HNF 461 1st Edition Lecture 32 Outline of Last Lecture 1 Evaluation of Protein Quality Cont 2 Determining Protein Requirement by Nitrogen Balance 3 Types of Nitrogen Balance 4 Body Protein Retention 5 Protein Metabolism a Food Intake b Fasting c Starvation 6 Assessing Diet Protein Requirements 7 Infant Protein Requirement 8 Adult Protein Requirement 9 Direct Amino Acid Oxidation DAAO 10 Indicator Amino Acid IAAO Method 11 Factorial Method for Protein Requirements Outline of Current Lecture 1 Nutrients Absolutely Required from Diet 2 Protein Energy Malnutrition 3 General Symptoms of PEM 4 Kwashiorkor 5 Marasmus 6 Recovery from PEM 7 Burns Surgery and Sepsis 8 Cancer 9 HIV AIDS 10 Exercise and Protein These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute Current Lecture Protein Malnutrition 1 Nutrients Absolutely Required from Diet a Essential Fatty Acids linoleic and alpha linolenic acids b Essential Amino Acids Leucine isoleucine valine lysine phenylalanine histidine threonine tyrosine tryptophan and methionine c Vitamins 9 water soluble and 4 fat soluble d Essential Minerals Ca P Mg K Na Cl Fe Zn Cu I Se Cr Mn and Mo e Water f Energy from any type of fat or sugar 2 Protein Energy Malnutrition a According to WHO of children 5 years exhibit symptoms of PEM i 1 4 of these are underweight and 1 3 have stunted growth ii PEM mediated mortality in sub Saharan Africa is 25 35 of deaths 3 General Symptoms of PEM a Vomiting diarrhea loss of appetite due to the fact that there is a high turnover of cells in the intestine when a person is protein deficient cells will not be replaced quickly enough and will trigger symptoms b Increased susceptibility to infections c Deficiencies manifest themselves in skin and hair problems due to high turnover rate of cells 4 Kwashiorkor a Deficiency of primarily protein adequate source of calories b Irritable behavior c Decreased hepatic protein synthesis edema d Fats cannot be transported out of liver due to decreased lipoprotein synthesis fat accumulation in liver fatty liver 5 Marasmus a Wasting loss of muscle mass b Severe lack of food Overall deficiency of macronutrients c Apathy 6 Recovery from PEM a Urea cycle enzymes down regulate in PEM concentrations decrease b During re feeding cannot provide a large amount of protein in a short time because the body will not be able to handle the extra amount of nitrogen in its system the body needs time to up regulate its enzymes c Need to control blood ammonia 7 Burns Surgery and Sepsis a Stress hormones and cytokines increase increased catabolism faster breakdown of proteins net protein loss b Insulin resistance c Amino acid catabolism in muscle loss of muscle mass 8 Cancer a Anorexia due to loss of muscle mass b Need to provide enough protein to counteract protein loss 9 HIV AIDS a Weight loss with increased 3M histidine excretion i Compared to a healthy adult a HIV patient s muscle breakdown is almost double b Poor nutrition c Reduced insulin and GH and increased catabolic hormones d Secondary infections 10 Exercise and Protein a Fasting state at rest break down of proteins in muscle b Fasting state during exercise exercise stimulates retention of protein in muscle c Fed state dietary protein at rest synthesis of proteins in muscle to replace those that were lost during the fasting state d Fed state dietary protein with exercise build muscle in addition to replacing proteins that were lost during fasting state
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