Advanced Nutrition and Human Metabolism, Eighth Edition
By Sareen S. Gropper, Jack L. Smith, Timothy P. Carr
CONTENTS
Preface xvii
SECTION I
CELLS AND THEIR NOURISHMENT
CHAPTER 1 The Cell: A Microcosm of Life 1
1.1 Components of Cells 1
Plasma Membrane 1
Cytosol and Cytoskeleton 4
Mitochondrion 5
Nucleus 6
Endoplasmic Reticulum and Golgi Apparatus 10
Lysosomes and Peroxisomes 11
1.2 Selected Cellular Proteins 11
Receptors 11
Catalytic Proteins (Enzymes) 13
1.3 Apoptosis 17
1.4 Biological Energy 18
Energy Release and Consumption in Chemical
Reactions 18
Units and Expressions of Energy 19
The Role of High-Energy Phosphate in Energy
Storage 22
Coupled Reactions in the Transfer of Energy 23
Reduction Potentials 24
Summary 25
PERSPECTIVE Nutritional Genomics 26
CHAPTER 2 The Digestive System: Mechanism for
Nourishing The Body 29
2.1 The Structures of the Digestive Tract and the
Digestive and Absorptive Processes 29
The Oral Cavity 33
The Esophagus 34
The Stomach 36
The Small Intestine 41
The Accessory Organs 45
The Absorptive Process 50
The Colon (Large Intestine) 52
2.2 Coordination and Regulation of the
Digestive Process 56
Neural Regulation 56
Regulatory Peptides 57
Summary 59
PERSPECTIVE The Nutritional Impact of Roux-En-Y Gastric Bypass,
A Surgical Approach for the Treatment of Obesity 60
SECTION II
MACRONUTRIENTS AND THEIR
METABOLISM
CHAPTER 3 Carbohydrates 63
3.1 Simple Carbohydrates 63
Monosaccharides 63
Disaccharides 66
SYRUPS – LIQUID SUGAR 67
3.2 Complex Carbohydrates 68
Oligosaccharides 68
Polysaccharides 69
3.3 Digestion 69
Digestion of Polysaccharides 70
Digestion of Disaccharides 70
3.4 Absorption and Transport 72
Membrane Transport 72
Intestinal Absorption of Glucose and Galactose 75
Intestinal Absorption of Fructose 75
Hepatic Metabolism of Dietary Monosaccharides 76
3.5 Maintenance of Blood Glucose Concentration 76
Role of Insulin 76
Blood–Tissue Barriers 78
Glycemic Response to Carbohydrates 78
3.6 Integrated Metabolism in Tissues 80
Glycogenesis 80
Glycogenolysis 83
Glycolysis 85
The Tricarboxylic Acid Cycle 88
Formation of ATP 92
The Pentose Phosphate Pathway (Hexose
Monophosphate Shunt) 98
UNCOUPLING ELECTRON TRANSPORT AND ATP SYNTHESIS 98
Gluconeogenesis 100
3.7 Regulation of Metabolism 103
Allosteric Enzyme Modulation 103
Covalent Regulation 104
Directional Shifts in Reversible Reactions 104
Enzyme Translocation 104
Genetic Regulation 105
Metabolic Control of Glycolysis and
Gluconeogenesis 105
Summary 106
PERSPECTIVE What Carbohydrates Do Americans Eat? 109
CHAPTER 4 Fiber 113
4.1 Definitions 113
4.2 Fiber and Plants 114
4.3 Chemistry and Characteristics of Fiber 114
Cellulose 114
Hemicellulose 117
Pectins 117
Lignin 117
Gums 117
β-Glucans 118
Fructans 118
Galactans 118
Resistant Starch 118
Mucilages (Psyllium) 119
Polydextrose and Polyols 119
Chitin and Chitosan 119
4.4 Selected Properties of Fiber and Their
Physiological Impact 120
Solubility in Water 120
Viscosity and Gel Formation 121
Fermentability 121
4.5 Health Benefits of Fiber 122
Cardiovascular Disease 122
Diabetes Mellitus 123
Appetite and/or Satiety and Weight Control 123
Gastrointestinal Disorders 123
4.6 Food Labels and Health Claims 124
4.7 Recommended Fiber Intake 125
Summary 126
PERSPECTIVE The Flavonoids: Roles in Health and Disease
Prevention 127
CHAPTER 5 Lipids 131
5.1 Structure and Biological Importance 132
Fatty Acids 132
Triacylglycerols (Triglycerides) 135
Phospholipids 137
Sphingolipids 139
Sterols 140
5.2 Dietary Sources 142
Recommended Intakes 145
5.3 Digestion 145
Triacylglycerol Digestion 145
THE GALLBLADDER 146
Phospholipid Digestion 148
Cholesterol Ester Digestion 148
5.4 Absorption 148
Fatty Acid, Monoacylglycerol, and Lysophospholipid
Absorption 148
Cholesterol Absorption 149
Lipid Release into Circulation 150
5.5 Transport and Storage 151
Lipoprotein Structure 151
Lipoprotein Metabolism 153
5.6 Lipids, Lipoproteins, and Cardiovascular
Disease Risk 159
The Lipid Hypothesis 160
Lipoprotein(a) 160
Apolipoprotein E 160
Dietary Cholesterol 161
Saturated and Unsaturated Fatty Acids 161
COCONUT OIL: HERO OR VILLAIN? 162
Trans Fatty Acids 162
5.7 Integrated Metabolism in Tissues 163
Catabolism of Triacylglycerols and Fatty Acids 163
Formation of Ketone Bodies 167
Synthesis of Fatty Acids 169
Synthesis of Triacylglycerols and Phospholipids 174
Synthesis, Catabolism, and Whole-Body Balance
of Cholesterol 174
5.8 Regulation of Lipid Metabolism 176
Fatty Acids 176
Cholesterol 176
5.9 Brown Fat Thermogenesis 177
5.10 Ethyl Alcohol: Metabolism and
Biochemical Impact 178
The Alcohol Dehydrogenase Pathway 179
The Microsomal Ethanol Oxidizing System 179
The Catalase System 179
Alcoholism: Biochemical and Metabolic
Alterations 180
Alcohol in Moderation: The Brighter Side 181
Summary 181
PERSPECTIVE The Role of Lipoproteins and Inflammation in
Atherosclerosis 184
CHAPTER 6 Protein 187
6.1 Amino Acid Classification 187
Structure 188
Net Electrical Charge 188
Polarity 188
Essentiality 190
6.2 Sources of Amino Acids 191
6.3 Digestion 191
Stomach 191
Small Intestine 193
6.4 Absorption 193
Intestinal Cell Absorption 194
Extraintestinal Cell Absorption 197
6.5 Amino Acid Catabolism 197
Transamination of Amino Acids 198
Deamination of Amino Acids 199
Disposal of Ammonia 200
Carbon Skeleton/α-Keto Acid Uses 201
Hepatic Catabolism and Uses of Aromatic
Amino Acids 202
Hepatic Catabolism and Uses of Sulfur-Containing
Amino Acids 205
Hepatic Catabolism and Uses of Branched-Chain
Amino Acids 209
Hepatic Catabolism and Uses of Basic
Amino Acids 209
SOME ROLES OF NITRIC OXIDE 211
Hepatic Catabolism and Uses of Other Selected
Amino Acids 212
6.6 Protein Synthesis 214
Slow versus Fast Proteins 214
Plant versus Animal Proteins 214
Hormonal Effects 214
mTOR, Intracellular Signaling, and Amino Acids 215
Protein Intake, Distribution, and Quantity at Meals 216
6.7 Protein Structure and Organization 216
6.8 Functional Roles of Proteins 219
Catalysts 219
Messengers 219
Structural Elements 219
Buffers 220
Fluid Balancers 220
Immunoprotectors 220
Transporters 221
Acute-Phase Responders 222
Other Roles 222
6.9 Functional Roles of Nitrogen-Containing
Nonprotein Compounds 223
Glutathione 223
Carnitine 223
Creatine 225
Carnosine 226
Choline 226
Purine and Pyrimidine Bases 227
6.10 Interorgan “Flow” of Amino Acids and
Organ-Specific Metabolism 232
Intestinal Cell Amino Acid Metabolism 232
Amino Acids in the Plasma 233
Glutamine and the Muscle, Intestine, Liver,
and Kidneys 234
Alanine and the Liver and Muscle 235
Skeletal Muscle Use of Amino Acids 235
Amino Acid Metabolism in the Kidneys 239
Brain and Accessory Tissues and Amino Acids 241
6.11 Catabolism of Tissue/Cell Proteins and
Protein Turnover 243
Autophagy-Lysosome Systems 243
Ubiquitin Proteasomal Pathway 244
Calpains 245
6.12 Changes in Body Mass with Age 246
Loss of Muscle Mass and Disease 246
6.13 Protein Quality and Protein and Amino
Acid Needs 248
Evaluation of Protein Quality 248
Protein Information on Food Labels 251
Assessing Protein and Amino Acid Needs 251
Recommended Protein and Amino Acid Intakes 252
Protein Deficiency/Malnutrition 254
Summary 255
PERSPECTIVE Stress and Inflammation: Impact on Protein 257
CHAPTER 7 Integration and Regulation of
Metabolism and the Impact of Exercise 261
7.1 Energy Homeostasis in the Cell 262
Regulatory Enzymes 262
7.2 Integration of Carbohydrate, Lipid, and
Protein Metabolism 266
Interconversion of Fuel Molecules 266
Energy Distribution among Tissues 267
7.3 The Fed-Fast Cycle 271
The Fed State 271
The Postabsorptive State 273
The Fasting State 274
The Starvation State 274
7.4 Hormonal Regulation of Metabolism 278
Insulin 278
HOW IS TYPE 1 DIABETES SIMILAR TO STARVATION? 279
Glucagon 280
Epinephrine 280
Cortisol 280
Growth Hormone 280
Adiponectin 281
7.5 Exercise and Nutrition 281
Muscle Function 281
Energy Sources in Resting Muscle 282
Muscle ATP Production during Exercise 282
Fuel Sources during Exercise 284
Summary 287
PERSPECTIVE The Role of Dietary Supplements in Sports Nutrition
by Karsten Koehler, PhD 289
CHAPTER 8 Energy Expenditure, Body
Composition, and Healthy Weight 293
8.1 Measuring Energy Expenditure 293
Direct Calorimetry 294
Indirect Calorimetry 294
Doubly Labeled Water 296
HOW TO MEASURE WHAT PEOPLE EAT 297
8.2 Components of Energy Expenditure 298
Basal and Resting Metabolic Rate 298
Energy Expenditure of Physical Activity 299
Thermic Effect of Food 300
Thermoregulation 301
8.3 Body Weight: What Should We Weigh? 301
Ideal Body Weight Formulas 301
Body Mass Index 302
8.4 Measuring Body Composition 303
Field Methods 304
Laboratory Methods 306
8.5 Regulation of Energy Balance and
Body Weight 307
Hormonal Influences 308
Intestinal Microbiota 310
Environmental Chemicals 310
Lifestyle Influences 311
8.6 Health Implications of Altered Body Weight 311
Metabolic Syndrome 311
Insulin Resistance 312
Weight-Loss Methods 313
Summary 313
PERSPECTIVE Eating Disorders 315
SECTION III
THE REGULATORY NUTRIENTS
CHAPTER 9 Water-Soluble Vitamins 321
DIETARY REFERENCE INTAKES (DRIs) 325
DAILY VALUES AND PERCENTAGE DAILY VALUES 326
9.1 Vitamin C (Ascorbic Acid) 326
Sources 327
Digestion and Absorption 328
Transport, Tissue Uptake, and Storage 329
Functions and Mechanisms of Action 329
Interactions with Other Nutrients 335
Metabolism and Excretion 335
Recommended Dietary Allowance 335
Deficiency: Scurvy 336
Toxicity 337
Assessment of Nutriture 337
9.2 Thiamin (Vitamin B1) 338
Sources 338
Digestion and Absorption 339
Transport, Tissue Uptake, and Storage 339
Functions and Mechanisms of Action 340
Metabolism and Excretion 344
Recommended Dietary Allowance 344
Deficiency: Beriberi 344
Toxicity 346
Assessment of Nutriture 346
9.3 Riboflavin (Vitamin B2) 346
Sources 346
Digestion and Absorption 348
Transport, Tissue Uptake, and Storage 348
Functions and Mechanisms of Action 349
Metabolism and Excretion 351
Recommended Dietary Allowance 351
Deficiency: Ariboflavinosis 351
Toxicity 352
Assessment of Nutriture 352
9.4 N iacin (Vitamin B3) 352
Sources 353
Digestion and Absorption 354
Transport, Tissue Uptake, and Storage 354
Functions and Mechanisms of Action 355
Metabolism and Excretion 356
Recommended Dietary Allowance 357
Deficiency: Pellagra 357
Toxicity 358
Assessment of Nutriture 358
9.5 Pantothenic Acid 358
Sources 358
Digestion and Absorption 360
Transport, Tissue Uptake, and Storage 360
Functions and Mechanisms of Action 360
Metabolism and Excretion 363
Adequate Intake 363
Deficiency: Burning Foot Syndrome 363
Toxicity 363
Assessment of Nutriture 363
9.6 Biotin (Vitamin B7) 364
Sources 364
Digestion, Absorption, Transport, Tissue Uptake,
and Storage 364
Functions and Mechanisms of Action 365
Metabolism and Excretion 368
Adequate Intake 369
Deficiency 369
Toxicity 369
Assessment of Nutriture 370
9.7 Folate (Vitamin B9) 370
Sources 370
Digestion and Absorption 372
Transport, Tissue Uptake, and Storage 372
Functions and Mechanisms of Action 373
Interactions with Other Nutrients 379
Association with Diseases 379
Metabolism and Excretion 380
Recommended Dietary Allowance 381
Deficiency: Megaloblastic Macrocytic Anemia 381
Toxicity 382
Assessment of Nutriture 382
9.8 Vitamin B12 (Cobalamin) 383
Sources 384
Digestion and Absorption 384
Transport, Tissue Uptake, and Storage 386
Functions and Mechanisms of Action 386
Metabolism and Excretion 387
Recommended Dietary Allowance 387
Deficiency: Megaloblastic Macrocytic Anemia
and Neuropathy 388
Toxicity 389
Assessment of Nutriture 389
9.9 Vitamin B6 390
Sources 391
Digestion and Absorption 391
Transport, Tissue Uptake, and Storage 391
Functions and Mechanisms of Action 392
Metabolism and Excretion 395
Recommended Dietary Allowance 395
Deficiency 395
Toxicity 396
Assessment of Nutriture 396
Summary 397
PERSPECTIVE Types of Human Research Studies and
Their Limitations 398
CHAPTER 10 Fat-Soluble Vitamins 401
10.1 Vitamin A and Carotenoids 402
Sources 403
Digestion and Absorption 405
Transport, Tissue Uptake, and Storage 408
Functions and Mechanisms of Action 411
Interactions with Other Nutrients 419
Metabolism and Excretion 419
Recommended Dietary Allowance 420
INTERNATIONAL UNITS – VITAMIN A 420
Deficiency 420
Toxicity 421
Assessment of Nutriture 422
10.2 Vitamin D 423
Sources 423
Absorption 425
Transport, Tissue Uptake, and Storage 425
Functions and Mechanisms of Action 427
Interactions with Other Nutrients 432
Metabolism and Excretion 432
Recommended Dietary Allowance 432
Deficiency 432
Toxicity 434
Assessment of Nutriture 434
10.3 Vitamin E 435
Sources 435
Digestion and Absorption 437
Transport, Tissue Uptake, and Storage 437
Functions and Mechanisms of Action 438
Interactions with Other Nutrients 441
Metabolism and Excretion 441
Recommended Dietary Allowance 442
INTERNATIONAL UNITS – VITAMIN E 442
Deficiency 442
Toxicity 443
Assessment of Nutriture 443
10.4 Vitamin K 443
Sources 443
Absorption 444
Transport, Tissue Uptake, and Storage 445
Functions and Mechanisms of Action 445
Interactions with Other Nutrients 449
Metabolism and Excretion 449
Adequate Intake 449
Deficiency 449
Toxicity 450
Assessment of Nutriture 450
Summary 451
PERSPECTIVE Antioxidant Nutrients, Reactive Species, and
Disease 452
CHAPTER 11 Major Minerals 463
11.1 Calcium 464
Sources 464
Digestion, Absorption, and Transport 465
Regulation and Homeostasis 468
Functions and Mechanisms of Action 470
AN OVERVIEW OF BONE 471
Interactions with Other Nutrients 474
Excretion 475
Recommended Dietary Allowance 476
Deficiency 476
Toxicity 477
Assessment of Nutriture 477
11.2 Phosphorus 478
Sources 478
Digestion, Absorption,
and Transport 479
Regulation and Homeostasis 480
Functions and Mechanisms of Action 481
Excretion 483
Recommended Dietary Allowance 483
Deficiency 484
Toxicity 484
Assessment of Nutriture 485
11.3 Magnesium 485
Sources 485
Digestion, Absorption, and Transport 486
Regulation and Homeostasis 487
Functions and Mechanisms of Action 488
Interactions with Other Nutrients 489
Excretion 489
Recommended Dietary Allowance 489
Deficiency 489
Toxicity 491
Assessment of Nutriture 491
Summary 492
PERSPECTIVE Osteoporosis and Diet 493
CHAPTER 12 Water and Electrolytes 499
12.1 Water Functions 499
12.3 Body Water Content and Distribution 500
12.3 Water Losses, Sources, and Absorption 501
12.4 Recommended Water Intake 501
12.5 Water (Fluid) and Sodium Balance 502
Osmotic Pressure 502
Hydrostatic (Fluid/Capillary) Pressure 503
Colloidal Osmotic Pressure 504
Extracellular Fluid Volume and Osmolarity and
Hormonal Controls 504
THE KIDNEYS: A BRIEF REVIEW 505
12.6 Sodium 508
Sources 508
ELECTROLYTES: CALCULATING MILLIEQUIVALENTS (MEQ) 509
Absorption and Transport 510
Functions and Interactions with Other Nutrients 511
Excretion 511
Recommendations, Deficiency, Toxicity, and Assessment
of Nutriture 511
12.7 Potassium 512
Sources 512
Absorption, Secretion, and Transport 512
Functions and Interactions with Other Nutrients 513
Excretion 513
Recommendations, Deficiency, Toxicity, and Assessment
of Nutriture 513
12.8 Chloride 514
Sources 514
Absorption, Secretion, and Transport 514
Functions 515
Excretion 515
Recommendations, Deficiency, Toxicity, and Assessment
of Nutriture 516
12.9 Acid–Base Balance: Control of Hydrogen Ion
Concentration 516
Chemical Buffer Systems 517
PRINCIPLES OF BUFFERS 517
Respiratory Regulation 519
Renal Regulation 520
Summary 521
PERSPECTIVE Macrominerals and Hypertension 522
CHAPTER 13 Essential Trace and Ultratrace
Minerals 525
13.1 Iron 525
Sources 526
Digestion, Absorption, Transport,
and Storage 528
Functions and Mechanisms of Action 536
Turnover 540
Interactions with Other Nutrients 541
Excretion 542
Recommended Dietary Allowance 542
Deficiency 542
Toxicity 544
Assessment of Nutriture 544
13.2 Zinc 546
Sources 546
Digestion, Absorption, Transport,
and Storage 547
Functions and Mechanisms of Action 551
Interactions with Other Nutrients 554
Excretion 555
Recommended Dietary Allowance 555
Deficiency 555
Toxicity 556
Assessment of Nutriture 556
13.3 Copper 557
Sources 557
Digestion, Absorption, Transport, and Storage 557
Functions and Mechanisms of Action 560
Interactions with Other Nutrients 562
Excretion 563
Recommended Dietary Allowance 564
Deficiency 564
Toxicity 565
Assessment of Nutriture 565
13.4 Selenium 566
Sources 566
THE SHIFTING SANDS OF SELENIUM 567
Digestion, Absorption, Transport, and Storage 568
Metabolism 568
Functions and Mechanisms of Action 570
Interactions with Other Nutrients 572
Excretion 573
Recommended Dietary Allowance 573
Deficiency 573
Toxicity 574
Assessment of Nutriture 574
13.5 Chromium 575
Sources 575
Digestion, Absorption, Transport,
and Storage 575
Functions and Mechanisms of Action 576
Excretion 577
Adequate Intake 577
Deficiency 577
Toxicity 577
Assessment of Nutriture 577
13.6 Iodine 578
Sources 578
Digestion, Absorption, Transport, and Storage 579
Functions and Mechanisms of Action 579
Interactions with Other Nutrients 581
Excretion 582
Recommended Dietary Allowance 582
Deficiency 582
Toxicity 583
Assessment of Nutriture 583
13.7 Manganese 584
Sources 584
Digestion, Absorption, Transport,
and Storage 584
Functions and Mechanisms of Action 585
Interactions with Other Nutrients 586
Excretion 586
Adequate Intake 586
Deficiency 586
Toxicity 586
Assessment of Nutriture 586
13.8 Molybdenum 587
Sources 587
Digestion, Absorption, Transport,
and Storage 587
Functions and Mechanisms of Action 587
Interactions with Other Nutrients 589
Excretion 590
Recommended Dietary Allowance 590
Deficiency 590
Toxicity 590
Assessment of Nutriture 590
PERSPECTIVE Nutrient–Drug Interactions 591
CHAPTER 14 Nonessential Trace and Ultratrace
Minerals 595
14.1 Fluoride 595
Sources 595
Absorption, Transport, Tissue Uptake, Storage,
and Excretion 597
Functions and Deficiency 597
Recommended Intake, Toxicity, and Assessment
of Nutriture 598
14.2 Boron 598
Sources 598
Absorption, Transport, Tissue Uptake, Storage,
and Excretion 599
Functions and Deficiency 599
Recommended Intake, Toxicity, and Assessment
of Nutriture 600
14.3 Silicon 600
Sources 600
Absorption, Transport, Storage, and Excretion 601
Functions and Deficiency 601
Recommended Intake, Toxicity, and Assessment
of Nutriture 601
14.4 Vanadium 602
Sources 602
Absorption, Transport, Storage, and Excretion 602
Functions and Deficiency 602
Recommended Intake, Toxicity, and Assessment
of Nutriture 603
14.5 Cobalt 603
Summary 604
PERSPECTIVE No, Silver Is Not Another Essential Ultratrace
Mineral: Tips to Identifying Bogus Claims and Selecting Dietary
Supplements 605
Glossary 609
Index 615
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