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HM B Lecture notes Lecture 1: Diet-related problems in Australia Rosemary Stanton Introduction • Integrated model (all are interrelated): o Health o What we eat o Social equity o Protection of land and water (climate change/sustainability) Australians • Eat more: o Snack foods, fast foods, restaurants, soft drinks/energy drinks, instant noodles (fat/salt), cheese, wine Expense is an important factor • Eat less: o Fruit, vegetables, milk, breakfast cereal, bread (wholegrain) • Problems: o Overweight (kJ), underweight o Dental caries (refined carbs) o Coronary heart disease, high blood pressure, diabetes (saturated fat) o Cancers – bowel, breast, prostate (saturated fat) o Nutrient deficiencies – especially iodine and vitamin D o Gall stones (fat), constipation, osteoporosis Dietary problems • Fat, especially saturated fats • Trans fats o Eg: oleic acid o Vegetable oils that have been partially hydrogenated for better shelf life o Increase LDL cholesterol and decrease HDL cholesterol • Poor quality carbohydrates • Salt • Alcohol Deficiencies • Iodine – dairies have stopped using iodine for milk processing o Especially important in pregnant women o Bread, begun using iodised salt • Vitamin D – produced by sun exposure o Fat soluble, a hormone o People are scared of skin cancers, and thus avoid the sun completely Should come out before 11 and after 2-3pm o Deficiency can result in misshapen bones o Risk: elderly, cultural, religious • Omega 3 fats, calcium (especially teenage girls) • Dietary fibre – from fruit and veges o Results in constipation • Potential problems o Vegans: Vitamin B12: only found in animal products, need supplements or fortified soy Iron, calcium Obesity • Reasons for: o Poor choices of fats, carbohydrates, and drinks • All ages and both genders are increasingly becoming fatter o Increase is rapid and continuing o Partially due to SES • People take no responsibility and are waiting for a miracle cure • Epidemiology: o Ages 2-18, 25-37% are overweight o Adults: male – 67%, female – 52% o Women worry, men do not (men: “it’s all muscle”) Measurement • BMI – doesn’t account for different body shapes • Waist – a better measure for visceral (surface) fat that better correlates with disease risk • Risk of weight problems: o Skinny – osteoporosis o Fat – heart disease, diabetes, increased blood pressure, cancers, gall stones Weight loss • Greatest problem is impatience – people have too high expectations o To lose 1kg, need a deficit of 32 000 kJ • Diets cause weight loss but not fat loss o Glycogen from muscles is lost taking water and the breakdown of proteins causes a diuresis and loss of water weight o No diet has been show to work in the long term Diets set off long term changes that are important in keeping the weight off o “quick fixes” that do not work • Advice: o Change habits (exercise) o Eat less, eat breakfast, don’t snack o Reduce sugar, alcohol o Avoid diets Prevention and risk of obesity • Breast feeding vs • High fibre foods • TV, sedentary • Physical activity • Energy dense food, fast food • Soft drinks, cordials, juice (liquid kJs) Strategies • Goals – to improve health rather than weight loss • Empowerment – look after own health/weight and understand it and how it happened • Hungry vs not hungry eating Physical activity • Controls appetite • Advantages o Cardiovascular, decreased cancer (colon, breast), osteoporosis • Doesn’t have to be obvious exercise, general everyday activity counts o A pedometer is a good tool Fats • Saturated fats – fatty meats and full fat dairy o Vegetable oils are hydrogenated for us in snacks, biscuits, spreads, etc Allows for better storage and reheating • Trans fats – not found in nature o Partially hydrogenated • Should decrease saturated fats, and eliminate trans fats • Good fats: o Fats in fish, omega 3 o Monounsaturated – olive oil, nuts, avocado o Polyunsaturated – soy bean, sunflower, walnut oil + margarines from these Omega 6, ok in small quantities, decreases LDL cholesterol Carbohydrates • Glycaemic Index (GI) gives a measure of how fast carbohydrates are converted to blood glucose vs glucose (100) o Lower GI is better because energy is released slower over many hours This is especially important in DMII • Problems: o Low GI can be confused with low carbohydrate, ie chocolate has lower GI than carrots These are often fatty, sugary, low GI but not healthy o Doesn’t help with increased weight • Want: o Low GI, high nutrient food – fruit, wholegrains, peas, corn, sweet potato, legumes, milk and yogurt Wholegrain bread – slow fermentation, sour dough bread • Some carbs have useful nutrients and for this reason are important although they have high GI o Others do not like: soft drinks, sugar, confectionary Drinks • Stick to: Tap water, tea (4-6 cups), coffee (2) o Avoid: juice (kJ, acidity – eats enamel), soft drinks (kJ, dental), alcohol (max 1-2/day) Salt • >80% of salt is already in food – especially snack food and eg. soy sauce o Solutions: Eat more fresh foods, put less salt in cooking, buy no salt foods Use other things for flavour (eg. spices, pepper, garlic, herbs) Deficiencies and solutions • Fruit/vegetables – eat them • Fibre – fruit and vegetables, good carbohydrates • Calcium – dairy, soy (fat reduced) • Iodine – fish, seafood, dairy, iodised salt • Omega 3 – fish (2x/week) • Vitamin D – sun/supplement Social equity • Low income correlates with a bad diet and health o Dependent on: access to food, knowledge skills o Solutions: subsidies for healthy products, tax on junk food, lobbying Sustainability issues • Agriculture produces a lot of greenhouse gases • Water • Soil fertility/fertiliser – superphosphate is running out • Processing, packaging, storage • Food crops for ethanol – food for cars or people? • Industrialised foods – wastage and overconsumption, preservatives, additives, lose origins of food Lecture 2: Design of metabolism Mike Edwards Metabolism • Metabolism – all chemical reactions that take place in a cell/organism o Catabolism – metabolic pathways that release chemical energy breaking down complex molecules into simple ones Release energy (ADP ATP) o Anabolism – metabolic pathways for the synthesis of complex molecules from simple ones Use energy for biosynthesis (ATP ADP) o Metabolism in cells and organisms have ordered sequences of events metabolic pathways • Energy is stored within cells as a molecule: ATP ATP o ATP ADP + Pi ADP + Pi • Energy in and out o If energy in from food catabolism is greater than energy expenditure, excess is stored and mass increases o If energy out from exercise and cellular processes is greater than energy taken in, stores are used and mass decreases • Respiration and fermentation o Amino acids and fats are broken down by respiration (O2-dependent) and are converted to CO 2 and H 2O o Carbohydrates have 2 pathways for breakdown Respiration – conversion to CO 2 and H 2O Fermentation – conversion of glucose to lactate (lactic acid, not ethanol!) • Only in skeletal muscle (intense exercise) and RBCs o Cell/tissues die in with a lack of oxygen Exceptions: RBCs, skeletal muscle Without O 2, cells can’t breakdown macronutrients to make ATP, thus they can’t function and die • Compartmentation o 2 compartments in the cell Cytosol (the factory) • Anabolism (synthesis) • ATP utilisation Mitochondria (the powerhouse) • Catabolism (breakdown) • ATP production • Stages of catabolism o Stage 1 (digestion in GIT) – macromolecules are broken down into smaller molecules No ATP made o Stage 2 – fatty acids, glucose, amino acids are processed into Acetyl Coenzyme A via common pathways, Small amount of ATP made o Stage 3 – Acetyl CoA via the citric acid cycle (TCA) and redox reactions, 8e -s are produced Small amount of ATP made o Stage 3 – electrons activate the respiratory chain and by oxidative phosphorylation ATP produce ATP Large amount of ATP made ATP Inside the cell Tissue utilisation • All cells/tissues use carbohydrates o Brain and related tissues (eg. retina) and RBCs can’t use fat or amino acids for energy Glucose dependent o All other tissues can break down fats or carbohydrates for energy (eg. liver, kidneys, skin, heart, lungs) Skeletal muscle generates ATP faster when breaking down carbohydrates vs fats of amino acids • Allows a higher intensity of exercise via carbohydrate catabolism • Muscle – heart and skeletal o Variable rates of catabolism to allow rapid and variable rates of ATP utilisation In skeletal muscle, there can be a change of 20x in rest vs exercise o Catabolism is aerobic in cardiac muscle Skeletal muscle is functionally anaerobic during intense, short duration exercise – producing lactate o Use glucose, fatty acids and ketones for fuel Cardiac muscle can also use lactate produced by skeletal muscle o Glucose can be stored by skeletal muscle as glycogen (the liver can also + some cardiac muscle) • Liver o High rates of catabolism with a rapid and constant rate of ATP utilisation o Supports other tissues by releasing metabolic fuels (glucose and ketone bodies) Released between meals into the blood stream o Uses glucose, fatty acids and lactate as metabolic fuels, but not ketone bodies o Stores glucose as glycogen and converts excess glucose and amino acids into fatty acids for storage • Brain o High rates of catabolism with a rapid and constant rate of ATP utilisation o Use glucose and ketone bodies (in prolonged starvation/fasting), not fatty acids • Adipose cells o Low rates of catabolism o Use glucose fatty acids and ketone bodies o Main site of triacylglycerol