Module 3 / Activity 4: Digestion Study Guide Answer Key Structure Mechanical Action/Function Mouth Teeth Chewing to bolus Tongue NA Salivary Glands NA Epiglottis Blocks trachea Esophagus Peristalsis (Gastroesophageal Keeps stomach acid Sphincter) out of esophagus Stomach Peristalsis to chyme “Holding tank” Chemical Digestion Hormone Regulation Neurosensory Regulation 1.Lingual lipase 2.Salivary amylase 1.Fat 2.Carbohydrate NA Thoughts, smells, sight of food NA NA NA NA 1.HCl acid 1.Pepsin 2.Gastric lipase 1.Protein Gastrin -stomach contraction, gastric juice Senses protein & distention Ghrelin -increases Senses emptiness Secretin -pancreatic Senses acid chyme CCK -gall bladder contraction, decreases appetite Insulin -lowers blood glucose / anabolic Senses fat Glucagon-raises blood Senses low blood glucose (Pyloric Sphincter) Slows emptying into small intestine Small Intestine Peristalsis 1.Disaccharidases 2.Peptidases (Ileocecal Valve) Slows emptying into large intestine Pancreas NA 1.Pancreatic amylase 2.Pancreatic protease 3.Pancreatic lipase Bicarbonate (base) Liver Produces bile Bile Gall Bladder Stores bile Large Intestine Nutrient(s) Digested Peristalsis Bacteria Water reabsorption (Rectal Muscle) Controls elimination 2.Fat appetite 1.Carbohydrate 2.Protein 1.Carbohydrate 2.Protein 3.Fat juice glucose / catabolic Fat NA Undigested carbohydrate/fiber NA Senses high blood glucose NA NA Body Basics Sheri Barke, MPH, RD, CSSD LA Mission College Why learn about chemistry? • Nutrients from food are made up of chemicals (atoms & molecules). • All the body’s cells, tissues, & organs are made up of (and fueled by) these nutrients. • The breakdown of nutrients from food into usable energy involves chemical reactions. Atoms • Ions = charged atom (Ca++, Mg++, Na+, K+, Cl-, I-, F-) • Electrolytes = when submerged in water separates into ions Chemical terms to know Element • Pure substance of only 1 type of atom (118 total) • 20 essential to human health (6 = 99% of our body mass: C, O, H, N, Ca, P) Molecule • 2 or more atoms joined in chemical bonds (water = H2O) • Macromolecules (carbs, proteins, lipids, nucleic acids DNA/RNA) • Glucose = C6H12O6 Cells make up the tissues within organs • Types of tissues in organs • Epithelial • Skin and inner lining of organs • Connective • Supports, connects, and anchors (bone, cartilage, blood, adipose) • Muscle tissue • Skeletal (voluntary) and smooth muscle (involuntary) • Neural tissue • Brain, spinal cord, nerves Table 3.4 Organ Systems Work Together Digestive System: Functions • Digestion • Carbs → sugars (saccharides) • Proteins → amino acids • Fats → glycerol + fatty acids • Absorption • Movement from intestines into blood or lymph for transport to all the body’s cells • Elimination & Excretion • Removal of undigested materials and metabolic waste FIGURE 3.7 Digestive Tract & Accessary Organs Copyright ©2016 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly acce ssible website, in whole or in part. 7 Mechanical Key Activities of Digestion Chemical Regulatory Mechanisms • Endocrine System • Nervous System How the Digestive System Works Mouth • Neurosensory Regulation • Thoughts, smells, sight of food • Teeth • M – chewing to form bolus • Tongue • C – lingual lipase (enzyme) • Salivary glands • C – salivary amylase (enzyme) • Epiglottis • M – blocks trachea NOTE: M = mechanical / C = chemical digestion Esophagus • M- Peristalsis • M- Gastroesophageal sphincter keeps stomach acid out GERD (GastroEsophageal Reflux Disease) • Eat small, frequent meals. • Avoid late night meals. • Don’t lie down for 2-3 hrs. after eating + elevate head of bed sleeping. • Avoid tight-fitting clothes. • Minimize high fat foods. (which lower pressure; allow sphincter to open) • Minimize caffeine, alcohol, chocolate. (which stimulate stomach acid secretion) • Don’t smoke! (nicotine relaxes sphincter) • When inflamed, avoid acidic & spicy foods. (which irritate esophagus) Stomach • Mechanical • Peristalsis continues to mix/churn contents into a thick liquid paste • Pyloric sphincter (at base) delays emptying so enough time to form chyme • Stomach serves as temporary “holding tank” • Chemical • HCl acid *NOTE: stomach cell wall protected from acid by gastric mucosal barrier • Pepsin (enzyme) **What causes gastritis? • Gastric lipase (enzyme) • Regulatory hormones • Gastrin – causes stomach to contract & release gastric juice (*triggered by sensation of protein and distention of stomach walls) • Ghrelin – increases appetite Gastric Bypass Surgery • Restricts stomach’s holding capacity • Can only eat/drink ½-1 cup at a time • Disrupts mechanical digestion • Must chew very well to pureed consistency • Disrupts chemical digestion • Not enough time for enzymes to work if bolus “dumps” into intestine quickly • Must limit foods high in fat & sugars, and focus on getting enough protein • Disrupts absorption (in duodenum) • Can’t absorb vitamin B12, iron, calcium • Must take vitamin & mineral supplements for life Small Intestine • Primary site of chemical digestion + nutrient absorption • 3 sections: duodenum, jejunum, ileum • M - peristalsis continues • M- ileocecal valve slows emptying into large intestine • C – disaccharidases, peptidases • Accessary organs • Liver • produces bile • Gall bladder • stores bile (*contraction regulated by CCK when senses fat) • Pancreas • produces bicarbonate and many enzymes: amylase, protease, lipase (*release regulated by secretin when senses acid) Large Intestine • Water and some electrolytes (Na+, Cl-, K+) reabsorbed. • constipation – too much water reabsorbed • diarrhea – not enough water reabsorbed • What contributes to constipation/diarrhea? • M- Rectal muscle controls elimination • C- Bacteria (GI microbiota) • act on undigested carbohydrate/fiber → gas • produce vitamin K, biotin, some lipids • Inhibit growth of disease-causing bacteria • Probiotics vs prebiotics GI Disorders • Disruptions in peristalsis • Gastroparesis – delayed stomach emptying (e.g. anorexia nervosa) • Ileus – no intestinal movement due to neuromuscular issue (e.g. abdominal surgery, narcotics/opiod drugs) • Intestinal blockage – no intestinal movement due to physical blockage (e.g. scar tissue post-surgery or due to diverticulitis, IBD, tumor, impacted stool) • NOTE: In these cases, fiber makes it worse! • Inflammatory Bowel Disease (IBD) – an autoimmune disease • Crohn’s – affects both small and large intestines • Ulcerative colitis – affects only large intestine • Irritable Bowel Syndrome (IBS) – a functional (not anatomical) disorder • Altered levels of serotonin in gut → constipation, diarrhea, increased sensitivity to bloating Absorption • What is the major site of absorption? • Small intestine specially designed for this function • Folded and lined with finger-like projections (villi, microvilli) • Creates HUGE surface area (size of tennis court!) for absorption • Water-soluble substances → blood • Fat-soluble substances → lymph • Once in the blood, what organ does everything travel to first? • Liver Excretion & Elimination • Liver functions as “detoxifier” • Removes toxins (e.g. drugs, alcohol) from blood • Either drops it back into intestine (as bile) for removal in feces or prepares it for transport to kidneys for removal in urine • Kidneys filter blood & excrete water and metabolic waste in urine • Undigested/unabsorbed material and waste (e.g. dead cells, bile, bacteria) eliminated in feces Energy Metabolism • The process of transforming nutrients’ energy into ATP • ATP = Adenosine TriPhosphate = cell’s energy • Occurs mostly in the mitochondria of cells • What happens when we consume more energy than our cells’ need? • Liver converts excess to either glycogen or adipose tissue • Liver glycogen can store ~100 g carbs (400 kcal)- to maintain blood glucose • Muscle glycogen can store 300-400 g carbs (1200-1600 kcal)for muscle only • Body fat/adipose tissue can store unlimited calories • How many extra calories = 1 lb. body fat? • 3500 calories = 1 lb. body fat Metabolic Pathways Catabolic pathways • Breakdown of molecules to release energy • i.e. glycogen/glucose, fatty acids, amino acids → ATP Anabolic pathways • Use of energy to construct a complex molecule • i.e. building glycogen, body fat/adipose tissue, muscle Brain-Gut Connection Thoughts & feelings affect appetite Thoughts & feelings affect gut function • Anxiety/depression and anorexia or overeating • Negative thoughts and ARFID/food avoidance • GERD • IBS • Elimination disorders Mindful Eating What is mindfulness? Why do it? Mindful Eating: Benefits • Relax mind, relax gut, improve gut function and appetite. • Better attention to hunger & fullness cues. Prevent under- or over-eating. • More enjoyment. Stress-reduction. • Chocolate meditation • HALT before eating • Am I really physically Hungry? (tummy hunger) • Or am I eating because of Habit, Anxious/angry, Lonely/sad, or Tired/bored? (head hunger) Listen to your body to avoid OVER-eating • If YES, I am physically hungry… • Sit down at table. Use plates/utensils. Eat slowly. • If NO, I’m NOT physically hungry… • Distance yourself from food. Delay eating. • Determine what you’re really feeling/needing? • Decide how you could meet this need without food? What if… • “I’m not physically or emotionally hungry, I just REALLY want chocolate?” (mouth hunger) Dealing with cravings Wait 20 minutes. If craving still there… Other tips: Ask self, “What do I really want?” Create a supportive “food environment” (ie. don’t Get one reasonable serving. Eat slowly, at table, without guilt! keep them in house/in sight). Plan to eat (not restrict) craved foods. • Slow down while living. • Plan to eat a MINIMUM of 3 meals/day. • NOTE: You may have to eat when not physically hungry (due to busy schedules or you’ve trained your body to not feel hungry). Listen to your body to avoid UNDER-eating • Eat on schedule when hunger and fullness cues can’t be trusted. • Due to anxiety, depression, eating disorder, certain medications… • De-Code “fat feelings.” • “Fat” is not a feeling & restricting won’t help/could hurt. • What are you really feeling/needing? • How could you meet this need without restricting? • It’s normal to sometimes eat when not hungry, and to sometimes NOT eat even when you are. • Most of the time, listen to your body; eat mindfully. Remember, it’s not “all or nothing” • Avoid dichotomous thinking with food/eating. • “good/bad, clean/cheat, healthy/junk, on/off diet” • Goal is to balance 1) nutrition & health with 2) pleasure & convenience. • Set “loving limits” with food/eating. • Loving limits set reasonable boundaries for when, what, why, where, how, & how much to eat. Examples of loving limits (*most of the time) • WHEN: Eat at least 3 times/day. No snacking outside of “snack time*.” • WHAT: Balanced meals (protein + grain/starch + veggie/fruit). No more than 1 small “fun food”/day*. • WHY: Mostly eating for hunger, but sometimes just for pleasure or convenience (i.e. 1-2 “special treats/extras” or fast food meals/week*). • WHERE/HOW: >1 sit-down “family meal” per day*. • HOW MUCH: Eat slowly, wait 5 min. before going for seconds*. Parents determine… • When food is available • What food is available • Where food is available Kids need loving limits too www.EllynSatterInstitute.org Division of responsibility with feeding Child determines… • How much to eat • Whether or not to eat Other tips for raising “competent eaters” • Get kids involved in growing, shopping for, and preparing food. • Make mealtimes relaxed & fun (an opportunity to communicate and connect with one another – no commenting/chastising about eating). • Role model balanced, mindful eating. • Avoid using food as a reward, bribe, or pacifier. • Use the SAME feeding guidelines for all kids, regardless of their size or body type. • Avoid letting kids watch TV, play with toys, or use electronic devices during mealtime. • Avoid telling kids to “clean their plate.” • Avoid forbidding kids to eat sugar or “junk food.” MODULE 3 / ACTIVITY 5: FOOD, HUNGER, & FEELING RECORD 0 1 2 3 4 5 6 7 8 9 10 0 - Starving & beyond! 1 - You are so hungry, you want to order everything on the menu. 2 - Everything on a menu begins to look good. You may be very preoccupied with your hunger. 3 - You are hungry, and the urge to eat is strong. Activity 5: Food Hunger Feeling Record 4 - A little hungry. You can wait to eat, but you know you will be getting hungry soon. 5 - Neutral. Not hungry. Not full. 6 - No longer hungry. You sense food in your belly, but you could definitely eat more. 7- Hunger is definitely gone. Stop here, and you may not feel hungry again for 3 to 4 hours. 8 - Not uncomfortable, but definitely have eaten a belly-full. 9 - Moving into uncomfortable. 0 1 2 Created by Sheri Barke, MPH, RD, CSSD 3 4 5 6 7 8 9 10 - Very uncomfortable! Maybe even painful!!! 10 Adapted from Karin Kratina, MA, RD Moving Away From Diets Serving-Size Chart FOOD SYMBOL COMPARISON SERVING SIZE Dairy: Milk, Yogurt, Cheese Cheese (string cheese) Pointer finger 1½ ounces Milk and yogurt (glass of milk) One fist 1 cup Cooked carrots One fist 1 cup Salad (bowl of salad) Two fists 2 cups Apple One fist 1 medium Canned peaches One fist 1 cup Dry cereal (bowl of cereal) One fist 1 cup Noodles, rice, oatmeal (bowl of noodles) Handful ½ cup Slice of whole-wheat bread Flat hand 1 slice Chicken, beef, fish, pork (chicken breast) Palm 3 ounces Peanut butter (spoon of peanut butter) Thumb 1 tablespoon Vegetables Fruits Grains: Breads, Cereals, Pasta Protein: Meat, Beans, Nuts HealthyEating.org Gráfica de Comparación de Porciones ALIMENTO SÍMBOLO COMPARACIÓN PORCIÓN Lácteos: Leche, Yogur, Queso Queso (queso para deshebrar) Dedo índice 1½ onzas Leche y yogur (vaso de leche) Un puño 1 taza Zanahorias cocidas Un puño 1 taza Ensalada (tazón de ensalada) Dos puños 2 tazas Manzana Un puño 1 mediana Duraznos enlatados Un puño 1 taza Cereal seco (tazón de cereal) Un puño 1 taza Fideos, arroz, avena (tazón de tallarines) Puñado ½ taza Rebanada de pan integral Mano extendida 1 rebanada Pollo, carne, pescado, puerco (pechuga de pollo) Palma 3 onzas Crema de cacahuate (cucharada de crema de cacahuate) Pulgar 1 cucharada Verduras Frutas Granos: Panes, Cereales, Pasta Proteína: Carne, Frijoles, Nueces HealthyEating.org
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