Comprehensive Exam Study

Question 1

Describe genetics vs. epigenetics

Answer 1

• Epigenetics - how our genetics are expressed as determined by our environment and behaviors (genes repressed or stimulated)
  * The genes you have may be fixed but their expression can be influenced by choices
  * Your health is not dictated by your past, your parent’s health, etc!

Question 2

What is bio-individuality and how is it relevant to work as an NTP?

Answer 2

• Each person has unique lifestyle, environmental, and genetic factors that determine his/her nutrient needs. There is no one diet or lifestyle that is “correct” or perfect for all people. An individualized approach is required!

Question 3

• Hunter-Gatherer What were some challenges to survival?

Answer 3

• Food was not easy to find
  
  • The size of community groups had to remain limited
  • Nomadic lifestyle to cover vast expanses of land and adapt to changing seasons to have enough food to survive

Question 4

• Agriculture - What benefits arose from the early development of cultivating plants?

Answer 4

• Provided wealth of nutrients and health benefits to support a large population
  
  • Allowed for permanent communities to be established, created new jobs and economic opportunity, and more stable food supply for populations to grow
  • Sustainable practices that benefited the environment

Question 5

Early colonization: What major impacts were seen, to people and to the land?

Answer 5

• Introduction of new people, animals, and plants that created a blend of cultures (English, Indian, raw nature, improvisation)
  
  • Wandering animals disturbed habitats for native plants, introduced non-native species , increased erosion affecting aquatic food stems, destroying root systems, and competing with wildlife for food
  • Vegetation was cleared for cash crops such as tobacco

Question 6

• Plantations What key shifts happened with the emergence of “cash crops”?

Answer 6

• Food for profit rather than nourishment, culture celebration, etc
  
  • Clearing out of vast areas of land/vegetation to grow the crops
  • Slavery/indentured servitude
  • Soil fertility diminished
  • Crop diversification/rotation ignored - land overuse
  • Profit for a few at the expense of many

Question 7

• Industrialization: What were some of the advancements? What were the resulting impacts?

Answer 7

• Transcontinental Railroad - easy transportation of food/goods
  * Spread of cultural influences across the world/U.S.
  
  • Electricity/lightbulb allowed extension of working hours and created more job opportunities - people no longer ate according to the natural rhythms of the day
    
    • Influx of people to cities
  • Mechanized farming equipment sped up production
    
    • More product with less effort - framers started looking for additional employment opportunities in the markets
  • Barbed wire eliminated open-range grazing of farm animals
  • Establishment of grocery store chains led people away from farmed food and toward food with longer shelf life/less prep time
    
    • Pesticides
  • Overall increased separation of individuals from where their food came from and increase in purchase of convenience foods
    
    • Eating according to the work schedule vice intuitively

Question 8

• Modern landscape: What current impacts are people navigating with regard to food?

Answer 8

• Media
  
  • Demonizing whole food groups (ie - carbs, fats, etc)
  • Hyper-palatable foods
  • Food convenience

Question 9

Fermenting benefits

Answer 9

• When a food is transformed by its environment into something more flavorful, nutrient-dense, easier to digest, and longer lasting
  *Reduces phytate, lectin, oxalate, and tannin
  * Promotes the growth of healthy microbes while inhibiting the growth of harmful microbes
  * Enhances the consumers relationship with food, minimizes food waste, and enhances health

Question 10

Soaking Benefits

Answer 10

• Helps breakdown the plant-protective compounds (lectins, oxalates, goitrogens, tannins, and phytic acid) that otherwise make it difficult for humans to digest/access the nutrients they offer
  *Can increase bio-availability of iron from 5% to 50%
  * Example - humans don’t have enough phytase (enzyme) to break down phytic acid in plants preventing us from access the minerals that are bound up in the phytates
  * Reduction in gas/bloating, faster cooking times, improved taste/texture

Question 11

Nose-to-tail/root-to-stem

Answer 11

• Encourage consumers to eat the whole plant/animal - especially parts that are normally discarded
  * Society creates perceptions about what part of the plant/animal is “best” and ignores the rest of the plant/animal - parts of which can provide unique nutrient value
  * Economical, environmentally friendly, respectful to resources, richer in nutrients

Question 12

Souring

Answer 12

• Another form of fermentation that is commonly used for preparing grains
  * “Enhanced soaking”
  * Promotes more phytase activation improving the bioavailability of minerals
  * Improves protein digestibility and extends shelf-life

Question 13

Gratitude and food

Answer 13

• Growing more aware of our food is contributing to our well-being
  * Our body responds to our psychological state
  * Milkshake experiment - those who thought they were receiving a nourishing drink actually did glean more nutrients and were more satisfied by it
  * Peace, nourishment, enjoyment in food = greater sense of health and wellbeing

Question 14

What common themes surround traditional food practices?

Answer 14

• Community
  
  • Traditional
  • Seasonal
  • Less waste
  • Intention
  • Can be applied to wide array of foods
  • Connection to food
  • Nutrient-dense

Question 15

Anatomy vs physiology & how do they relate?

Answer 15

• Anatomy - structure of the body
  
  • Physiology - function
  • How do they relate?
    
    • Often the anatomy of something points to its physiology. Certain organs, for instance, are shaped certain ways and located in particular areas in the body in order to fulfill their function or physiology.

Question 16

Define homeostasis

Answer 16

• The state of steady internal conditions regardless of external environment (ex - temp, O2 in blood, blood sugar, blood pH)

Question 17

How is homeostasis regulated?

Answer 17

• Through a feedback system/negative feedback loop. When the body senses a shift from a set point, information is relayed to the brain which further communicates an appropriate gland or organ to adjust in response.

Question 18

• What are some body parameters maintained through homeostasis?

Answer 18

• Fluid balance, body temperature, O2 and CO2 in the body, blood pH, blood sugar

Question 19

Six levels of structural organization

Answer 19

Chemical
Cellular
Tissue
Organ
Organ System
Organism

Question 20

Purpose/example of chemical level of structural organization

Answer 20

• Purpose - elements and molecules that build our cells
  * Example - carbon, hydrogen, oxygen, nitrogen

Question 21

Purpose/example of cell

Answer 21

• Purpose - basic unit of life
  * Example - WBC, RBC, epithelial cells, nerve cells

Question 22

Purpose/example of tissue

Answer 22

• Purpose - groups or layer of common cells that work together to form a common function
  * Example - muscle, connective, adipose, nervous

Question 23

Purpose/example of organ

Answer 23

• Purpose - anatomically distinct structure (recognizable shape) with a specific function when it comes to physiology
  * Example - heart, stomach, liver

Question 24

Purpose/example of organ system

Answer 24

• Purpose - organs working together to serve a common function
  * Examples - lymphatic, circulatory, immune

Question 25

Purpose/example of organism

Answer 25

* Purpose: To perform the physiological functions that maintain and sustain life * Example: Human beings

Question 26

Why do the levels of structural organization matter nutritionally?

Answer 26

* The foods we eat provide the chemical elements to build our cells which affects all of the other levels.

Question 27

Describe the structure and function of the plasma membrane

Answer 27

* Structure: a network of lipids and proteins that form the boundary between a cell’s contents and the environment outside of the cell; phospholipid bilayer (water-loving head faces outward, water-fearing tail faces inward; also contains cholesterol and proteins * Function: to protect the cell from its surrounding environment and regulate substances that enter/exit the cell

Question 28

Describe the structure and function of the nucleus

Answer 28

* Structure: central organelle surrounded by the nuclear envelope (regulates passage of molecules between nucleus and cytoplasm) and the nucleolus (which produces ribosomes) * Function: controls and regulates activities of the cell such as growth and metabolism; houses cell’s DNA

Question 29

Describe the structure and function of the mitochondria

Answer 29

* Structure: consist of an outer and inner lipid bilayer; inner bilayer is folded and houses a series of pre tins and enzymes for chemical reactions to create ATP * Function: Generate the energy needed to fuel the cell’s biochemical activity

Question 30

Describe the structure and function of the endoplasmic reticulum

Answer 30

* Structure: network of channels adjacent to the nucleus; can be rough or smooth; rough ER has ribosomes, smooth ER has no ribosomes but constrains enzymes for lipid synthesis * Function: provides a network for passage of molecules from one area of the cell to another; ribosomes synthesize proteins; smooth ER breaks down and metabolizes toxins

Question 31

Describe the key organs and roles of the integumentary system

Answer 31

* Key organs: skin (epidermis, dermis, hypodermis), hair and nails, sweat glands * Key roles: protective barrier for the organism

Question 32

Describe the key organs and roles of the skeletal system

Answer 32

* Key organs: bones, cartilage and joints, tendons and ligaments * Key roles: provides supportive structure to the body, facilitates movement w/ muscular system, site of blood cell production and mineral storage

Question 33

Describe the key organs and roles of the muscular system

Answer 33

* Key organs: muscles (3 types of muscle tissue: skeletal, smooth, cardiac) * Key roles: body structure and movement, organ structure and movement

Question 34

Describe the key organs and roles of the nervous system

Answer 34

* Key organs: brain, spinal cord, cranial and spinal nerves * Key roles: 3 main functions * Sensory * Integration * Motor

Question 35

Describe the key organs and roles of the endocrine system

Answer 35

* Key organs: hypothalamus & pituitary, pineal, adrenal, thyroid, parathyroid, pancreas, gonads * Key roles: hormone production and regulation, hormone driven communication

Question 36

Describe the key organs and roles of the cardiovascular system

Answer 36

* Key organs: hearts, blood vessels and arteries, capillaries (exchange of gases) * Key roles: transporting blood through the body, carrying oxygen, nutrients, immune cells, waste products

Question 37

Describe the key organs and roles of the lymphatic and immune system

Answer 37

* Key organs: lymph nodes and vessels, spleen, lymph, thymus * Key roles: transporting immune cells through the body, filter lymph for pathogens, produce immune cells

Question 38

Describe the key organs and roles of the digestive system

Answer 38

* Key organs: mouth, stomach, pancreas, liver, gall bladder, small intestine, large intestine * Key roles: break down and absorb nutrients from the food we eat, remove waste products

Question 39

Describe the key organs and roles of the respiratory system

Answer 39

* Key organs: nose, nasal cavity, pharynx, larynx, trachea, bronchi, lungs * Key roles: breathing!

Question 40

Describe the key organs and roles of the urinary system

Answer 40

* Key organs: kidneys, bladder, ureters, and urethra * Key roles: filtration and elimination of liquid waste, maintain blood volume, pressure, and pH

Question 41

Describe the key organs and roles of the reproductive system

Answer 41

* Key organs: penis, scrotum, testicles, vagina, uterus, ovaries * Key roles: produce and maintain sex hormones, create new life * Note - if you have a client with issues regarding fertility/sex hormones, likely looking more at hormonal responses than A&P

Question 42

What are the six classes of nutrients?

Answer 42

Carbohydrates Protein Fat Water Vitamins Minerals

Question 43

What is the purpose of carbohydrates and what are some examples?

Answer 43

Energy Ex - saccharides, disaccharides, glucose

Question 44

Describe protein and its purpose?

Answer 44

Protein is a chain of amino acids Purpose - muscle synthesis, making antibodies, hormones, and neurotransmitters

Question 45

What is the purpose of fats and give examples?

Answer 45

* Purpose: build cell membranes, allow us to absorb our fat soluble vitamins, source of energy * Satiety, slow burning energy * Ex - oils, * Chemical - triglycerides (made of fatty acids [short/med/long chain], phospholipids, sterols])

Question 46

What is the purpose of water?

Answer 46

* Purpose: hydration, temperature regulation/sweat, hydrates mucous membranes, maintains blood volume/cell volume, large component of bodily fluids (blood/lymph), urinary system to flush waste, moistens oxygen we breathe, cushions bones and joints, universal solvent for chemical reactions

Question 47

What is the purpose of vitamins?

Answer 47

* Purpose: support immunity, metabolism, energy conversion, maintaining healthy skin/nails, cell growth, antioxidants help prevent damage to cells

Question 48

What is the purpose of minerals?

Answer 48

* Purpose: nerve function, pH balance, cofactors for countless bodily functions/enzymatic reactions, bone/teeth health

Question 49

How do fats/proteins influence the integumentary system?

Answer 49

Act as a neutral moisturizing factor

Question 50

How does protein affect the muscular system?

Answer 50

Helps build muscle; iron in protein carries oxygen to muscle tissue

Question 51

How do calcium, Vit D, and Vit K affect the skeletal system?

Answer 51

Calcium absorption and bone mineralization; protein helps provide bone matrix

Question 52

How to carbs, fat, and protein affect the nervous system?

Answer 52

* Fat (60% of brain is fat) * Carbohydrates (glucose) - unrefined/complex carbs are important * Protein for neurotransmitters

Question 53

What are the large scale considerations for endocrine health?

Answer 53

Blood sugar balance, digestion, liver support (large scale hormone conjugation goes on in the liver)

Question 54

How does iron affect the cardiovascular system?

Answer 54

Iron is needed for hemoglobin

Question 55

What vitamins/minerals are important for lymphatic/immune health?

Answer 55

Vit C, Vit D, antioxidant rich foods, protein for antibodies, water for lymph

Question 56

What vitamins/minerals/nutrients are important for respiratory health?

Answer 56

water Antioxidant vitamins (C,D,E) Magnesium for relaxing smooth muscles of air passages and lungs

Question 57

What nutrients are important for the urinary system?

Answer 57

Water

Question 58

What nutrients support pre-conception/fertility, pregnancy, lactation?

Answer 58

* Folate - brain and spinal cord development; enables DNA synthesis * Calcium, iron, omega-3s ***??

Question 59

What nutrients support the infancy and toddler years?

Answer 59

* 6 months - BM or quality formula * Iron - baby’s stored iron runs low around 4-6 mo * Calcium/Vit D for bones * Fiber for bowel movements * Toddler appetites are all over the place

Question 60

What nutrients support childhood and adolescence?

Answer 60

* Careful to avoid sugary foods * Calcium and Vit D ***? * Dietary fats***? * Formative time for children to form a relationship with food * What special considerations around diet arise in the adolescent years?***

Question 61

What nutrients support adulthood?

Answer 61

* Stable for calorie/nutrient need * Preventative - foods with antioxidants, phytonutrients** * Pre-conception/fertility, pregnancy, lactation Healthy fats * Quality protein at every meal * Reducing sugars and refined starches

Question 62

What nutrients support older adult/senior years?

Answer 62

* Essential fatty acids, micronutrients, fluids * Energy need starts to decline * Micronutrients and antioxidants are still required * Hydration very important as thirst declines with age * B vitamins for brain health

Question 63

Define the different stages of sleep and optimal sleep ranges for diverse populations.

Answer 63

* Stages (good graphic for this in the Why We Sleep book) * Awake * NREM1 - light sleep, easy to wake, alpha/beta brain waves? * NREM2 - spindles, spend the most time during, heart rate starts to slow, a bit deeper sleep * NREM3 - deep sleep, restorative, brain detox, * REM * Ranges * 0-6 years old: multiphasic * Adults: 7-9 hours

Question 64

Explain the impact sleep has on our physical and mental wellbeing.

Answer 64

* A poor night’s sleep leads to… * Increased ghrelin levels and decreased leptin levels * Increased cortisol levels and decreased insulin sensitivity * Suppressed immune function, renal stress, cardiovascular stress * Less recovery, physically, mentally, emotionally! * Focusing on the unconscious hours has the greatest impact on the conscious hours! * A good night’s sleep leads to… * Better everything! * Immune health * Blood sugar regulation * Stress hormone levels and stress management * Digestion * Food choices and choices in general * Recovery * Detoxification * Attitude and outlook on life!

Question 65

Identify effective and accessible strategies for nutrition and lifestyle habits that support improved sleep quality.

Answer 65

* Sleep hygiene + stress + NDD = good sleep? Will take you a long way! **need to brain storm more

Question 66

What is the difference between stress and stressors?

Answer 66

* Stress - how your body responds to stressors * Stressors - things/events/circumstances (stimuli) that cause a stress response * Distress/eustress - cortisol vs adrenaline

Question 67

Explain the impact stress has on our physical and mental wellbeing.

Answer 67

* Chronic distress will literally rewire and change the shape of our brains * Can chronically elevate cortisol * High cortisol can impact melatonin release and, therefore, sleep * Cortisol is catabolic to muscle tissue (will break it down) * Adrenaline is anabolic to muscle tissue * As our body undergoes a stress response, we are drawing energy away from other systems in the body (ie - digestion)

Question 68

Explain the brain’s role in the north to south path of digestion and identify possible dysfunction.

Answer 68

* Need to be in the parasympathetic state * Vagus nerve connects the brain to the digestive tract (gut-brain axis) * Want to feel relaxed at meal time to ensure efficient signaling Dysfunction * Stress puts us in a sympathetic state * Compromised vagal nerve communication * Compromised output of digestive secretions

Question 69

Explain the mouth’s role in the north to south process of digestion and identify possible dysfunction

Answer 69

* Tongue sends message through the vagus about what you are eating to stimulate digestive secretions * Saliva moistens the food; salivary amylase and lingual lipase begins to breakdown of food * Chewing physically breaks down food Dysfunction * Not chewing well/eating quickly * Taking big bites * Doesn’t allow the saliva to coat the food surfaces so that the enzymes in saliva can start to act on the food

Question 70

Explain the esophagus’ role in the north to south path of digestion.

Answer 70

* Food passes through the esophagus and into the lower esophageal sphincter as a bolus

Question 71

Explain the stomach’s role in the north to south path of digestion and identify possible dysfunction.

Answer 71

* Protein begins to be digested and broken down into polypeptides/amino acids * Not much is being absorbed * HCl decontaminates food/kills any harmful microbes/food-borne pathogens we may have ingested before moving to the permeable parts of our digestive system Dysfunction * Low stomach acid * Proteins won’t break down as well * May not be able to kill pathogens that are ingested * Delayed gastric emptying due to low acidity (follow on steps aren’t triggered) which can contribute to feelings of fullness/bloating and inflammation of the pyloric valve

Question 72

Explain gastrin’s role in the north to south path of digestion.

Answer 72

* Vagus nerve communicates the presence of amino acids in the food resulting in Gastrin which stimulates parietal cells to create HCl

Question 73

Explain HCl’s role in the north to south path of digestion

Answer 73

* Stomach acid - kills microbes in the food * Lowers pH of the stomach (1.5-3) triggering the opening of the pyloric valve and movement of the chyme into the small intestine

Question 74

Explain pepsin’s role in the north to south path of digestion.

Answer 74

* Part of gastric juice * Active form of pepcinogen

Question 75

Explain mucous’ role in the north to south path of digestion.

Answer 75

Part of gastric juices

Question 76

Food leaves the stomach as ______ and enters the _________.

Answer 76

Chyme Small intestine

Question 77

Explain the duodenum’s role in the north to south path of digestion.

Answer 77

* First part of the small intestine * Chyme enters the duodenum in a very acidic state triggering the release of secretin and a series of other reactions (through bile); breaking down food; after duodenum, absorption starts to happen

Question 78

Explain secretin’s role in the north to south path of digestion.

Answer 78

* Released in response to the acidity of the chyme

Question 79

Explain cholecystokinin’s (CCK) role in the north to south path of digestion.

Answer 79

* Released if chyme has protein and fats in it for the release of pancreatic enzymes * Tells gallbladder to release bile

Question 80

Explain bicarbonate’s role in the north to south path of digestion.

Answer 80

* Released by pancreas after triggered by the acidic chyme * Brings the pH of the chyme up closer to the pH of blood which makes it easier for nutrients to pass into the blood (blood pH is closer to neutral) * Also neutralizes the acidity of the chyme for the preservation of the lining of the small intestine

Question 81

Explain the role of pancreatic enzymes in the north to south path of digestion and identify possible pancreatic dysfunction.

Answer 81

* CCK triggers the release of amylase, lipase, and protease * Active at a neutral pH - so chyme must be neutralized for these to be active! Dysfunction * If signaling north of the pancreas is off, we may have sub-optimal enzyme output * Can result in lower bicarbonate output which may result in more acidic chyme - can irritate the small intestine/prevent the release of pancreatic enzymes

Question 82

Explain the role of the gallbladder in the north to south path of digestion and describe possible dysfunction of the liver/gallbladder.

Answer 82

* Releases bile (triggered by CCK) Dysfunction * Gall stones due to billiarystasis can prevent the efficient delivery of bile and result in poor digestion of fats * Low quality bile if not I taking the necessary adequate nutrient co-factors

Question 83

Explain the role of bile in the north to south path of digestion.

Answer 83

* Made in the liver * Made of fats, cholesterol, amino acids

Question 84

Explain the role of villi/microvilli in the north to south path of digestion.

Answer 84

* Increases the surface area of the lining of the intestine * Lining held together closely via tight junctions * Very thin lining of the intestine * Molecules that will be absorbed are first filtered through the liver and then into the blood stream

Question 85

Explain the role of the large intestine in the north to south path of digestion and identify possible dysfunction.

Answer 85

* Everything that wasn’t absorbed in the small intestine move to the large intestine (fiber, water, bile) Dysfunction * If poorly digested food, bacteria, etc reach the colon, setting the stage for dysbiosis and the opportunity for pathogenic bacteria to feed/grow * Imbalance of microbes

Question 86

Explain the role of the microbiome in the north to south path of digestion.

Answer 86

* Community of bacteria, yeasts, microbes, viruses, parasites, etc located in the large intestine * Break down fiber, produce SCFAs (ex - butyrate - beneficial to colon); can produce serotonin

Question 87

Describe possible dysfunction of the small intestine in the north to south path of digestion.

Answer 87

* If poorly digested food is in the small intestine, can result in bacterial overgrowth (where it shouldn’t be) * Can increase intestinal hyper-permeability which creates a route for larger particles of poorly digested food to enter the blood stream - can trigger an immune response * If had low HCl, harmful microbes may reach small intestine and then leak into the blood stream as well, also triggering immune response

Question 88

What are some examples of functional foods?

Answer 88

bone broth, leafy greens, mushrooms

Question 89

What is the key difference between SIBO and Candida overgrowth?

Answer 89

* SIBO = bacterial overgrowth; when opportunistic or pathogenic microbes proliferate into abnormal populations in the small intestine * Candida = yeast (fungi); can diminish populations of beneficial bacteria

Question 90

Define cofactors

Answer 90

Nutrients that we need to build the secretions from north to south

Question 91

Example of cofactors required for the north to south path of digestion

Answer 91

Zinc for HCl Vit C for bile

Question 92

What are some examples of compounds that provide mucus membrane support?

Answer 92

Aloe, licorice root (for someone who has reflux/irritation)

Question 93

What are some examples of compounds helpful for tissue repair?

Answer 93

L-glutamine, collagen, aloe, licorice root, other mucinogenic compounds

Question 94

What are some examples of digestive stimulants?

Answer 94

ACV, citrus, bitters

Question 95

What are some examples of replacement compounds to support the north to south process?

Answer 95

* Replacing something the body should be making on its own * Exogenous HCl * Digestive enzymes * Supplemental ox bile for fat digestion

Question 96

What are some examples of microbiome modulators?

Answer 96

* Probiotics/prebiotics to boost commensal gut flora * Oregano oil to eradicate bacteria (be cautious using as a practitioner - non-discriminate…will also kill good bacteria)

Question 97

Describe the intent and process behind an elimination trial.

Answer 97

* Remove foods completely for a set amount of time to allow the immune system to calm down, reduce symptoms to see how the body reacts

Question 98

Describe the two phases of an effective elimination trial

Answer 98

* Elimination and re-introduction (systematic) to assess how body responds

Question 99

Understand the difference between IgE allergies, non-IgE hypersensitivities, and functional intolerances

Answer 99

IgE allergy - true allergy; B cells from the adaptive immune system produce IgE antibodies (immunoglobulins) to a specific protein sequence resulting in an innate and adaptive immune response including the release of cytokines and histamine (think - classic allergy symptoms) Non-IgE hypersensitivities - not considered allergies; elevated levels of immunoglobulins in response to trigger foods (IgG and IgA); reactions are often delayed (ex - joint pain, headaches, irritable bowel, etc) Functional intolerances - non-immunological reactions; relate to the body’s inability to digest and eliminate certain food components

Question 100

Explain the three phases of bio transformation and elimination (detoxification).

Answer 100

* Phase I * Activation - makes toxins more water soluble * CYP450 enzymes * Lots of Phase II but not Phase I = inefficient. * Phase II * Conjugation - adds a chemical group to the compound * Also makes toxins more water soluble * If we have a lot of Phase I activity but not Phase II, we will have a build up of the intermediary metabolites which can be more reactive than Phase I. * Phase III * Elimination * Issues with Phase III - not going to the bathroom - can result in recirculation of toxins throughout the body

Question 101

What is the difference between glycogen stored in the liver vs skeletal muscle tissue?

Answer 101

Skeletal muscle - can only be used locally Liver - can be circulated throughout the body for us

Question 102

What happens to any excess glucose in the blood stream that can’t be stored in the muscle tissue/liver?

Answer 102

Converted into triglycerides for deep storage in adipose tissue

Question 103

What part of the body acts as the “watch keeper” of blood sugar?

Answer 103

Hypothalamus/pituitary glands - if BS is too high/low, will trigger a hormonal response to mediate

Question 104

What happens when blood sugar is too high?

Answer 104

Pancreas releases insulin which helps us to store sugar in the skeletal muscle and liver (glycogenesis)

Question 105

What happens when blood sugar is too low?

Answer 105

Pancreas releases glucagon to increase glucose levels 3 process: glycogenolysis, lipolysis, gluconeogenesis Liver transforms stored glycogen into glucose (glycogenolysis) Liver creates glucose from amino acids/glycerol (gluconeogenesis) Cortisol and epinephrine will be called on to raise blood sugar levels if the above processes are insufficient Once blood sugar rises, these releases shut off due to negative feedback loops

Question 106

How does cortisol and epinephrine help raise blood sugar levels?

Answer 106

Hypothalamus releases CRH > communicates to the pituitary > pituitary releases ACTRH > ACTRH tells the adrenals to release cortisol which ****? Cortisol and epinephrine will also continue to promote glycogenolysis, lipolysis, and gluconeogenesis

Question 107

What is the theory behind supplementing glandular tissue?

Answer 107

These are tissues from the pancreatic, adrenal, liver tissues of animals that tend to drive function. The tissues have mineral cofactors that the glands in our body need (enzymes, phospholipids, etc)

Question 108

What are examples of insulin sensitivity enhancers?

Answer 108

Chromium, magnesium

Question 109

What are examples of foods/supplements that slow carbohydrate absorption and metabolism?

Answer 109

Fiber, dietary fats and proteins, magnesium, gemnima (?)

Question 110

Explain the role antioxidants play in BSR

Answer 110

Oxidative stress contributes to BSDR due to inflammation. Antioxidants help minimize oxidative stress and the overall stress response of the body thus promoting healthy BSR

Question 111

What are adaptogens?

Answer 111

Herbals/botanicals/mushrooms that help normalize ours stress response

Question 112

Whole foods are ? Provide examples

Answer 112

unprocessed foods that have nothing added to them or taken away. Examples include fruits, vegetables, legumes, grains, pulses, dairy, eggs, meat, and fish.

Question 113

Nutrient Density means

Answer 113

High vitamin and mineral content relative to caloric value, meaning the less calories and the more vitamins and minerals, the better it is rated

Question 114

The importance of diversity in the diet is

Answer 114

To ensure adequate intake of all the necessary vitamins, minerals, phytonutrients, and essential fatty acids To allow our body to determine what it thrives on

Question 115

We should consider eating in season when we can because

Answer 115

Lends itself to eating a variety of foods Produce in season is more readily available limiting the possibilities of it being picked too early, sprayed with preservatives, and shipped long distances to the customer More affordable Also helps support local farmers and the environment as a whole - mono crops planted season after season and the use of pesticides destroys the soil as well as vital insect cultures and our own health (overburdened detox systems)

Question 116

Sourcing our food matters because

Answer 116

-Animals are often raised inhumanly and pumped full of antibiotics and growth hormones to increase their size -large monocrop farms often plant the same thing season after season and spray pesticides which destroys the soil, insect populations, and more -Sourcing food allows us to have a say - we can support small business and encourage the cultivation of food that is cleaner, more nutritious, healthier for the planet, and kinder to plant/animal populations

Question 117

What are some of the most common nutrient inhibitors, and what possible benefits do they provide?

Answer 117

Phytate (phytic acid) - stored form of phosphorus within plant foods -Because humans lack phytase, phytate can travel through the digestive tract and bind to minerals such as zinc, magnesium, and calcium, and prevent their full absorption -Phytates can also act as antioxidants Oxalates (oxalic acid) -Can bind to calcium and prevent its absorption in the small intestine Lectins - protein structures that bind to carbohydrates Can inhibit iron, zinc, and calcium and affect the microbiome glucoinsolates - sulfur containing compounds -Can inhibit iodine uptake Tannic acid -Can inhibit iron absorption

Question 118

The benefits of soaking include • The benefits of sprouting include • The benefits of fermentation include • What are the pros and cons to raw foods and cooked foods?

Question 119

Sprouting benefits

Answer 119

-Produces enzymes that assist with the digestion of the vitamins and minerals present in the plant -Reduces nutrient inhibitors -Increases nutrient values (more than soaking) such as B12, folate, iron, zinc, magnesium, Vitamins A, E, and C, and protein and fiber absorption -Decreases phytic acid significantly

Question 120

What are the pros and cons to raw foods?

Answer 120

Raw Foods Benefits -Easy -Avoid heat spares some nutrients and enzymes from being destroyed -More hydrating -Raw foods are naturally lower in calories - promotes weight lost Raw Foods Drawbacks -Less variety/difficult to get protein -May be less appealing in certain seasons -Difficult to digest -More likely to be exposed to food-borne pathogens -Potential to overly-restrict if only eating a raw foods diet

Question 121

What are the pros and cons to cooked foods?

Answer 121

Benefits of Cooked Foods -Can improve the bioavailability of some nutrients -Can reduce nutrient inhibitor content -Generally more appealing to most people Drawbacks of Cooked Foods -Denatures some nutrients -Cooking at too high of a temperature can create Advanced Glycation End Products (AGEs) and other harmful byproducts and create a burden of free radicals resulting in cell damage and increased inflammation levels The more something is cooked, the more calories absorbed (can be good or bad)

Question 122

What are three different types of meal plans and what are the benefits of each?

Answer 122

1. Weekly meal planning -for clients who are highly organized/purchase food at grocery store -helpful for busy clients with several obligations throughout the week 2. Night-before planning -Allows for spontaneity/less restrictive -Good for clients who feel weekly planning is too daunting -Good for clients who shop at CSAs or farmers markets and are comfortable cooking without recipes 3. Focusing on one single meal or snack a day to optimize it -Good for a client who needs to start small/feels overwhelmed by large meal plans and changes

Question 123

What are three strategies you can include in meal planning to make things easier?

Answer 123

1. Finding a chunk of time to do most of the prep for the week (ie - weekend afternoon). 2. Prepare various components of a meal ahead of time 3. Selecting simple recipes with few ingredients Others: batch cooking, pressure cooker, slower cooker

Question 124

What is the 3 step process for meal planning?

Answer 124

1. Information gathering – food preferences, budget, cooking skills, timing needs 2. Macro/caloric estimates – what’s realistic? Want to ensure we aren’t significantly under or over specific nutrients 3. Create a plan - utilize info from steps one and two as well as simple strategies for meal planning -what does your client need and how will you achieve it using your strategies?

Question 125

What are 3 issues that can complicate meal planning?

Answer 125

-Food sensitivities/allergies -Difficult schedules (shift workers) -Known nutrient deficiencies

Question 126

Does intuitive eating have a role to play? What are the pros and cons of including it as part of your plan?

Answer 126

Can be mixed in depending on the bio-individual needs of the client Pros -Helpful if one is in tune with their body and eating for the right reasons -Practicing intuitive eating can help improve one’s mindfulness around food -Eases anxiety around the foods one is choosing to eat -Helpful for those with a negative relationship with food or those who are neurodivergent Cons -Satiety and hunger signals may not be trustworthy - disrupted by daily stressors, lack of sleep, dehydration, sedentary lifestyle, etc

Question 127

Name the 4 stages of sleep and what happens in each (wakefulness is not included)

Answer 127

4 stages: NREM 1 NREM 2 NREM 3 REM NREM 1 -light sleep -not fully conscious or unconscious -theta brain waves NREM 2 -50% of sleep time spent here -heart rate slows, body temp drops -spindles (decr brain activity w/ active bursts) -memory consolidation NREM 3 -Deep sleep -delta brain waves (unconscious, restorative) -most crucial for health/well-being (detox) REM -Dreams -memory solidification -body in brief state of paralysis -increased heart rate/brain activity -natural wakening most likely to occur

Question 128

How do we cycle between the stages of sleep?

Answer 128

Naturally, if uninterrupted 75% of time in NREM sleep, with the length of time spent in REM increasing as the night progresses and cycles continue (time spent in NREM 3 decreases)

Question 129

What is the suprachiasmatic nucleus, where is it located, and what does it control?

Answer 129

A small group of cells within the hypothalamus in the brain that controls the circadian rhythm and the subsequent bodily responses (The hypothalamus as a whole controls hormone signaling - the SCN is just the piece that regulates the daily internal clock)

Question 130

What is the difference between a circadian rhythm and a diurnal rhythm?

Answer 130

Circadian Rhythm -The cyclic hormonal pattern of the *internal* biological clock -Associated hormonal and bodily processes fluctuate with the rising and setting of the sun Diurnal Rhythm -rhythms of night and day dependent on the rising and setting of the sun

Question 131

What role does melatonin play in sleep? How does cortisol interact with it?

Answer 131

-Doesn’t trigger fatigue for sleep, but rather sets up the internal bodily conditions to allow for rest to take place - best way to regulate is for regular sun exposure in the AM/PM -Cortisol is a hormone that promotes wakefulness and alertness The timing of these hormones is ideal. Cortisol releases early in the day promotes wakefulness and also suppresses their secretion at later points in the day allowing melatonin levels to rise at the appropriate time.

Question 132

How much sleep do we need during the different phases of life (infant – elderly)?

Answer 132

Newborns: 14-17 hrs Infancy: 12-15 hrs Toddlers: 11-14 hrs Children 3-5: 10-13 hrs Elementary (6-13): 9-13 hrs Early Adolescence: 8-10 hrs Adults (20-65): 7-9 hrs Elderly (65+): 7-8 hrs

Question 133

What role does light play in sleep and wakefulness?

Answer 133

Sunlight - can help regulate cortisol/melatonin release to optimize circadian rhythm Use of artificial light after natural darkness can work against our genetic and hormonal patterns (circadian rhythm) geared toward sleep Blue light stimulates the brain in a way that makes us feel alert and suppresses melatonin release (the more luminance, the more disruptive) Red light can promote relaxation

Question 134

How does sleep impact cortisol levels?

Answer 134

At the time of waking, cortisol levels have already been rising and will peak mid morning and decreases by the evening allowing for melatonin to increase. Cortisol is downregulated at night to help promote sleep. Interrupted sleep can cause cortisol levels to be elevated the next day.

Question 135

How does sleep impact ghrelin levels?

Answer 135

Ghrelin is upregulated when sleep is delayed or disrupted

Question 136

How does sleep impact leptin levels?

Answer 136

Leptin is downregulated with poor sleep (one will feel less satiated)

Question 137

How does sleep impact insulin sensitivity?

Answer 137

Lack of sleep results in decreased insulin sensitivity as the body tries to make glucose available for the tissues that need it - particularly the brain

Question 138

Explain the connection between sleep and brain detoxification.

Answer 138

Brain detoxification occurs during deep sleep (NREM 3). The brain shrinks to 60% of its normal size creating pathways for cerebrospinal fluid to flush cellular build up from the ay’s activities allowing the brain to detox itself.

Question 139

How does a lack of sleep impact the immune system?

Answer 139

-Lack of sleep interrupts the creation/circulation of various T and B cells, neurotransmitters, and proteins that boost defenses -Thus, more prone to infection with lack of sleep -Interruptions in digestion and BSR due to poor sleep also impact immunity as 70-80% of immune cells are in GI tract

Question 140

How is the brain impacted by sleep – what symptoms might manifest because of it?

Answer 140

-Brain growth, detoxification, proper functioning will all be impaired by poor sleep -Less metabolic activity occurring in a sleep deprived brain -Downregulates more complex functions in favor or primitive functioning -Brain inflammation Symptoms -poor condition -poor control -poor judgment -grogginess -unstable emotions -temper -mental health issues (depression, anxiety, etc)

Question 141

What is the mechanism by which caffeine impacts wakefulness?

Answer 141

Caffeine blocks adenosine receipts and prevents the drowsy feeling from “sleep pressure” that is normally experienced as the day goes on. Adenosine is a byproduct of cellular energy use and builds in concentration through the day as a result of being active and alert. It builds despite not having access to the receptors. Once the caffeine wears off, the adenosine floods the receptors resulting in a “crash” and feelings of drowsiness. Additional factors related to caffeine crash are the rise and drop of adrenaline and cortisol throughout the cycle of caffeine ingestion and metabolism. They can exacerbate the crash and restart the cycle of reaching for more caffeine!

Question 142

How do we leverage diurnal rhythms to help with sleep?

Answer 142

Keeping it dark inside when it’s dark outside and light when it’s light out! Sleep and function in rhythm with the rising and setting of the sun.

Question 143

What is sleep debt, and how do we overcome it?

Answer 143

Sleep debt is the difference between optimal and actual sleep. Focus on getting the minimum 7 hours every night vice “making up for the debt on the weekends” which doesn’t actually work and may worsen the issue. Naps can help

Question 144

What is sleep inertia?

Answer 144

When nighttime grogginess spills over into the morning. A transition state between sleep and wakefulness which can be indicative of a disrupted circadian rhythm, interruption of sleep during deep sleep (NREM 3), etc. Can vary in severity from person to person.

Question 145

Are depressants (alcohol, nicotine, cannabis) helpful for sleep? Why or why not?

Answer 145

No Though they trigger relaxation and drowsiness, they disrupt the normal homeostatic sleep cycle and hormone shifts that are supposed to occur resulting in poor quality and quantity of sleep (more like external sedatives than sleep aids). Alcohol in particular eventually upregulates glutamate which promotes wakefulness and disrupts the end of sleep cycles keeping us from reaching deep sleep and REM Alcohol, nicotine, and cannabis should be avoided within at least 3 hours of bedtime

Question 146

How should naps be leveraged, if at all?

Answer 146

Should be in the form of 15-30 minute power naps OR Long enough to allow for 1 full sleep cycle (60-90 minutes) and be taken as far away from bedtime as possible Long/improperly timed naps can be disruptive to nighttime sleep because it decreases the amount of “sleep pressure” in the body

Question 147

What are the 4 major sleep disorders?

Answer 147

1. Insomnia 2. Narcolepsy 3. Restless leg syndrome 4. Apnea

Question 148

How do we incorporate meal timing and macros to leverage better sleep and entrain ourselves into a better rhythm?

Answer 148

In general, avoid large meals/snacks 2-3 hrs before bed as it prevents internal temperatures from dropping appropriately and can interrupt the metabolic processes that our bodies prioritize during sleep. Also don’t want to go to bed hungry as BS too low can interrupt sleep! Eating balanced, satiating snacks before bed as well as in the late afternoon/dinner time to support balanced blood sugar and restful sleep. Complex carbs are required for hormone production, esp serotonin, which is converted to melatonin. Avoid alcohol, spicy foods, fast foods, carbonation, etc before bed.

Question 149

What is sleep hygiene, and how can we leverage it with clients?

Answer 149

Sleep hygiene is all of the habits and environmental adjustments that can be made to ensure a restful night’s sleep Examples -wake up/wind down routine (sunlight exposure) -going to bed/waking up at the same time every day -dark room -minimizing blue light exposure -keeping home at around 65 degrees for sleeping -reducing media consumption/work before bed Can leverage by helping them find routines, options that they enjoy incorporating and starting small, seeing improvements, and growing from there. Encourage consistency!

Question 150

Define eustress, and distress.

Question 151

Define eustress vs distress

Answer 151

Eustress is “good stress” - causes only a small shift in the body’s effort to maintain internal balance and may strengthen certain physiological functions such as immunity (first date, strength training, etc) Distress is “bad stress” - causes a major disruption in the body’s internal balance and impairs physiological function (family conflict, toxic work environment, etc)

Question 152

Define allostatic load.

Answer 152

The overall burden of chronic stress and life events and the body’s required effort to respond and re-establish internal stability

Question 153

What are the social determinants of health?

Answer 153

Conditions that have a major impact on people’s health, well-being, and life to include where a person lives, transportation, neighborhood/community crime rate, economic status, education level, income, healthy food and health care services, literacy skills, race

Question 154

What are the three main systems involved in the stress response?

Answer 154

HPA Axis Sympathetic nervous system (SNS) Parasympathetic nervous system (PSNS)

Question 155

Explain the role of cortisol in day-to-day living and in a stress response.

Answer 155

-Increased blood pressure and functioning of the cardiovascular system to provide additional blood to the muscles -Activates gluconeogenesis -The majority of cell’s contain cortisol receptors resulting in a wide array of impacts including metabolic impacts, insulin response, digestion, circadian rhythms and sleep, immune health, reproductive system, mental health, brain function, cellular health, hormone balance

Question 156

Explain the role of hormesis in stress.

Answer 156

Hormesis is the adaptive response of cells and organisms to moderate intermittent stress. Activates the stress response for a short period of time and are generally favorable as they benefit aging, longevity, resilience, and bodily functions such as immunity (ex - cold plunges, saunas, exercise)

Question 157

Distinguish between acute and chronic stress.

Answer 157

Acute stress - develops quickly but also ends quickly (ex - alarm going off, taking an exam, etc) Chronic stress - prolonged activation of the sympathetic nervous system and HPA axis which can suppress immune function and lead to numerous health conditions

Question 158

Briefly explain some of the potential negative effects of chronic stress? -Blood glucose levels -Insulin signaling -Ghrelin levels -Leptin levels -Cardiovascular system -Immune function -Oxidative stress -Bone health -Digestion -Reproductive health -Mental health

Answer 158

Blood glucose levels - stress increases blood glucose through gluconeogenesis Insulin signaling - stress causes poor insulin signaling (muscle and liver cells become resistant to allow more glucose to remain in the blood for immediate energy/brain support) Ghrelin levels - stress and rise in coristol elevates ghrelin which makes one feel hungry and also further inhibits insulin secretion and decreases insulin sensitivity Leptin levels - cortisol decreases leptin levels leaving one feeling less satiated Cardiovascular system - stress resulted in elevated heart rate and blood pressure as blood vessels constrict and heart contractions increase for the movement of oxygen and blood to the muscles Immune function - chronic stress results in low grade inflammation throughout the body and suppressed immune function Oxidative stress - can be caused by prolonged stress/inflammation; causes cell damage, accelerated aging, and various chronic conditions Bone health - chronic psychological stress contributes to bone loss and increased risk of fractures and osteoporosis due to increased osteoclast activity and inhibition of osteoblast activity Digestion - chronic stress contributes to alterations in the gut microbiome, intestinal permeability, slower motility, and inflammatory digestive conditions as blood is directed away from the GI tract in support of the body’s stress response Reproductive Health - chronic stress results in decreased production of estrogen, progesterone, and testosterone; cortisol suppresses ovary function; hormone balance/fertility issues Mental Health - stress can snowball into feelings of anxiety and depression, poor sleep, low self worth, weight gain, overwhelm; also causes alternations in neurotransmitter metabolism including lower levels of serotonin and dopamine and alterations in the gut microbiome

Question 159

What are the positive impacts of exercise on stress levels?

Answer 159

-Increase in self-esteem, self-efficacy, emotional well-being, self-confidence, life satisfaction, sleep quality, social support -Lower cortisol response to psychological stress Mechanism of action: -endorphin release -increase in brain-derived neurotrophic factor (BDNF) anti-inflammatory molecules and various hormones/neurotransmitters associated with a positive mood -increase in dopamine, oxytocin, 5-HTP, and norepinephrine

Question 160

What are the positive impacts of sleep on stress levels?

Answer 160

Proper sleep habits help improve HPA function and regulate healthy cortisol levels Maximizing rest/recovery helps us in our ability to handle stress

Question 161

How do the following nutrients help with stress handling: Vitamin C Vitamin E Glutathione B Vitamins Magnesium Omega 3s

Answer 161

Vitamin C - helps produce adrenal hormones (cortisol, norepinephrine); acts as an antioxidant during times of oxidative stress Vitamin E - antioxidant Glutathione - “master antioxidant” as it can regenerate Vitamin C into its active form which can recycle Vitamin E back into its active form (helpful in combating oxidative stress) B Vitamins - reduces stress symptoms; support adrenals, regulate blood sugar, synthesis of mood-boosting neurotransmitters, conversion of food into energy for the nervous system (which controls the HPA axis!) Magnesium - involved in almost all major metabolic and biochemical processes in the body and a cofactor in 300+ enzymatic reactions; promotes calm and relaxation; inhibits glutamate (excitatory neurotransmitter) and promotes GABA activity (calms nervous system); reduces the release of the pituitary hormone (ACTH) which controls cortisol production Omega 3s - anti-inflammatory to combat the inflammation and cortisol levels caused by chronic stress/immune suppression

Question 162

Explain the importance of mindfulness to stress handling. What are some different forms of mindfulness that can be incorporated easily throughout the day?

Answer 162

Mindfulness is the practice of pausing and choosing to respond, vice react, to stressors -Deep breathing, body scan, guided imagery, journaling, yoga, tai chi, gratitude, “find your feet”

Question 163

How do natural environments contribute to stress regulation?

Answer 163

-Exposure to sunlight, especially early in the morning, regulates circadian rhythm and supports mood, energy, and sleep -Natural environments (green spaces) reduce perceived stress and cortisol levels

Question 164

Explain the role of finding purpose in managing stress levels.

Answer 164

-Allows one to find meaning in ordinary tasks promoting motivation over discouragement -Fosters healthy self-esteem and self-efficacy

Question 165

How does reframing impact stress levels?

Answer 165

Helps lessen the damage stress has on the body Can help shift one’s perspective of a situation and allow them to focus on how they are capable of handling it/opportunity to grow

Question 166

Explain the importance of incorporating hobbies for those that are not currently making time for them.

Answer 166

-Provide a meaningful break from work/responsibilities to recharge -Promotes a sense of purpose -Helps one feel productive, happy, and recharged -Associated with lower blood pressure, cortisol, waist size, and BMI and better psychological, physical, and social functioning

Question 167

Explain the role of relationships in managing stress levels.

Answer 167

-Humans have a fundamental need to form emotional connections with others -Helps buffer the negative effects of the stress by dampening the effect on the HPA axis and increases resilience by reducing stress-induced cortisol release -Helps reduce anxiety and develops feelings of security -Increases social support to help cope with stress and mitigate its ill effects

Question 168

Explain gastrin’s role in the north to south path of digestion.

Answer 168

Secreted by epithelial cells in the stomach in response to a meal being consumed. Functions include: -Mucous membrane protection -Stimulates gastric motility -Stimulates HCl and intrinsic factor (IF is necessary for absorption of B12 in the small intestine) secretion Disfunction: -Surgical procedures and/or low protein diets can reduce gastrin production -Pylori infection can increase gastrin and thus HCl

Question 169

Explain pepsin’s role in the north to south process of digestion.

Answer 169

Active form of pepsinogen (which is released by chief epithelial cells in the stomach in response to HCl) -Pepsin works with HCl to break down protein in the stomach As well as the bonds of potentially infectious microbes (ie. H. Pylori) -Pepsin production will be reduced if we have reduced stomach acid which can result in delayed gastric emptying and maldigested food in the stomach as well as back pressure/reflux

Question 170

Explain the role of mucous in the north to south path of digestion.

Answer 170

Mucous is secreted along the lining of the duodenum (upper part of small intestine) in response to the acidity of the chyme Mucous membrane lines the small intestine Mucous membrane contains groupings of lymphoid follicles called Peyer’s patches which house a variety of immune cells Helps shuttle nutrients from the lumen to the enterocytes for absorption Also secreted by mucoid cells in the stomach - contains bicarbonate ions which buffers against the acidity of the gastric juices Disfunction: -Low mucous production in a stressed state -H. Pylori can disrupt mucous production

Question 171

What is the relationship between cortisol and blood sugar regulation?

Answer 171

Hypothalamus tells pituitary to make adrenocorticotropic hormone (ACTH) which stimulates the adrenal glands to release cortisol Cortisol promotes the release of stored fuel to increase blood glucose supply via glycogenolysis, gluconeogenesis, and lipolysis Reduces insulin sensitivity Decreases pancreatic production of insulin (“stop storing”) Increases glucagon production (“release fuel”)

Question 172

Explain the role of adrenaline/epinephrine in blood sugar regulation.

Answer 172

Produced by the adrenal medulla in response to signals from the Central Nervous System (CNS) (considered “catecholamines”) Part of fight/flight response - quick response time Stimulates the same metabolic pathways as cortisol: -glycogenolysis -lipolysis -gluconeogenesis Lowers the pancreatic production of insulin Cortisol and adrenaline will also be released in cases of reactive hypoglycemia (“emergency” low blood sugar)

Question 173

How does Peptide YY affect appetite?

Answer 173

-Released in the small intestine after eating -Slows the rate at which food passes through the digestive tract to increase nutrient breakdown and absorption -Signals satiety -Highest within 2 hours of eating

Question 174

How does glucagon-like peptide-1 (GLP-1) affect appetite?

Answer 174

-Secreted in the small and large intestines -Stimulated by food intake and remains elevated for a few hours after -Slows gastric emptying, decreases appetite, promotes release of insulin for BSR

Question 175

What is a prebiotic?

Answer 175

Refers to nutrients (primarily carbs) that preferentially feed strains of bacteria associated with health benefits Other benefits: -Support healthy bowel movements -Reduce IBS symptoms -Reduce markers of inflammation -Improve metabolic health 3 criteria: 1. Resistant to gastric acidity and hydrolysis by mammalian enzymes and GI absorption 2. Can be fermented by intestinal microflora 3. Selectively feeds good bacteria -Foods rich in prebiotics include legumes, dandelion greens, Jerusalem artichokes, berries, garlic, onions, leeks, asparagus, bananas, oats, apples, flax, seaweed

Question 176

What is a probiotic?

Answer 176

Refers to living organisms/food and supplements that contain microorganisms to support a healthy symbiosis between multiple populations of beneficial microbes in the microbiome Probiotic foods: -fermented foods -cultured dairy

Question 177

What is a postbiotic?

Answer 177

Refers to the metabolic byproducts from microbes which are more recognized for eliciting biological responses in the host and other members of the microbiota

Question 178

What is dysbiosis?

Answer 178

An imbalance between the beneficial and harmful bacteria in the gut microbiome Ex: -Alterations in the ratios between the major phyla groups (firmicutes and bacteroides) -Decline in the number of diversity of beneficial bacteria -Overgrowth of opportunistic strains of bacteria -Strongly linked to autoimmune disease -Can cause elevated levels of endotoxins as released by harmful bacteria -Can exacerbate and be exacerbated by stress hormones

Question 179

IBS vs IBD

Answer 179

IBS - functional disorder (not autoimmune); no sign of tissue damage or inflammation during colon exam Symptoms: constipation, diarrhea, gas, bloating, nausea, abdominal pain/cramping -Mediated by microbiome and gut-brain axis communication IBD - umbrella term for autoimmune disease that involves chronic (permanent) tissue damage/inflammation of the GI tract Symptoms: abdominal pain/cramping, change in BM frequency, chronic diarrhea or constipation, urgent BMs, blood/mucus in stool, nausea, vomiting, feelings of incomplete evacuation Secondary symptoms: body aches, fatigue, loss of appetite, deficiencies Ex - Chron’s, ulcerative colitis General: Disease - clear cause, pathophysiology, progression, treatment Syndrome - common group of symptoms that do no always have a well-known or shared cause

Question 180

Celiac vs. gluten allergy/non-celiac gluten sensitivity (NCGS)

Answer 180

Celiac - autoimmune characterized by the production of IgA antibodies against tissue transglutaminase (protein-based enzyme in the intestines); damages the tissues of the small intestine; symptoms: blasting, diarrhea, constipation, gas, loose, greasy, or foul-smelling stool, nausea, vomiting, abdominal pain as well as malabsorption and fatigue, joint/bone pain, depression, anxiety, headaches, etc Gluten allergy - IgE-mediated (“true” allergy) NCGS - thought to include IgA, IgG, and IgM anitbodies; symptoms: bloating, abdominal pain, diarrhea, other digestive symptoms, low grade inflammation outside of GI tract

Question 181

How does nutrient dense diet support digestion?

Answer 181

-Whole food diets provide the dietary fiber and polyphenols to feed and maintain a healthy and diverse gut microbiome -Processed foods with many additives can alter the health of the gut microbiome -Nose-to-tail (unique nutrient profile), herbs and spices, connection to food to support parasympathetic state

Question 182

How does stress impact digestion?

Answer 182

Sympathetic-dominant state inhibits and disrupts parts of the digestive system as the body diverts attention away from digestion Symptoms: disruption in gastric motility, stomach acid and enzyme production, intestinal permeability, gut microbiome balance, hunger signals and appetite regulation Disruption in the GI tract can contribute to stress and mental health disorders via the gut brain axis

Question 183

How can disregulated blood sugar impact digestion?

Answer 183

-In severe cases, high BS can damage the vagus nerve resulting in delayed gastric emptying (ex - diabetic neuropathy of the vagus nerve) -In treating glucose disregulation, one may limit carb intake which can reduce dietary fiber and impact the health of the GI tract -reduced MMC length with chronically high blood glucose levels resulting in disrupted nutrient absorption, BMs, and microbial balance -Non-alcoholic fatty liver disease (NAFLD); symptoms: abdominal pain, feeling of fullness in upper right side of belly, nausea, diarrhea, weight loss, loss of appetite

Question 184

Explain how antioxidants relate to digestion

Answer 184

Help reduce oxidative stress on the body allowing the body to devote more energy to the digestive process. Help facilitate detoxification in the body particularly between Phase I and Phase II detox

Question 185

Explain how gut associated lymphoid tissue (GALT) relates to digestion

Answer 185

Represents 70% of the entire immune system -Microbiome interacts with GALT impacting intestinal permeability, immune tolerance toward foods/pathogens/host tissues and dampens or amplifies systemic inflammation -Probiotics and foods that promote a healthy microbiome can enhance GALT

Question 186

How do beneficial bacteria relate to digestion?

Answer 186

-A healthy and diverse microbiome in right balance supports immunity, mental health, and overall bodily health. -Produce SCFAs which protect the tissues of the colon from damage, impact gut-brain interactions, and neuro-immunoendocrine function

Question 187

Explain how the endocrine system relates to digestion (nutrient absorption, digestive hormones, thyroid/metabolism)

Answer 187

Nutrient absorption - endocrine system is reliant on nutrients absorbed via the digestive tract as macro and micronutrients serve as cofactors in hormone synthesis and are essential to signaling of metabolic pathways of hormones -ingestion of endocrine-disrupting chemicals can come via the digestive tract Digestive hormones - pancreas endocrine function is the production of hormones for blood sugar regulation (Note - pancreatic release of bicarbonate and digestive enzymes is considered exocrine - triggered by secretin and CCK); gastrin in stomach, secretin in gut which triggers pancreatic release of bicarbonate; ghrelin, leptin, peptide YY, GLP-1 Metabolism - thyroid hormone production (T4 and T3) influences catabolic and anabolic processes of metabolism which can affect the health of all bodily tissues; link between hypothyroidism and hypochlorhydria and constipation; hyperthyroidism and rapid bowel movements

Question 188

Explain the connection between digestion and reproductive health.

Answer 188

-Many nutrient cofactors must be absorbed to support steroid hormone/sex hormone production -Strong links between reproductive disorders and inflammatory/autoimmune disorders (endometriosis, PCOS, irregular menstruation, infertility, pregnancy loss) -Male infertility can be due to malabsorption of nutrients that are important for sperm production (zinc, selenium, Vitamin E) -Poor microbiome health has been linked to reduced sperm health -dysbiosis can result in bacteria that reconvert estrogen into its active form and ultimately result in higher levels of circulating estrogen in the body resulting in a myriad of reproductive issues for both men and women

Question 189

Explain the connection between the digestive system and the cardiovascular system.

Answer 189

Poor blood flow to digestive organs = digestive problems -Blood helps pick up incoming nutrients -Upper GI symptoms 2x more common in people with cardiovascular disease Issues with the gut microbiome (inflammation) increases the likelihood for atherosclerosis Lipopolysaccharides can increase LDL cholesterol

Question 190

Explain the connection between the Nervous System/Gut-Brain and the digestive system. Gut/brain axis Microbiome Protective Factors

Answer 190

Gut-brain axis & vagus nerve - 80-90% of the signals transmitted via the vagal nerve travel from the gut to the brain Microbiome produces neurotransmitters related to the function of the enteric nervous system (ENS) Protective factors (SCFA, BDNF) -SCFA: produced in large intestine, maintain gut barrier function, can impact brain physiology and function -BDNF: Brain Derive Neurotrophic Factor; protein found in brain and spinal cord that promotes growth, maturation, and survival of neurons, active in the synaptic spaces between neurons where cell-to-cell communication takes place, modulates brain inflammation and immunity (low levels associated with a wide array of neurodegenerative disease and mental illnesses)

Question 191

Understand how each of the following categories has the potential to support digestive function, and at least one example of each: • Phytonutrients • Culinary spices and herbs • Fermented foods • Prebiotic foods • Functional foods

Answer 191

• Phytonutrients - bioactive compounds found in plant foods; benefits include anti-inflammatory, antioxidant, detoxification capabilities, joint health support, brain health support, cardiovascular health, antimicrobial Ex - carotenoids (red, orange, yellow fruits/vegetables); anti-inflammatory Ex - Polyphenols - antioxidant, anti-inflammatory, and anticarcinogenic properties; prebiotic effects, enhances microbial diversity, modulates intestinal barrier function; found in nuts, seeds, legumes, grains, greens, tubers, berries, fruits • Culinary spices and herbs - aid in the breakdown and absorption of nutrients; provide comfort and relief to. Stressed digestive system Ex - cinnamon - increases appetite; eases gas, burping, bloating; reduces H. Pylori Ex - oregano - antimicrobial • Fermented foods - aid in digestion, liberate nutrients in our food convert less useful nutrients to forms we can benefit from, provide living populations of health microbes for the gut Ex - kefir, kombucha, sauerkraut • Prebiotic foods - food for beneficial bacteria which proliferate and produce SCFAs, support health bowel movements, reduce symptoms of IBS, reduce markers of inflammation, improve metabolic health Ex - starch and glucose-derived oligosaccharides (found in unripe bananas and cooked then cooled potatoes); pectin (rinds of citrus fruits, skins of apples, pears, and berries) • Functional foods Ex - bone broth - contains vitamins and minerals, support joint health Ex - leafy greens - act as a prebiotic and stimulate the production of digestive secretions in the body Ex - mushrooms - wide array of vitamins and minerals and anti-inflammatory, antioxidant, anticarcinogenic, antibacterial, and anti fungal capacities

Question 192

What are three different methods one could use to better connect to a parasympathetic state?

Answer 192

Eat mindfully - eat slowly, focus on food, avoid distraction, take deep breaths before meals Chew properly - 30x per bite! Mechanical breakdown of food and coating with saliva and salivary enzymes Remove unsupportive habits - alcohol, smoking, eating late into the evening Also: movement, stress management

Question 193

How does a nutrient dense diet support detoxification?

Answer 193

Phase I and Phase II require key nutrients/enzymatic cofactors: B2, B3, B6, B12, folate, glutathione, BCAAs, flavonoids, phospholipids Antioxidants to support oxidative stress between Phase I and Phase II Amino acids, allium, cruciferous vegetables, and Polyphenols for Phase II pathways Eating cleaner food and drinking high quality water can lower the burden of toxicity on the body

Question 194

How does sleep support detoxification?

Answer 194

-Large share of detox happens while sleeping -During the overnight fast, the circulatory and lymph systems don’t have as much of a work loading shuttling incoming nutrients and can focus on moving toxins out of the body -Sleep hygiene: avoid late night eating, sweets, alcohol to allow the body to focus on detox while asleep

Question 195

How does stress management support detoxification?

Answer 195

Sympathetic dominant state can interrupt hormones, enzymes, and cellular processes involved in detox Ex - impairs liver enzyme activity, depletes glutathione levels, chronic inflammation, oxidative stress, alterations in gut microbiome and intestinal permeability (increased risk for reabsorption of Phase II conjugates), mental health issues

Question 196

How does digestion impact detoxification?

Answer 196

Any disruption of bile production and release can inhibit Eli action of toxins via bile Gastrointestinal motility issues can slow down transit time of food and waste products through the GI tract resulting in prolonged contact between toxins and intestinal lining/increased risk of reabsorption Lack of fiber and dysbiosis can also increase the risk of reabsorption of toxins (certain forms of bacteria can cleave the bonds of Phase II conjugates) Low nutrient absorption affects the level of cofactors available for detox pathways

Question 197

How does BSR affect detoxification?

Answer 197

Chronically high blood sugar overburdens the liver (converts dietary glucose into glycogen) impairing its ability to assist with detox

Question 198

What it metabolic flexibility and why is it important?

Answer 198

The capacity of an organism to adapt fuel utilization to fuel availability. Can shift between fuel sources based on circumstances that maintains our energy and overall function (ie - in a lack of available carbs, the body can use fats and proteins to make energy) -Important for maintaining steady energy levels, reducing cravings, and the ability to tap into stored fuel which supports healthy weight management

Question 199

Briefly describe the process of glycogenesis.

Answer 199

When the liver converts dietary glucose into glycogen for storage in the liver or skeletal muscles -Does so after consuming a meal rich in carbs and to avoid overloading the cells with glucose, the liver manages the extra via glycogenesis

Question 200

Briefly describe the process of lipogenesis.

Answer 200

When the glycogen stores in the liver and skeletal muscles are full, the liver converts excess glucose into fatty acids and triglycerides for storage in adipose tissue via lipogenesis

Question 201

Briefly describe the process of gluconeogenesis.

Answer 201

When the body converts sources other than carbs to glucose (ie - fats and proteins); usually utilized when carbs are low and protein supplies are high or during a prolonged fasted state.

Question 202

Briefly describe the process of glycogenolysis.

Answer 202

The breakdown of stored glycogen for use in order to increase blood glucose during times of low circulating glucose supply

Question 203

Briefly describe the process of lipolysis.

Answer 203

The breakdown of stored lipids (triglycerides) in the adipose tissue to be used as alternative fuel, fatty acid beta-oxidation rather than glycolysis to make ATP

Question 204

Understand glycation and why the formation of AGEs is problematic.

Answer 204

Glycation is a chemical reaction that occurs when glucose molecules in the bloodstream bind to proteins or lipids; a non-enzymatic process that occurs when blood glucose levels are elevated and leads to the formation of advanced glycation end products (AGEs) *Glycation is considered irreversible* AGEs persist and accumulate in tissues over time and cause damage to cells and tissues throughout the body; like “aging in fast forward”

Question 205

What are the four phase of dysglycemia and what are the key characteristics of each?

Answer 205

1. Reactive hypoglycemia -sharp blood sugar swings -in reaction to a high glycemic meal -overproduction of insulin to shuttle glucose into cells resulting in sharp drop in blood sugar 2. Insulin Resistance and Hyperinsulinemia -After years of hyperglycemia -Cells become less responsive to insulin, so blood glucose levels don’t drop as sharply -Results in the accumulation of glucose and insulin in the blood for longer periods of time -Can cause high BP, dyslipidemia, inflammation, hormonal disregulation, fatigue, weight gain 3. Metabolic Syndrome & Pre-diabetes -MS: broader condition that encompasses a combination of specific biometrics related to metabolic health; a cluster of interconnected metabolic abnormalities that increase the risk of cardiovascular disease and T2D -PD: refers to elevated blood glucose levels just below diagnostic criteria for diabetes 4. Type 2 Diabetes -When the increased insulin production is no longer sufficient to compensate for insulin resistance -persistent hyperglycemia -Possible impaired insulin secretion from pancreas

Question 206

What are the key characteristics of Type 1 diabetes?

Answer 206

An autoimmune condition characterized by the destruction of pancreatic beta cells, which produce insulin (not caused by insulin resistance in peripheral cells) Results in uncontrolled elevations of blood sugar and prescribed insulin injections

Question 207

What is the relationship between genetics and blood sugar dysregulation?

Answer 207

Over 120 genetic variants have been associated with the development of T2D

Question 208

How does the health of the microbiome relate to blood sugar dysregulation?

Answer 208

Phyla ratios don’t clearly correlate with health outcomes: -Elevated ration of firmicutes to bacteroidetes was considered an indicator of metabolic disorders in the past -Several studies do not show significant changes in this ration in individuals w/ metabolic conditions Intestinal dysbiosis contributes to blood sugar dysregulation via the following mechanisms: -inflammation (endotoxins impair insulin signaling) -barrier dysfunction resulting in immune response which contributes to insulin resistance -Elevated zonulin -reduced production of SCFAs which are known to enhance insulin sensitivity -disrupted bile metabolism -impaired gut hormone regulation (GLP-1 and PYY) -production of metabolites associated with insulin resistance Also, the opposite is true as well. Diets high in refined sugars and starch can contribute to alterations in the gut microbiome that promote insulin resistance

Question 209

How does intest

Question 210

How does blood sugar dysregulation relate to non-alcoholic fatty liver disease?

Answer 210

Caused by excess glucose associated with increased risk for GERD and other digestive complaints

Question 211

How does blood sugar dysregulation relate to general GI complaints?

Answer 211

In diabetics, symptoms are more common the less glycemic levels are managed

Question 212

How does blood sugar dysregulation relate to the migrating motor complex (MMC)?

Answer 212

Elevated blood glucose levels reduce the cycle length of the MMC

Question 213

How does blood sugar dysregulation relate to vagal nerve and gastric motility?

Answer 213

Diabetic neuropathy is a leading cause of gastroparesis

Question 214

How does blood sugar dysregulation affect sleep?

Answer 214

Increased night time urination can be the body’s attempt to lower glucose levels in the bloodstream Reactive hypoglycemia can result in blood sugar levels dipping during the night, the elevation of stress hormones, and resulting sleep disturbances

Question 215

How does blood sugar regulation relate to the body’s stress response?

Answer 215

-Reactive hypoglycemia places a burden on the HPA axis -The body views blood sugar crashes as an emergency and secretes adrenaline and cortisol in response

Question 216

How does blood sugar affect the nervous system?

Answer 216

-Diabetic nerves exhibit excessive glycation -Higher levels of AGE deposits are associated with reduced myelination of nerve fibers -AGEs promote neuronal cell death -Peripheral diabetic neuropathy = most common diabetic complication

Question 217

How does chronic blood sugar dysregulation affect the brain?

Answer 217

-Prolonged hyperglycemia damages blood vessels in the brain -Alzheimer’s Disease (AD): caused by insulin resistance in the brain -Increased likelihood of depression, anxiety, and stress with the consumption of foods high on the glycemic index (GI)

Question 218

How does blood sugar dysregulation affect the cardiovascular system?

Answer 218

-Endothelial cells of the vascular lining are vulnerable to injury and glycation when exposed to elevated glucose -Hyperinsulinemia can increase blood pressure -Dyslipidemia: abnormal distribution of lipids (including elevated levels of LDL cholesterol, reduced levels of HDL cholesterol, and elevated triglycerides)

Question 219

How does blood sugar dysregulation affect the immune system?

Answer 219

-Chronic inflammation is a driver and a result of BSDR -Chronic inflammation can impair insulin signaling and disrupt metabolism -Elevated levels of glucose and free fatty acids in the bloodstream stimulate inflammation -Chronic inflammation can impair immune responses making diabetic more susceptible to certain infections -Impaired wound healing - reduced blood flow, immune cell migration, and production of growth factors necessary for tissue repair

Question 220

How does blood sugar relate to the endocrine system?

Answer 220

Blood sugar is regulated by endocrine hormones! Thyroid -Thyroid conditions can promote insulin resistance -Link between insulin resistance and sub clinical hypothyroidism

Question 221

How does blood sugar relate to the reproductive system?

Answer 221

-Insulin resistance can lead to higher estrogen production -In males, insulin resistance can directly lead to lower levels of testosterone -In some females, insulin resistance can be related to high levels of androgens which relate to PCOS

Question 222

How does blood sugar relate to the urinary system?

Answer 222

-Prolonged hyperglycemia damages blood vessels in the kidneys, promotes oxidative stress and inflammation -Diabetic (chronic) kidney disease - leading contributor to kidney stone formation, end-stage renal disease, and kidney failure -Reduced ability for kidneys to convert Vitamin D2 into the active and usable form of D3 -Decreased calcium absorption into bone

Question 223

How does blood sugar relate to the skeletal system?

Answer 223

-AGEs negatively affect the collagen that makes up bone -Significant associations between the consumption of sugar-sweetened beverages and decreased bone mineral density and increased risk of bone fractures

Question 224

In the mouth, what begins the chemical breakdown of carbs?

Answer 224

Salivary amylase

Question 225

HCL in the stomach is responsible for activating…

Answer 225

The enzyme pepsin

Question 226

What part of the digestive system is primarily responsible for nutrient absorption?

Answer 226

Small intestine

Question 227

Which hormone stimulates the pancreas to release bicarbonate-rich juice?

Answer 227

Secretin

Question 228

CCK stimulates what?

Answer 228

Gallbladder to release bile

Question 229

Bicarbonate is important in the small intestine because it…

Answer 229

Neutralizes stomach acid

Question 230

What do the villi and mircovillie do in the small intestine?

Answer 230

Secrete digestive enzymes Increase surface area for absorption Transporting nutrients into the bloodstream

Question 231

The primary role of the large intestine in digestion is to..

Answer 231

Absorb water and electrolytes

Question 232

How does leptin affect appetite?

Answer 232

By signaling the brain to decrease appetite when fat stores are sufficient

Question 233

What is a potential outcome of hypochlorhydria?

Answer 233

Nutrient malabsorption issues

Question 234

How does pancreatic insufficiency affect digestion?

Answer 234

Causes malnutrition and digestive discomfort due to inadequate enzyme production

Question 235

What is a common cause of SIBO?

Answer 235

Compromised motility and structural issues

Question 236

How can symptoms of dysbiosis in the large intestine manifest?

Answer 236

Digestive discomfort and symptoms of IBS

Question 237

Diabetic neuropathy of the vagus nerve can affect the digestive system how?

Answer 237

Gastroparesis (delayed gastric emptying)

Question 238

How does dysbiosis affect the immune system?

Answer 238

By leading to an overactive immune response that can result in inflammation and autoimmune diseases

Question 239

How does the thyroid gland influence metabolism?

Answer 239

By producing thyroid hormones that regulate the body’s metabolic rate

Question 240

Which nutrient is essential for the production of thyroid hormones?

Answer 240

Iodine

Question 241

Which nutrient is essential for the synthesis of steroid hormones which are crucial for reproductive health?

Answer 241

Cholesterol

Question 242

Which digestive disorder is associated with increased rates of male infertility?

Answer 242

IBD

Question 243

How is poor microbiome health linked to reduced sperm health?

Answer 243

By decreasing the body’s overall nutrient absorption, including those crucial for sperm production By alternating the hormonal balance necessary for sperm production

Question 244

What role does the gut microbiome play in the development of atherosclerosis?

Answer 244

It can contribute to atherosclerosis through inflammation and altering bile acids

Question 245

What effect do lipopolysaccharides (LPS) have on the cardiovascular system?

Answer 245

They contribute to the development of cardiovascular diseases by promoting inflammation and dyslipidemia.

Question 246

What are Short Chain Fatty Acids (SCFAs) and how do they benefit the brain?

Answer 246

SCFAs are metabolites produced by gut bacteria that can have a protective effects on the brain, including supporting neuron function

Question 247

What is brain-derived neurotrophic factor (BDNF) and why is it important?

Answer 247

A protein that promotes the growth and survival of neurons playing a key role in brain health and resilience against neurodegenerative diseases

Question 248

How does the gut brain axis influence mental health?

Answer 248

Gut microbiome produces neurotransmitters and other compounds that impact brain function and mood

Question 249

L-glutamine is recognized for its role in what?

Answer 249

Tissue repair in the digestive tract

Question 250

Digestive bitters are known as what?

Answer 250

Digestive stimulants promoting the production of digestive secretions

Question 251

______ is considered a cofactors that supports digestive function by aiding in enzyme activity.

Answer 251

Zinc

Question 252

Adiponectin, a hormone secreted by adipose tissue, plays a role in blood sugar regulation by…

Answer 252

Enhancing insulin sensitivity and fatty acid oxidation

Question 253

Describe the process of lipolysis.

Answer 253

The breaking down of triglycerides into fatty acids and glycerol for energy

Question 254

How does glycation specifically affect the body’s systems?

Answer 254

By altering the structure and function of proteins and lipids leading to cellular damage

Question 255

How does elevated blood glucose affect the migrating motor complex?

Answer 255

It reduces the cycle length of the MMC

Question 256

How does insulin resistance affect estrogen production?

Answer 256

It can lead to higher estrogen production

Question 257

How does AGEs affect the skeletal system?

Answer 257

Negatively affect collagen reducing blood strength and flexibility

Question 258

How does fat contribute to healthy blood sugar regulation?

Answer 258

-Can help maintain stable energy levels and increase satiety -Low-carb, high-fat diets are proven beneficial for those struggling with metabolic conditions -Aim for high quality fats in their original form -Boost Omega 3s and limit highly processed omega 6s -Fiber along with fats can help maintain health of microbiome limiting inflammation and supporting healthy BSR

Question 259

How does protein support healthy BSR?

Answer 259

-Protein stimulates insulin which can help clear blood glucose more quickly -Certain amino acids can be insulinoogenic contributing to insulin resistance -Increasing protein in the place of carbs is an effective strategy for those dealing with MS, prediabetes, and diabetes -Protein sources that are low in BCAAs are best for those dealing with BSDR -Collagen and plant-based protein powders have less insulinogenic properties than dairy-based powders

Question 260

How does fiber contribute to healthy BSR?

Answer 260

-Slows down the absorption of sugar in the intestines -Improves insulin response -Improves serum lipid profiles -Promotes satiety -Supports healthy microbiome -Supports healthy BP -Supports healthy weight regulation Soluble fiber is the most effective in supporting blood sugar regulation

Question 261

How do probiotics support healthy blood sugar regulation?

Answer 261

-Improve glucose, lipid, and inflammatory markers -Some strains show reduction in BMI, total cholesterol, LDL cholesterol, increased antioxidant capacity

Question 262

Understand the how the following categories can support blood sugar, and identify at least one example for each: • Insulin Sensitivity Enhancers • Carbohydrate Absorption and Metabolism • Antioxidants • Vitamin and Mineral Cofactors • Adaptogens • Glandulars • Probiotics

Answer 262

Insulin sensitivity enhancers - improve body’s response to insulin Ex - magnesium, Vitamin D, Omega 3 fatty acids Carbohydrate Absorption and Metabolism - reduces/slows the absorption of glucose from the digestive tract, speed urinary excretion of glucose, help cells create energy from glucose Ex - magnesium, l-carnitine, gymnema Antioxidants - counteract oxidative stress which can contribute to insulin resistance and BSDR Ex - Vitamin C, Vitamin E, CoQ10 Vitamin and Mineral Cofactors - act as building blocks for the enzymes involved in insulin action and glucose metabolism Ex - zinc, magnesium Adaptogens - normalize the stress response preventing chronically high stress hormones and BSDR Ex - some mushrooms Glandulars - tissues from other organisms consumed to nourish the corresponding gland in the human body Ex - pancreas, liver, adrenal glands Probiotics - nourish the microbiome which impacts inflammation and overall BSR Ex - fermented foods are probiotic-rich

Question 263

What does calories in/calories out represent?

Answer 263

Calories in - what we wear Calories out - total energy expenditure (thermic effect of food, RMR, physical activity energy expenditure [non-exercise activity thermogenesis vs. exercise])

Question 264

Is resting metabolic rate the same as basal metabolic rate?

Answer 264

Resting and basal metabolic rate (BMR) are similar and only differ in that BMR is usually measured in the morning, after an overnight fast, no exercise for the previous 24 h, free from emotional stress, familiar with the apparatus, and the subject completely rested.

Question 265

What is the thermic effect of food and how does it vary for fat, carbs, and protein? What difficulties arise in measuring it?

Answer 265

Measurement of how much our metabolism increases after eating Fat - 0-3% Carb - 5-10% Protein - 20-30% Difficulties: Range of increase in metabolism is variable and very difficult to accurately measure

Question 266

Describe physical activity energy expenditure and the difficulties that arise in trying to calculate it.

Answer 266

Difficulties: -Excess Post-Exercise Oxygen Consumption (“after burn”) -Devices we use to calculate are inaccurate -Entirety of daily movement is difficult to account for -Need to take into account stress and fed states

Question 267

What is EPOC?

Answer 267

Excess Post-Exercise Oxygen Consumption “Afterburn” The increase in metabolism to pay off the oxygen debt you accrued from exercise

Question 268

Define metabolism.

Answer 268

The sum of the chemical reactions that take place within each cell of a living organism and that provide energy for vital processes for synthesizing new organic material OR Total energy expenditure = RMR + Thermic effect of food + Physical Activity Energy Expenditure

Question 269

Define anabolism.

Answer 269

When the body uses energy to build up/create more complex molecules (growth and repair)

Question 270

Define catabolism.

Answer 270

When the body breaks down complex molecules to release energy

Question 271

What are catecholamines and how do they differ from cortisol? How does stress play in?

Answer 271

Catecholamines and cortisol come from two different systems and two sets of precursors Catecholamines (ie - epinephrine/norepinephrine) -Released by the Sympathetic Adrenal Medullary axis -Precursor = phenylalanine -Quicker-acting -More involved with stressors that present as a challenge -Can have anabolic and catabolic impact on muscles Cortisol -Comes from the HPA axis -Precursor = cholesterol -Slower acting/takes longer to break down -Release is associated with stressors perceived as a threat -Catabolic to all muscle tissues Stress management and an improved outlook can help us view stressors as challenges vs. threats. Cortisol-driven stress responses puts one in a chronically catabolic state decreases metabolic active muscle tissue and increase adipose tissue that costs less to maintain.

Question 272

What are the basic caloric goals for weight loss, weight gain, and weight management?

Answer 272

Weight loss: -Aim to lose no more than 1-2 lbs per week -Focus on sleep, general exercise, stress, and diet (improving insulin efficiency, focus on Whole Foods) Weight gain: -Increase calories -Increase insulin in a healthy manner -Reduce excess and unnecessary movement Weight management: -As we age, we may gain weight from the same amount of calories we used to eat. May lose muscle, gain adipose tissue. To avoid, engage in strength training, eat enough protein, and trade refined foods for lower-calorie whole foods.

Question 273

How does each macronutrient (carb, protein, fat) play into weight management?

Answer 273

Carbs -Reduce refined carbs -Replace refined carbs with complex carbs/fiber and fats -Can also improve insulin sensitivity/efficiency with a high-carb, low-fat diet Protein -Highest TEF -Recommended to increase to aid in weight loss -Consuming protein induces muscle protein synthesis -Increases satiety Fat -Slows absorption of glucose -Increases satiety and stabilizes energy levels