BIO SCI 35 Lecture Notes - Lecture 9: Grapefruit Diet, Disordered Eating, Eating Disorder
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Based on âMorgan: A case of Diabetesâ by Lisa Rubin and Clyde Freeman Herreid (National Center for Case Study Teaching in Science)
The Patient:
Morgan Water is a 27-year old Native American that lives on a reservation in Oklahoma. Nearly ¼ of Morganâs tribe has diabetes but she has no direct family history of diabetes, heart disease, or other serious conditions. She is however obese (BMI = 32) and leads a sedentary lifestyle. Morgan has been suffering from an increasing persistence of symptoms including unusual thirst, dizziness, blurred vision, and numbness in her right foot. The symptoms have been developing over several months but as she is planning her wedding she attributed them to nerves. She is finally persuaded to see her family doctor. Her non-fasting blood glucose level was elevated so the doctor has her return the next morning for a fasting blood sample so they could more accurately measure her blood glucose and insulin. Her blood results are below:
| Test | Morganâs values | Normal range | Pre-Diabetic range | Diabetic range |
| Plasma glucose, mg/dl | 260 | 70 -139 | 140 - 199 | ⥠200 |
| Fasting glucose, mg/dl | 140 | ⤠99 | 100 - 125 | ⥠126 |
| A1C, % | 7.6 | ~ 5 | 5.7 â 6.4 | ⥠6.5 |
| Fasting Insulin, mIU/ml | 34 | 2 - 10 | 10 - 20 | ⥠20 |
The recommendation of Morganâs doctor was to improve her exercise, good nutrition, and weight loss. He recommends meeting with a nutritionist to assist Morgan in her weight loss goals. When Morgan got home and told her family the diagnosis they however had LOTS of suggestions on how she can lose weight. Below is a description of the advice given to her by three family members.
Best friend Savannah:
âYou know how Iâve been losing weight? Well, Iâve been on the Atkinsâ Diet. I heard about it on TV. Itâs great! You get to eat steak, chicken wings, and all the good stuff. All you have to do is limit carbohydrate intake. You should definitely give it a try. This diet has been around for years and it has worked for lots of people, including me.â
*Note: Atkinâs Diet recommends: 10% carbohydrates, 55% fats, 35% protein
Brother Alan:
âI think the best thing for you to do is exercise and stop eating all of that pizza and candy and food filled with fat. Our people never used to eat that junk. I say eat meals that are nutritionally balanced and high in fiber and low in refined sugars and saturated fats. And run a lot. Stop sitting around the house.â
Grandfather:
âMorgan, it is true that it is best to live in harmony and balance â to eat a nutritionally balanced diet that includes carbohydrates, proteins, and âgoodâ fats to meet your bodyâs needs. That is good. But look to your heritage. Our people were never overweight before we started eating âcivilizedâ food. Look to our native diet. I think you should look to traditional herbal remedies for help. What Alan says is true. Exercise is good. But it is sometimes not enough. Our people have always looked to natural medicine for cures. They will lift your spirits and energize you. Then you will lose weight and you will be healthy again. I hear the herbs from the diet shop are safe and good. But you must take them like the medicine label says. It canât hurt to try them.â
*Note: these herbal supplements Morganâs grandfather is recommending contain the herb
ephedra (ephedrine).
Question 5:
Given Morganâs metabolic state, what is the primary fuel source for her cells currently?
A. Carbohydrates (glucose)
B. Fats
C. Proteins
D. It is a balance of all three
Question 6:
Metabolic ketoacidosis is a common problem with diabetics, which is caused by which of the following?
A. Excessive oxidation of fatty acids, leading to an accumulation of ketone bodies in the blood.
B. Excessive oxidation of glucose, leading to an accumulation of ketone bodies in the blood.
C. Excessive oxidation of proteins, leading to an accumulation of ammonia in the blood.
D. Hyperglycemia.
Question 7:
Which weight loss suggestion is designed to achieve some level of ketosis?
A. Atkins Diet
B. Exercise
C. High fiber diet
D. Herbal treatments
Question 8:
One major side effect of the herbal supplement can be hot flashes and increased perspiration due to increased thermogenesis, what is the likely cause of the heat production?
A. Increasing the activity of phosphfructokinase-1.
B. Increasing the activity of the pyruvate dehydrogenase complex.
C. Increasing the activity of citrate synthase.
D. Increasing the activity of uncoupling proteins.
Question 9:
Would substituting fiber and complex carbohydrates (larger % cellulose) for the simple sugars and starches (high sucrose and amylose/amylopectin) help Morgan lose weight, why?
A. Yes, because complex carbohydrates like cellulose are largely indigestible so they pass through
the digestive tract without being absorbed.
B. Yes, cellulose contains less glucose residues than amylose or amylopectin.
C. Yes, because the fructose in sucrose is much more responsible for weight gain than the glucose.
D. No, because cellulose, amylose, and amylopectin are all composed of glucose so it doesnât
matter.
Question 10:
Which weight loss suggestion will lead to an increased need for gluconeogenesis?
A. Atkins Diet
B. Exercise
C. High fiber diet
D. Herbal treatments
QUESTION 11
A sustainable environment means to be maintained indefinitely and when we use products that have been altered by GMO's, genetically modified organisms, those crops cannot reproduce themselves.
True
False
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QUESTION 12
Which foods would not make a complement of 20 amino acids, to make a complete protein?
| Corn and beans | ||
| Brown rice and peas | ||
| Peanut butter and white bread | ||
| Yogurt and walnuts |
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QUESTION 13
Which nutrition tip would you not recommend?
| It is recommended to chew your food well. | ||
| It is recommended to go long periods of time without eating to loose weight. | ||
| When you eat out you can expect to get more salt and fat from the food. | ||
| Eating often will not cause weight gain because one is less likely to overeat. |
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QUESTION 14
Regarding fiber, which one is not correct?
| If you want to add fiber in your diet also eat the seeds and skins in fruits and vegetables. | ||
| The removal of the outer husk or bran from our wheat diminished the integrity of our grains. | ||
| The lack of fiber in the Western diet (that's our diet) was causing gastrointestinal problems that many countries and continents had not seen: diverticulitis, diverticulosis, constipation, increase in colon cancers, etc. | ||
| You cannot eat too much fiber. |
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QUESTION 15
Whey protein is a protein in milk that is most efficient in building muscle.
True
False
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QUESTION 16
Quinoa has been around for thousands of years, it is gluten free and a complete protein.
True
False
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QUESTION 17
Most of us donât get enough Vitamin D since our sun exposure is limited in the northern states. Vitamin D is made in our body with the help of the ultraviolet rays from the sun being absorbed by the skin. Vitamin D is vital for our immune system, skeletal structure hormone balance, and other bodily functions.
In answering this question, the other way we can get Vitamin D is primarily by eating fruits.
True
False
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QUESTION 18
The hypothalamus is our brain's appetite control center.
True
False
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QUESTION 19
The following explains information about antioxidants but one, which one is incorrect?
| We can't stop aging or get rid of the sun or live in a perfectly clean world but we can provide our body antioxidants that will fight free radicals. | ||
| We know from our readings antioxidants are vitamin K and the minerals biotin and selenium. | ||
| The foods with antioxidants are: all berries are great (strawberries, blackberries, blueberries, etc.), green leafy vegetables, carrots, tomatoes, dark chocolate, nuts, kidney beans and all beans, all herbs and foods mother nature provides us. | ||
| The most effective compounds that can fight off free radicals are antioxidants, just as the name implies they counteract oxidation, the harmful reaction that takes place. |
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QUESTION 20
It's best to drink beverages without calories. The calories from food leave us more satisfied than fluids and it's much easier to get additional unwanted calories from sodas, juices and lattes.
True False
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