Chapter 11: Water and the Major Minerals

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Recap of last lecture

• Alcohol
• Alcohol drug interactions
• Effects on brain
• Symptoms of cirrhosis
• Caffeine

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23 Outline for today

• Alternative sweeteners
• diet sodas,
• Hi-energy drinks
• Blood sugar levels
• Trans fatty acids, fats, lipids
• Next time more on fats

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Artificial sweeteners

• The FDA has approved five sugar substitutes
  Aspartame, Saccharin, Acesuflame K, Neotame, and
  sucralose. The first three are widely used
  throughout the World.
• Aspartame is a very common sweetener that is
  found in both Equal and Nutrasweet. It is 180
  times sweeter than sugar, but it is not
  chemically stable and is destroyed during
  cooking. (AspPheMe) (Basically safe, in spite of
  many web pages devoted to it being responsible
  for all ills)

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• Saccharin, most commonly known as Sweet N Low,
  is 300 times sweeter than sugar, and its
  sweetening powers are not destroyed by cooking.
  The FDA tried unsuccessfully to ban the additive
  due to research studies that linked it with
  bladder cancer in rats. There are no studies
  linking it to cancer in humans.
• Acesuflame K, found in Sunnette and Sweet, is 200
  times sweeter than sugar, and can withstand high
  cooking temperatures. It has been approved by the
  FDA and has not been associated with cancer or
  any other disease

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• Another less common sweetener is Neotame (a
  derivative of aspartame) it has been approved by
  the FDA. It is 5000 times sweeter than sugar, is
  heat stable and can be used for cooking. It does
  contain phenylalanine in very small amounts. The
  manufacturers claim that the levels are so low
  that it is safe for people with PKU.
• Sucralose, (Splenda), is FDA approved. It is the
  only sweetener actually derived from sugar. It is
  600 times sweeter than sugar, is stable for
  cooking, and is not known to produce any health
  risks. New on the mkt.

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Sucralose

• Three atoms of chlorine replace three hydroxyl
  groups on the sugar molecule. Sucralose tastes
  like sugar.
• The exceptional stability of sucralose allows
  both food manufacturers and consumers to use it
  virtually anywhere sugar is used, including
  cooking and baking.
• Sucralose is not utilized for energy in the body
  because it is not broken down like sucrose. Most
  is excreted directly.
• Sucralose has been extensively tested in more
  than 100 studies during a 20-year period and
  found to be a safe and remarkably inert
  ingredient.

7
Sodas

• Sodas are sweetened, acidic, often caffeinated
  carbonated drinks.  There is "regular" pop that
  is sweetened with different kinds of sugar
  sweeteners and "diet" pop that is sweetened with
  artificial sweeteners.  
• Double trouble for teeth.  It's not just sugar
  that's bad for teeth, but the acids included in
  many popular drinks weaken the enamel and make
  teeth more prone to caries. The pH of regular and
  diet pops ranges from 2.47-3.35.

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• The average American today drinks over 600
  servings of soda a year
• People who drink 3 or more sugary sodas daily
  have 62 more dental decay, fillings and tooth
  loss!
• The average American drinks more than 53 gallons
  of carbonated soft drinks each year, more than
  any other beverage, including milk, beer, coffee
  or water.
• Mountain Dew-20 oz is the worst pop, it contains
  19 tsps of sugar and 93 milligrams of
  caffeine.......nearly equivalent to adult dose of
  NoDoz.

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Too much soda?

• Potential health problems associated with high
  intake of sweetened drinks are
• 1) overweight or obesity attributable to
  additional calories in the diet
• 2) displacement of milk consumption, resulting in
  calcium deficiency with an attendant risk of
  osteoporosis and fractures and
• 3) dental caries and potential enamel erosion.

10
Diet Soda

• Drinking carbonated soft drinks regularly can
  contribute to the erosion of tooth enamel
  surfaces.
• Soft drinks, which contain sticky sugars that
  break down into acids, adhere easily to tooth
  surfaces. 
• These acids can soften tooth substance and
  promote formation of plaque, which erodes the
  enamel. 
• Enamel breakdown leads to cavities. 

11
Product Acid Sugar per 12 oz

• Diet Coke 3.39 0.0
• Mountain Dew 3.22 11.0 tsp.
• Gatorade 2.95 3.3 tsp
• Coke Classic 2.63 9.3 tsp.
• Pepsi 2.49 9.8 tsp.
• Sprite 3.42 9.0
• Diet 7-Up 3.67 0.0
• Diet Dr. Pepper 3.41 0.0
• Surge 3.02 10.0
• Gatorade 2.95 3.3
• Hawaiian Fruit Punch 2.82 10.2
• Orange Minute Maid 2.80 11.2
• Dr. Pepper 2.92 9.5
• (OSHA rules preclude pouring these down the
  drain!!)

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Energy Drinks

• Energy drinks are beverages loaded with caffeine,
  sugar, and other ingredients such as ginseng,
  taurine, guarana, and B-complex vitamins.
• Some energy drinks, such as Extreme Ripped Force,
  4m energizer, and Xtreme NRG, contain ephedrine.
• One energy drink, Hansen Beverage Company's Hard
  E, contains 5 percent alcohol.
• Red Bull, originating in Austria, controls nearly
  two-thirds of the energy drink market in the
  United States, earning 300 million in 2002 and
  1.2 billion worldwide

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Adverse Effects

• Energy drinks can become dangerous when taken
  with alcohol.
• Adverse effects include dehydration, insomnia,
  headaches, nervousness, nosebleeds, and vomiting.
  
• Reports claim that energy drinks have caused even
  more severe reactions, such as seizure, heart
  arrhythmia, and death.
• The stimulating effect of energy drinks is
  deceiving, causing people to feel less
  intoxicated than they actually are and making it
  harder for bartenders to determine whether their
  patrons should no longer be served. As a result,
  people may be more inclined to drive while
  impaired.

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• Suspected deaths linked to energy drinks have
  been reported in Australia and Ireland.
• Three people died in Sweden after drinking Red
  Bull two had mixed Red Bull with alcohol, and
  the third drank it after an exercise session.
  There is debate regarding whether the drinks
  caused these deaths.
• Norway, Denmark and France, however, sell Red
  Bull only in pharmacies because of its high level
  of caffeine. The Swedish National Food
  Administration recommended that Red Bull not be
  mixed with alcohol or consumed after exercise.
• The U.S. FDA took note of Sweden's advisement,
  but commented it cannot regulate imported drinks
  or herbal supplements.

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Blood sugar levels

• Normal fasting 70 to 110 mg/dL
• Note mg/dL milligrams per deciliter
• Even after you have eaten, however, your glucose
  should be below 180. 
• Above 180 is termed hyperglycemia
• Concentrations of less than about 30 mg/dL or
  greater than about 300 mg/dL can produce
  confusion or unconsciousness
• Diabetes mellitus -- fasting blood glucose of
  greater than 126 mg/dL
• Impaired fasting glucose -- 110 to 126 mg/dL -- a
  prediabetic state

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• The "gold standard" for diagnosing diabetes is an
  elevated blood sugar level after an overnight
  fast (not eating anything after midnight). A
  value above 140 mg/dl on at least two occasions
  typically means a person has diabetes. Normal
  people have fasting sugar levels that generally
  run between 70-110 mg/dl

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Glucose tolerance test

• The person being tested starts the test in a
  fasting state (having no food or drink except
  water for at least 10 hours but not greater than
  16 hours).
• An initial blood sugar reading is taken and then
  the person is given a "glucola" bottle with a
  high amount of sugar in it (75 grams of glucose).
  
• The person then has their blood tested again 30
  minutes, 1 hour, 2 hours and 3 hours after
  drinking the high glucose drink.
• A person is said to have a normal response when
  the 2-hour glucose level is less than or equal to
  110 mg/dl.
• A person has diabetes when oral glucose tolerance
  tests show that the blood glucose level at 2
  hours is equal to or more than 200 mg/dl. 

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Regulation of blood sugar levels

• Insulin and glucagon are the hormones involved
  secreted from the pancreas
• Insulin is normally secreted by the beta cells (a
  type of islet cells) of the pancreas.  The
  stimulus for insulin secretion is a HIGH blood
  glucose.
• Although there is always a low level of insulin
  secreted by the pancreas, the amount secreted
  into the blood increases as the blood glucose
  rises.  Similarly, as blood glucose falls, the
  amount of insulin secreted by the pancreatic
  islets goes down. 

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• Glucagon is secreted by the alpha cells of the
  pancreatic islets in much the same manner as
  insulin...except in the opposite direction.   If
  blood glucose is high, then no glucagon is
  secreted.  When blood glucose goes LOW, however,
  (such as between meals, and during exercise),
  more and more glucagon is secreted. 
• Like insulin, glucagon has an effect on many
  cells of the body, but most notably the liver. 
• The effect of glucagon is to make the liver
  release the glucose it has stored in its cells
  into the blood stream, with the net effect of
  increasing blood glucose. 

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• Greater than normal levels (hyperglycemia) may
  indicate
• Acromegaly (very rare)
• Cushing's syndrome (rare)
• Diabetes mellitus
• Prediabetic state
• Hyperthyroidism
• Pancreatic cancer
• Pancreatitis
• Insufficient amount of insulin
• Excessive food intake

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• Lower than normal levels (hypoglycemia) may
  indicate
• Hypopituitarism
• Hypothyroidism
• Insulinoma (very rare)
• Injection of too much insulin
• Insufficient dietary intake

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• Hypoglycemia occurs when your body's blood sugar,
  or glucose, is abnormally low.
• Hypoglycemia is relatively common in diabetics.
  It occurs when too much insulin or oral
  antidiabetic medication is taken, not enough food
  is eaten, or from a sudden increase in the amount
  of exercise without an increase in food intake.
• Sometimes the cause of hypoglycemia is unknown
  (idiopathic). In these cases, people who are not
  diabetic and who do not have another known causes
  of hypoglycemia experience these
  symptoms.Hypoglycemia can occur because of an
  insulin-secreting tumor of the pancreas, liver
  disease, or as a response to the ingestion of
  alcohol. It affects approximately 1 out of every
  1,000 people.

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Symptoms

• Fatigue
• General discomfort, uneasiness, or ill feeling
  (malaise)
• Nervousness
• Irritability, or even aggression
• Trembling
• Headache
• Hunger
• Cold sweats
• Rapid heart rate
• Blurry or double vision
• Confusion
• Convulsions
• Coma

• Excessive sweating
• Sleeping difficulty
• Paleness
• Muscle pain
• Memory loss
• Palpitations, or feeling your heartbeat
  (heartbeat sensations)
• Hallucinations
• Fainting
• Different size pupils
• Dizziness
• Decreased consciousness

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Hypoglycemia - Treatment   

• A snack or drink containing sugar will raise the
  blood-glucose levelIf the person's blood-sugar
  levels are so low that he/she becomes unconscious
  or unable to swallow, this is called insulin
  shock, and emergency medical treatment is needed.
  An injection of glucose solution or the hormone
  glucagon will be given immediately.In the
  longer term, you may need to modify your diet so
  that you get glucose into your body more evenly
  throughout the day. This may prevent further
  hypoglycemic episodes. Small, frequent meals with
  complex carbohydrates, fiber, and fat and
  avoiding simple sugars, alcohol, and fruit juice
  are the type of dietary modifications that may be
  recommended. You should also eat meals at regular
  intervals, and balance extra exercise with extra
  food.

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Diabetes

• Diabetes is a very common disease, affecting
  about 2 of the general population, that results
  from insulin deficiency or insensitivity by the
  body to the level of insulin present.

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Syndrome X or Insulin Resistance Syndrome

• Insulin resistance is a reduced sensitivity in
  the tissues of the body to the action of insuln.
• Abnormalities in glucose and lipid metabolism,
  obesity, and high blood pressure

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• When insulin resistance, or reduced insulin
  sensistivy, exists, the body attempts to overcome
  this resistance by secreting more insulin from
  the pancreas.
• This compensatory state of hyperinsulinemia (high
  insulin levels in the blood) is felt to be a
  marker for the syndrome.

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People who may be at risk for the insulin
resistance syndrome

• those who are overweight,
• those who have a parent or sibling with Type II
  diabetes,
• women who had diabetes which occurred during
  pregnancy.

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• Many adults have some insulin resistance most
  are able to produce enough insulin to maintain
  non-diabetic glucose levels.
• Some of these individuals will go on to develop
  overt type 2 diabetes, however the majority will
  not develop diabetes, but are still at
  significant increased risk for heart attack or
  stroke and other diseases.
• Over 80 of the 16 million Americans who have
  type 2 diabetes are insulin resistant.
• One in ten women have polycystic ovary syndrome,
  placing them at high risk for cardiovascular
  disease and type 2 diabetes

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FATS, trans fatty acids
Atherosclerosis
35
Saturated Fatty Acid Structure
H H H H H H H H H H H H H H
H H H O H-C--C--C--C--C--C--C--C--C--C--C--C--C--
C--C--C--C-C-OH H H H H H H H H H
H H H H H H H H

• omega end alpha end

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Monounsaturated Fatty Acid Structure
H H H H H H H H H H H
H H H H O H-C--C--C--C--C--C--C--C--CC--C--C-
-C--C--C--C--C--C-OH H H H H H H H H
H H H H H H H H H

• omega end alpha end
• One double bond

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Polyunsaturated Fatty Acid Structure
H H H H H H H H
H H H H H O H-C--C--C--C--C--CC--C--CC--C-
-C--C--C--C--C--C--C-OH H H H H H H H
H H H H H H H H H H

• omega end alpha end
• gt 2 double bonds

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Chain Length of Fatty Acids

• Long chain FA
• gt 12 Carbons
• Medium chain FA
• 6 - 10 Carbons
• Short chain FA
• lt 6 Carbons

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Essential Fatty Acids

• Linoleic (w-6) and a-linolenic (w-3)
• Body can only make double bonds after the 9th
  carbon from the omega end
• Needed for immune function, vision, cell
  membrane, and production of hormone-like compounds

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Essential Fatty Acid- Omega-3 (alpha-linolenic
acid)
H H H H H H H H H H H H H H
H H H O H-C--C--CC--C--C C--C--CC--C--C--C--C
--C--C--C--C-OH H H H
H H H H H H H H

• omega end alpha end
• 1st double bond is located on the 3rd carbon
  from the omega end

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Omega-3 Fatty Acid

• Primarily from fish oil
• Also found in canola or soybean oil
• Eicosapentaenoic acid (EPA) and docosahexaenoic
  acid (DHA) are related
• Metabolized to form eicosanoids
• Recommend intake of 2 servings of fish per week

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Essential Fatty Acid- Omega-6 (alpha-linoleic
acid)
H H H H H H H H
H H H H H O H-C--C--C--C-- C--C
C--C--CC--C--C--C--C--C--C--C--C-OH H H
H H H H H H H H H H H H H H H

• omega end alpha end
• 1st double bond is located on the 6th carbon
  from the omega end

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Omega-6 Fatty Acid

• Found in vegetable oils
• Only need 1 tablespoon a day
• Arachidonic acid can be made from
• omega-6
• Metabolized to form eicosanoids

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Eicosanoids

• A group of hormone-like compounds
• Regulate blood pressure, childbirth, clotting,
  immune responses, inflammatory responses,
  stomach secretions

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Eicosanoids Have Different Effects

• Omega-6 eicosanoids Archidonic acid
• increase blood clotting
• increase inflammatory responses
• Omega-3 eicosanoids, DHA, EPA
• decrease blood clotting
• reduce heart attack
• excess may cause hemorrhagic stroke
• Eicosanoid has different effect on different
  tissues

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Signs and Symptoms of Essential Fatty Acids
Deficiency

• Flaky, itchy skin
• Diarrhea
• Infections
• Retarded growth and wound healing
• Anemia

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Hydrogenation of Fatty Acids

• Process used to solidify an oil
• Addition of H to CC double bonds
• Formation of trans fatty acid

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Rancidity

• Decomposed oils
• Breakdown of the CC double bonds by ultraviolet
  rays, O2
• Yields unpleasant odor, flavor, and sickness when
  consumed
• PUFA more susceptible
• Limits shelf life

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Prevention of Rancidity

• Hydrogenation
• Addition of vitamin E
• Addition of Butylated hydroxyanisol (BHA) and
  Butylated hydroxytolune (BHT)