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Lecture 9

Lecture 9 - Alcohol and Minerals.doc

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Department
Health Studies
Course
HLTH 230
Professor
Jeffery Lalonde
Semester
Winter

Description
Lecture 9 - Alcohol ALCOHOL alcohol: a class of organic compounds containing hydroxyl groups (OH) -ethanol: particular type of alcohol found in beer, wine, distilled liquor -most widely used and abused drug in our society (b/c it is legal!) -legal non-prescription drug that produces euphoria *the alcohol we drink! Alcohol • can rapidly penetrate into cells and destroy cell structures -> ultimately killing it -ex. alcohol hand wipes to clean the skin • toxic in small amounts • toxicity can be used to kill microbial cells • ethanol is less toxic than other alcohols if diluted and taken in small amounts, ethanol can be used with low risk • • affects every organ - NOT A NUTRIENT! • disruptive behaviour most evident in liver -ex. liver cells normally use FA as fuel (packages excess into TG, ship to other places) with alcohol present, FAs accumulate while liver is busy breaking down alcohol -alcohol metabolism can permanently change the liver cell structure impairing its ability to metabolize fats (contributes to fatty liver in heavy drinkers) __________________________________________________________________________ Alcohol Trivia - don’t need to know :) What alcoholic beverage is made from what plant? Sugar cane - rum Grapes - wine Wheat - beer Potato - vodka Apple - cider, brandy Barley - ale, porter Rice - sake Agave - tequila Corn - bourbon One standard drink - 13.6g of alcohol (1/2 oz pure alcohol) • 142 ml (5 oz) of wine (approx. 12% alc) • 43 ml (1.5 oz) of hard liquor (approx. 40% alc) • 341 ml (12 oz) of beer (approx. 5% alc) Distilled liquor is often stated in proof • 80 proof = 40% alcohol Lecture 9 - Alcohol Production of Alcohol - don’t need to know in great detail! • through fermentation -grains, cereals, fruits, potatoes, other carb rich foods (need the sugars from carbs) Fermentation • Yeast consumes carbs ----> alcohol + CO2 • 1 molecule of fermented glucose: -2 molecules of ethanol -2 molecules of CO2 -2 molecules of H20 • simple sugar, yeast, water combined and left at room temp • Stage 1: yeast cells multiply, use sugar for energy and produce small amounts of alcohol • Stage 2: O2 depleted, yeast ferments remaining sugar to alcohol and CO2 under anaerobic conditions (O2 is no longer present) • Fermentation complete when sugar is used up OR alcohol content is high enough to inactivate yeast Production of Alcohol • Malted alcohol -yeast requires sugar (not starch) therefor malting must occur -during malting: grain seeds are allowed to sprout, produces enzymes that break starches into simple sugars __________________________________________________________________________ Alcohol in Body Alcohol is unique! • does not require digestion! • approx. 10-30% of alcohol is absorbed directly from an empty stomach and can reach brain in 1 minute • can lead to an immediate euphoric feeling Alcohol in Stomach • breakdown begins in stomach with Alcohol Dehydrogenase (ADH) • Difference between sexes -women produce less ADH in stomach compared to men -> women will absorb more alcohol from a drink compared to a man of the same size Alcohol in Small intestine • rapidly absorbed -‘priority customer’: gets absorbed and metabolized before most nutrients *body doesn’t want it sitting around, wants to deal with it as quickly as possible • preferential treatment is because: -alcohol can not be stored Lecture 9 - Alcohol -is potentially toxic Alcohol in Liver How does liver break down some of alcohol before it moves through the rest of body? • capillaries of digestive tract merge and carry blood (with alc.) to liver • liver cells are the only cells other than stomach that produce enough ADH to metabolize alcohol -> helps break it down and save the body • generally, liver can process about 1/2 ounce of ethanol/hour -affected by health, drinking experience, size, food intake max. rate of alcohol breakdown in liver determined by ADH available • • too much alcohol for liver to handle -> alcohol circulates throughout the whole body until liver can catch up => no more than 1 drink/hour! -Canadian Centre for Addiction and Mental Health recommends: 2 drinks/3 hours Alcohol Dehydrogenase (ADH) • amount of ADH enzyme varies based on genes and recent food intake • drinking after not eating all day causes increased effects because: 1) rapid absorption 2) slowed breakdown (decreased enzymes from protein breakdown) -if you don’t eat all day, your body does not produce as much ADH -> more alcohol circulating throughout body -> more effects on body ADH breaks down alcohol by removing hydrogens in 2 steps: 1) Alcohol dehydrogenase oxidizes alcohol to acetaldehyde -high concentration of acetaldehyde in brain and tissues -> damaging effects 2) Acetaldehyde dehydrogenase converts acetaldehyde to acetate, which is then converted to Acetyl-CoA These reactions produce Hydrogen ions (H 7-3) B vitamin Niacin (coenzyme NAD) picks up these hydrogens thereby diminishing NAD and accumulating NADH Alcohol Disrupts Liver During alcohol metabolism, rxns requiring NAD (glyc, TCA, ETC) falter and “traffic backs up” or “alternate routes are taken” Consequences include: -accumulation of H+ ions -> decreases pH -interference causes lactate to be made from pyruvate, lactate interferes with excretion of uric acid causing inflammation of joints -alcohol enters a.a. and protein metabolism -> synthesis of proteins important to immune system slows -accumulation of NADH slows the TCA cycle -> build up of acetyl CoA -Acetyl CoA then takes route to FA synthesis -> leads to fatty liver -> instead of being used for energy, Acetyl CoA is used as a building block to make fatty liver Lecture 9 - Alcohol • liver accumulates fat which it can not handle causing liver cells to become less efficient at performing its regular tasks: -activation of vitamin D -producing and releasing bile • synthesis of FA accelerates with exposure to alcohol • accumulation of fat can be seen after night of heavy drinking fatty liver • -1st stage of liver deterioration -> interferes w. distrib. of nutrients + O2 to liver cells -if fatty liver lasts (continued alc. consumption), liver cells die and form scar tissue fibrosis: 2nd stage of liver deterioration • some liver cells can regenerate with good nutrition and abstinence from alcohol cirrhosis: advanced liver disease in which liver cells harden and permanently lose their function -the least reversible *some people can drink all their life and not develop cirrhosis Alcohol alters a.a. and protein metabolism -protein synthesis slows, protein depletion occurs -heavy drinkers’ liver deaminates the a.a. ingested in food and uses the carbon fragments to make fat or ketones -must stop drinking to protect a heavy drinker from protein depletion -eating healthy is not enough Alcohol Metabolism -liver’s priority treatment of alcohol affects the way the body handles drugs • MEOS (microsomal ethanol-oxidizing system) handles approx. 1/5 of a person’s alcohol consumption as well as several other drugs • seasoned drinking stimulates synthesis of enzymes in MEOS -> more efficient metabolism of alcohol *body gets used to person drinking more and more, has the MEOS to regulate it • drinking alcohol -> MEOS will metabolize alcohol instead of drug, leaving drug to build up with possible dangerous results. ALCOHOL IS PRIORITY! *if someone is taking a medication that needs MEOS to breakdown, the medicine will not be metabolized because MEOS will be breaking down alcohol • when not drinking, MEOS will metabolize drugs more quickly - making dosing the drug difficult (hard to prescribe drugs in heavy drinkers) Other ways alcohol exits the body • 10% of alcohol will leave body via breath and urine • amounts in breath and urine are proportional to amount still in blood stream and brain Lecture 9 - Alcohol Alcohol and Brain - in textbook! step by step diagram • alcohol was used as anesthetic for many years (difficult to dose) is a depressant that sedates inhibitory nerves • • brain responds to alcohol in a particular order: 1) sedates frontal lobe -> impairs judgement and reasoning 2) speech and vision centres in midbrain are sedated 3) voluntary muscular control is affected including those used in speech, eye-hand coordination, and limb movements 4) respiration and heart action are last to be affected -conscious brain (Pons, medulla oblongata) completely subdued and person passes out (good thing: prevents further drinking that would anesthetize breathing and heartbeat, causing death) -possible that so much alcohol consumed prior to passing out that death may still occur vodka and redbull - caffeine keeps you awake, allows you to drink more, stops you from passing out -> BAD! • liver cells and brain cells die with excessive exposure • liver cells can be replaced, brain cells can not • not clear if moderate alcohol consumption effects cognition longterm, but heavy drinkers incur longterm brain damage • alcohol depresses production of antidiuretic hormone ->dehydration and possible increase in alcohol consumption Alcohol and Malnutrition Moderate Drinkers • alcohol adds extra calories and often stimulates appetite • efficiently metabolized in moderate doses, can contribute to body fat and weight gain • central obesity appears to accompany alcohol consumption -alcohol contributes to central obesity, fat around the middle/beer belly Heavy Drinkers • consume alcohol as a substitute for energy • eat poorly alcohol 7kcal/gram but alcohol is ‘empty calories’ (does not provide nutrition) • => many nutritional problems (folate, thiamin, B6, vitamin D, vitamin A deficiency) Folate Deficiency • liver loses ability to retain folate kidneys increase excretion of folate in urine • • folate is secreted in bile and reabsorbed in intestines - intestines damaged by folate deficiency and alcohol toxicity therefore decreasing folate absorption Lecture 9 - Alcohol • alcohol interferes with converting homocysteine to methionine - increase homocysteine (linked to heart disease) folate deficiency => viscous circle OIL IS THE MOST ENERGY DENSE, NOT A DONUT!! -oil is ALL fat and fat is the most energy dense!!! Thiamin Deficiency • inadequate intake and impaired absorption • Wernicke-Korsakoff syndrome - B vitamin lecture (eye twitch) B6 Deficiency • Acetyladlehyde dislodges B6 from its binding protein causing deficiency and lowered production of RBC Thiamin, Folate, B12 • decreased absorption Vitamin D • liver cells lose efficiency at converting Vitamin D Vitamin A • liver cells lose efficiency at converting Vitamin A Alcohol causes increased acid production by stomach cells -possible ulcer formation/irritating GERD Alcohol Effects - don’t need to know! Short Term • 20% of all boating fatalities • 23% of all suicides • 47% of all homicides • 65% of all domestic violence incidents • 39% of all traffic fatalities • 40% of fire victim fatalities Canada’s Low Risk Alcohol Drinking Guidelines 1) no more than 10 drinks a week for women, no more than 2 drinks most days no more than 15 drinks a week for men, no more than 3 drinks most days 2) no more than 3 drinks (women) 4 drinks (for men) on any single occasion 3) no drinking while driving, taking medicine, dangerous PA, pregnant, living with mental/physical heath problems 4) no drinking when pregnant/planning to be pregnant, before breastfeeding -> no alcohol is the best choice Tips Lecture 9 - Alcohol -set limits for yourself and abide by them -drink slowly, have no more then 2 drinks/3 hours -eat before and while drinking -for every alcoholic drink, have one non-alcoholic drink Table H7-2 Alcohol blood levels 0.05 - can give you impaired judgement, relaxed inhibitions, altered mood 0.40 to 0.60 - unconsciousness, shock, coma, death THE MINERALS (pg. 377-394 and 403-427) Major minerals in 60kg body (Figure 12.9) Calcium - 1150g (largest quantity because it is in bones!) • • Phosphorus - 600g • Potassium - 210g • Sulfur - 150g Sodium - 90g • • Chloride - 90g • Magnesium - 30g *know that calcium and phosphorus are the most abundant! Trace minerals in a 60kg body - MUCH SMALLER AMOUNTS! • Iron - 2.4g • Zinc - 2.0g • Copper - 0.09g Manganese - 0.02g • • Iodine - 0.02g • Selenium - 0.02g minerals: inorganic elements that retain their chemical identity and remain in body until excreted -minerals and cooking -> can leach into cooking water -minerals are not destroyed by cooking (all minerals in food will be in ash) Body’s handling of minerals • can differ between minerals (some will be stored, like fat soluble/some will be excreted like water soluble vitamins) -Potassium: easily absorbed, transported freely and excreted by kidneys -Calcium: needs a carrier for absorption and transportation -some minerals can be toxic in very high levels Have varying bioavailability in food bind on to nutrients, absorption is prevented • -Phytates - primarily in legumes and grains -Oxylates - rhubarb and spinach Lecture 9 - Alcohol Nutrient interactions • interactions can affect absorption, metabolism, and excretion -Na+ and Ca+ have interactions when Na+ is high -> causes both to be excreted -Phosphorous binds Mg in GI tract -> Mg absorption is limited when P intake is high Varied roles • fluid balance, bone health, etc. • wide range of functions in the body SODIUM • taste is generally appealing • enhances other flavours - most likely but suppressing bitter flavours • foods generally provide more than the body requires Roles in body • principle cation of extracellular fluid and primary regulator of its volume • helps maintain acid-base balance • assists in nerve impulse and muscle contraction AI: 1500mg UL: 2300mg -Mean Canadian Intake: 3400mg/day (CCHS 2004) - WAY OVER UL -for Canadians between 9 and 70 (CCHS 2004) -over 85% of men were above UL -between 63% and 83% of women above UL *hypertension Canada now changed their intake from 1500 to 2000mg Hypertension -salt (NaCl) seems to have a greater effect on blood pressure than either sodium or chloride alone salt sensitivity: respond to high salt intake with an increase in blood pressure and a low salt intake with a decrease in blood pressure -blood pressure increases in response to excess salt intake most notably for: -individuals with hypertension -people over the age of 40 -african americans DASH (Dietary Approaches to Stop Hypertension) • emphasis on fruits, vegetables, and low fat milk products (potassium rich) • includes whole grains, nuts, poultry, fish • reduction of sodium, red and processed meats, sweets and sugar containing beverages Lecture 9 - Alcohol *people who went in the this group had drastic drops in blood pressure Sodium and Osteoporosis • high Na+ intake associated with Ca+ excretion but influence on bone loss is less clear In general, up to 75% of Na+ in people’s diets come from salt added by manufacturers Examples of high sodium foods -salt, soy sauce -processed foods (processed meals, foods prepared in brine, salted snacks, cheese, canned soup) *processed vegetarian foods are much higher in sodium! *processed foods have a lot more sodium compared to unprocessed foods -when you process, the amount of potassium is greatly decreased and sodium is added! Sodium Deficiency generally not from inadequate intake • • blood sodium may drop with excess sweating, vomiting or diarrhea • endurance athletes can lose a lot of salt and drink too much water -> become hyponatremic -symptoms of headache, confusion, stupor, seizures, CONVULSIONS, coma Sodium Toxicity • immediate symptoms: high blood pressure, edema • prolonged excessive Na+: hypertension CHLORIDE CL2: poisonous gas • • CL-: essential nutrient Roles • major anion of extracellular fluid moves freely across membranes • • active in maintaining fluid balance • part of HCl, the strong acid in stomach Deficiency & Toxicity diet rarely lacks chloride • • heavy sweating, chronic diarrhea and prolonged vomiting may lead to Cl losses • high blood chloride may occur with dehydration • toxicity symptoms: vomiting Significant sources: salt, soy sauce, processed foods, moderate amounts in milk and eggs -same as sodium Lecture 9 - Alcohol POTASSIUM Roles • major cation inside cell • major role in fluid and electrolyte balance and cell integrity • nerve impulses and muscle contraction through Na+/K pump -K is very important to heartbeat Sources: primarily in fresh fruits and vegetables, “whole foods” Deficiency • blood pressure: low K intake raises blood pressure high K intake prevents and corrects hypertension • most common electrolyte imbalance usual causes: • -prolonged vomiting and diarrhea -regular use of diuretics, steroid
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