THE HUMAN BODY
How It Works

Digestion and Nutrition

THE HUMAN BODY
How It Works

Cells, Tissues, and Skin The Circulatory System Digestion and Nutrition The Endocrine System Human Development The Immune System The Nervous System The Reproductive System The Respiratory System The Senses The Skeletal and Muscular Systems

THE HUMAN BODY How It Works Digestion and Nutrition Robert Sullivan .

2. recording. For information. QP145.DIGESTION AND NUTRITION Copyright © 2009 by Infobase Publishing All rights reserved. associations.S86 2008 612. cm. without permission in writing from the publisher. 3. Nutrition. Title. Because of the dynamic nature of the Web. including photocopying. ISBN 978-1-60413-367-7 (hardcover) 1. or sales promotions. p. Robert J. or by any information storage or retrieval systems. electronic or mechanical. All links and Web addresses were checked and verified to be correct at the time of publication. (Robert James) Digestion and nutrition / Robert Sullivan.com Text design by Erika Arroyo. Digestive organs. some addresses and links may have changed since publication and may no longer be valid. Erik Lindstrom Cover design by Ben Peterson Printed in the United States of America Bang FOF 10 9 8 7 6 5 4 3 2 1 This book is printed on acid-free paper. You can find Chelsea House on the World Wide Web at http://www.chelseahouse. No part of this book may be reproduced or utilized in any form or by any means. Please call our Special Sales Department in New York at (212) 967-8800 or (800) 322-8755. — (The human body: how it works) Includes bibliographical references and index. . I. institutions. contact: Chelsea House An imprint of Infobase Publishing 132 West 31st Street New York NY 10001 Library of Congress Cataloging-in-Publication Data Sullivan.3—dc22 2008030741 Chelsea House books are available at special discounts when purchased in bulk quantities for businesses. Digestion.

M. Absorption.Contents Introduction Denton A.D. Cooley. and Elimination Chewing and Swallowing The Stomach and Small Intestine The Large Intestine and Elimination Common Health Problems Guides to Healthy Eating 6 1 2 3 4 5 6 7 8 9 10 12 23 32 41 52 67 76 80 98 99 110 111 114 115 120 Appendix: Conversion Chart Glossary Bibliography Further Resources Picture Credits Index About the Author . Texas Introduction to Digestion and Nutrition Nutrition and Major Nutrients Minor Nutrients and Metabolism Digestion. President and Surgeon-in-Chief of the Texas Heart Institute Clinical Professor of Surgery at the University of Texas Medical School. Houston.

Our cells and tissues are constantly wearing out and being replaced without our even knowing it. From a purely physical standpoint. pain is a very effective alarm system that lets us know the body needs attention. Although the heart beats about 100. it is a source of strength. When all of the musicians play together. gastrointestinal. including the musculoskeletal. and wonder. In order of size. we do not normally think about these things. sodium. Even without medical help. If the pain does not go away. the elements of the body are organized into cells. endocrine. our bodies tell us through pain and other symptoms. When it is working properly. we tend to ignore it. respiratory. and iron. cardiovascular. phosphorous. We can also compare it to a symphony orchestra in which each instrument has a different part to play. In fact. the blood-clotting system works to seal the cut right away.Introduction The human body is an incredibly complex and amazing structure. If we cut ourselves. In fact. and organs. sulfur. At best. the body has an amazing ability to heal itself. much of the time. and the immune  . When something goes wrong. We can compare the healthy body to a welldesigned machine whose parts work smoothly together. we may need to see a doctor. however. magnesium. including calcium. potassium. beauty. We are also made of many minerals. tissues.000 times per day and we breathe more than 10 million times per year. chlorine. our bodies are made mainly of water. they produce beautiful music. and reproductive systems. Related organs are combined into systems. nervous. we take the body for granted.

we can replace it altogether. Now that these diseases can be avoided. these repairs can be done through a tiny “keyhole” incision that speeds up patient recovery and leaves hardly any scar. which killed 20 to 40 million people worldwide. researchers are doing a lot of work at the cellular level. These days. Also. smallpox. pneumonia. we are able to open the heart and repair its valves. In many cases. and connections. Scientists recently finished mapping the human genome.” After penicillin and other antibiotics became available in the 1930s and 1940s. polio. tuberculosis. Because chronic diseases tend to involve many organ systems or even the whole body. During the past 50 years. and arthritis. If the entire heart is diseased. flu. doctors have gained the ability to repair or replace almost every part of the body. the introduction of modern vaccines allowed us to prevent childhood illnesses.Introduction  defense system sends out special blood cells that are programmed to heal the area. arteries. Today. are unknown except in history books. Even a simple scratch could become infected and lead to death from “blood poisoning. people are living long enough to have long-term (chronic) conditions such as cancer. either with a donor heart or with a mechanical device. the use of mechanical hearts will probably be common in patients who would otherwise die of heart disease. infections and contagious diseases related to viruses and bacteria were the most common causes of death. diabetes. In the future. doctors were able to treat blood poisoning. and other contagions that used to kill or cripple thousands. which is a set of coded . and many other bacterial diseases. chambers. In my own field of cardiovascular surgery. trying to find the underlying causes of chronic illnesses. Until the mid-twentieth century. plagues such as the “Spanish flu” epidemic of 1918–1919. heart failure. they cannot always be cured with surgery.

water. is an excellent introduction . The Human Body: How It Works. including our age. I encourage you to learn as much as you can about your body and to treat your body well. overweight. The average person knows more about the human body than ever before. the human genome will help researchers prevent and treat disease at its source. These things may not seem too important to you now. Our modern lifestyle offers many advantages. called risk factors. abusing alcohol. We can also help clean up our environment. Fortunately. or use addictive drugs. thanks to the Internet and other forms of media coverage. and out of shape. the most important things we can do for our bodies are to eat right. while you are young. or other serious disorders. overuse alcohol. These simple steps will lower our chances of getting cancer. we tend to be stressed. or using drugs. and environment. They want to play a more active role. within the cells themselves. behavior. but the habits and behaviors that you practice today will affect your physical well-being for the rest of your life. Each cell contains 3 billion “letters” of this code. Many of us have unhealthy habits such as smoking cigarettes. At any age. By showing how the body is made. heart disease. In western Europe and the United States. Other important risk factors include our lifestyle. Our air. Some risk factors. and food often contain hazardous chemicals and industrial waste products. The body’s long-term health depends on many factors. and family history of certain diseases. people are more aware of health-related matters. in making medical decisions and in taking care of their own health. Patients want to understand their medical conditions and treatment options. and refuse to smoke. we can do something about most of these risk factors. along with their doctors. exercise regularly. This book series. dIgestIon and nutrItIon “instructions” programmed into our cells. sex. but is not always good for our bodies. These days. get enough sleep. are beyond our control.

I hope that it will awaken within you a lifelong interest in these subjects. Denton A. President and Surgeon-in-Chief of the Texas Heart Institute Clinical Professor of Surgery at the University of Texas Medical School. Texas .D.Introduction  to human biology and anatomy. Houston. M. Cooley.

She is in a hurry. fries. The food may not be the tastiest in the world or very good for her. This process takes the food we can see. She knows the burger and fries have lots of fat and salt that she does not need. smell. She also knows the shake is risky for her. She has a form of lactose intolerance that sometimes results in abdominal cramping and diarrhea after ingesting milk products. These nutrients are relatively simple chemicals that can pass through the cells in the walls of the digestive tract and into the blood. which transports them to all the cells of the body. 10 . fries. her digestive system processes the hamburger. and she knows that the meal will be served fast and that the food will be safe. and then chemically into nutrients that can be used by the cells. first physically into smaller and smaller pieces. But she is in a hurry. but it will get her through until dinner. and chocolate milkshake into nutrients her body can use.1 Introduction to Digestion and Nutrition On the way home from her morning classes. and taste and breaks it down. she has been thinking about the chocolate shake all morning. Amy has eaten in this kind of place hundreds of times before. besides. Amy stops for lunch at a fast-food restaurant. and a chocolate shake. After Amy eats her lunch. She orders a burger. and at least she knows what she gets here.

The process by which nutrients pass through the walls of the digestive tract and into the blood is called absorption. Why do we need a variety of carbohydrates. As you read through the chapters. where they are absorbed to provide energy and needed structural materials. As you read about the anatomy of a specific portion of the digestive tract. The food mass is then swallowed. you will follow Amy’s lunch on its journey through her body. The process begins in the mouth when a bite of food is chewed. or the way this portion works. thereby breaking it down into smaller pieces and mixing it with saliva. how does it get into the body? There is also a discussion of accessory organs that contribute to digestion. but it is still not small enough. The hamburger and fries she eats contain a lot of fat and salt. is discussed. . and the milkshake will most likely make her feel sick. how it is digested. lipids. the physiology.Introduction to digestion and nutrition Digestion is the physical and chemical breakdown of 11 food into forms that can be used by the body’s cells. such as the liver and pancreas. The food has been reduced to a smaller size. and how it is absorbed into the cells. The blood transports the nutrients to the cells of the body. or broken down. vitamins. You will also learn how this is related to her lactose intolerance. Digestive anatomy and physiology are integrated as much as possible throughout the chapters. proteins. Digestion continues in the stomach and intestines until the food particles are an appropriate size and the nutrients can travel to the body’s cells. You will read about what is really in her food. Finally. and minerals? If we cannot absorb food until it is broken down into much smaller pieces. this book will discuss some nutritional controversies and health problems related to the digestive tract and nutrition. You will read about why we need nutrients.

In order to fulfill these needs. and growth. A hydrogen bond is a type of weak chemical bond. An ionic bond forms between charged atoms where positive and negative charges attract each other. the body also needs the energy that food provides. building more muscle tissue. It bonds substances together during chemical reactions or fine-tunes the structure of complex compounds so that they can function properly.2 Nutrition and Major Nutrients Why Do hUMANS hAve To eAT? Humans and other animals need to eat because they need resources that their bodies cannot provide. Food provides the material for the structural needs of the body. Hydrogen bonds also exist between water molecules and anything mixed 12 . The digestive system and its accessory organs have evolved to supply individuals with the energy they need to work with these chemical bonds. to hold these compounds together. These bonds are fairly strong. but not so strong that energy is needed to alter them. There are three types of chemical bonds. such as replacing worn-out cells and tissues. and to change them. This energy is used to make and break chemical bonds in complex biochemical compounds.

nutrition and Major nutrients

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in water. Hydrogen bonds allow the water molecules to support the compounds that are dissolved in the solution, but are weak enough to allow the compounds to diffuse through the water. Hydrogen bonds are so weak that the chemicals held with them can separate just by drifting off into the surrounding water. The third type of chemical bond, a covalent bond, requires energy to make or break it. Covalent bonds are formed when atoms share electrons. The electrons from two or more atoms are found in the space around the nuclei of the atoms, forming a tight bond, almost like a wall. Energy released by the breaking of chemical bonds must be put into a form that cells can use. The chemical energy used by cells is stored in the bonds of adenosine triphosphate (ATP), an RNA nucleotide. The three phosphates in ATP are attached to the adenosine in series so that the molecule looks like this: A-P-P-P (Figure 2.1). The phosphates are negatively charged and repel each other. Attaching the second and third phosphate requires energy to force the phosphates onto the molecule. The energy stored in ATP is the energy in the bonds that hold the repelling phosphates together. When the energy is needed, the third phosphate is removed, and the energy that was holding the phosphate onto the ATP molecule is used to make or break a covalent bond. The loss of the phosphate from the ATP produces adenosine diphosphate (ADP). ADP can become ATP by extracting energy from a nutrient and using it to attach another phosphate. These energy transport molecules function like rechargeable batteries, with the difference being that the energy is mostly discharged each time the ATP is used.

TypeS of NUTrieNTS
There are major and minor nutrients. Major nutrients—carbohydrates , proteins , and lipids —serve as energy sources or as building blocks for larger biochemical compounds. Minor nutrients, which include all vitamins and minerals , assist the chemical reactions that occur with major nutrients.

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dIgestIon and nutrItIon

figure 2.1 atP is an energy–storage compound that contains three phosphate groups. Cells obtain the energy they need to carry on their life functions from the breakdown of atP. When the bond between the last two phosphate groups is broken, the energy released can be used by the cell for anything from replication and division to making proteins and extracting nutrients from food.

A balanced diet includes all of the necessary major and minor nutrients. If the diet is not balanced, some energy sources or building blocks will be missing, and the body will not function properly.

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Carbohydrates
Carbohydrates, a group of molecules that include sugars and starches , provide energy for the body when the molecules are broken down. All carbohydrates contain carbon, hydrogen, and oxygen. They are categorized by size: monosaccharides ; disaccharides ; and polysaccharides , or complex sugars.

Monosaccharides Monosaccharides, such as glucose, fructose, and galactose, are simple sugars. Usually, the ratio of carbon to hydrogen to oxygen is 1:2:1 such that there is one carbon to two hydrogens to one oxygen. Most of the sugars used in the body are six-carbon sugars, so their formula is written as C6H12O6. The body’s sugar biochemistry is based on the breakdown of glucose. Fructose and galactose feed into the pathway of these chemical reactions. Disaccharides Two monosaccharides bonded together form a disaccharide. There are three types of disaccharides: sucrose, lactose, and maltose. Each one has glucose as at least one of its sugar units. Sucrose, which is made of glucose and fructose, is common table sugar. Lactose, made of glucose and galactose, is the sugar found in dairy products. Maltose, made of two glucose molecules, is found in anything “malted” and is also the sugar primarily used to make beer. Because disaccharides are too large to pass through cell membranes, they must be broken down into monosaccharides before they can be used by the body. Polysaccharides Polysaccharides, or complex carbohydrates, are composed of many monosaccharides linked in a chain. There are two

The liver can convert amino acids into glucose. amino acids are converted to glucose instead of being used in protein synthesis. but less complex. When glucose is broken down. depending on the complexity of the structure: amylose and amylopectin. There are two types of starch. Mono.1 dIgestIon and nutrItIon types of polysaccharides of importance to the body: starches and glycogen. Glycogen is similar to amylopectin. If not enough glucose is available. legumes. honey. Glycogen is present in all animals. Simpler sugars provide a spike in absorbed sugars. These are made up of glucose subunits and have slightly different forms. sugarcane. depending on their source and the types of chemical bonds holding them together. the liver breaks down glycogen to release glucose. some of the energy released from the chemical bonds goes into the synthesis of ATP from ADP molecules. Starches are storage carbohydrates found in plants. a process called gluconeogenesis. and root vegetables. If adequate sugar is not available in the diet. carbohydrates are used for energy. although the primary source is beef.and disaccharides are found in fruits. Amylopectin has a more complex structure. Polysaccharides must be digested to their individual glucose units for the body to be able to use the energy. which may lead to increased fat production. and milk. including a large number of crosslinkages between the strings. This longer time provides a steady supply of monosaccharides for absorption and metabolism. sugar beets. As mentioned earlier. molasses. Starches are found in grains. they are converted to glycogen or fat and stored. Amylose is easily digestible and has a simple structure resembling a bunch of strings made up of glucose molecules linked together in a straight line. Polysaccarides in food take longer to digest and absorb than simple sugars or dissacharides. . Both plants and animals use polysaccharides as a form of short-term energy storage. If carbohydrates are not immediately needed. and is more difficult for the body to digest. Glycogen is the storage carbohydrate form found in animals.

Fiber also helps to regulate the digestive tract and keep people “regular. this means that the item is made mostly of sugar. probably sucrose. When carbohydrates are ingested along with proteins.” proTeiNS Proteins have many functions in the body. Keratin is found in the outermost layer of skin. and they are basic components of hormones and enzymes. including muscle. Collagen provides strength to the tendons and ligaments that hold bones and muscle together. and not much of anything else.nutrition and Major nutrients 1 Cellulose is a type of polysaccharide found in plants. it is considered roughage or fiber. Although we get no nutritional value from cellulose. vitamins. they form many different structural parts. In general. they form part of a balanced diet that fills our nutritional needs. It is a major component of wood. where it “seals” YOUR HEALTH: EMPTY CALORIES sometimes foods are described as having empty calories. and minerals. which are strandlike in appearance. They include collagen. They can be used for energy. The chains of amino acids bend and twist to a three-dimensional form. so it is not digestible. When we ingest cellulose. The function of a protein depends on its structure. and the contractile proteins of muscles. Fibrous proteins. keratin. are called structural proteins. depending on the sequence of the amino acids. lipids. Proteins are made of long chains of 20 different kinds of amino acids. It cannot be broken down into smaller units by the human digestive system. the structure and appearance of proteins can be classified as fibrous or globular. The structure of proteins ranges from small and simple to large and very complex. it binds cholesterol in the intestine and helps us eliminate this chemical. .

such as premature aging. that the human body cannot synthesize. Globular proteins. methionine. have a wide variety of functions. which helps regulate growth in the body. and it is used to determine an individual’s nutritional status. called essential amino acids. preventing evaporation of water from underlying tissues and keeping invading microorganisms out. the production of protein exceeds protein breakdown. which results in a protein deficiency. In a healthy person. If they are not supplied. they must be supplied in the diet. lysine. proteins cannot be made. or shorten. Contractile proteins of muscles allow muscle tissue to contract. Plants can also provide amino acids. there are eight. leucine.1 dIgestIon and nutrItIon the skin surface. Some are found in hormones. and the nitrogen balance is said to be neutral. It is also a major component of hair and nails. and isoleucine. histadine. which are compact. valine. Nitrogen balance is an evaluation of the amount of protein in the body. The most complete sources of dietary proteins are found in animal tissues because they contain all the essential amino acids. Protein deficiency during childhood can result in developmental problems that restrict both mental and physical development. These eight amino acids are tryptophan. Because humans cannot make them. and bleeding in joints and the digestive tract. Enzymes are globular proteins that increase the rate of chemical reactions in the body. In a person who is growing or repairing tissue damage and has adequate amino acid resources for protein production. but you may have to eat more than one kind of plant food at one meal to supply all the essential amino acids at the same time. proTeiNS AND DieT Of the twenty different amino acids. Protein deficiencies in adults cause a number of problems. and the . the production of proteins is equal to the breakdown of proteins. threonine. such as human growth hormone. spherical proteins. problems in fighting infections.

Just as there are . These forms of triglycerides behave slightly differently in the body. and thus they are difficult to carry in the blood. This tissue provides the body with insulation to keep warm and cushions joints and organs for protection.nutrition and Major nutrients 1 person is said to be in positive nitrogen balance. Triglycerides are composed of three-carbon glycerol molecules with a fatty acid molecule attached to each of the three carbons. Fatty acids are chains of 12 to 30 carbon atoms. If all the possible hydrogen atoms are attached to the chain. while fats are more solid at room temperatures. The terms lipids and fats can usually be used interchangably. the fatty acid is unsaturated. the fatty acid. which are made in the liver to store excess energy from carbohydrates. Triglycerides. Attached to the carbon atoms are hydrogen atoms. Phospholipids are mostly tied up in cell membranes and do not play a significant role in energy metabolism. Lipids are categorized as triglycerides. except those derived from coconuts or the palm tree. the person is said to be in negative nitrogen balance. or the triglyceride. make up a major portion of adipose tissue. fATS AND LipiDS Lipids are insoluble in water. The fatty acid portion of the triglyceride is the “fat” in the molecule and gives it the lipid characteristics. and unsaturated triglycerides are found in nearly all plants. Negative nitrogen balance means that the person needs supplemental proteins and amino acids to achieve a neutral or positive nitrogen balance. and steroids. Lipids are frequently liquid. phospholipids. The principal dietary lipids in the body are cholesterol (a steroid) and triglycerides. is said to be a saturated fat. If proteins are being broken down faster than the body can replace them. Saturated triglycerides contribute more to the buildup of plaque in arteries and are considered less healthy than unsaturated fats. If any of the hydrogen atoms are missing. Saturated triglycerides are found in all animal tissues. which is not good.

different proteins give different characteristics to these lipid-protein mixtures. stearic acid.2). it can travel to capillaries. where it may get stuck and completely block the smaller vessel. Linoleic acid is found in vegetable oils. especially corn and safflower oils.20 dIgestIon and nutrItIon essential amino acids that must be supplied by the diet. which is water-based. the lipids and proteins tend to separate. About 90% of the body’s dietary fat intake consists of the fatty acids palmitic acid. If part of the plaque breaks off from the vessel wall. DID YOU KNOW? Fats are not soluble in water. LdL is assembled in the liver from proteins. a stroke results. When this blockage occurs in the blood vessels of the heart. all dietary fats are needed by the body. thus. Essential fatty acid deficiencies contribute to dermatitis. (this is analogous to the separation of water and oil in salad dressing. If the plaque becomes large enough. Linoleic acid is also called omega-6 fatty acid and α-linolenic acid is called omega-3 fatty acid. they can no longer travel in the blood or mix well in cells. anemia. a depressed immune system. such as cholesterol and triglycerides. infertility. the lipids are mixed with proteins that can dissolve in water. and respiratory problems. there are two types of essential fatty acids that must be supplied by the diet: linoleic acid and α-linolenic acid (α is the Greek letter alpha). in the blood. for the body to carry lipids. If the fats separate from their protein carriers.) In the blood. If this blockage occurs in the brain. and linoleic acid. growth retardation. it can close off part of the blood vessel. these floating lipids attach to fatty deposits called plaque on the walls of blood vessels (Figure 2. and cardiac. and α-linolenic oil is found in rapeseed oil. oleic acid. and triglycerides and sent into the blood to deliver these fats to the body’s tissues. cholesterol. especially if there is an increase . neither one of them is good or bad. liver. just not in excess. which are called hDL (high-density lipoprotein) and LDL (low-density lipoprotein). the proteins act as carriers for the fats. a heart attack results.

These are unsaturated fatty acids that have some of the harmful properties of saturated fats. The figure 2.” .nutrition and Major nutrients 21 TrANS fATS Some triglycerides contain what are called trans fats.2 Plaque (yellow) blocking the aorta. Plaque that occurs in the major vessels of the heart can cause a heart attack. extra fat in the body can accumulate in blood vessels and form plaque. It is estimated that Americans consume about a bit less than 6% of their fats as trans fats. a digestive fluid. as in hypertension. it has earned the name “good cholesterol. Because HdL removes cholesterol from tissues and does not significantly contribute to the buildup of plaque. Its job is to scavenge cholesterol from the body’s tissues and blood vessels. this is slightly less than 3% of our caloric intake. in blood pressure. The advantage of using trans fats in food products for commercial use is that they have a longer shelf life and allow prepared foods to stay fresher longer. LdL has earned the name “bad cholesterol. When the HdL proteins are full of cholesterol.” HdL protein is made in the liver and released into the bloodstream without any lipids. Although trans fats contain unsaturated fatty acids. the arrangement of the hydrogens in these molecules produces damage to the heart and blood vessels. thus. they are removed from the blood by the liver and the cholesterol is made into bile. this plaque can grow large enough to block the flow of blood through the vessel.

but this compound cannot be absorbed by humans and does not contribute to dietary fats. Testosterone and estrogen. They also found in prepared meats and hard margarine. such as cakes. pies. The major nutrients include carbohydrates. where it makes them pliable. Vitamins and minerals are types of minor nutrients and will be discussed in Chapter 3. which are reproductive hormones. cookies. ConneCtions The body takes food and breaks it down into the nutrients it can use. Trans fats are most frequently found in prepared foods. and breads. Cholesterol. a steroid hormone from the adrenal cortex.22 dIgestIon and nutrItIon hazard to consumers is that they think they are substituting unsaturated fats for saturated ones in their diets. Cholesterol forms the chemical framework of steroid hormones. but they are not. Steroids are another type of lipid that have hydrocarbon rings. Cholesterol is also found in cell membranes. from cell repair to muscle contraction. Its presence in the membranes of red blood cells allows the cells to squeeze through small capillaries. one of the most important steroids. and lipids. proteins. assists in the renal conservation of sodium. Plants have a counterpart to cholesterol called phytosterol. are both steroids. is both made in the liver and ingested in food from animal sources. Aldosterone. both major and minor. These fatty acids contribute as much to the clogging of arteries as saturated fats. Nutrients serve as building blocks for larger chemicals and the energy that fuels all of the body’s processes. .

(See Table 3. and K.) Vitamin D is made in the skin when it is exposed to ultraviolet light from the sun. and lipids. vitamins and minerals also play a vital role in our diet.1 for details on these vitamins. modify. These vitamins are absorbed the same way as other fats (see Chapter 6). proteins. and fats receive a lot of attention in discussions of nutrition. viTAMiNS Vitamins and minerals are classified as minor nutrients. Vitamins do not supply energy or serve as building blocks for other compounds.3 Minor Nutrients and Metabolism Although sugars. they work with the chemicals that make. and metabolize the major nutrients. The four fat-soluble vitamins are A. D. Nutri23 . These compounds are vital to the body. This chapter examines these nutrients and also includes a brief discussion of the way we actually extract energy from nutrients through biochemical pathways. E. but are needed in much smaller amounts than carbohydrates. Instead. proteins. Vitamins are classified as either fat or water soluble. Fatsoluble vitamins are stored in the body and may reach toxic levels if a person ingests too much of them.

Vitamin K is involved in the process of blood clotting.1 ImporTanT VITamIns viTAMiN A (Retinol) D E iMporTANCe Used for production of chemicals in vision Calcium absorption Antioxidant probLeM exCeSS Neurological problems Neurological problems Neurological problems Neurological problems None—excess secreted in urine None—excess secreted in urine None None probLeM DefiCiT Night blindness “Soft” bones Damage from chemical free radicals Bleeding. including vitamin C and several B vitamins. A common blood thinner taken after a heart attack or stroke inactivates vitamin K and decreases the blood-clotting factors from the liver. The decrease in clotting factors results in a lower tendency to clot and helps prevent a second heart attack or stroke. Vitamin K is found in many leafy vegetables. There are many water-soluble vitamins. none of the water-soluble vitamins are stored Table 3. inability of blood to clot Scurvy K Production of blood clotting factors Antioxidant C (Ascorbic acid) B Complex Energy carriers in metabolism Participates in DnA synthesis Participates in DNA synthesis Metabolism problems Anemia Anemia B12 Folic acid .24 dIgestIon and nutrItIon tional supplementation of vitamin D is usually necessary during childhood to ensure proper bone growth. and it is also produced by the bacteria that inhabit the intestines (see Chapter 7). Except for storage of vitamin B12 in the liver.

but no extra folic acid. sodium. and molybdenum. During pregnancy. chloride. and iron. Countries that do not add iodine to their salt. Metabolism is the . magnesium. fluorine. MiNerALS The body needs several minerals. in very low concentrations.Minor nutrients and Metabolism 25 in the body. Vitamin B12 is only found in meat. iodine. Calcium. phosphate. potassium. People with a deficiency of this hormone have a lower-thannormal metabolic rate. copper. including calcium. Individuals in the United States usually receive adequate iodine from iodized salt. have a high incidence of goiter. manganese. Vitamin C. Care should be taken if supplements are used. including zinc. Other vitamins can be found in a variety of fruits and vegetables. they take part in a wide range of biochemical reactions. sulfur. is found in citrus fruits. as metals such as selenium and chromium are toxic in excess. magnesium. selenium. women are especially prone to folic acid deficiency and need to take supplemental vitamins to help maintain the development of the fetus. and phosphate provide strength to bones and teeth. Iodine is a vital part of the hormone made by the thyroid gland. Humans usually have about one year’s supply of vitamin B12 stored in the liver. Iron is important in hemoglobin and other oxygen-carrying compounds. such as China. also called ascorbic acid. Thyroid hormone controls the body’s metabolic rate. The body also needs trace metals . MeTAboLiSM Once nutrients have entered the body cells. Excess amounts of these vitamins are excreted in the urine. while folic acid is present in leafy vegetables. affecting growth and development in childhood and overall body metabolism in adults. Iodine deficiencies result in marked swelling of the thyroid gland and neck. producing a goiter.

anabolism is the synthesis of larger molecules from smaller ones. Metabolic reactions either make molecules or structures or break them down. The energy released from one reaction can run another reaction. the bonding of amino acids to make proteins. sum of the chemical reactions that occur in cells. The rest of the ATP is made by harnessing the energy of the electrons of hydrogen atoms. Anabolism refers to reactions in which larger molecules are made from smaller ones. Catabolism refers to reactions in which large or complex molecules are broken down into smaller ones (Figure 3. there is energy left over.2 dIgestIon and nutrItIon figure 3. Phosphorylation is the process of adding a phosphate group (PO4-) to an atom or group of atoms. A substrate is a compound being acted upon by an enzyme. while catabolism is the breakdown of larger molecules into smaller ones. .1 anabolism and catabolism are both metabolic processes. This process accounts for relatively little of the ATP produced.1). a process called substrate phosphorylation. Catabolic reactions tend to release energy from the compounds. This energy can be used to add a third phosphate onto ADP to form ATP. Energy is extracted from compounds in two ways. When some chemical reactions occur. for example. Anabolic reactions usually require the addition of energy to proceed.

2. 1. the number of calories should be adjusted appropriately. If the person eats more calories than this. the result is the number of calories a person should burn in a day to maintain body weight. and the electrons are passed through a series of reactions resulting in a large amount of ATP. or is recovering from an illness.Minor nutrients and Metabolism 2 These atoms are split.. Because triglycerides hold a large number of hydrogen atoms. YOUR HEALTH: CALCULATING BMR to estimate the number of calories the body needs each day. The addition of two electrons to oxygen attracts two hydrogen ions (protons) from the surrounding medium. and the result is water (H2O). table 3. storing twice the energy of carbohydrates. Multiply this number by 24. the person will gain weight. If the person eats less than this. The reactions of aerobic cellular respiration require oxygen. The overall process by which energy for metabolism is extracted from nutrients is called cellular respiration.2). fatty acids are much more efficient as energy storage molecules. the person will lose weight. Oxygen is used in this process. Males should then proceed to the next step. is actively growing. Calculate body weight in kilograms (pounds divided by 2. when it receives an electron.2 on page 2 shows the number of calories burned through different activities. Females should first multiply the kilogram figure by 0. then proceed to step 2. but only at the end. If a person changes their level of activity. This second method of producing ATP is called oxidative phosphorylation. . while those of anaerobic cellular respiration do not require oxygen. the basic metabolic rate (BMr) must be calculated.

2 glucose is broken down to carbon dioxide and water by some reactions of glycolysis. Pyruvic acid loses a carbon and becomes acetyl Coa. electrons from the Krebs cycle enter the electron transport chain. the acetyl Coa enters the Krebs cycle. the Krebs cycle. . a -carbon sugar. the result is 34 molecules of atP. glucose. and the electron transport chain.2 dIgestIon and nutrItIon figure 3. which can be used as a source of energy for the life processes of cells. is broken into two 3-carbon molecules of pyruvic acid. First. which produces atP.

Minor nutrients and Metabolism

2

All multicelled organisms must carry on aerobic respiration because they cannot survive on the small amount of energy produced by anaerobic processes. Cellular respiration most commonly involves the breakdown of glucose for ATP production using three connected chemical pathways: glycolysis, the Krebs cycle, and the electron transport chain (Figure 3.2). Glycolysis is sometimes an anaerobic process—the reactions can continue in the absence of oxygen. Other times glycolysis, as well as the Krebs cycle and the electron transport chain, are aerobic processes in that they cannot continue in the absence of oxygen. Glucose enters glycolysis as a 6-carbon sugar and comes out as two 3-carbon molecules of pyruvic acid. This process also results in the production of two ATP molecules. Pyruvic acid loses a carbon dioxide and forms an acetyl group that combines with a form of vitamin B6, resulting in a compound called acetyl CoA. This compound enters the second phase of glucose oxidation, the Krebs cycle. Because two pyruvic acids produce two acetyl groups, the Krebs cycle runs twice

Table 3.2 approxImaTe number by aCTIVITy
ACTiviTy
Bicycling, 6 mph Bicycling, 12 mph Jogging, 5.5 mph Jogging, 10 mph Jumping rope Swimming, 25 yds/min Swimming, 50 yds/min Walking, 2 mph Walking, 4.5 mph Tennis (singles)

of

CalorIes burned
240 410 660 1,280 750 275 500 240 440 400

per

Hour

100 Lb perSoN
160 270 440 850 500 185 325 160 295 265

150 Lb perSoN

200 Lb perSoN
312 534 962 1,664 1,000 358 650 312 572 535

30

dIgestIon and nutrItIon

for each glycose molecule broken down. The pyruvic acid can also be used to form the amino acid alanine, which can be transformed into other amino acids. The acetyl group is added to an existing compound in the Krebs cycle, and the resulting series of chemical reactions results in the removal of electrons from hydrogen atoms to send to the third phase, the electron transport chain, and the production of a single ATP molecule through substrate phosphorylation. The final chemical in the series receives a new acetyl group and the cycle begins again. The waste product of the Krebs cycle is carbon dioxide. Several intermediate chemicals produced during the Krebs cycle can be removed for amino acid synthesis. These amino acids can also be fed into the Krebs cycle through these intermediate chemicals. The last pathway, the electron transport chain, is a series of chemical reactions that pass electrons from one chemical to the next. During this process, 34 ATP molecules can be produced for each glucose molecule that started the process. It is possible to make a total of 38 ATP molecules through the three pathways. Because many of the intermediate compounds are used for other purposes, the maximum number of ATP molecules is seldom produced, except in skeletal muscle, where all of the ATP is needed for muscle contraction.

ConneCtions
Humans need to eat to gain energy for chemical reactions involving a type of chemical bond called a covalent bond. This bond keeps complex biological chemicals together and requires energy that is crucial for repair, growth, or development. Metabolic pathways for carbohydrates, proteins, and lipids intersect. Thus, the body can use nutrients to make needed compounds, or to convert the nutrients to compounds that can

Minor nutrients and Metabolism

31

be burned for energy. Carbohydrates exist as monosaccharides, disaccharides, and polysaccharides, depending on the number of sugar units. Monosaccharides include glucose, fructose, and galactose. Disaccharides include sucrose, lactose, and maltose. Biologically important polysaccharides come either from plants as starch or from animals as glycogen. Proteins are made from a mixture of 20 amino acids and fulfill a variety of functions in the body. Cholesterol and triglycerides are important dietary lipids. Triglycerides are an important form of long-term energy storage and are made from excess carbohydrates. Both vitamins and minerals are important in metabolizing the major nutrients of carbohydrates, proteins, and lipids. Deficiencies of vitamins or minerals compromise cell metabolism.

and are made up of two monosaccharides 32 .4 Digestion. proteins. The digestive tract is a long tube (about 30 feet when relaxed) with openings at both ends (Figure 4. are disaccharides. The starch molecules in the bread and potatoes are made up of hundreds of monosaccharides. but foods that are inside the digestive tract are not yet actually in the body. and Elimination Let’s get back to Amy and her lunch.g. and the shake contain carbohydrates.. it is processed and broken down gradually so the nutrients (e. fries.1). As food passes through the digestive tube. milk. which was discussed in Chapter 1. the fries. Absorption. Glucose is the simple sugar used most in metabolism. such as those in table sugar. and fats) can be absorbed by the cells in the walls of the digestive tract. The hamburger bun. and beer. or simple sugars. and chocolate shake. Carbohydrates must be broken down to monosaccharides. and anything that enters it must pass through the cells that make up the walls of the tube in order to enter the bloodstream and be transported to the body’s tissues. how do the nutrients in these foods get to the tissues in her body that need them? This may sound strange. Other sugars. This tube is contained within the body. The question is: When Amy eats her hamburger. sugars.

so any disaccharides not broken down to monosaccharides are used by bacteria living in the intestines. absorption. small and large intestines. stomach. Anything larger than a monosaccharide cannot be absorbed through the walls of the digestive tube.digestion. and rectum. As a result of this . and elimination 33 figure 4. bonded together. with an opening at the mouth (for intake) and an opening at the anus (for excretion). esophagus.1 the digestive system is a tube within the body. the digestive system includes the mouth.

The beef of the hamburger also contains fats. as does the oil in which the fries are prepared. Proteins are composed of hundreds of amino acids and must be broken down into individual amino acids in order to be absorbed into the cells lining the digestive tube.) Triglycerides are composed of a single glycerol and three fatty acid chains. If a person eats food that is high in saturated fatty acids. (Triglycerides cannot pass through any cell membrane intact. These . but cholesterol can. submucosa. may or may not be broken down to get them into the cells lining the digestive tube.) Cholesterol is absorbed whole.34 dIgestIon and nutrItIon bacterial metabolism. the walls of the organs are made up of four tissue layers: the mucosa. which is discussed in Chapter 8. Fats. The innermost part of the mucosa is the epithelium. muscularis. Most of the epithelial layer is made up of a single layer of cells called columnar epithelial cells. This layer is composed of three parts: the epithelium. while triglycerides are broken apart every time they enter or leave a cell. some people experience abdominal cramping and diarrhea. the lamina propria. for example. or adventitia (Figure 4. Because the fatty acid chains are absorbed through the digestive tube “as is.2). and the muscularis mucosa. STrUCTUre of The DigeSTive TUbe Throughout the digestive tube. The innermost layer of the digestive tube is the mucosa. (Different types of fats were described in Chapter 2. and serosa. The body will use these amino acid building blocks to make body proteins. These are symptoms that may occur when a person is lactose intolerant. also called lipids.” the body will build up a supply of triglycerides that contains whichever type of dietary fatty acids have been ingested. The fatty acid chains can be either saturated or unsaturated. the saturated fatty acids will be transported to the tissue of the body and stored there. The meat in the burger is a good source of protein.

the muscularis (external muscle layer). and the serosa. the submucosa.2 the walls of the digestive tube are made up of four layers: the mucosa. cells are lined up like columns with one end exposed to the material in the digestive tube and the other end forming the connection between the epithelial layer and the tissue beneath . and elimination 35 figure 4.digestion. absorption.

mucussecreting cells called goblet cells because of their unique shape (narrow bottom and wide top) are found throughout the tube. lymph nodules to screen for foreign material that may cause antibodies to be made. which helps protect the tissue underneath them. similar to the lamina propria but thicker. has connective tissue and blood vessels. This protective layer of cells is found in the upper part of the digestive tube. This layer. These cells. This layer helps move food through the digestive tube. This layer contains loose connective tissue with blood and lymphatic capillaries to carry material away from the columnar cells and to the body’s tissues. a layer of connective tissue that supports the absorptive cells. In addition to the columnar cells. can be stacked up. the tissue within the wall of the tube would be exposed and subject to further damage and infections from ingested material. The submucosa also has some nerves to assist in regulating the digestive process. which are flat and resemble a pancake with a nucleus in the center. depending on the part of the tube. and sometimes glands. The second major layer of the digestive tube wall is the submucosa. Beneath the epithelium is the lamina propria. The muscularis mucosa has a thin layer of smooth muscle around the lamina propria. . as well as on the body surface. The mucus becomes especially important farther along in the tube. These adaptations to the submucosa will be discussed in the following chapters. At the beginning of the digestive tube. the epithelium is made up of squamous epithelial cells. when the intestinal contents are dehydrated into feces. If a single layer of cells lined this part of the digestive tract and these cells were to die.3 dIgestIon and nutrItIon the lining. Strong chemicals that are ingested may also be harmful until they are neutralized in the stomach. Everything absorbed into the body must pass through these cells. which are specialized for protection. to protect the tissue from abrasion and prevent further damage to the body.

or adventitia.digestion. especially for . and certain types of hot dogs. kielbasa. and elimination 3 The third layer of the digestive tube wall is the muscularis. In the mouth. the outer covering is called the adventitia. At the end of the digestive tube. SUMMAry of The DigeSTive proCeSS The process of taking food into the mouth is called ingestion. called a bolus . pushing the material. The inner layer of muscle is arranged in a circular pattern around the tube. This layer is made of dense. the covering is called the serosa. based on the location of that part of the tube. On the esophagus. but is much thicker and has two layers of smooth muscle. The last and outermost major layer of the digestive tube is called the serosa. The serosa/ adventitia of both cattle and pigs is used commercially as the outer covering or casing on sausages. In addition to the physical breakdown of food into smaller pieces. This layer is similar to the muscularis mucosa. This covering is also called the visceral peritoneum.3). Contraction of the inner layer nudges the material along with constrictions of the rings of muscle. The parallel arrangement causes waves of constriction that press on the tube. the ingested food is broken down into smaller pieces and mixed with saliva. The only difference is the name given to the covering. some chemical digestion begins in the mouth. meaning the connective tissue covering of the visceral organs in the abdominal cavity. fibrous connective tissue throughout the tube. Contraction of these muscle layers propels the contents through the digestive tube via a process called peristalsis (Figure 4. absorption. Contraction of the outer layer pushes digestive contents through the tube. The outer layer of muscle cells runs parallel to the tube. The resulting food mass. The muscularis has nerves between the two layers of smooth muscle that assist in regulating peristalsis. is sent to the pharynx and then into the esophagus.

It is pushed down the esophagus by waves of contraction called peristalsis. The figure 4.3 (opposite page) With swallowing. including disaccharides. the walls of the esophagus alternately constrict and relax to move the bolus of food toward the stomach. It consists of a combination of ingested food. Bile from the gallbladder aids in the absorption of fats in the small intestine. saliva. and triglycerides. most enter the bloodstream and go either to the body’s tissues or to the liver.3 dIgestIon and nutrItIon starches. . protein fragments. The final breakdown of the ingested food. When nutrients leave the digestive tract. The liver is an accessory organ to the digestive tract that regulates much of what is removed from the blood. The contents of the stomach are squirted into the small intestine at regular intervals. A specific description of this part of the process can be found in Chapter 5. Additional digestive juices enter the small intestine from the pancreas and gallbladder. One of the digestive chemicals produced in the stomach is hydrochloric acid at a concentration strong enough to eat away shoe leather. The digested food at this stage is called chyme. The pancreas contributes enzymes that break down what is left of starch. Nearly all the absorption of nutrients occurs in the small intestine. and stomach juices. The nutrients are then absorbed into the lining cells. A large amount of mucus present in the stomach protects the cells of the stomach lining from this acid. A detailed description of this part of the process can be found in Chapter 5. food leaves the mouth and enters the esophagus. The stomach acts as a blender. mixing the food with digestive juices secreted by specialized cells in the stomach lining. The esophagus transports the bolus of food to the stomach. Locally produced hormones control this process. Most of the water that enters the digestive tract with food or from the digestive juices of the stomach and pancreas is actively removed from the tube by the large intestine. occurs at the surface of the columnar cells lining the tube.

and elimination 3 . absorption.digestion.

The large intestine salvages most of the water from the intestinal contents and prepares the solid waste for elimination. and the stomach blends it with digestive juices. muscularis. while cholesterol is absorbed intact. The final breakdown of the food is completed in the small intestine where nutrients are absorbed. ConneCtions Nutrients must be broken down to a size that allows them to be absorbed into a microscopic cell. and a connective tissue covering called a serosa or adventitia. For proteins. this basic unit is a monosaccharide.40 dIgestIon and nutrItIon removal of most of the water from the digestive tube creates the material that is eliminated from the body in the form of feces. submucosa. . The mouth and esophagus ingest and transport food. Each section of the digestive tube has specific functions. The wall of the digestive tract is made up of four major layers: mucosa. this is an amino acid. For sugars. Whatever has not been broken down or absorbed in the digestive process is eliminated through the rectum and the anus. A large number of goblet cells located in this portion of the tube produce the mucus necessary to move the feces through the rest of the tract. Lipids in the form of triglycerides are broken into glycerol and fatty acid chains. This is discussed further in Chapter 6. Each type of nutrient has a basic building block that can be absorbed.

MoUTh The mouth starts with the lips in front and extends back to an area called the oropharynx. allowing the natural red coloring of blood to tint the lips. Chewing starts the breakdown of food to a manageable size that can pass into the cells lining the digestive tube. eventually. from side to side. With the help of the tongue. Her tongue moves the food around in her mouth. The skin at the edges of the lips is thin. The lips have a circular skeletal muscle called the orbicularis oris. When Amy bites into her burger and bun. The 41 . or a bolus. respectively. now a pulpy mass. This bolus is a mixture of saliva and the ingested food. which allows lip movement. The oropharynx is where both food and air pass to enter the digestive tube and respiratory tract. Other teeth called canines. While Amy chews. teeth called incisors cut it into bite-size pieces. and swallows it. the food. is formed into a rounded lump. and. chews. or eyeteeth. as in a pucker or a smile. toward the back of her mouth so she can swallow the bolus. teeth called premolars and molars grind the food.5 Chewing and Swallowing Digestion starts when Amy takes a bite of her burger. help her tear up some of the food.

1 Humans are born with two sets of teeth: (a) deciduous (milk) teeth and (b) permanent teeth. .42 dIgestIon and nutrItIon figure 5. which are gradually replaced by the permanent teeth. the deciduous teeth erupt from the gums around six months of age. crack. so they must be moistened on a regular basis or the skin may become dry. and generally finish growing at about two years. and possibly bleed. children begin to lose their baby teeth. lips do not have any sweat glands. at about age .

2). but kept moist by saliva. The inside of each cheek is covered with a stratified squamous epithelium that is not keratinized like skin. 4 canines. contain a skeletal muscle called the buccinator. If it is damaged. The rear portion of the roof of the mouth is called the soft palate and has skeletal muscle. begins to push the baby teeth out when a child is about 7 years of age. above the mouth lining. preventing a person from inhaling and swallowing at the same time. A complete set of permanent teeth consists of 8 incisors. totaling 32 teeth (Figure 5. or roof. The permanent teeth continue to emerge up to about age 25.Chewing and swallowing 43 The sides of the mouth. All teeth have basically the same structure (Figure 5.1b). the crown. of the mouth is called the palate. until all 20 teeth have emerged. The top. The soft palate rises during swallowing to block the opening to the nasal cavity at the top of the oropharynx. the tongue presses against the hard palate. Humans are born with two sets of teeth hidden in the upper and lower jaws. 4 canines. or cheeks. called permanent teeth. the . or deciduous teeth. The front part of the roof of the mouth is the hard palate and has bone above the tissue lining the mouth. This muscle helps move food around in the mouth and also helps in forming facial expressions. not bone. The first set of teeth consists of 8 incisors. The visible part of the tooth. TeeTh Amy’s teeth. The first set of teeth continues to penetrate through the gums up to about two years of age. children begin to get their first teeth. 8 premolars. A small. called baby teeth. just as with all adults.1a). are her second set of teeth. At about six months of age. so it is not dry. when the wisdom teeth have emerged. is covered with hard enamel. The enamel cannot be replaced. and 8 molars (Figure 5. and 12 molars. The second set of teeth. When a person chews and forms certain speech sounds. fingerlike projection of the soft palate at the rear of the mouth is called the uvula. This type of epithelium is discussed in Chapter 4.

and the root. canine. the crown covers the dentin. The shape of the crown determines whether the tooth is an incisor. or molar. the root contains blood vessels and nerves. which lies below the gum. The neck of the tooth starts at the gum line and extends through the gum. which lies above the gum.2 teeth are made up of two sections: the crown. which reaches into the root cavity. underlying tissues of the tooth may be exposed. More of this portion of the tooth may be .44 dIgestIon and nutrItIon figure 5. resulting in the degeneration and loss of the entire tooth.

which are attached to the bones of the skull and in the neck. and bitter. ToNgUe The tongue moves the food around in the mouth. extends through the crown. Depending on the type of tooth. Although enamel cannot be replaced. individuals perceive a fifth taste that is stimulated by an amino acid called glutamate. and root of the tooth and makes up the bulk of the tooth. Below the neck. the lymphocytes in the tonsils make antibodies that help defend the body from attack. teeth may have from one to three roots. The tongue is also involved in speech. but are contained completely within the tongue. salty. These muscles are not attached to bones. Some of the skeletal muscles in the tongue are used to change its shape. blood vessels. in the oropharynx. Tonsils are found on the rearmost area of the tongue and in the surrounding soft tissue of the oropharynx. are used to change the tongue’s location. forming the bolus of food and saliva. or MSG. found in some foods as well as in the seasoning monosodium glutamate.Chewing and swallowing 45 exposed as the gum recedes with age. Dentin. so some repair of damage or decay takes place throughout a person's lifetime. a mixture of connective tissue. The root is held in place by a calcified type of connective tissue called cementum that attaches the tooth to a periodontal ligament. sour. Other muscles. can hide in the tonsils and cause . neck. such as Streptococcus. If these organisms are detected. and nerves. The surface of the tongue has projections of tissue called papillae. This pulp extends through the tooth to the base and forms the root canal. At the back of the mouth. which are sensitive to tastes of sweet. Some of the papillae contain taste buds. The central core of each tooth is filled with pulp. a bonelike substance. The tonsils are aggregates of lymphoid tissue that screen the incoming food for microorganisms that might attack the body. Some bacteria. the root of the tooth is embedded in the jawbone. dentin can.

The physical aspects of digestion in the mouth occur when we bite. trapped sugars. may damage the seal between the tooth and the gums. These glands are found under the tongue and in front of the masseter muscle . they may also be life-threatening. The parotid glands produce a watery secretion. and mouth debris—sticks to teeth. the muscle that provides most of the force in biting. digestion is a process that breaks down food to sizes that can be absorbed by cells. and sublingual. SALivA As stated earlier.4 dIgestIon and nutrItIon recurring throat infections. the bacteria break down the proteins of the tooth and cause tooth decay or cavities. called tartar or calculus. There are two components to the process: physical and chemical. and the submandibular glands make a combination of a watery and mucoid secretion. and may sometimes lead to loss of the affected tooth or teeth. chunks. these bacteria continue to hide in the tonsils and cause infection again. these infections can be quite painful. In extreme cases. Chemical digestion in the mouth involves saliva. The combination of secretions from these YOUR HEALTH: THE IMPORTANCE OF BRUSHING YOUR TEETH tooth decay begins when dental plaque—a layer of bacteria. once the enamel is damaged. Most of the saliva is secreted by three pairs of salivary glands: the parotid. and chew food. allowing bacteria to get into the gums and cause serious infections. This breaks the food into smaller. the sublingual glands produce a very mucoid secretion. submandibular. Periodontal disease may result if the plaque builds up on the gums. but still fairly large. If the infection is not treated properly. Bacterial waste consists of assorted acids that damage tooth enamel. tear. Plaque provides a safe haven for bacteria to live and metabolize the bits of trapped food. this buildup. .

In addition. The oropharynx and the laryngopharynx are lined with stratified squamous epithelial cells to protect the underlying tissue from damage. Amylase starts the digestion of starch by breaking down the complex structure of starch molecules into smaller combinations of glucose units that are separated further along the digestive tube.Chewing and swallowing 4 glands makes up normal saliva. Two enzymes in the saliva begin the chemical breakdown of food: amylase and lingual lipase. the laryngopharynx . at the back of the mouth. moistening food to form a bolus. the nasopharynx . is just one of three parts of the pharynx . is exclusively part of the respiratory tract. A person produces about 1 to 1. including cleansing the mouth.5 quarts (about 1 to 1. This epithelium has the first goblet cells found in the digestive tube. Because amylase works at an alkaline ph. Saliva has several purposes. such as excess acids or bacterial toxins. The muscularis .5 liters) of saliva per day. serves as a passage for both air and food. The salivary glands produce saliva when stimulated by the presence of food in the mouth or by certain acidic foods. The goblet cells secrete mucus that helps the bolus of food get to the esophagus and stomach. Sometimes. The area above the oropharynx. the saliva produced is thick and comes mostly from the sublingual glands. If a person is dehydrated. the thought or smell of food will result in saliva release. dissolving food to enhance taste. Lingual lipase is a form of lipase that separates triglycerides into their components of glycerol and fatty acids. and starting the chemical digestion of starches and some lipids. The area immediately below the oropharynx. saliva contains bicarbonate to maintain these conditions. the salivary glands will release saliva. phAryNx The oropharynx. if the small or large intestine is irritated by some substance. such as vinegar or citric juices.

3 illustrates the anatomy of both the pharynx and the esophagus. .3 structures of the pharynx and esophagus. The two layers work together to propel food by peristalsis to the stomach. the esophagus connects the pharynx to the stomach. Figure 5. figure 5. Here. the inner layer is longitudinal and the outer layer is circular. but in the opposite arrangement from that found throughout the rest of the digestive tube.4 dIgestIon and nutrItIon layer of the pharynx has two layers of smooth muscle.

) The cardiac sphincter loosely controls the opening of the esophagus into the stomach. (A sphincter is a circular muscle. The larynx rises. the mucosal and submucosal layers of the esophagus fold along the length of the tube when it is empty. The presence of the food in the esopha- . The esophagus passes through the diaphragm located just above the stomach. is collapsed when empty. the last third has smooth muscle. This muscular tube. The first third of the esophagus has skeletal muscle in the muscularis layer. it enters the esophagus. When a person swallows. The esophagus is made up of four layers of tissues. This muscle assists the cardiac sphincter in limiting access to the stomach. closing off the windpipe. as in the mouth and pharynx. which is called the cardiac sphincter. and the middle portion has a mixture that gradually goes from skeletal to smooth muscle cells. the soft palate rises to close the connection with the nasal passage.Chewing and swallowing 4 eSophAgUS Once the bolus of food passes through the oro. located behind the windpipe. is made up of stratified squamous cells. the inner circular and the outer longitudinal. The esophagus is about 10 inches (25. Next. the innermost layer. causing a lid-shaped piece of cartilage and soft tissue called the epiglottis to cover the opening to the trachea. the esophagus has an outer layer called the adventitia that blends the tube covering with the surrounding tissue and holds the esophagus in place in the throat.and laryngopharynx. the tongue blocks the possibility of reentry of the food into the mouth. that opens and closes a tube. SWALLoWiNg Swallowing is actually a complex process. a series of reflexes occur that ensure that the action occurs properly. Finally. and ends at the opening of the stomach. but not all of the muscle is the same type. First. starts at the bottom of the laryngopharynx. usually made up of smooth muscle cells. The epithelial lining.4 cm) long. Then. The muscularis has two layers of muscle.

It is fairly easy to overcome these barriers and bring stomach contents back up into the tube. gus stretches the tube and causes the muscle contractions that result in peristalsis. the scarring also leaves the tissue susceptible to further damage due to the loss of the stratified epithelial layers that protect the underlying tissue. and grind food and saliva into a paste. the stomach is overfull. If this occurs. the bolus no longer resembles the food it started out as. The nutrients have been partly digested. ConneCtions Digestion starts with the first bite of food. the cardiac sphincter and the diaphragm do not entirely close off the connection to the stomach. Further digestion is necessary and continues in the stomach and small intestine. this regurgitation can occur when a person vomits. liquids in 1 to 2 seconds. or a person is obese. All teeth have a common structure and have hard enamel to protect underlying tissues from decay and damage. as will be described in the next chapter. . or about the strength of a car’s battery acid. tear. Because the pH of the stomach fluids is usually below 4. Teeth cut. but they are still not ready to be absorbed into the body. When food is swallowed.50 dIgestIon and nutrItIon YOUR HEALTH: HEARTBURN heartburn occurs when the stomach contents pass back up into the esophagus. the esophagus does not fold when empty or propel food properly through peristaltic contractions. Solid food passes to the stomach in 4 to 8 seconds. pregnant. Baby teeth start erupting from the gums at about 6 months of age and begin to be replaced by permanent teeth at about 7 years of age and continue to age 25. or running. the acid burns the epithelial layers of the esophagus and may cause scarring of the tissue.

and pharynx. passes from the mouth to the pharynx and into the esophagus for passage to the stomach. The tongue helps to manipulate food during chewing. palate. floor. The process of swallowing is a reflex that propels food and prevents it from entering the respiratory tract. Taste buds on the tongue are stimulated by different chemicals. and it is also essential in speech. The saliva produced by salivary glands moistens the food and begins the chemical digestion of starches and triglycerides. in the form of a bolus.Chewing and swallowing 51 The mouth is bordered by the lips. cheeks. Food. .

is shaped somewhat like the letter J. making it look similar to a donut. SToMACh The connection between the stomach and the esophagus is called the cardiac sphincter. The stomach. In the innermost layer.1) and turns the bolus of food into chyme. The muscularis in the stomach consists of three distinct layers. Below the esophagus. Before they leave the small intestine.6 The Stomach and Small Intestine The bolus of food that enters the stomach contains some partially digested food and some food that has not been broken down at all. Digestion of protein begins in the stomach. The positioning of these layers allows the stomach to constrict in all directions. Amylase and lingual lipase begin the digestion of starch and triglycerides. respectively. all of the nutrients that can be absorbed into the lining cells of the digestive tube will be absorbed. The largest part of 52 . The outermost layer runs longitudinally. the fibers are oblique to the other layers The middle layer is arranged in a circular pattern. the stomach works to digest proteins in the food (Figure 6. which is really a section of the digestive tube.

It connects to the esophagus at the cardiac sphincter and to the duodenum of the small intestine at the pyloric sphincter.1 the stomach is located below the diaphragm. the stomach.the stomach and small Intestine 53 figure 6. Folds of the mucosa called rugae increase the surface area of the organ. The portion of the stomach above the body but below the connection to the esophagus is called the . is where most of the stomach’s digestive activity occurs. the body. three layers of smooth muscle make up most of the wall of the stomach.

These pits are lined with a mixture of columnar epithelial cells and special cells that secrete chemicals to aid in digestion. Goblet cells secrete mucus to protect the stomach lining from other secretions. it is converted into an active enzyme called pepsin. This cell secretes a chemical called pepsinogen. the vitamin is not absorbed and a syndrome called pernicious anemia results. especially the hydrochloric acid secreted by the parietal cells. especially after a large meal. Parietal cells also secrete a chemical called intrinsic factor that is necessary for the absorption of vitamin B12 in the small intestine. The epithelial cells extend into the underlying layers of the mucosa to form depressions called gastric pits (Figure 6. including bacteria and medications. If intrinsic factor is not available. A third type of cell found in the epithelia of the gastric pits is the chief cell. Pepsin begins the digestion of proteins by breaking large. The acid digests everything. large folds called rugae are created in the mucosa that can be seen without magnification. more food is brought from the fundus to continue the digestive process. In this way. some of it stays in the fundus while the rest is mixed with stomach fluids. The mucosa of the stomach has several adaptations not found anywhere else in the digestive tract. complex proteins into smaller molecules that will be further . As the food in the body of the stomach leaves to enter the small intestine.2). salivary amylase continues to break up starch. These folds expand the surface area of the inside of the stomach. the fundus acts like a storeroom for excess food until there is space in the body of the stomach. while a full one is considerably larger. When food enters the stomach. When pepsinogen comes in contact with hydrochloric acid.54 dIgestIon and nutrItIon fundus. When the stomach is empty. While the food is in the fundus. The acid aids digestion by indiscriminately breaking up larger compounds into smaller ones. An empty stomach is about the size of a fist.

The fourth specialized epithelial cell. broken down in the small intestine. secretes a hormone called gastrin that is primarily responsible . called the G cell. found in the lining of the stomach. pepsin will not be formed from pepsinogen and the digestion of protein will not begin.2 gastric pits.the stomach and small Intestine 55 figure 6. If hydrochloric acid is not present. a micrograph of gastric pits shows the cells up close. contain special cells that secrete chemicals used in digestion.

The presence in the small intestine of protein fragments called peptides and fatty acids from triglyceride breakdown also inhibits the nervous system's stimulation of the G cells and slows the mixing of the stomach contents.5 dIgestIon and nutrItIon for stimulating the other three types of cells. The stomach functions to prepare food for further digestion and absorption in the small intestine. and . In addition to continuing digestion in the intestine. Stomach fluids are produced when the G cells are active. These nerves relay a signal that stimulates gastrin secretion. it stretches the walls of the stomach. enters the small intestine. certain chemicals. The thought. When food enters the stomach. Glucose. this control process includes the neutralization of stomach acid. In addition to the action of the stretch receptors. cause stomach fluids to be produced. Few materials are absorbed through the stomach lining. such as caffeine and alcohol. Stomach digestion is also slowed by the actions of the small intestine. Highly alkaline food also causes stomach secretions to flow. sight. regULATiNg DigeSTioN iN The SToMACh Digestion in the stomach can be stimulated in a variety of ways. specialized nerves within the smooth muscle layers of the stomach. The small intestine does not have the relatively thick protective layer of mucus found in the stomach. caffeine. When chyme. the acidic stomach contents. the nervous system stimulation of the G cells is inhibited. resulting in pressure on stretch receptors . The hydrochloric acid would harm the intestinal lining and cause a type of ulcer (see the “Your Health” section concerning ulcers on page 58). or smell of food can stimulate the stomach to secrete digestive fluids. The interaction of the stomach and small intestine ensures that the small intestine receives chyme in amounts that it can handle. Increasing amounts of hydrochloric acid in the stomach cause the parietal cells to decrease secretion of the acid. slowing production of pepsin and slowing down the initial breakdown of proteins.

the stomach and small Intestine 5 alcohol are three chemicals that are absorbed through the stomach lining. thereby . the pyloric sphincter cannot be easily forced open. Unlike the cardiac sphincter. The jejunum. the pyloric sphincter regulates the amount of food that enters the small intestine. digestion is completed. and twisted to fit into the abdominal cavity. The products of digestion are absorbed through the digestive tube lining and transported to the rest of the body’s tissues by the blood and lymphatic vascular systems. Water is absorbed in the stomach only if it contains a sufficient amount of dissolved glucose. The last portion of the small intestine. or middle segment of the small intestine. The formulation of sports drinks for athletes takes advantage of this dual absorption to rapidly increase the body’s energy supply for muscle metabolism and to rehydrate the body after extensive sweating. about one ounce of fluid at a time. The small intestine is bent. is about 6 feet long. is about 3 feet long. the jejunum. The small intestine has three sections: the duodenum. The stomach empties slowly. Chyme from the stomach enters the duodenum portion of the small intestine. At the junction of the stomach and the small intestine. Its opening and closing is controlled by the amount of food in the stomach and by feedback from the small intestine. into the small intestine. and the ileum. the ileum. folded. The mucosa is folded into circular folds that increase the surface area of the small intestine and force the intestinal contents to go through the tube in a spiral pattern. which is about 10 inches long. It may take hours to empty the stomach after a big meal. Both of these effects increase the contact of the tube’s contents with the epithelial layer. The adaptations of the digestive tube wall in the small intestine involve the mucosa and submucosa. SMALL iNTeSTiNe In the small intestine.

YOUR HEALTH: ULCERS Imagine the body attacking and damaging its own tissues. such bleeding results in severe anemia. are still believed to be a cause of ulcers. If the damage is severe. ulcers are treated by giving the person a 10. alcohol use. H.to 14-day supply of two antibiotics and a bismuth compound to enhance healing of the stomach “sore. the microorganism also makes enzymes that damage the mucosa and allow the hydrochloric acid to further damage the stomach lining in areas where ammonia is not present. ulcers were believed to be caused by stress. this damage to the mucosa may go through the lining to the blood vessels in the submucosa and result in significant bleeding in the digestive tract. Currently. . the hydrochloric acid attacks the walls of the stomach. aspirin and other nonsteroidal anti-inflammatory drugs. 5% of ulcers recurred. but they are not the most common cause. damaging the mucosa. pylori burrows under the mucus layer in the stomach and produces ammonia. or use of excessive amounts of aspirin. resulting in a lifethreatening infection called peritonitis. until the 10s. such as ibuprofen.” the antibiotics kill the bacteria while the bismuth salicylate protects the stomach lining from acid and inhibits growth of the bacteria. a bacterium called Helicobacter pylori is now believed to be the primary cause of ulcers and the cause of their recurrence. which neutralizes stomach acid in the small area surrounding the bacteria. treatment usually involved removing the damaged part of the stomach. When a person has a gastric or peptic ulcer.5 dIgestIon and nutrItIon increasing the chances of nutrients being absorbed into the lining cells. this may lead to bleeding so severe that it compromises the body’s ability to deliver adequate oxygen to tissues. Before the bacterium was identified as the cause of ulcers. a hole may be created in the wall of the stomach that would allow food and microorganisms access to the abdominal cavity.

3). The duodenum has glands called brunner’s glands in the submucosa. The jejunum has no specialized microscopic adaptations in its submucosa. The Brunner’s glands secrete an alkaline mucus that helps to neutralize the acidic chyme from the stomach. The center of each villus contains two capillaries: a blood capillary and a lymphatic capillary. enter the lymphatic capillary. Water-soluble materials. such as sugars and amino acids.the stomach and small Intestine 5 The mucosa also has fingerlike projections called villi. These fats are sent around to the body and are used by the body’s tissues as a source of energy or as structural materials needed for growth or repair of body tissues. but are dumped into the bloodstream by way of the jugular and subclavian veins in the neck. All blood drained away from the digestive tract goes directly to the liver. This lymphoid tissue helps to screen the ingested material in a way similar to what the tonsils do. The blood capillary contains blood and connects an artery to a vein. the liver is the body’s chemical processing plant and uses the nutrients from digestion for multiple purposes. Materials that have been absorbed into the digestive tube’s lining pass into one of these capillaries. The adaptations in the submucosa help to identify the three portions of the small intestine. . The ileum has clumps of lymphoid tissue called peyer’s patches in its submucosa. and ultimately into the blood. The membrane of each mucosal epithelial cell has projections from the surface called microvilli (Figure 6. As will be discussed in Chapter 6. such as cholesterol and triglycerides. The lymphatic capillary contains a fluid called lymph that will pass into the lymphatic system. These projections are a third way of increasing the surface area of the small intestine to aid in the digestion and absorption of digested material. enter the blood capillary. which greatly increase the surface area for absorption. The fats in the lymphatic capillaries do not go directly to the liver. while fat-soluble material.

0 dIgestIon and nutrItIon .

along with protein fragments and fatty acids in the chyme.the stomach and small Intestine 1 ACCeSSory orgANS: The Liver. The liver has several important functions in the body. The pancreas produces hormones. . cholesterol. It regulates carbohydrate. thus increasing the potential for nutrient absorption. The hormone cholecystokinin (CCK) causes the gallbladder to constrict and pump figure 6. Bile is composed of bile salts . and microvilli are smaller projections stemming from the villi. The acid. and phospholipids. bile is released from the gallbladder into ducts that connect to the small intestine. it triggers several events. When needed. The chyme also causes the release of two hormones from the duodenum. which is stored in the gallbladder. causes cells at the beginning of the duodenum to secrete intestinal fluid. which contains some mucus. the liver eliminates bilirubin . AND pANCreAS The liver and the gallbladder are two important accessory digestive organs that work with the small intestine. Villi are fingerlike projections on the surface of the intestine. and lipid metabolism and detoxifies body wastes and drugs that have entered the body.3 (opposite page) Villi and microvilli act to increase the surface area of the small intestine. is alkaline and helps to neutralize the acidic chyme and protect the duodenum from the effects of the acid. About 1 to 2 quarts (1 to 2 liters) of this digestive fluid is produced each day. insulin and glucagon are two pancreatic hormones that work within the body to control blood glucose levels. gALLbLADDer. as well as other substances. This fluid. digestive enzymes. The intestinal juice. DigeSTioN iN The SMALL iNTeSTiNe When acidic chyme enters the duodenum. protein. by incorporating it into bile. a waste product of dead red blood cells. In addition. helps digestion by emulsifying fats into smaller molecules for absorption. and bicarbonate to deliver to the duodenum to help digestion.

After the neutralization occurs. and carboxypeptidase. Enzymes from the epithelial cells of the villi break down disaccharides. The bicarbonate neutralizes most of the hydrochloric acid from the stomach. they cannot easily diffuse across cell membranes. chymotrypsin. such as sucrose (from table sugar and fruits) and lactose (from milk) that are ingested. and nucleotides into their most basic components. These include trypsin.2 dIgestIon and nutrItIon bile into the small intestine via the bile duct. by several pancreatic enzymes that are collectively called peptidases. The nucleotides will also be further digested at the surface of the villi. the small intestine contents are alkaline. the disaccharides. these droplets are then digested by enzymes called lipases and eventually form micelles. proteins. thus. creating the conditions needed for the digestive enzymes to work. peptides. The final digestion of material occurs at the villi. the lipids combine with bile salts to form emulsion droplets. figure 6. which can pass into the cell. have not been broken down. .4 (opposite page) Because fats are not water soluble. triglycerides. DNA and RNA. the body has found an alternate way to transport fat droplets into cells. CCK also causes the pancreas to secrete digestive enzymes into the duodenum. including the disaccharide maltose. Digestive enzymes break starch. which are short chains of amino acids. and nucleic acids into intermediate-sized molecules. Thus far in the digestive process. The nucleic acids. Dietary triglycerides are broken apart by pancreatic lipase. Proteins are broken into peptides. Pancreatic amylase breaks down starch into smaller pieces. are broken into nucleotides (their building blocks) by enzymes called nucleases. The peptides that are formed as a result of the action of these enzymes are structurally very short and will be further broken down at the surface of villi and microvilli. The hormone secretin causes the pancreas to secrete large amounts of bicarbonate into the small intestine. First. but not into glucose molecules. elastase.

the stomach and small Intestine 3 .

triglycerides. they have been combined with cell proteins that help carry them in the lymph and blood. Lipid absorption is a more complicated process.4). This combination of cholesterol. This process works very efficiently because the final breakdown of nutrients occurs at the exact site of nutrient absorption.4 dIgestIon and nutrItIon which makes them suitable for absorption. Glycerol and short-chain fatty acids from triglycerides are absorbed by simple diffusion across the cell membranes in the digestive lining. digests proteins Emulsifies fats Digests starch Digests triglycerides Digests nucleic acids Digests proteins Final steps in digestion SoUrCe: eNzyMeS/CheMiCAL ACTioN Saliva: Amylase Saliva: Lingual lipase Stomach Goblet cells: Mucous Parietal cells: Hydrochloric acid Chief cells: Pepsinogen Gallbladder Pancreas Bile salts Amylase Lipase Nucleases Peptidases Villi Assorted enzymes . These spheres can pass through the cell membranes and transport the fats into the cells.1 summary orgAN Mouth of THe dIgesTIVe proCess Digests starch Digests triglycerides Protects stomach lining Converts pepsinogen to pepsin: As pepsin. This material passes through the lining cell membranes and into the blood capillaries of the villi almost immediately. Cholesterol and long-chain fatty acids cannot diffuse through the cell membranes and must be handled differently. and lining cell proteins is called a chylomicron. The chylomicrons will circulate in Table 6. By the time the fats leave the lining cells. Bile salts combine with these fats to form tiny spheres called micelles (Figure 6.

Table 6. iron. Digestive functions in the stomach are controlled by hormones secreted by the lining cells and by hormones (continues) . nitrate.the stomach and small Intestine 5 the blood. About 9 quarts (8. The digestion of starch is halted by the hydrochloric acid in the stomach. blending the nutrients with digestive juices. calcium. Much of the water that enters the large intestine is reabsorbed into the blood so that very little is excreted in the feces. Most of the water is reabsorbed through the small intestinal walls. potassium. 1 quart of saliva. Eventually. The lining of the stomach contains specialized cells that secrete digestive enzyme precursors. and 1 quart of intestinal juice. 2 quarts of pancreatic juice. and phosphates. 2 quarts of stomach (gastric) juices. but most of it enters into the system at various points during the digestive process to aid in the breakdown of food. and bicarbonate and trace elements such as iodate. and some water leave the small intestine and enter the large intestine. acid.5 liters) of water enter the small intestine each day. the chylomicron remnants will be picked up by the liver. and a chemical to aid in vitamin absorption. Some of this water is ingested with food (like Amy’s chocolate shake). including the electrolytes sodium. 1 quart of bile. In addition to the nutrients discussed. magnesium.1 summarizes the process of digestion. The three layers of smooth muscle in the muscularis allow the stomach to compress its contents in all directions. The source of these fluids is approximately as follows: 1 to 2 quarts with food. waste. other materials are also absorbed through the lining of the small intestine. Any leftover nutrients. carrying triglycerides to body tissues. ConneCtions A bolus of food and saliva enters the stomach and is combined with digestive juices that are a mixture of strong acid and enzymes that begin the breakdown of proteins and lipids. chloride.

and bile to assist in lipid absorption. dIgestIon and nutrItIon (continued) originating in the first part of the small intestine. Digestive juices are secreted into the duodenum from the gallbladder and pancreas. jejunum. proteins and lipids. Structures found in the submucosa differentiate the three portions of the small intestine. The small intestine is divided into three parts: the duodenum. and ileum. The mucosa of the small intestine has villi that increase the surface area of the tube and provide the enzymes necessary for the final steps of digestion. Few materials are absorbed through the stomach lining. enzymes to break down carbohydrates. . These juices contain bicarbonate to neutralize stomach acid.

is used by the liver to make proteins that play a role in blood clotting. which is one of those vitamins.7 The Large Intestine and Elimination The chyme that enters the large intestine is different from the chyme that enters the small intestine. but a type of digestion still takes place in the large intestine. These bacteria make vitamins that are absorbed and used by the body. About 1 quart (1 liter) is left and all but about 3 to 4 ounces (90 to 120 milliliters) of this water will be absorbed by the large intestine. Vitamin K. various parts of the body can bleed two to three days after the bacteria are removed. Large numbers of bacteria that live in the large intestine finish digesting the chyme and use the nutrients for their own metabolism and growth. Vitamin K is so important to us that if these bacteria are removed by diarrhea or excessive antibiotic use.  .5 liters) of water that were present in the small intestine have also been removed by this point. Most of the 9 quarts (8. All of the nutrients that can be absorbed from the food have been absorbed. producing the feces that will be eliminated from the body. The bacteria also make a variety of B vitamins that are used in the metabolism.

is about 3 inches (7. and anal canal. The appendix can easily be twisted or blocked.6 cm) long. and largest. which is attached to the cecum. shorter. The appendix has no function in digestion or absorption. It is open to the cecum at one end and closed at the other end. On the left side of the abdomen is the descending colon. It is wider than the previous sections of the digestive tube and can store material for 12 to 24 hours until elimination. There are four major sections of the large intestine: the cecum. pouch-shaped portion of the tube that stores small amounts of chyme until it passes into the colon. the longest part of the large intestine. The part of the colon that is in front of the stomach just under the diaphragm is called the transverse colon. which is on the right side of the abdomen. . parts of the large intestine. The cecum. which connects to the small intestine.5 inches (6.5 meters) long and 2. The colon begins to twist and bend down toward the middle of the body at this point. This portion is called the sigmoid colon and the twisting brings the tube in line with the last two. section of the large intestine is the colon. causing acute infections that are difficult to treat and may lead to death.1) is a tube about 5 feet (1. The large intestine is connected to the small intestine by the ileocecal valve. is a 6-inch-long (15 cm). the bacteria that inhabit the large intestine can gain access to the abdominal cavity. The appendix. This section is divided into four regions based on the direction or shape of the tube. rectum. After chyme leaves the cecum. colon. If the appendix bursts. but has several large aggregates of lymphoid tissue and may play a role in the immune system. dIgestIon and nutrItIon LArge iNTeSTiNe ANAToMy AND DigeSTioN The large intestine (Figure 7.4 centimeters) in diameter. The second. it goes into the ascending colon. causing an inflammation called appendicitis. the rectum and the anal canal.

in . and anal canal. There are several differences between the walls of the small and large intestines. the mucosa of the large intestine has no villi.1 the large intestine consists of the cecum. First. rectum. The mucus-secreting cells increase in number throughout the large intestine.the Large Intestine and elimination  figure 7. It is the last place where the body will remove nutrients before the waste is excreted. colon. which. The mucosal epithelium is made up of columnar cells and goblet cells.

increases the amount of mucus secreted. The last component. The regular constrictions of the teniae coli result in a muscle tone that gives the appearance of a series of pouches. E. About 1 pint (0.5 liter) of this gas is produced daily. along the colon. This process is called haustral churning and results in the physical digestion that occurs in the large intestine. however. As stated above. dimethyl sulfide. Some acids will also be produced and. coli. The bacteria produce waste material that includes gases such as hydrogen. . carbon hydroxide. The large intestine appears as though a piece of string were loosely tied around the diameter of the tube every couple of inches. (It does not. resulting in diarrhea. These microorganisms are collectively called normal flora because they are normally found in the colon. the chemical digestion that occurs in the large intestine is carried out by bacteria. The muscularis contains two layers of smooth muscle. methane. which is not far from the urethra. As chyme travels through the large intestine. in the large intestine. may cause abdominal pain and increase motility. is responsible for the strong odor of these gases.) The end of the intestinal tract is the anus. a bacterium that has received a lot of attention.0 dIgestIon and nutrItIon turn. The mucus assists the passage of intestinal contents that are becoming increasingly dehydrated. the opening for voiding urine. The intestinal bacteria use whatever carbohydrates have not been absorbed in the small intestine. and dimethyl sulfide. in higher than normal concentrations. but the outer layer is made up of three bands of muscle called the teniae coli. nitrogen. or moveability of materials. The transfer of bacteria from one opening to the other can result in a painful urinary tract infection. is one of the organisms that normally exist in the large intestine. or haustra. normally exist in the urinary tract. where it is the most frequent cause of urinary tract infections. it moves from haustra to haustra with some mixing and storage at each stop.

The anal canal is short. the feces are white or gray colored. If there is no bile coming from the liver or gallbladder. The sphincter at the begin- . it is made up of 2 to 3 ounces (60 to 90 milliliters) of water. which produces the normal brown color of feces.5 inches (4 cm) long. about 1. building up feces in the rectum. dead epithelial cells. By the time the content of the digestive tube has reached the anal canal.the Large Intestine and elimination 1 The bacteria also convert any amino acids that enter the large intestine into fatty acids and pass them in the feces. resulting in initiation of the defecation reflex. Defecation results from the movement of chyme/feces through the large intestine by mass peristaltic movements during the day. and travel to the anal canal. They are both involved in the elimination of feces. The bacteria convert bilirubin from the liver into a chemical called stercobilin. This whitish coloring and increased fat content indicates gallbladder problems. one at the beginning and one at the end. DefeCATioN Defecation is the process of eliminating feces. Feces are collected in a bag attached to the outside of the abdomen. This procedure is called a colostomy. Care must be given to supply the vitamins that are usually absorbed from the large intestine. There are two muscle sphincters in the anal canal. and undigested material. In cases of cancer of the digestive tract. a mixture of inorganic salts. and ends at the body opening called the anus. and usually high in undigested fats because bile was not present to emulsify digestive fats. unabsorbed material. which is about 8 inches (20 cm) long. The feces cause the rectal wall to stretch. A person can live without the large intestine. Feces enter the rectum. the large intestine can be removed and the person’s intestine attached to an opening in the abdominal wall. bacteria (about 30% by weight). This reflex involves local nerves and the two sphincters of the anal canal.

the signal is not received in time to voluntarily keep the second sphincter closed. Insoluble fiber speeds up motility in the intestine and helps people have regular bowel movements. which helps to decrease the cholesterol in the body and lower the risk of heart disease and stroke. is under voluntary control and can remain closed. is a condition that occasionally happens to all of us. soluble types of fiber are found in beans. diabetes mellitus. local nerves send a signal to the brain of the need to have a bowel movement. two-thirds of the cholesterol that enters the intestine is reabsorbed. Increased fiber in the diet also decreases the risk of developing obesity. apples. from teen to elderly. atherosclerosis. oat. DiArrheA Diarrhea. this fiber forms a gel that slows the movement of chyme through the intestine and binds cholesterol. the frequent elimination of fluid feces. ordinarily. When children become “potty trained. there are two types of fiber: soluble and insoluble. Osmotic diarrhea occurs when a large DID YOU KNOW? Fiber is important for digestion at any age. broccoli. It can occur for a variety of reasons. The defecation reflex causes this sphincter to open. and colorectal cancer. barley. Fiber keeps cholesterol in the digestive tube until elimination.” they are able to keep this sphincter closed until they choose to defecate. At this point. The second sphincter. A person who has become incontinent has lost the ability to keep the second sphincter closed.2 dIgestIon and nutrItIon ning of the canal is made of smooth muscle. In the case of an infant human. this type of fiber is found in fruit skins and the bran of wheat and corn. . hemorrhoids. allowing feces to enter the anal canal. made of skeletal muscle. prunes. and citrus fruits.

As stated in Chapter 6. Medications containing large amounts of sodium and magnesium sulfates will have this effect. If the diarrhea affects the small intestine. both damaging the wall and causing severe inflammation. Peristalsis can be increased to the extent that the chyme is forced through and out of the intestine. resulting in water pouring into the intestines. the acid-base balance of the blood and tissues will be affected. The person’s tissues will become more acidic. diarrhea results in the loss of fluid and other substances from the body. Diarrhea can also occur when the mucosa becomes inflamed or damaged. Loss of these chemicals causes electrical imbalances in the body that affect heart and nerve function. and body proteins will not function normally. coli. Inflammation of the digestive tube can result in large amounts of mucus and blood collecting in the intestine. The reabsorption of water that occurs in the intestines can be reversed by bacterial toxins. and a related organism called Shigella cause diarrhea by this method.the Large Intestine and elimination 3 amount of unabsorbed material is retained in the intestine. heart function will be compromised and the central nervous system will cease to work efficiently. Some of the substances lost as a result of diarrhea are electrolytes. necessary nutrients will be lost with the fluid. instead of being removed. . bicarbonate is released into the small intestine to neutralize hydrochloric acid from the stomach. If the bicarbonate is not reabsorbed. Staphylococcus. Types of E. To keep this material in solution. This type of diarrhea can be caused by various drugs or by stress. Two principal electrolytes are sodium and potassium. resulting in diarrhea. If the loss is severe enough. Whatever the cause. The type of Salmonella bacteria that causes typhoid fever invades the intestinal wall. more water than usual is retained in the tube. The microorganism that causes cholera produces a toxin that results in so much diarrhea that the person may die as a result of fluid loss.

This form of cancer causes bleeding into the digestive tract that can be detected in the feces. the person develops an infection of the bloodstream and possibly other organs of the body. Improper handling of food may also cause bacterial contamination. This material can also be used to screen for a type of malignancy called colorectal cancer.4 dIgestIon and nutrItIon Perhaps the most damaging effect of diarrhea is the loss of water. the bacteria can be transmitted to foods that might not be cooked to the same high temperatures as chicken. also. If colorectal cancer is YOUR HEALTH: FOOD POISONING Food poisoning occurs when bacteria in food are not killed before being ingested. If chicken or fish. WhAT feCeS TeLL US AboUT The boDy Feces that have been eliminated from the body can be used to obtain information about the health of the person. are not cooked properly before they are eaten. As stated above. if the infected chicken or fish is prepared on the same surface as other foods without that surface being adequately cleaned. eventually causing the body tissues to lose function and shut down completely. resulting in death.to 24-hour incubation period before symptoms of severe diarrhea appear. the microorganism frequently damages the walls of the intestinal tract to the point that it can get through the lining cells and gain access to the rest of the body. people may become ill. it provides an ideal growth medium for staphylococcus bacteria. which usually harbor salmonella. it is drawn from the body tissues to keep the blood liquid. if food is left out in the summer heat. For example. If food is kept refrigerated. As water is lost. the color of feces and the presence of increased fat can indicate gallbladder problems. particularly anything containing dairy products. salmonella has a 12. When this happens. . the bacteria cannot grow and produce the chemical toxins that cause symptoms. this type of infection can be life-threatening.

ConneCtions Material to be digested enters the large intestine as chyme and leaves as feces. colon. Along the way. saving the person’s life. The digestive tube of the large intestine is divided into four major parts: the cecum. especially vitamin K for blood clotting. These bacteria are normal and produce vitamins that the body needs. rectum. and anal canal. . Colorectal cancer is the second leading cause of death in men and the third leading cause of death in women. it can be eliminated.the Large Intestine and elimination 5 detected early enough. bacteria finish digesting any nutrients that were not broken apart and absorbed in the small intestine.

Drinking any milk products that contain lactose. or cottage cheese. such as yogurt. will result in discomfort. As babies. lose the ability to produce lactase as they become adults. the carbohydrate component of milk. LACToSe iNToLerANCe Because Amy has a form of lactose intolerance. This is important because the breast milk of humans contains more lactose than that of any other mammal. most often in the jejunum. however. Many people. glucose and galactose. hard cheese. such as that chocolate shake she had with her lunch. about 90%  . to be absorbed in the small intestine. must be broken into its two monosaccharides.8 Common Health Problems There are many conditions that affect the way the body digests food. These people can no longer tolerate milk or milk products except those that have been partially broken down. she cannot digest milk unless it is in the form of yogurt. the enzyme that digests lactose. In the United States. most people produce lactase. Lactose. Two common conditions are lactose intolerance and malabsorption.

milk solids. about 20% of prescription drugs and 5% of overthe-counter drugs contain lactose. whey (the liquid from milk). so some of the sugar from the shake will be absorbed in the intestine. bloating. The sugar is retained in the small and large intestines and causes more water to be retained in the digestive tube than normal. Lactose is also found in breads. Amy makes some lactase. Anyone with lactose intolerance should avoid milk. which is milk protein.Common Health Problems  of Asian Americans. The lactose that cannot be used by her body is used by the bacteria in her intestine. a collection of conditions that cause problems in get- . and nondairy powdered creamers. because total absence of the enzyme is extremely rare. instant soups. and 20% of Caucasians are lactose intolerant. These bacteria ferment the sugar and produce hydrogen and carbon dioxide gases. MALAbSorpTioN Lactose intolerance is one of type of malabsorption syndrome. cereals. Biologists suggest that the persistence of the production of lactase into adulthood by some people may have occurred because of the development of dairy farming thousands of years ago. a B vitamin. 75% of African Americans. People whose ancestors depended on dairy farming tend to continue to be able to consume milk all their lives. which affects abdominal sensory nerves and causes the abdominal cramping. she may experience diarrhea. In addition. Drinking acidophilus milk or taking a pill containing lactase can also help avoid the digestive problems. A short time after drinking the shake. and abdominal cramps. People with lactose intolerance need to be careful not to become deficient in calcium or riboflavin. 50% of Hispanics. The bacteria also produce acid. gas. The severity of the symptoms that Amy experiences depends on how much lactase her body makes. instant potatoes. This accounts for the bloating feeling in the abdomen. salad dressings. and casein.

D. micelles are not formed from cholesterol and long-chain fatty acids. The combination of inadequate amino acid absorption and insufficient iron results in iron deficiency anemia. will decrease. Albumin is an important blood protein in maintaining osmotic pressure between the blood and tissues. a condition called steatorrhea. If the liver does not get enough building blocks for the proteins. dIgestIon and nutrItIon ting nutrients from the digestive tract to the cells of the body. inadequate vitamin D will lead to decreased calcium . such as lactose. or (4) congenital or developmental problems with the part of the circulatory system that transports absorbed water-soluble nutrients to the liver for processing (see Chapter 6). the volume of stool increases. If the pancreas does not produce enough lipase. If lipids are not absorbed properly. As stated in Chapter 6. Some forms of cancer and some parasitic infections can also cause these transport problems. If the albumin levels get too low. Malabsorption syndromes lead to deficiencies in nutrients. nutrients will not be used properly. (2) a problem with the production or delivery of gastric juices into the stomach. deficiencies of vitamin A can result in night blindness. (3) a problem with the production or delivery of enzymes from the pancreas or bile from the gallbladder to the small intestine. and it becomes frothy and very foul smelling. If there is something wrong with this part of the circulatory system. Long-term malabsorption will cause a deficiency in vitamin B12. and these chemicals are not absorbed. the liver makes most of the proteins found in blood. which also causes anemia. As a result. If the gallbladder does not contribute bile to the small intestine. water will leave the blood and pool in body cavities. especially of albumin. their concentrations. E. neither are the fat-soluble vitamins A. or K. triglycerides are not broken down. primarily in proteins and lipids. There are four kinds of malabsorption problems: (1) There can be a problem with the absorption of only one type of nutrient. and they remain in the intestines and are excreted as part of the feces. If fats are not absorbed.

ConneCtions Different conditions can affect the processing and availability of food. supplements of vitamins and trace minerals like calcium. and low levels of vitamin K can lead to bleeding due to a deficiency of blood-clotting factor. anemia. magnesium. The symptoms of malabsorption syndromes are similar and include weight loss.Common Health Problems  absorption and eventually to weakened bones. such as diarrhea and possibly nutritional deficiencies. the body experiences problems. Short. In very young children. . it must be addressed and the malabsorption will be eliminated. diarrhea. are not digested or absorbed. vitamin E deficiency can cause damage to cells from chemicals produced in metabolism. When specific types of nutrients. Therapy for malabsorption conditions depends on the cause of the problem. such as lactose.and mediumlength fatty acids can be absorbed without being made into micelles. If there is an underlying disease or abnormality. malabsorption may lead to a general failure to grow and develop normally. and abdominal distress. Children who suffer from malabsorption may not grow to their full potential height due to inadequate nutrients during growth spurts. If the malabsorption cannot be cured. Substitutions can be made for the triglycerides that cannot be absorbed. and iron are used.

9 Guides to Healthy Eating Although the body needs nutrients from a wide variety of foods. A third method bases obesity on a calculation called the body mass index (BMI). obeSiTy An estimated 60% of Americans are overweight and 25% of them are obese. This method does not take into account an athlete who may weigh more than a nonathlete because of muscle. This index calculates a 0 . the recommendations have changed accordingly. One method states that a person who weighs more than 20% over the ideal weight according to the height/weight chart is obese. If a person’s body fat is more than 25% for a man or 30% for a woman. there have been different recommendations about what people should eat to maintain a healthy diet. For example. that person is considered obese. Another method of measuring obesity is to measure percentage of body fat. it does not need them in all the same amounts. the body requires more carbohydrates than fats. instead of fat. For many years. Obesity can be measured in several ways. As experts have learned more about nutrition and the human body.

As modern conveniences in the home and workplace have spread. Overweight = 25–30. Because of obesity. Obese = > 30 According to the World Health Organization (WHO). sometimes consuming 20. Problems that were once considered limited to developed or industrialized countries now affect everyone. There are many reasons why people may become obese. and hypertension has increased around the world. humans developed methods of conserving fat to survive possible famines. uterine. as follows: BMI = Body Weight in Pounds x 705 (Height in Inches)2 Normal = < 25.guides to Healthy eating 1 ratio of body weight to height and attempts to adjust for body size. Although people . In the past. These people probably eat less than normal and still gain weight. They have an increased risk of breast. An even smaller group of people have a very low metabolic rate because of thyroid problems and cannot metabolize nutrients properly. Many people have desk jobs instead of doing manual labor. Many others have to schedule time to exercise. obesity has become a worldwide problem that has significant effects on health. Obese individuals are also prone to pulmonary disease. Another group of people cannot control their eating. More people watch sports instead of participate in them.000 calories at one meal. The incidence of obesity has increased for a variety of reasons. so has a more sedentary lifestyle. no matter what. varicose veins. and gallbladder disease. the incidence of diseases such as heart disease. instead of it being a natural part of their lives. fat has become a principal component of people’s diets. Over many years. A small number of people are genetically programmed to convert nutrients to fat. type 2 diabetes mellitus. and colon cancers. People ride or drive rather than walk.

however. This method should only be used when the person is morbidly obese. A more radical procedure. and when other methods have been unsuccessful. called a gastric bypass. meaning more than 100 pounds (45 kg) overweight. A more radical method of weight loss involves surgery. Diets high in fat are valued in developing countries and have replaced local diets that have been in place for centuries. Some weight reduction programs have helped people lose weight through behavioral modification. Several surgical interventions exist. this can lead to dehydration. These programs usually last about twelve weeks and must be conducted under medical supervision. Eating a very low-calorie diet can also help people lose weight. makes a small stomach within . which involves psychological counseling and exercise to achieve weight loss. involves stapling part of the stomach to make a smaller pouch and attaching a segment of the small intestine to this pouch (Figure 9. This method limits both the amount taken into the stomach and the amount of nutrients that can be absorbed through the small intestine. Some people resort to diet suppressant drugs. and central nervous system complications. All of the procedures either limit the amount of food that can be taken into the digestive tract or limit the absorption of nutrients once the food gets into the system. but nearly all of these drugs have been found to have harmful side effects and should not be taken for weight loss. The simplest way to prevent being overweight or obese is to eat less and exercise more. called vertical banded gastroplasty. potassium loss. This band can be tightened or loosened as needed to restrict the size of the stomach. they still have metabolisms that conserve fat whenever possible. Diuretics provide short-term weight loss through loss of water.2 dIgestIon and nutrItIon have increased their consumption of it. an adjustable gastric band can be placed around the stomach. The weight is immediately regained when the person is rehydrated. A third surgical method.1). In one procedure.

the U. and thus the glucose cannot be used to produce energy. and gradual improvement. In 2006. Type 1 diabetes.2b). Most people with type 2 . but is oriented as a triangular pie chart that is color coded for classifications of food. This program provides consumers with help in establishing their own caloric needs and choices for healthy eating. Type 2 diabetes. the result is that too much glucose remains in the bloodstream. The result is similar to the earlier food pyramid that was proposed in 1992. moderation. which restricts the amount that can be eaten. fooD pyrAMiDS AND DiAbeTeS By the late 1980s. The program also emphasizes personal activity. eating proportionately. In 1992. Sample diets tailored to an individual can be developed through an interactive component. Department of Agriculture (USDA) published revised recommendations entitled “MyPyramid” (Figure 9. vegetables. and meats and beans. In both cases. If too much is ingested. fruits. such as grains. There are two major types of diabetes: type 1 and type 2. is a disease in which the body does not produce any insulin. the person vomits it back out. milk.S. Individuals with this condition must take insulin injections. variety in the diet. which accounts for 90% of people with the condition. is a disease in which either the amount of insulin produced is inadequate or the insulin receptors on the cells do not work properly. which accounts for 10% of people with the condition. These last two methods do not affect future eating. Diabetes is a condition in which glucose does not pass normally from the blood into certain body tissues. the federal government released nutritional recommendations in the form of the Food Guide Pyramid (Figure 9. Actual removal of fat is achieved through liposuction and plastic surgery. the increased amount of fat in Americans’ diets was causing an increase in heart attacks and strokes.guides to Healthy eating 3 the stomach. oils. but remove existing fat.2a).

4 dIgestIon and nutrItIon figure 9. diabetes are overweight. it has worked for some people. The increased body weight and sedentary lifestyles of many individuals are believed to be significant contributors to the development of type 2 diabetes. although drastic. . It is only recommended for individuals who are more than 100 pounds overweight.1 gastric bypass surgery is a radical way to fight obesity by making the stomach smaller.

and all carbohydrates are good. fish. oils. eggs. the vegetable group. the recommended numbers of servings are listed with each group. and pasta group. cereal. and thus the Harvard researchers developed still another food pyramid (Figure 9. some fats may actually improve health. and fats. while many carbohydrates create conditions that ultimately harm the body.2c). and nuts group. The original pyramid recommendations were based on the assumption that all fats and carbohydrates are equal: All fats are bad. research at the Harvard School of Public Health has revealed that the government recommendations were based on some faulty assumptions. rice. The Harvard alternative pyramid is called the Healthy Eating Pyramid. Since the Food Guide Pyramid was first recommended. the fruit group.guides to Healthy eating 5 figure 9. these groups include the bread. and the meat. poultry. and sweets are to be used sparingly. the dairy group. This guide takes into account the differences . In reality.2a the original food pyramid created by the united states government urges americans to eat from each of the five basic food groups each day. dry beans.

among types of fats and carbohydrates. Instead of four tiers. there are seven (daily exercise has been added). the pyramid focuses on the number of times a day the food should be eaten. The new pyramid focuses on individual foods and is designed for lifelong health. not short-term weight loss. dIgestIon and nutrItIon figure 9.2b “MyPyramid” provides consumers with some general guidelines for healthy eating. Instead of food being measured in terms of servings. .

Saturated and trans fats contribute to the development of arteriosclerosis. fruits. or hardening of the arteries. tend to be healthier than beef fats.guides to Healthy eating  figure 9.2c a food pyramid designed by researchers at Harvard university suggests that americans need to eat more whole grains. and vegetables and less red meat and refined grains. Fats or oils derived from plants tend to have unsaturated fatty acids that are healthier than animal-derived fats that are high in saturated fatty acids. which ultimately results in heart attacks and strokes. Fish oils. however. Unsatu- .

The recommendations were an effort to decrease fat intake. which was good. other companies have produced a modified unsaturated fat called a partially hydrogenated fat in which extra hydrogen atoms have been added to unsaturated fatty acids. The more sugar a person eats. which are higher in saturated fats than other plant oils. converting them to a saturated form. mostly as triglycerides (see Chapter 2). so food manufacturers prefer to use saturated fats in their products. the sugar is stored. Many consumers are aware of the differences between the two types of fatty acids and prefer to buy products that they feel are healthier. the fatter the DID YOU KNOW? Food prepared with unsaturated fats spoils faster than food prepared with saturated fats. Insulin facilitates the transfer of sugar (glucose) from the carbohydrates into the liver. Once inside these three types of tissues. but retaining the original chemical name indicating an unsaturated product. margarine. thus. these altered fats can be found in some brands of shortening. but they also decreased the intake of helpful fats. and body fat. the sugar is metabolized or stored. When complex carbohydrates are broken down and absorbed from the digestive tract. their presence in the blood stimulates the release of insulin from the pancreas. dIgestIon and nutrItIon rated fats do not contribute to clogging our arteries. The original pyramid grouped all animal foods with nuts and dry beans and made no mention of plant oils. With the exception of oils from the palm plant or from coconuts. a principal component of body fat. muscle. If the body has more sugar than is needed for energy. which was harmful. Carbohydrates create an interesting problem. . some food manufacturers no longer prepare their products with saturated fats. and other products that were once derived from animal products. unsaturated fats are healthier for the body.

or dry beans. In addition. the person’s blood glucose concentration increases quickly with a corresponding high insulin level. Daily. rice. three servings of vegetables. the body can no longer eliminate glucose from the blood adequately. Different types of carbohydrates are broken down and absorbed at different rates from the digestive tract. resulting in the development of diabetes. eggs. more than 300 foods have been evaluated and put on a scale called the glycemic index . about five servings of meat. Thus. gLyCeMiC iNDex To determine which carbohydrates release glucose quickly and which ones release it slowly. the rapid increase in the concentration of glucose in the blood may contribute to the development of diabetes. nuts. Whole grains break down slowly. or pasta. the liver. poultry. and three servings of milk. The higher the food is on the scale. cereal. As stated above. muscle. The more glucose the body has in the blood. The current theory on the development of type 2 diabetes states that if these spikes of glucose and insulin occur frequently. The average American diet is now fairly close to the federal government recommendations. cheese. yogurt. fish. a person eats about seven servings of bread. flooding the blood with glucose. the higher the levels of insulin released to handle the sugar. and fat tissues may lose sensitivity to insulin. it also causes more of the glucose to be converted to fats for storage. If a person eats a meal that gets glucose into the blood rapidly.guides to Healthy eating  person gets. Fats and sweets have risen to the top tier. and fruit. but with a heavier emphasis on animal products than is recommended. while refined grains break down quickly. the more quickly its glucose enters the bloodstream and the higher the spike of insu- . This fat storage contributes to obesity if the energy is not used in exercise. The original pyramid did not differentiate between these types of carbohydrates.

1 glyCemIC Index examples fooD Rice (instant) Corn flakes Cheerios Bagel Saltines Macaroni and cheese Raisins Rye bread Banana Danish pastry Oatmeal cookies Orange juice Pita bread Pound cake Oatmeal cereal Ice cream Rice (parboiled) Macaroni Baked beans Grapes Spaghetti Apple Yogurt Milk Chickpeas gLyCeMiC iNDex 91 83 74 72 72 64 64 64 62 59 55 55 54 54 53 50 47 46 43 43 40 38 38 34 33 . The lower the food is on index.0 dIgestIon and nutrItIon lin that results. the more slowly it raises the blood sugar level and the more gradual the increase of insulin. The glycemic index was Table 9. Such insulin spikes increase the probability of developing diabetes and obesity.

In March 2003.2c). she would have consumed a total of 610 calories. . cream. and 760 mg of sodium. cellulose gum. salt. ketchup. and vitamin A palmitate. nonfat milk solids. The chocolate syrup in the shake was made from high fructose corn syrup.190 calories for lunch with 33. and sodium acid pyrophosphate. guar gum. The fries were made of potatoes. natural beef flavor.6% of the fat as saturated fats. 182 grams of carbohydrates. the carbohydrates to 64 g. sucrose. water. and the sodium to 680 mg. 29 g of protein. “regular” corn syrup. dextrose. mustard. 80 g of carbohydrates. fAST-fooD DiLeMMAS Amy’s lunch at the fast-food restaurant of burger. natural and artificial flavors. Glucose is rated at 100. potassium sorbate. Change the medium fries to a small size and the total calories drop to 480. Amy consumed 1. carrageenan. The number of calories and the amount of fats and carbohydrates in this meal may be acceptable occasionally. partially hydrogenated soybean oil.2). It is no longer confined to the developed countries. 25 mg of cholesterol. The chocolate shake contained whole milk. imitation vanilla flavor. The index is useful to anyone wishing to choose among the options of the Healthy Eating Pyramid (Fig 9. pickles. mono. She had 75 milligrams of cholesterol.guides to Healthy eating 1 originally created to help patients with diabetes control their blood sugars. and chocolate shake filled her up. but with what? Amy’s hamburger was made of a 100% beef patty along with the bun. they can cause long-term harm. salt. and vanillin.and diglycerides. onions. fries. If she had substituted a small-size diet soda for the shake. In all. the WHO and the United Nations Food and Agriculture Organization (FAO) released a report stating that the ingestion of large amounts of sugars has become a worldwide problem. processed cocoa. and 990 mg of sodium in the meal (Table 9. but eaten regularly. and pepper. corn syrup solids. but has spread to the developing countries.

stroke. lower the amount of sodium (salt) in their diet. and diabetes that were once considered limited to industrial countries have become worldwide epidemics. The organizations suggested that people reduce the intake of energy-rich foods that are high in saturated fat and sugar.2 dIgestIon and nutrItIon largely due to increased urbanization and modernization of traditional diets. and they fre- Table 9. Diseases such as heart disease. Some recommend eating all protein. Fat Sodium Protein Cholesterol Carbohydrates 250 9g 0.5 g 12 g 25 mg 35 g of fasT foods ChoC. usually without medical supervision. Calories Total Fat Trans Fat Sat. ShAKe 580 14 g 1g 8g 13 g 50 mg 102 g MeD. they recommend eating an extremely low number of calories.5 g 4g 0 mg 45 g SMALL frieS 230 11 g 0g 1. increase the fruits and vegetables. The report recommended that people change their daily eating habits and increase their levels of exercise. They promise dramatic weight loss over a short period of time. No matter what the fad diet. fAD DieTS Currently.5 g 3g 0 mg 29 g DieT SoDA 0 0g 0g 0g 20 mg 0g 0 mg 0g 520 mg 220 mg 140 mg 250 mg . while others recommend special drinks or pills. there are many fad diets being advertised. unsound weight loss programs tend to have some similar characteristics.5 g 3. frieS 360 18 g 0g 2. and exercise regularly. Their recommendations are close to the Healthy Eating Pyramid discussed earlier.2 nuTrITIonal faCTs hAMb.

Several diets suggest a diet high in proteins and fats and low in carbohydrates. individuals should consult their physicians about their ideal body weight and the best way to achieve that weight. but the weight will return immediately when normal hydration is restored. usually provided by the program for a fee. These diets will result in immediate weight loss. These diets also cause the body to increase its production of ketones that will cause the body’s pH to become more acidic and cause significant problems in diabetic individuals. According to the National Association of Anorexia and Associated Disorders (ANAD). Some of these diets suggest food combinations that they claim will either accelerate weight loss. stomach. It is estimated that as many as 7 million women and 1 million men have the condition. In addition. the body can handle the resulting low ketone levels. Any decrease in caloric intake will result in the body losing water during the first several days. This can account for the loss of several pounds. Before going on any diet. Each type of food is handled separately in the mouth. If fats are used slowly. It affects minorities and people of all socioeconomic levels. 86% of people with anorexia . Ketones are produced whenever fats are burned. ANorexiA NervoSA Anorexia nervosa is a disease approaching epidemic propor- tions in the United States. but mostly from water loss.guides to Healthy eating 3 quently try to make adherents to the diet depend on certain foods. People who use these diets to lose weight almost always gain the weight back because the changes the diets suggest are short-term changes that do not affect the person’s life on a long-term basis. Both of these concepts are false. or cancel each other out in the intestine. and intestine. many of these diets do not include any exercise regimens.

a cup of fresh fruit equals the size of a baseball. and result in lower calories and fats. but they are not healthy. there are choices. use the following criteria: • • • • • • • 3 ounces of meat. If the main course is large. do not force yourself to eat it all. one medium potato is equal to the size of a computer mouse. fish. is another option. but it is high on the glycemic index. ordering and eating smaller portions is one way of eating healthy. Consider ordering two appetizers instead of a large main course. ask about how food is cooked and whether or not the sauce is made from cream. however. for fries or heavy side dishes. one cup of vegetables is the size of a fist. to determine portion sizes. and then use exactly the amount wanted.4 dIgestIon and nutrItIon EATING HEALTHY IN RESTAURANTS although it may be easy to read labels for food cooked at home. or poultry is about the size of a deck of cards. such as fruit or vegetables. and low in other needed nutrients. . the bread may taste good. share one or a small number of desserts with the whole table. If possible. substituting lower-calorie foods. ask for sauces on the side. for making meals healthier when eating out. Instead of ordering a big dessert. a teaspoon of butter is equal to the tip of the thumb. an ounce of cheese equals 4 dice. these also taste great. For example. Cream sauces taste good. avoid eating bread before a meal. Bring half of it home for a later meal. but some of the oil used in cooking is always retained in the food and adds a lot of calories and grams of fat to the meal. this both halves the cost of the meal and halves the calorie and fat intake. Half a cup of rice is half a tennis ball. avoid fried foods. low in fiber. it is more difficult to learn about the nutritional content of food when eating in a restaurant. this alternative will be cheaper.

guides to Healthy eating 5 report that the condition began before they reached age 20. if female. and. Some of the warning signs of the syndrome include: selfinduced starvation in the face of significant weight loss and fear of gaining any weight. especially the way his or her body looks. and display moody behavior. About 6% of anorexic patients die. Eventually. People who suffer from anorexia nervosa will be malnourished. the person is always hungry. have an intense fear of weight gain (even when underweight). Two-thirds of sufferers say that it lasts up to 10 years. but appear to just pick at the food. which will affect most of their body functions.000 per case. hair loss or excessive body hair. and 10% report onset before 10 years of age. To that person. a person must be below 85% of his or her ideal weight. patients will exhibit early aging. in fact. The person who has anorexia may be described as a perfectionist. including their ability to grow. frequently obsessed with food. Outpatient treatment may exceed $100. have a distorted view of his or her body weight or shape. absent or irregular menstruation. have missed three successive menstrual periods. If they survive and the condition continues. and. That person may prepare fancy meals for others. Everything must be perfect for that person. and fight infections. They may have trouble sleeping. In the face of real starvation. sensitivity to cold (loss of body fat decreases insulation in the body). To be diagnosed with anorexia. heal cuts or bruises. be chronically fatigued. compulsive exercise (the person may actually be a successful athlete). but fights the impulse to eat. he or she will view the body as overweight when it is obviously not. mostly from heart problems caused by low potassium levels. Experts describe anorexic patients as having low self-esteem and as being depressed. they will lose bone mass to the extent that they will have osteoporosis. . the body can never be too thin.

and healthy. the Food and drug administration (Fda) has also defined several health claims that can be used to describe food. Food described as being “a good source of calcium” must have at least 100 mg of calcium per serving. the federal government has set strict definitions for 12 terms that are used frequently on food labels. carbohydrates. good source. light. reduced. or a 50% reduction in sodium. less. extra lean. reading the nutritional information on food labels is an important way to learn how many calories the food contains and the distribution of fats. “Light” may mean one-third fewer calories or half the fat of a reference food. “sugar free” foods cannot have more than 0. high. Food with “more iron” means that it has at least 10% more than the minimum daily requirement. dIgestIon and nutrItIon INFORMED CHOICES ABOUT EATING the first and most important aspect in eating a healthy diet is learning about food. lean. “Low fat food” means it contains 3 g or less per serving. as follows: • • • • • “High protein” must have at least 10 g of protein per serving. low. and other substances. “reduced calorie” or “fewer calorie” foods must have at least 25% fewer calories per serving than a reference food. including free. more.5 grams of sugar per serving. fewer. • • .

guides to Healthy eating  ConneCtions Healthy eating requires eating certain foods in the correct proportions that the body needs. Dietary guides. heart attack. provide information on how to eat healthy. and stroke in the United States can be attributed to the higher incidence of obesity and unhealthy eating among Americans. The incidence of type 2 diabetes. such as the Food Pyramid and the Healthy Eating Pyramid. .

035 ounces (oz) 1 pound (lbs) 1 ounce (oz) 0.94 L 0.06 quarts 1 gallon (gal) 1 quart (qt) 1 pint (pt) Milliliter Microliter mL or cc µL 1 mL 0.35 g (1/1.2 pounds (lbs) 0.62 mile (mi) 3.Appendix: Conversion Chart UNIT (METRIC) LENGTH Kilometer Meter km m METRIC 1 km 1m 1 cm TO ENGLISH ENGLISH TO METRIC 1.609 km 0.039 inches (in) (one-millionth of a meter) Micrometer µm WEIGHT (MASS) Kilogram Gram Milligram Microgram kg g mg µg 1 kg 1g 2.47 L 29.034 fluid ounce (fl oz) 1 fluid ounce (fl oz) 3.000 gram) (one-millionth of a gram) VOLUME Liter L 1L 1.4 mm 0.394 inches (in) 1 mile (mi) 1 foot (ft) 1 inch (in) 1 inch (in) Centimeter cm Millimeter mm 1 mm 0.305 m 2.57 mL (one-millionth of a liter) TEMPERATURE °C = 5/9 (°F – 32) °F = 9/5 °C + 32 98 .54 cm 25.785 L 0.454 kg 28.28 feet (ft) 0.

Absorption The process by which nutrients pass through the walls of the digestive tract and into the blood. drugs. and assorted chemicals.Glossary Abdominal cavity Anatomical cavity below the diaphragm. Amylopectin Highly branched form of starch. Adrenal cortex Outer portion of the adrenal gland that produces assorted steroid hormones. Acidophilus milk Milk product containing lactase. Adventitia Connective tissue covering of the digestive tube. Adenosine diphosphate (ADp) Precursor molecule to adenosine Adenosine triphosphate (ATp) Molecule that provides energy used by cells to perform metabolic processes. produced in the salivary glands and the pancreas. also known as serosa. excess levels of acetyl groups lead to ketone production. Anabolism Synthesis of complex biochemicals in the body from simpler ones. Aerobic cellular respiration The pathways of cellular respiration that Albumin Primary blood protein that functions to control osmotic pressure between blood and tissues and as a carrier of ions. Adipose tissue Fat. reabsorption of sodium in the kidneys. triphosphate. require oxygen. functions as energy storage and insulation to retain body heat. Amylose Unbranched form of starch.  . the digestive enzyme needed to break apart the sugar lactose found in milk. Aldosterone Adrenal cortical hormone primarily responsible for the Amylases Enzymes responsible for the breakdown of starch. Acetyl group A two-carbon molecule made from pyruvic acid or the breakdown of fatty acids. mostly triglycerides.

Anorexia nervosa Syndrome resulting in severe weight loss. and secreted into the small intestine. secreted bolus Rounded mass of food and saliva that is swallowed. Calorie The unit of energy needed to raise the temperature of one gram of water by one degree Celsius. . brunner’s glands Glands found in the submucosa of the duodenum. Anemia Inability of the blood to deliver an adequate amount of oxygen to body tissues. found in bile. sites of exchange of materials between the vessels and surrounding tissues. Anal canal Short section of the large intestine that ends at the anus. it increases the water solubility of digestive fats to facilitate absorption. Atherosclerosis Development of fatty plaque deposits in the blood vessels.100 dIgestIon and nutrItIon Anaerobic cellular respiration The pathways of cellular respiration that do not require oxygen. basic metabolic rate (bMr) Rate at which the body expends energy bile Substance produced by the liver. Calculus Another name for tartar. it may clog the vessel. over a specific period of time. restricting blood flow through the vessel. bile salts Salts derived from cholesterol. Capillaries Smallest vessels of the circulatory and lymphatic sys- tems. buccinator Skeletal muscle used in chewing. in bile. Appendix Structure attached to the cecum of the large intestine. The plaque collects in the lumen of the vessel. If a portion of the plaque breaks off and moves through the vessel. the solubility of digestive fats. stored in the gallbladder. Appendicitis Inflammation of the appendix. primarily arteries. Antibodies Proteins produced by lymphocytes (white blood cells) that attack microorganisms and other foreign cells. they increase bilirubin Breakdown product of the heme in hemoglobin. damaging the surrounding tissue. a state of starvation with associated tissue degeneration and damage.

excess cholesterol is related to increased risk of heart disease. found in the lining of the stomach. Carboxypeptidase One of several pancreatic enzymes that break down proteins. Chymotrypsin One of the pancreatic enzymes that break down proteins. Colorectal cancer Cancer of the colon or rectum. Collagen Protein substance that gives strength to tissues. Columnar epithelial cell Type of cell found lining the respiratory and Connective tissue Type of primary tissue containing cells. Catabolism Breakdown of complex biochemicals in the body. . Cellular respiration The process by which nutrients. Cementum Chemical that holds teeth in place. a precursor of pepsin that assists in protein breakdown. Cellulose Polysaccharide that is not digestible. Cholesterol Lipid used to make steroidal hormones and found in cell membranes. digestive tracts. Chief cell A cell that makes pepsinogen. the digestive tract to body tissues. fiber in the diet. Chylomicrons Combinations of proteins and lipids that travel from Chyme Material that leaves the stomach and enters the intestines.glossary Carbohydrate General term for sugar or starch or similar 101 compound. are broken down to obtain energy for metabolism. they are ultimately removed from the blood by the liver. Cholecystokinin (CCK) Hormone made in the duodenum that stimu- lates gallbladder contractions and pancreatic secretions. mainly glucose. Colostomy Removal of part of the colon and attachment of the end of the large intestine to a hole made in the abdominal wall. Colon Longest part of the large intestine. fibers. where it increases flexibility. Cecum Pouch of tissue at the juncture of the small and large intestines. and an intracellular matrix.

lactose.102 dIgestIon and nutrItIon Covalent bond Strong chemical bond based on the sharing of elec- trons around atoms in the bond. the part that is visible above the Defecation Process of elimination of feces. and bicarbonate. Crown The upper part of a tooth. enamel Hard material that coats the outside of teeth. including sodium. DNA (Deoxyribonucleic acid) Nucleic acid that contains the heredity information. chloride. that help regulate the body’s metabolic processes. electrolytes Substances. and maltose. rial metabolism.. sucrose. Duodenum First section of the small intestine.g. Dehydration Loss of water from the body resulting in increasing density of cell cytoplasm and compromised cellular functions. energy is needed to make or break this type of bond. type 1 involves deficiencies in insulin production. frequently from bacteDermatitis Inflammation of the skin. Digestion The physical and chemical breakdown of food into nutri- ents that can be absorbed by the cells of the body. a common sugar. e. electron transport chain Series of oxidation and reduction reactions that result in the production of ATP. Disaccharide Sugar made up of two monosaccharide molecules joined together. using the energy contained in electrons. gums. type 2 involves a decrease in the sensitivity of the cells to insulin. elastase A pancreatic enzyme that helps break down proteins. Diuretics Chemicals that cause increased urination. Dextrose Synonym for glucose. Diaphragm Skeletal muscle that divides the thorax from the abdo- men. enzymes Proteins that increase the rate of chemical reactions. . contraction of the diaphragm causes the lungs to fill with air. potassium. Diabetes mellitus Disease involving the clearance and proper metabolism of glucose. Dental plaque Buildup of material on teeth.

stimulates the production of other stomach digestive juices. produces secondary sex charac- teristics in females. such as hydrochloric acid and pepsinogen. does not require oxygen. glycemic index Calculation giving an estimate of the amount that a food will increase blood glucose levels. fat Any organic chemical with no surface charges. glucagon Hormone produced by the pancreas that increases blood gluconeogenesis Making glucose from other biochemicals. glycerol Three-carbon compound. and less of those that appear on the top. may be saturated or unsaturated. also referred to as lipids.glossary epiglottis Part of the larynx. covers the opening to the trachea dur- 103 ing swallowing. glucose levels. fundus The part of the stomach below the connection to the gallbladder Organ that stores bile. estrogen Reproductive hormone. opposes the actions of insulin. may be in single or multiple layers. . essential fatty acids Fatty acids that must be included in the diet because humans cannot make them. fad diets Diets promising significant weight loss. usually from amino acids. fatty acid Chain of carbon atoms with hydrogen atoms attached. resembles starch from plants. esophagus and above the body. glycogen Energy-compound storage found in animals. epithelium Tissue that covers or lines body organs or structures. fats are insoluble in water. part of triglycerides. essential amino acids Eight amino acids that must be included in the diet because the body cannot synthesize them. usually concen- trating on one nutrient. food pyramid Method of organizing the diet to emphasize greater intake of certain materials that appear at the bottom. part of triglycerides. gastrin Hormone secreted by the stomach lining. glycolysis Reaction pathway beginning the breakdown of glucose.

into the esophagus.104 dIgestIon and nutrItIon goblet cells Mucus-producing cells found in the respiratory and digestive systems. needed for the absorption of vitamin B12. growth hormone Pituitary hormone that regulates body growth up to puberty and contributes to carbohydrate metabolism throughout life. including hydrochlo- ric acid. insulin Hormone that decreases the level of blood glucose and increases the storage of energy for the body. scavenges cholesterol from tissues and returns it to the liver for elimination in bile. hydrogen ion Hydrogen atom that is missing an electron and has a positive charge. hemoglobin Chemical that carries oxygen in red blood cells. heartburn Regurgitation of stomach contents. hormones Chemicals released from glands in the body that control tissue and organ functions. causing damage to the lining of the throat. intrinsic factor Substance produced by the parietal cells of the stom- ach lining. hydrogen bond Chemical bond based on the unequal sharing of electrons. . hemorrhoids Swelling of blood vessels around the anus. high-density lipoprotein (hDL) Combination of proteins and choles- terol frequently called “good cholesterol”. Keratin Protein that fills the skin cells and helps make the skin waterproof. resulting in weak positive and negative charges on the surface of a compound. usually from the attack of a microorganism. negative ions. ingestion The process of taking food into the body. inflammation Normal body reaction to cell damage. ionic bond Chemical bond formed by the attraction of positive and Jejunum Middle portion of the small intestine. heart attack Blockage of a coronary artery resulting in damage to heart tissue and the compromise of cardiac function. ileum Last portion of the small intestine.

needed to break down lactose. and detoxifies drugs and poisons. Lymph nodules Concentrations of lymphocytes found in tissues.glossary Ketones Acidic chemicals produced when excess acetyl groups. and acetone. Krebs cycle One of the pathways in aerobic respiration. Lamina propria Layer of the mucosa. Loose connective tissue Form of connective tissue found around blood vessels. processes carbohydrates. is not produced in adequate amounts. leads to . Increased levels of LDLs are associated with increased risk of heart attack and stroke. The Krebs cycle accepts acetyl groups and cycles them through a series of reactions. results in intestinal cramping and diarrhea. nutritional deficiencies. Highenergy electrons are stripped of intermediate chemicals for ATP production in the electron transport chain. are present. breaking the acetyl group to CO2 and water. makes blood proteins and clotting factors. they help screen for foreign material to protect the body from microorganisms. the body’s “chemical factory”. Lactose intolerance Condition in which the enzyme lactase. Malabsorption Inability to absorb nutrients adequately. Liver Major organ of the abdomen. and triglycerides. they drain excess fluid from tissues and receive fat-soluble material from digestive tube epithelia. Lymphatic capillaries Blind-ended.” made of proteins. Low-density lipoprotein (LDL) “Bad cholesterol. helps break down dietary triglycerides. the inner portion of the wall of the digestive tube. produces antibodies. smallest vessels of the lymphatic Lymphocyte Type of white blood cell that is involved in the immune response. Lingual lipase Form of lipase made in the salivary glands of the mouth. beta-hydroxybutyric acid. it transports triglycerides to tissues and organs. Lipids Another term for fats. Laryngopharynx Part of the larynx extending from the back of the mouth to the larynx. cholesterol. 105 such as acetoacedic acid. system.

sodium. galactose are monosaccharides. made of smooth muscle. mag- nesium. Metabolism Sum of the anabolic and catabolic biochemical path- ways in the body. fructose.10 dIgestIon and nutrItIon Masseter muscle Muscle found in the cheek and used in chewing. Microvilli Projections of the membranes of digestive epithelia that increase surface area in the small intestine.g. . and iron. potassium. Minerals Metallic elements needed by the body. Monosaccharide Simple sugar molecule. obese Grossly overweight. e. orbicularis oris Skeletal muscle that makes up the lips. Muscularis Third layer of the wall of the digestive tube. mucosa. Muscularis mucosa Thin layer of smooth muscle. and a sugar.. expressed as nitrogen content. access genetic information. part of the Nasopharynx Portion of the pharynx found at the back of the nasal passage. and Mucosa Innermost layer of the wall of the digestive tube. osteoporosis Abnormal process resulting in a decrease of bone density. calcium. phosphate. Nitrogen balance Determination of an adequate amount of amino acids to support body growth and development. oropharynx Portion of the pharynx found at the back of the mouth. contains a nitrog- enous base. Micelles Mixture of lipids and bile salts that are absorbed from the small intestine into the epithelial cells. osmotic pressure Balance of dissolved material on both sides of a membrane that controls the passage of water between cells and their surrounding tissues. Nucleic acid Form of a biochemical that the body uses to store and Nucleotide Basic building block of nucleic acids. limits may be set by different criteria. glucose.

A pH of 1 to 6. pancreas Organ that produces hormones related to glucose metabo- lism (insulin and glucagon) and digestive chemicals. papillae Structures on the top surface of the tongue. some of which contain taste buds. which is the membrane that covers the organs in the abdominal cavity. begins the diges- tion of proteins. has phospholipids Mixture of phosphates and fatty acids that make up phytosterol Type of plant lipid analogous to cholesterol. parietal cells Cells found in the stomach epithelia that produce hydrochloric acid and intrinsic factor. peritonitis Inflammation of the peritoneum.1 to 14 is alkaline.glossary oxidative phosphorylation Process used by the electron transport 10 system to generate ATP from the energy in electrons derived from the Krebs cycle. and laryngopharynx. peptide Short chain of amino acids. . most of cell membranes. peyer’s patches Lymphoid tissue. three parts: naso-. periodontal ligament Ligament that connects a tooth to the jaw. pharynx The passage between the mouth and the esophagus. 7. pepsinogen Precursor to pepsin. peristalsis Waves of contractions of smooth muscles that move material through the digestive tube. similar to saturated fats. serve as an anatomical marking for the ileum. resulting in vitamin B12 deficiency. and 7 is neutral. ph Scale from 1 to 14 measuring the degree of acidity or alkalinity. pancreatic lipase Pancreatic enzyme that breaks down triglycerides. added. cannot be absorbed by animals. made in the stomach by chief cells. oro-. partially hydrogenated fat Fatty acids that have had hydrogens pepsin Digestive enzyme made from pepsinogen.9 is acidic. pernicious anemia Deficiency of intrinsic factor.

it closes off Squamous epithelial cell Flat cell. . rectum End portion of the intestines. Serosa Connective tissue covering of the digestive tube. especially with dairy products. which is then broken down by the Krebs cycle. part food residue. Salmonella Infectious bacteria.10 dIgestIon and nutrItIon plaque Buildup of material on teeth. polysaccharide Multiple monosaccharides linked together. such as starch. Secretin Hormone made in the duodenum. frequent cause of food poison- ing. pulp Part of the tooth located at the center of the crown. makes up a significant part of the digestive tube wall. access to a portion of the digestive tube. pyruvic acid End product of glycolysis. proteins Complex molecules made of linked amino acids. Smooth muscle Type of muscle not under voluntary control. rugae Folds of the lining of the stomach that allow for expansion. stimulates gastric secre- tion and motility and pancreatic secretions. frequent cause of food poisoning. as adventitia. stratified. blood vessels. Saturated fat Form of fatty acids that contain the maximum num- ber of hydrogen atoms. Starch Polysaccharide made by plants for energy storage. it is converted into lactic acid or to an acetyl group. and cellulose. also known Shigella Infectious bacteria. glycogen. frequent cause of food poisoning. Small intestine Site where digestion is completed and nutrients are absorbed into the blood and lymph. part bacteria. composed of many glucose units linked together. when constricted. adjacent to the anus. Sphincter Circular smooth muscle. may be in a single layer or Staphylococcus Infectious bacteria. and connective tissue. contains nerves. Salivary glands Paired glands around the mouth that produce mucoid or watery saliva.

concentrations. Trace metals Minerals that are required by the body in low Trans fats Unsaturated fats that have been partially hydrogenated and made into stiff. enzymes needed for final digestive steps are found on the villi. saturated-like fats. blood vessels. controls rate of metabolism. Teniae coli Bands of smooth muscle in the large intestine. Tonsils Lymphoid tissue found on the back of the tongue and at the back of the mouth. brown. they facilitate enzyme functions. Thyroid gland Gland found in the neck. Testosterone Male hormone that stimulates sperm production and is responsible for secondary male sexual characteristics. Trypsin Digestive enzyme. vitamins Chemicals that must be ingested in low concentrations. long-term energy storage compound in animals. Stroke Rupture of a blood vessel causing bleeding in the cranium and pressure on the brain. under the mucosa.glossary Steatorrhea Increased fat in feces. or yellow-brown deposits on teeth. activates other pancreatic enzymes and Unsaturated fat Fatty acid without the maximum number of villi One-millimeter structures found in the small intestine that increase the surface area for absorption. may be a result of gallbladder 10 problems. works on proteins. also known as calculus. Stretch receptors Specialized neurons that monitor the stretch of the digestive tube. Steroids A type of lipid containing hydrocarbon rings. Triglyceride Type of lipid consisting of glycerol and three fatty acids. . hydrogens. over from a particular chemical reaction. and nerves. Submucosa Second layer of the digestive tube wall. Substrate phosphorylation Synthesis of ATP using the energy left Tartar White. contains connective tissue.

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Human Biology. New York: John Wiley & Sons. 1993. The Glycemic Index—Sample.htm. ed. Saunders Co. 2003): 44–72. McDonald’s Nutrition Facts. New York: Benjamin Cummings. Whitney. M. Available online at http://www.Bibliography Burtis. and E. Available online at http://www. 2008. 2008... Tortora.. National Association of Anorexia and Associated Disorders. Grabowski. Understanding Nutrition.. 6th ed. and S.R. and S. Rev.J.R. New York: Benjamin Cummings. Eating Disorders. Human Anatomy & Physiology.R. Revised January. Rolfes.N.D..who. Tietz Textbook of Clinical Chemistry. org. WHO Expert Report on Diet and Chronic Disease..com. “Health for Life. Available online at http://www. E. 2007. G.N. eds. Ashwood. Johnson.B.com/~johnharker/table3. Principles of Anatomy and Physiology. E. Marieb. 2nd ed.” Newsweek (January 20.mcdonalds. btinternet.int/mediacentre/releases/2003/ pr20/en/ 110 . 2007.A. C. New York: West Publishing Co. Inc. 2005.anad. Available online at http://www. Philadelphia: W.

M. Hamm. Dijkstra. N. Society and the Supermarket: The Opportunities and Challenges of Nutrigenomics. Champaign.: Morgan James Publishing.L. Enriched Wheat and High Fructose Corn Syrup. R. Science. Berkeley. J.J. Amino Acids and Proteins for the Athlete: The Anabolic Edge. Di Pasquale. Hoboken. Baltimore. 2007. Nancy Clark’s Sports Nutrition Guidebook. Cline.J. Irven. J.: CRC Press. 2008.J. Singer.S. 2007. Fats Are Good for You: How Saturated Fat and Cholesterol Actually Benefit the Body. 111 . A.: CRC Press.. Driskell. N. Daar. Chow. ed. Giroux. 2007.: North Atlantic Books. Gastrointestinal System at a Glance. Ritchie. American Dietetic Association Complete Food and Nutrition Guide.A.K. 2006. Fla. Calif. N. A.J. Boca Raton. N. Sports Nutrition: Fats and Proteins. I. C.: Lippincott Williams & Wilkins. Fatty Acids in Foods and Their Health Implications. LLC. Please Don’t Eat the Wallpaper!: The Teenager’s Guide to Avoiding Trans Fats. S. 2006. Trans Fatty Acids.G. and W. Dosil. eds.A. 2007. Hamilton. Boca Raton.J. C. Ill.: John Wiley & Sons. Boca Raton.: Wiley-Blackwell. Tsamis. Hoboken. and American Dietetic Association Staff. Hoboken.J.. N. Fla. 2008.. D. Eating Disorders in Athletes. and P. 2007 Duyff. J. P...Further Resources American Dietetic Association. New Family Cookbook for People with Diabetes. and C.: John Wiley & Sons.: John Wiley & Sons. Clark. 2008.L. Fla. ed. N. Garden City. Md. 2007.: John Wiley & Sons.. Castle.Y.J. Keshav. New York: Simon & Schuster Adult Publishing Group. Applications and Case Studies in Clinical Nutrition. R. 2008. 2008. N. N. Kabara.J.: CRC Press.: Human Kinetics Publishers. Hoboken. Hoboken. 2nd ed.

Warshaw. Everything Lactose Free Cookbook: Easy-to-Prepare. Food Pyramid. 2008. Rohrbough.. Alameda. Ojeda. C. N.. New York: W. Rinzler. and E.. C.J.. C. New York: Simon & Schuster Adult Publishing Group. Mass.. L. R. The Bloodless Revolution: A Cultural History of Vegetarianism from 1600 to Modern Times. Self-Denial. and M. Offices.K. N. A. T. 2008. 2008. 2008. and Recovering from Anorexia. Going Hungry: 20 Writers on Desire. Practical Carbohydrate Counting. Cambridge. McWilliams.W. 2008. Platkin. Calif. Bolderman. M. K. Iowa Dietetic Association ed. N. Weight Loss Surgery with the Adjustable Gastric Band: Everything You Need to Know Before and After Surgery to Lose Weight Successfully. Avon. McCracken. for Special Occasions and More. Graf.. Norton & Co. ed. Upper Saddle River. Body Structures and Functions. J. 2007.A. A. New York: Knopf Publishing Group. .: John Wiley & Sons. Larsen. Restaurants. 2008. H. Fong. Safe Dieting for Teens. Scott.. Simplified Diet Manual.: Adams Media Corp. T. Thompson.J. the Movies. New York: McGrawHill Co..W. 2008.J. Ky. 2008.: Da Capo Press. Florence. Taylor-Butler.: John Wiley & Sons. 2008.: Prentice Hall.M. Gluten-free Nutrition Guide.: Thompson Delmar Learning.: Hunter House. 2008. Sewell. Kitchens.S. Low-Dairy Alternatives for Your Favorite Meals. Taylor. Food Fundamentals. and K. San Francisco: Children’s Press. Hoboken. 2008.W.S. Hoboken. Controlling Cholesterol for Dummies.: American Diabetes Association. and L. Alexandria. Stuart. and L. Mass.112 dIgestIon and nutrItIon Maher. 2008. Diet Detective’s Calorie Bargain Bible: More than 1.000 Calorie Bargains in Supermarkets. Va.

Further resources

113

Weitzner, A. Ayudando a Personas Con Anorexia, Bulimia Y Comer Compulsivo: Guia Practica Para Maestros, Terapeutas Y Medicos. Santa Cruz, Atoyac, Mexico: Editorial Pax Mexico, 2008.

Web SiTeS
American Gastroenterological Association

www.gastro.org
Digestive Disorders Foundation

www.digestivedisorders.org.uk
Foodborne and Diarrheal Diseases—Centers for Disease Control and Prevention

www.cdc.gov/ncidod/dbmd/foodborne/index.htm
Mayo Clinic—Diarrhea

www.mayoclinic.com/health/diarrhea/D500292
Movie of Stomach Functions

www.brainpop.com/search/?keyword=digestion
NAMI: Anorexia Nervosa

www.nami.org/helpline/anorexia.htm
National Digestive Diseases Information Clearinghouse

www.digestive.niddk.nih.gov/index.htm
National Institute of Diabetes and Digestive and Kidney Diseases

www.niddk.nih.gov/index.htm
A Voyage Through the Digestive Tract—Colorado State University

www.vivo.colostate.edu/hbooks/pathphys/digestion

Picture Credits

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114

Index

A

absorption, 11, 32–34, 36, 62–64 acetyl groups, 29–30 adipose tissue, 19 ADP (adenosine diphosphate), 13, 26–27 adrenal cortex, 22 adventitia, 34, 37, 40, 49 aerobic cellular respiration, 27–29 albumin, 78 alcohol, 57 aldosterone, 22 α-linoleic acid, 20 amino acids, 17–19, 26, 34, 40 amylase, 47, 52, 54, 62 amylopectin, 16 amylose, 16 anabolism, defined, 26 anaerobic cellular respiration, 27 anal canal, 68, 72 anemia, 20 anorexia nervosa, 93–95 antibiotics, 58 anus, 70, 71 appendicitis, 68 appendix, 68 arteriosclerosis, 87–88 ascorbic acid. See vitamin C aspirin, 58 atherosclerosis, 72 ATP (adenosine triphosphate), 13, 26–27, 29, 30

bilirubin, 61, 71 bismuth salicylate, 58 blood capillaries, 59 blood clotting, 24, 79 BMI (body mass index), 80–81 bolus, 37, 38, 39, 41 bread, 94 Brunner’s glands, 59 buccinator muscle, 43

C

B

B vitamins, 24–25, 54, 67, 77, 78 bacteria, 45–46, 58, 68, 70–74 basic metabolic rate (BMR), 27 beef, 16, 34 behavioral modification, 82 bicarbonate, 62, 73 bile, 20, 38, 61, 71 bile salts, 61, 64

caffeine, 56–57 calcium, 25, 46, 79, 96 calories, 27 capillaries, 20, 22, 36, 59 carbohydrates, 15–17, 22, 31–33, 76–77, 88–91. See also starches; sugars carbon dioxide, 30 carboxypeptidase, 62 cardiac sphincter, 49, 50, 52 catabolism, defined, 26 cecum, 68 cellular respiration, overview of, 30 cellulose, 17 cementum, 45 chemical bonds, 12–13, 30–31 chewing, overview of, 41–49 chief cells, 54 cholecystokinin (CCK), 61–62 cholera, 73 cholesterol, 17, 19–22, 34, 40, 64–65 chylomicrons, 64–65 chyme, 38, 56 chymotrypsin, 62 collagen, 17 colon, 68, 70 colorectal cancer, 72, 74–75 colostomy, 71 columnar epithelial cells, 34, 36, 38, 54, 70 covalent bonds, 13, 30–31 crowns, 43–44

115

12–13. 61–65 stomach and. 82 gastric pits. 62 electrolytes. 54 gastrin. 34 large intestine and. 34. 92. 37–40 small intestine and. 61 gluconeogenesis. fad. 57. 49. See also specific enzymes epiglottis. 18 glucagon. 82. 74–75. 23 fatty acids absorption of. 49. coli. 68 dextrose. 78 obesity and. 15 fundus. 47 as building blocks. 40. 32–34. 61 F fad diets. 40 hamburger and. 96 malabsorption syndromes and. 50 diarrhea. 26. 74–75 defecation reflex. 39. 11 digestive tract building blocks of. 73 electron transport chain. defined. See also lipids beef and. 61 process of digestion and. 45 descending colon. 40 digestive tract and. 43–44. 34 fad diets and. 37. 17. 74 food pyramids. 54 E. 82 gastric bypass surgery. 27 triglycerides and. 74. 61. 71–72. 34–36 esophagus. 91–92 fats. 40. 15. 17–18 folic acid. 83–89 fructose. 88–89 glutamate. 34. 17. 20 estrogens. 82 DNA. 46 dentin. 49 epithelium. 95 E G G cells. 70. pancreas and. 19 feces. 45 glycemic index. 55–56 globular proteins. 91 diabetes. gallbladder. proteins and. 85 food poisoning. 29. 89–91. 71 oxidative phosphorylation and. 81–82 overview of. 56–57. 62 duodenum. 10. 30–31 enzymes. 29 . 34–40 dimethyl sulfide. 50 essential amino acids.11 dIgestIon and nutrItIon D defecation. 72–74 diet. 25 Food Guide Pyramid. 83–85. 65. 73 elastase. 82 dental hygiene. 83. 92–93 digestion. 71. 62–64 diuretics. 82 diets. 17 enamel. 16. 39. 19–20 vitamins and. 15. 72 dehydration. 93 healthy eating and. 83–84. 57–59. 64 amylase and. 55–56 galactose. 92–93 fast food. 16 glycolysis. 30 empty calories. 78 gastric bands. 40. 94 glycerol. 46 energy. 19. 72 fibrous proteins. 32 liver. 16 glucose. 64 glycogen. See also defecation fiber. 47. 29. 52–57 structure of. 87–88. 18–19 essential fatty acids. 18–19 diet drugs. 22 exercise. 31. 15 gallbladder. 47. 89 diaphragm. 70 disaccharides. 72.

67. 58 nucleases. 57 ingestion. 34–37. 54. 65. 20 lipase. 34. 76–77 lactose intolerance. 61. 43 haustra. 34-37. 70 HDL (high-density lipoprotein). 67–75 laryngopharynx. 22. 70–71 NSAIDs (nonsteroidal anti-inflammatory drugs). 93 Krebs cycle. 17. 22. overview of. 68 ileum. 58 hemoglobin. 25–31 methane. 45–46 11 H hair. 40. 96 lingual lipase. 47–48. 70 mucus. See also fats liver. 47–48. 18 gums. 59 N K keratin. 62 nucleotides. 29–30 L lactase. 61. 73 hydrogen bonds. 15. 36 low-calorie foods. 18 hard palate. 45 mucosa. 78. 78 loose connective tissue. 25 growth hormone. 20–21 light foods. 25. 15–17 . See also lactose intolerance minerals. 91. 78 nitrogen balance. 40 mouth. 50 Helicobacter pylori. 13. 40. 72 hormones. overview of. 47 night blindness. 96 lymph nodules. 52 linoleic acid. 20. 18–19 normal flora. 70 muscularis mucosa. 54 ionic bonds. 47. 57. overview of. 15 masseter muscle. 78 lipids. 12–13 I ileocecal valve. 62–64 nutrients carbohydrates as. 59. 36. 40. 43 ketones. 88–89 intestinal fluid. 31. 38. 38. 37–39 insoluble fiber. 76–77 lamina propria. 49 LDL (low-density lipoprotein). 56. 41–43 MSG (monosodium glutamate).Index goblet cells. 24. 16. 57–59. 17–18. 58. 40 M J jejunum. 19–20. 59 lymphocytes. 20–21 Healthy Eating Pyramid. keratin and. 61 intrinsic factor. 40. 96 malabsorption syndromes. 77–79 maltose. 46 large intestine. 38. 92 heart attacks. 10. 70 micelles. 38. 34. 87–88 heartburn. 36 nails. 55–56 hydrochloric acid. 58. 62. 36. 70 goiter. 38. 47 larynx. 36 lymphatic capillaries. 54–55. 64–65. 78 milk. 25 hemorrhoids. 61 muscularis. 40. 49. 12 iron. 46 metabolism. 72 insulin. 25 monosaccharides. 59. 76 jugular vein. 15. 54. 76–77. 64. 18 nasopharynx. 36. 85–88. 32–34. 62.

62 roots. 20 saliva. See vitamin A RNA. 68 small intestine. 30 phytosterol. 34. 54 Peyer’s patches. 43. 50. 38. 22 overview of. 46 peristalsis. 47–48 phosphates. See linoleic acid orbicularis oris. 73. 20 omega-3 fatty acid. 92–93 healthy eating and. 45 rugae. 27 pulp. 47 osmotic diarrhea. 61. healthy eating and. 15–17. 47. 68 reduced calorie foods. 27–29. 96 respiration. 37. 45. 46–47 partially hydrogenated fat. 70 smooth muscle. 37-38. 94 potassium. 87–88 secretin. 56 peptides. 29 R P palate. 19 phosphorylation. 73 soft palate. 93 pharynx. 19–20. 19. 61–65. 25. 27–28. 34. 13 phospholipids. 40. 62 pancreatic lipase. 50. 17–18 pepsin and. 31 diet and. 61. 27 oxygen. 31 portion size. 32 fats. 38–40 digestive tract and. 94 retinol. 54 S safflower oil. lipids as. 78 osteoporosis. 62 fad diets and. 41–42 oropharynx. 38. 46–47 Salmonella bacteria. 19–20 overview of. 57 pyruvic acid. 58 pernicious anemia. 59 pH. 62 serosa. 72 . 40. 57–59. 49 Shigella. 36-37 sodium. 62–64 periodontal disease. 46 polysaccharides. 80–83 oils. 45 parietal cells. 95 oxidative phosphorylation. 96 lipid solubility and. 87–88 oleic acid. 54–55. 34. 54–55 protons. 20–21 as major nutrients. 73 sigmoid colon. 46–47 salivary glands. 26–27. See α-linoleic acid omega-6 fatty acid. 23–25. 40 chemical bonds and. 41. 43 palmitic acid.11 dIgestIon and nutrItIon digestive process and. determination of. 73 peritonitis. 13–14 proteins as. 54. 73 osmotic pressure. 20–21. 21–22 nutritional status. 20 pancreas. 17–19 reasons for need for. 29–30 O obesity. 74 saturated fats. 12–13 trans fats and. 22 plaque. 62 papillae. 20 rectum. 37. 73 proteins building blocks of. 18–19 digestive process and. 45 pyloric sphincter. 18–19 plaque (dental). 49 solubility. 20 rapeseed oil. 88–89 pepsinogen. 30 restaurants. 56 parotid salivary gland.

68 triglycerides absorption of. 38. 41. 21–22 trypsin. 46 taste buds. 43–45. 78–79 vitamin E. 78 overview of. 22 thyroid. 82 fad diets and. 43 V T tartar. 39–40 diuretics and. 36. 62–63 vitamin A. 79 vitamin K. 46–47 submucosa. 62 11 U ulcers. 24. 91–92. 45–46. 78 vitamin C. 73–74 digestive process and. 52 stearic acid. 52 malabsorption syndromes and. 47 Staphylococcus bacteria. 82–83 villi. 45 teeth. 45–46 trace metals. 21–22 transverse colon. 70 uvula. 59 substrate phosphorylation. 34. 27 trans fats and. 93 hydrogen bonds and. 59. 20 steatorrhea. 31 digestive tract and. 22. 20 lingual lipase and. 88–89 chemical bonds and. 47. 57 . 17. 67. 79 vitamins. 78–79. 71 steroids. 87–88 subclavian vein. 70 testosterone. 19–20. 24–25 vitamin D. 49–51 carbohydrates and. 46–47 submandibular salivary gland. 45–46 stretch receptors. 73. 49 tonsils. 67. 49 squamous epithelial cells. 23–24. 30 substrates. 26 sucrose. 78 stercobilin. 25. 15 sugars. 47 building blocks of. obesity and. See also specific vitamins W water absorption of. 82–83 Streptococcus bacteria. 50 teniae coli. 74 starches.Index speech. 40 vegetable oils. 82–83 swallowing. 59 sublingual salivary gland. 43. 25 trans fats. 40 LDL and. 26–27. 65 diarrhea and. 23–25. 34-36. 67 stomach and. 22 stomach. 45 sphincters. 15–16. 12–13 large intestine and. 13. 20 vertical banded gastroplasty. defined. 40. 56. 87–88 urinary tract infections. 64–65 amylase and. 81 tongue. 96 surgery. 20. 40. 19 oxidative phosphorylation and. 24. 52–57. 56 strokes. 43. 38. 16. 19. 58 unsaturated fats. 46.

His research interests include the toxic effects of heavy metals in alternative medicines. the use of medical laboratory assays to evaluate the nutritional status of athletes. Dr. is an associate professor of medical laboratory sciences at Marist College in Poughkeepsie. MT (ASCP).About the Author Robert Sullivan. Sullivan teaches in both the medical laboratory science and the biology curriculums.D. and international issues in laboratory medicine. 120 .. New York. Ph.

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