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Links to Nutrition Resources

If you identify better resources or determine there is a dead link please email Dr Lynch ( clynch@psu.edu ).   Faculty will review student identified resources for addition to this site.   If you are a SECOND YEAR STUDENT, Log in with PSU Access Account Credentials to access blogging and feedback elements of the site (Log in directions).   Use bluebar breadcrumbs for navigation back to to home page.  Images should become larger on click and links should open in new window

Nutrition Resources, Best Practice Guides & Reviews

Vitamin and Mineral Deficiency Disorders Resources as a class

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Table: Vitamin and Mineral Resources Individually

Fat Soluble Vitamins

Water Soluble Vitamins

Minerals

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Table related images  (click to expand)

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Nutrition and Disease Prevention

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 for weight loss - Am J Clin Nutr 2006    

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 also you can download Mac and PC app


Nutrition and Cancer

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from AICR.org

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  (e.g., GI, liver etc...) from AICR.org


Nutrient and Endocrine Signals affecting Gut

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 - Current Biology 2013

This link and following THREE expandable figures (click on them) are from a 2013 Current Biology Review on CNS and GI satiety signals 

"Integration of satiety signals by the central nervous system. Examples of peripherally derived signals that act on central nervous system pathways to affect food intake. Nutrient sensing is distributed across multiple regions of the central nervous system. Circuits in the hypothalamus (Hypo) and brainstem interact with higher centers to initiate and terminate meals. ARC, arcuate nucleus; NA, nucleus accumbens; NTS, nucleus of the solitary tract; PFC, prefrontal cortex; VTA, ventral tegmental area; GLUT2, glucose transporter 2; IR, insulin receptor."


Nutrient-sensing in intestinal I-cells. Luminal nutrients activate specialized receptors coupled to Gq proteins at the surface of enteroendocrine I-cells. The activation of phospholipase C (PLC), and downstream effector pathways triggers membrane depolarization and the release of cholecystokinin (CCK: orange dots), which activates CCK1 receptors expressed on vagal afferent fibers. Following uptake into epithelial cells, monoglycerides and free fatty acids can either diffuse across the cell and exit into circulation from the basolateral membrane, or be re-synthesized into triglycerides (TG) by the 2-monoglyceride (2MG) or α-glycerol-3 phosphate (G3P) pathways. The re-synthesized TGs are assembled into chylomicrons before undergoing exocytosis by the Golgi apparatus. Once in circulation, a portion of the Apo A-IV dissociates from the chylomicron and acts on CCK1 receptors via an unknown mechanism (depicted by the question mark). DAG, diacylglycerol; IP3, inositol (1,4,5) trisphosphate; PK3, protein kinase 3.

Nutrient-sensing in intestinal L-cells. The schematic shows G-protein coupled receptors and their effector pathways that have been identified as potential nutrient sensors on intestinal L-cells. Activation of these receptors by specific nutrients in the lumen triggers elevations in intracellular Ca2+ stores and activation of the Ca2+-sensitive transient receptor potential channel M5 (TRPM5) 135 and 136. The resulting depolarization triggers the release of GLP-1 (red dots) and the subsequent activation of GLP-1 receptors expressed on vagal afferent fibers. AC, adenylyl cyclase; IP3, inositol (1,4,5) trisphosphate

 

 

"Schematic summary of digestion and absorption of dietary fats in the gastrointestinal lumen. C, carbon atoms; FA, fatty acid; MG, monoglyceride; TG, triglycerides."

 

Nutritional Disorders/Deficiencies & Adverse Food Reactions

  Vitamin and Mineral Deficiency Disorders or Toxicities (if toxic) as a class

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Table: Vitamin and Mineral Deficiency Disorders or Toxicities Individually

Fat Soluble Vitamins

Water Soluble  Vitamins

Minerals

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Health Disparities example

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Pellagra





  
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Zinc deficiency  PDF in new window

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  the links below are for IBD and Nutrition

Figure legend:  "Evolving conceptual model of FGIDs (functional gastrointestinal disorder - IBS, functional bowel disorder); GI, gastrointestinal, CNS, central nervous system. "

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Figure Legend: "Signaling from the upper gastrointestinal tract (GIT) during and after food intake. Left: During and initially after food intake, gastric distension and gastric accommodation are major determinants of nutrient signaling. Signals are generated from gastric mechanosensitive receptors, which relay their information via vagal nerves to the brain. Right: After food intake, when the stomach gradually empties, the role of gastric distension in nutrient signaling decreases and the focus is shifted to signaling-related intestinal exposure to nutrients. The presence of various types of nutrients is mainly sensed by entero-endocrine cells in the mucosa of the small intestine that release a variety of peptides and small molecules. These can act locally, activate vagal nerves that signal to the brain, or enter the blood stream and act as hormones." 

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Figure Legend:  "Lipids normally trigger a range of physiological effects on gut motility and sensitivity. Patients with functional gastrointestinal disorder... ...are further exacerbated by fat due to hypersensitivity and hyperreactivity to luminal lipids, which may explain the development of symptoms.

Dietary Proteins and Functional Gastrointestinal Disorders  The following figure and link are also from the 2013 Rome Foundation Working Group series, this one is on Dietary PROTEINS and their role in Functional Bowel Disorders like Irritable Bowel Syndrome.  Several helpful figures in this review.

"Categorization of adverse reactions to food. Any abnormal reaction resulting from the ingestion of a food is considered an adverse food reaction. Such reactions may be immune-mediated, termed food allergy, or nonimmune mediated, termed food sensitivity or food intolerance.... "

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  This link and expandable figure below are also from the 2013 Rome Foundation Working Group series, this one is on Dietary SHORT-CHAIN CARBOHYDRATES and their role in Functional Bowel Disorders like Irritable Bowel Syndrome.

Figure Legend: Features of the mechanisms of action of poorly absorbed short-chain carbohydrates (FODMAPs) for the development of gastrointestinal symptoms in FGID. (a) FODMAPs are poorly absorbed in the small intestine and arrive into the colon, populated with microbiota. (b) Their osmotic activity leads to increased water retention within the lumen of the small and large bowel. (c) FODMAPs are substrates for colonic bacterial fermentation, resulting in the rapid production of gas and subsequent luminal distension.   

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 The following figure and link are also from the 2013 Rome Foundation Working Group series, this one is on Dietary FIBER and its role in Functional Bowel Disorders like Irritable Bowel Syndrome.  

Clinical Correlations 

  Case of psychosocial stress affecting gut motility and visceral sensitivity -PDF from NEJM 2013  Vomiting and nausea caused chronically by psychosocial stress in a child with confounding psychiatric and celiac disease causing initial confusion about the diagnosis.


These are resources for you to hopefully find answers to otherwise unanswered questions you have or LOs you are trying to tick off or perhaps things that you might be interested in.   This is not intended to overload or stress you.  Take from these pages what you need to study and consider what is reasonable for a second year if you are stressed.  Vitamins and minerals basics and disorders are low hanging fruit for USMLE and there seems to be a disproportionate amount of that on step 1 in our experience looking at practice exams.   

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