit food to enter the esophagus y Swallowing/Deglutition y Coordinated in the medulla and lower pons y Collectively called deglutition or swallowing center. y Glossopharyngeal and vagus nerve In summary: y Pharyngeal stage is a reflex act. y Never initiated by direct stimuli to the swallowing center from higher regions of CNS y Almost always initiated by voluntary movement of food into the back of the mouth Effects of the pharyngeal stage of swallowing on respiration y Interrupts respiration in less than 1-2 seconds y Swallowing center inhibits respiratory center of the medulla during this time, halting respiration at any point in the cycle to allow swallowing to proceed.Even when a person is talking. Esophageal stage of swallowing y Primary peristalsis y Continuation of the peristaltic wave that begins from the pharynx y ~8 to 10 seconds y Second peristaltic wave y Distention of esophagus by retained food y Receptive relaxation of the stomach y As the esophageal peristaltic wave passes toward the stomach, a wave of relaxation, transmitted through myenteric inhibitory neurons, preceeds the peristalsis. y Duodenum becomes relaxed thus they prepare ahead of time to receive food propelled down the esophagus. Vagovagal reflex initiated by distention of the stomach; abolished by vagotomy. Orad region of the stomach relaxes to accommodate the ingested food. CCK increases the distensibility of the orad stomach In summary y Slow wave which sets the maximal frequency of contraction y Wave of contraction closes the distal antrum (retropulsion) y Gastric contraction increase by vagal stimulation and decrease by sympathetic stimulation y During fasting, tcontractions occur at 90 minute intervals and clear stomach of residual foods ( migrating myoelectric complex) y Mixing and Propulsion of Food in the Stomach y The Basic Electrical Rhythm of the Stomach y Mixing and Digestion y Caudad region contracts to mix the food with gastric secretions and begins the process of digestion y Reduction of food particle size.