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Chapter 6 Digestion and Absorption; Alcohol What Happens to the Food We Eat?  The food we eat undergoes three processes: 1) Digestion 2) Absorption 3) Elimination  These processes occur primarily in the gastrointestinal tract. What Happens to the Food We Eat?  Gastrointestinal (GI) tract: series of organs arranged as a long tube  The GI tract includes:  organs such as the stomach, liver, and intestines  Table 6.1  sphincters  muscles that control the passage of material from one organ to the next Gastrointestinal Tract Digestion  Digestion  the process of breaking large food molecules down into smaller molecules  Digestion includes breaking food down:  Mechanically  Includes peristalsis  chemically Digestion Overview – Smell/Taste Digestion Overview - Mouth  Digestion begins in the mouth  Mechanical  Chewing  Chemical  Saliva: lubricates and contains enzymes  Start to digest CHOs  Food becomes a bolus  Bolus enters esophagus  Peristalsis  No digestion Enzymes  Enzyme  A protein that induces a chemical change in another substance  Enzymes speed up the rate of chemical reactions.  Typically end in “ase” (amylase)  Digestion is dependent on many different enzymes. Digestion Overview - Stomach  The lower esophageal sphincter separates the esophagus from the stomach.  Digestion in the stomach includes:  extensive mechanical digestion, mixing food with gastric juice to produce chyme  chemical digestion of proteins and fats  Holds food for 2 to 6 hours Gastric Juice What It Is What It Does Mucus Keeps stomach from digesting itself HCl Denatures PRO; activates pepsin Intrinsic Factor Protects vitamin B12 until it can be absorbed Proenzyme converted to pepsin (an Pepsinogen Hormones enzyme) for PRO digestion Regulate digestive process and enzyme release Gastric lipase Enzyme that begins digestion of fat Anatomy of Stomach Digestion Overview - Small Intestine  Duodenum  Neutralizes stomach acid (bicarb)  Pancreatic enzymes take over  Gallbladder releases bile  Jejunum  Majority of digestion and absorption  Ileum  Vitamin B12 absorption and immune functions Small Intestine Anatomy Folds Villi & Microvilli  Secrete digestive enzymes and absorb nutrients Small Intestine Anatomy Small Intestine Summary Accessory Organs  Liver: largest digestive organ  produces bile  emulsifies fats  Receives products of digestion  Gallbladder  Stores and releases bile  Pancreas  produces many hormones and digestive enzymes  produces bicarbonate Digestion Overview – Large Intestine  Very little digestion*  Absorption of water and sodium  Formation of waste for elimination  Remains 12-24 hours  *Filled with bacteria! Bacterial Flora  About 100 trillion bacteria in large intestines  They help metabolize remaining nutrients  Break down some fibers to create short-chain fatty acids  Fuel supply for colonic cells  They produce vitamin K and B vitamins  Why newborns get a vitamin K shot  Is this why pre/probiotics are important? Pre/Probiotics  Probiotics:  Live microbial products (lactobacillus and Bifidobacterium) that health of the gut  Restore microbial balance  Prebiotics:  Food for the probiotics and good gut bacteria  Indigestible CHO sources (inulin)  Synbiotics  Combo of pre and probiotics (supplements) Pre/Probiotics  Possible health benefits include:  Decreased diarrhea and constipation  Decreased growth of H. Pylori  Enhanced immunity  Increased nutrient absorption  Reduced risk of colon cancer  Fewer allergies in kids  Improved blood lipids  Lower blood pressure © 2013 Pearson Education, Inc. Pre/Probiotics Where To Find Prebiotics: Where To Find Probiotics:  Asparagus  Fermented Foods:  Bananas  Yogurt  Oatmeal  Kefir  Jerusalem artichokes  Buttermilk  Legumes  Tempeh  Onions  Miso  Leeks  Sauerkraut  Cabbage  Some pickles Follow The Path  Now that we have learned the basics, let’s look at what happens when we eat a turkey sandwich on whole wheat bread with lettuce, tomato, cheese, and avocado Digestion - Mouth  Digestion begins in the mouth.  Chewing is the mechanical digestion that breaks all food into smaller pieces.  Some chemical digestion takes place.  Saliva lubricates and contains amylase – an enzyme produced by the salivary glands.  Salivary amylase begins the chemical digestion of carbohydrates.  Maltose & dextrins Salivary amylase Mouth Summary Digestion – Through Esophagus Digestion - Stomach  Acidic HCl (from gastric juice) stops salivary amylase activity  No CHO digestion  HCl activates enzymes that start PRO and fat digestion  Pepsinogen Pepsin  Lingual and gastric lipases (fats)  HCl denatures PROs  Mechanical digestion through churning  Still, minimal digestion takes place  Absorption of alcohol Digestion - Stomach Lingual/Gastric lipase Pepsin Minimal digestion Smaller PRO units Stomach Summary Digestion – Small Intestine  From the stomach, chyme is slowly released through the pyloric sphincter to the small intestine.  **Most digestion and absorption occur in the small intestine.  Absorption: the process by which molecules of food are taken from the GI tract into the body. Small Intestine - CHOs  Pancreatic amylase dextrins maltose  Intestinal cells release disaccharide-specific enzymes Enzyme Digests Into Maltase Maltose Glucose + glucose Sucrase Sucrose Glucose + fructose Lactase Lactose Glucose + galactose  Monosaccharides are absorbed into capillaries  Go to liver All become glucose Small Intestine - Fat  Problem:  Fats and watery digestive juices do not mix well Bile gallbladder  _______ is released from the _______________ to help  Process is called:  Emulsification Bile  Very important in lipid digestion  Sometimes called bile salts  Acts as an emulsifier  What is an emulsifier?  A substance that suspends lipid/fat in a watery solution Water Lipid Emulsification Lipid does not like water and sits on top Fat is emulsified in watery fluid E M U L S I F I E R Small Intestine - Fat  Now that fats are emulsified  Pancreatic lipase can digest triglycerides  Fatty acids and glycerol Pancreatic lipase Small Intestine - Fat  Now that triglycerides broken down  Absorbed and reformed in chylomicrons  With fat-soluble vitamins and cholesterol  Get transported from lacteal to lymph  Empty into blood through left subclavian vein  Go to liver and cells Small Intestine - Protein  Pancreas releases peptidases  Proteins into peptides  Small intestine releases other enzymes  Peptides into amino acids Protein Peptides Amino Acids  Amino acids absorbed into capillaries and go to the liver Small Intestine Summary Large Intestine  Fiber and other undigested particles  Colonic bacteria digest some fibers  Short-chain fatty acids  Make some vitamins (K & B)  Absorb water and sodium  Prepare waste for elimination  After 12-24 hours Large Intestine Summary Vitamins & Minerals & Water  Vits/Mins: Already in the smallest form  Fat-soluble vitamins need to be transported in chylomicrons  A, D, E, K  Water-soluble nutrients go through blood  B12 needs intrinsic factor  Water absorbed in small and large intestines  Follows sodium, glucose across intestinal wall Digestion Review  Digestive System Video Disorders Related to Digestion  The lining of the stomach is designed to cope with hydrochloric acid (HCl), but other regions of the GI tract are not.  Heartburn is caused by HCl in the esophagus.  GERD, or gastroesophageal reflux disease, is painful, persistent heartburn. GER or GERD Disorders Related to Digestion Peptic ulcers are regions of the GI tract that have been eroded by HCl and pepsin. The bacterium Helicobacter pylori contributes to the production of both gastric and duodenal ulcers. Disorders Related to Digestion  Food intolerance is a group of GI symptoms associated with eating a particular food.  No immune system involvement  Symptoms may include gas, pain, and diarrhea.  Lactose intolerance is an example. Disorders Related to Digestion Food allergies: a response of the immune system caused by a particular food component In some people, food allergies can be mild. In others, food allergies can be quite severe and require immediate medical attention. Disorders Related to Digestion  Celiac disease is an immune system response to eating gluten, a protein found in wheat, rye, and barley.  The immune response damages the villi in the small intestine, leading to decreased absorption of certain nutrients.  Celiac disease is considered a genetic disorder.  Treatment involves a gluten-free diet. Disorders Related to Digestion  Diarrhea:  can be caused by infection of the GI tract, chronic disease, food intolerances, stress, and bowel disorders  can lead to severe dehydration  is more dangerous for infants, young children, and older adults Disorders Related to Digestion  Constipation:  can be caused by the disruption of a person's schedule, a change in diet, or certain medications  may be treated by increasing fluid and fiber consumption Disorders Related to Digestion  Irritable bowel syndrome (IBS) is a disorder that interferes with normal colon function.  Symptoms of IBS include:  abdominal cramps and bloating  either diarrhea or constipation  IBS is more common in women than in men. Disorders Related to Digestion: IBDs Ulcerative Colitis Crohn’s Disease  Inflammation of the large intestine  Inflammation of the small and large intestines Alcohol  Contained in beverages made from fermented fruits, vegetables, or grains  High-energy compound: contains 7 kcal/g  Not a nutrient since it is not essential and impairs body functions Alcohol  Dietary Guidelines for Americans recommends that any alcohol consumption should be done in moderation.  What is moderation?  No more than 1 drink/day for women, 2 drinks/day for men  There is no safe level for women who are pregnant or breastfeeding.  “Legal” BAC limit in AZ <0.08%  If >0.08% = loss of license  See Table 6.4 Alcohol  One drink is the amount of a beverage that supplies ½ fluid ounce of alcohol:  1 ½ oz of distilled spirits  5 oz wine  12 oz beer  1 wine cooler Metabolism of Alcohol  Alcohol is not digested but is absorbed directly through the stomach and intestine.  Alcohol is transported to the liver, where it is metabolized at the rate of approximately 1 drink/hour.  Excess alcohol is released to the blood and excreted in urine, breath, and sweat.  Does coffee/caffeine help? Levels of Consumption Level Amount Moderate Up to 1 per day women; 2 per day men Heavy 8+ drinks/week women; 15+ drinks/week men Binge 3+ drinks/time women; 5+ drinks/time men Alcohol and Liver Metabolism  Liver is the ONLY organ that can metabolize alcohol  Alcohol absorbs faster than nutrients  Alcohol absorbs faster on empty stomach  Liver metabolizes at rate of 1 drink per hour Alcohol and the Brain  Decreases inhibitions, reasoning, judgment  Induces relaxed feelings  Impairs speech, vision, muscle movements  Impairs breathing, heart rate  Loss of consciousness  Kills brain cells Alcohol and the Brain Alcohol and Health Benefits  Moderate alcohol consumption is linked to:  Improved lipid profiles  Reduced risk of blood clots in arteries  Stimulated appetite in the elderly  Possible lower risk of cognitive impairment and other forms of dementia  Stronger bones in older adults  Red wine contains polyphenols  Catechin and resveratrol  Found in grape skins/seeds Alcohol and Health Risks  Moderate alcohol consumption is linked to:  Possible increase in the risk for breast cancer  Possible increase in the risk for hypertension  Possible increased total calorie consumption and therefore increased risk of obesity  Interactions with medications  Possible reduced intake/absorption of vitamins/minerals  Wernicke-Korsafoff syndrome Alcohol and Health Risks  Alcohol abuse:  drinking too much, too often, or at inappropriate times or situations  Binge drinking:  the consumption of five or more drinks on one occasion.  Alcohol consumption that overwhelms the liver's ability to detoxify the blood can result in alcohol poisoning. Alcohol and Health Risks  Chronic alcohol abuse can lead to alcoholism, a disease characterized by:  craving alcohol  inability to stop drinking  physical dependence  tolerance  Chronic alcohol abuse severely damages the liver. fatty liver hepatitis cirrhosis Fetal Alcohol Syndrome  Alcohol is a teratogen –  a substance known to cause birth defects.  Alcohol crosses the placenta and enters the fetus.  A fetus cannot metabolize alcohol, so it accumulates in the fetal bloodstream. Fetal Alcohol Syndrome  Fetal alcohol syndrome (FAS) is a group of birth defects found in children whose mothers consumed alcohol during pregnancy.  Children with FAS typically have emotional, behavioral, social, learning, and developmental problems throughout life. 100% Preventable!! Don’t Do It!!!