1. NUTRITION
CHPTR 6
PROTEINS

2. What are proteins? They are the basic material of every body cell
Greek meaning “of first importance”

3. Function of protein Builds and repairs tissue
Protein can provide energy if there aren’t enough carbs and fats

4. More functions of proteins…
Protein helps maintain fluid and electrolyte balances in the body preventing edema. Where there is protein, there is water…water dilutes the big protein molecules to separate them. Protein takes up a lot of space in the blood, it needs water to push molecules apart
Proteins are essential for the development of antibodies which = a healthy immune system

5. In order for proteins to build and repair tissue and cells, the correct number of amino acids must be present

6. How many calories are in 1 gram of protein?

7. Sources of protein
Animal food provides the highest quality they include:
Meats fish
eggs
Poultry Milk and cheese
(These also contain saturated fats and cholesterol) people must be careful

8. Catabolism & Anabolism
Are important in the cells breaking down during metabolism (catabolism)
AND
From that breakdown, some amino acids are released into the blood and are recycled to build new and repair other tissue (anabolism)

9. Amino acids
Are the building blocks of proteins and are the end products of protein digestion or hydrolysis
Proteins themselves are too big to fit through digestion, they must be broken down to fit

10. Complete protein
When we talk about amino acids, we talk about complete proteins…
Complete proteins are proteins that contain all the essential amino acids

11. Essential amino acids
Are necessary for normal growth and development and MUST BE PROVDIDED IN THE DIET
The nonessential amino acids are produced in the body from essential amino acids, vits and minerals

12. Incomplete proteins
These proteins don’t have all of the essential amino acids therefore, they cannot do the job of building and repairing
The value of the incomplete protein becomes increased when you combine other incomplete proteins together (like vegetarians) they must combine foods to get all the amino acids

13. Remember that protein-rich foods usually contain lots of saturated fat which is not good for you

14. There are 20 amino acids but only 10 are essential to humans

15. Proteins contain…
Carbon
Hydrogen
Oxygen AND….
Nitrogen

16. Digestion Food enters the mouth and is chewed up
Ptylin (amylase) mixes with the food in saliva
The bolus is swallowed and travels down the esophagus
It enters the cardiac sphincter and to the stomach

17. It gets kneaded and torn
And mixed with gastric lipase to act on any fat and HCL which prepares the stomach for pepsin which is an enzyme that reduces the proteins to polypeptides (a chain of 10 or more amino acids) 

18. Polypeptide chain – this is still too big to fit as a whole string

19. The polypeptides(chain of 10 or more amino acids) and chyme, travel to the duodenum where the final and last breaking down of anything you ate occurs
The pancreas squirts out 3 enzymes, one is called protease which breaks down this polypeptide/amino acid chain into little pearl-like balls and removes it from its chain

20. After Digestion…
The amino acids are now ready to be absorbed and travel to the jejunum and ileum to be pushed out of the intestinal wall, into the villi and out to capillaries
At this point…

21. What’s being pushed out of the intestines are amino acids from the original protein you ate

22. The amino acids continues on into the bloodstream and travels to the cells to be used and metabolization occurs = energy, heat water and CO2.
It is at this point that something new happens to the amino acid after the cell uses it…it turns to ammonia….yuck

23. To the liver
The cell spits out the ammonia molecule and sends it back to the bloodstream.
The liver picks up the ammonia molecule and strips, filters, deaminates the ammonia molecule in order to make it small enough to be excreted out of the kidney.
Now it turns into a small uric acid or urea molecule

24. UREA
UREA is a nitrogenous waste which mean it’s going to be part of the urine and this is normally found in urine

25. Urea Urea contains nitrogen…
Urea is the chief nitrogenous waste product of protein metabolism and must get excreted out of the kidney

26. The urea then leaves the liver and travels through the bloodstream that’s also filled with nutrients such as glucose, fatty acids (fat), and electrolyte salts
This nutrient filled blood goes into the heart and out to the rest of the body including the kidneys where the urea is excreted out in urine from the kidneys

27. What makes urine yellow?
The ammonia that was converted to urea which is a nitrogenous waste

28. Your bloodstream carries the nutrients, amino acids and electrolytes out to the cells and all of the body organs. Your kidneys know that urea is present and the kidneys don’t like urea so they rid the body of the urea
***The amino acids can repair and rebuild as needed in the cells*** NCLEX

29. Broken Liver

30. Ammonia Can’t Be Broken Down
When the amino acids can’t be broken down d/t liver failure, huge ammonia molecules float around the blood stream
These ammonia molecules can’t go out of the kidney cause their too big
They end up floating around the blood stream and go to the brain…
Oh no 

31. Encephalopathy The medication: Lactulose P.O. is used
This med is usually a laxative but the ammonia molecules will bind to it and leave the body in the stool

32. Encephalopathy
Encephalopathy (in-sef-a-lop-ithy) is mental confusion caused by the failure of the liver to remove ammonia and other toxins from the blood.
Signs & Symptoms (S&S) 

33. Encephalopathy symptoms
Impaired consciousness
Sluggish or impaired speech
Drowsiness
Confusion
Coma
Mousy odor to breath
Pt can’t explain the meaning of simple sayings
Attempts to draw simple figures is impossible

34. Other treatments
Exchange transfusions of (blood) may occur

35. Dietary Requirements Protein requirement is determined by Age sex Size
Recommendation is 15-20% of ones daily caloric intake

36. Protein supplements
Are not good, our body is designed to take in protein by EATING it not supplementing it

37. Protein Deficiency
If you don’t eat enough protein, muscle wasting occurs over a long time
This is known as Marasmus
ALSO CALLED PROTEIN ENERGY MALNUTRITION (PEM)
And…

38. Now you have water in your vessels and the water has no where to go (remember, water follows protein in the body because protein molecules are bigger than water molecules and water tries to spread the protein molecules apart)

39. If there’s no protein to spread apart, water shifts from the vessels to find protein
Then shifts out into other spaces (third spacing) which usually goes out into the abdominal cells and edema occurs in abdomen = Kwashiorkor

40. Vegetarians
Must calculate protein intake regularly as to not become protein deficient
Vegans must eat several incomplete proteins in order to get enough in

41. 2 Deficiency Diseases from lack of protein
1) Marasmus – severe muscle wasting caused by lack of protein and all nutrients, happens over a long period of time
2) Kwashiorkor – deficiency disease caused by lack of protein, and fat deposits in the liver
spindle-like arms and legs with bloated belly d/t fluid shift because there are no proteins. Skin lesions and changes in pigmentation are seen

42. Besides the protein deficiencies…
Other symptoms of no protein include:
Decreased appetite
Decreased strength and healing
Lethargy
depression

43. Who needs the most protein?
Children
Pregnant moms
Breast-feeding moms
Elderly
Burn pts
Surgical pts

44. Protein Excess This is bad, kidneys and liver don’t like it
Foods that have complete proteins usually contain saturated fat and cholesterol
This leads to heart disease

45. People who eat excessive amts of protein-rich foods, ignore the essential fruits and veggies
Excess protein means more filtration through the liver and kidneys to filter out the urea = liver and kidney damage over time

46. People with liver damage…
Cannot filter the ammonia and amino acids
Therefore, the urea travels around the circulation and ends up traveling into the bloodstream and eventually to the brain

47. Increased ammonia to the brain = encephalopathy of the brain and possible death
Pts become very disoriented

48. Vegetarian diet
Usually these people don’t eat enough proteins to get the complete protein requirement
Therefore…
They must eat various incomplete proteins in order to complete the requirement of a complete protein

49. The End