Vegetarian Diet - Essential Amino Acids Case File

https://medical-phd.blogspot.com/2021/03/vegetarian-diet-essential-amino-
acids.html

Authors: Eugene C.Toy, MD, William E. Seifert, Jr., PHD, Henry W. Strobel, PHD,
Konrad P. Harms, MD

❖ CASE 41
A 37-year-old female presents to your clinic to discuss her plans for a new vegetarian
diet. The patient heard from a friend about a new vegetarian diet that promised rapid
weight loss. The diet consists of many leafy vegetables with no pork, chicken, beef,
eggs, or milk. She is also planning on working out regularly with the goal of running a
marathon within the year. After listening to the patient, you refer her to a nutritionist
for further assistance and guidance.

◆ What is an essential amino acid, and how many are there?

◆ List the essential amino acids.

ANSWERS TO CASE 41: VEGETARIAN DIET - ESSENTIAL AMINO ACIDS

Summary: A 37-year-old female who is planning to undertake a radical new

vegetarian diet is in your office for counseling.

◆ Essential amino acids: The amino acids that cannot be synthesized by the body.
There are a total of nine essential amino acids.

◆ List of essential amino acids: Histidine, isoleucine, leucine, lysine, methionine,

phenylalanine, threonine, tryptophan, and valine.

CLINICAL CORRELATION
The vegetarian should be careful to ensure a balanced ingestion of proteins, fats,
carbohydrates, and vitamins. Most animal proteins contain all the essential amino
acids; however, vegetable proteins often lack one or more of them. Often, plant amino
acids are of low biologic value and incompletely digested. Vegans often benefit from
nutritional consultation, which would allow the patient to make sure that she ate foods
that complemented each other in providing the essential amino acids.
APPROACH TO ESSENTIAL AMINO ACIDS

Objectives

1. Be aware of the importance of essential amino acids.

2. Know about the synthesis of other amino acids.
3. Be aware of some of the problems with inadequate essential amino acid intake.

Definitions

Essential amino acids: Amino acids that the human body cannot synthesize (or
cannot synthesize in sufficient quantities to meet cellular needs) and must be taken in
the diet. If essential amino acids are deficient, the result is a condition of negative
nitrogen balance.
Nonessential amino acids: Those amino acids that are synthesized by the human
body in sufficient quantities to meet cellular needs.
Phenylalanine hydroxylase: The enzyme that converts the essential amino acid
phenylalanine to the amino acid tyrosine using tetrahydrobiopterin and molecular
oxygen. A genetic deficiency in this enzyme gives rise to the disease phenylketonuria.
Phenylketones: Normally minor metabolites of phenylalanine that result from the
transamination of phenylalanine and further reduction. These include phenylpyruvate
and phenyllactate. These metabolites are elevated when the conversion of
phenylalanine to tyrosine is impaired.
PKU: Phenylketonuria; the pathologic condition of increased excretion of
phenylketones in the urine because of impaired conversion of phenylalanine to
tyrosine. Classical PKU is because of a genetic deficiency of phenylalanine
hydroxylase; however, other causes are deficiencies in dihydropteridine reductase or
in the biosynthesis of tetrahydrobiopterin.