Digestive System

DIGESTION
AND
ABSORPTION
ANATOMY OF THE DIGESTIVE TRACT
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DIGESTIVE ORGANS
GI TRACT – Flexible muscular tube measuring about 15 ft
from the mouth to the anus
 Digestion begins in the mouth ; SALIVA – mixes and

moistens food and helps dissolve
ESOPHAGUS – tube wherein BOLUS( food that is

swallowed) slides down going to the stomach; EPIGLOTTIS
– closes off air passage to prevent choking
LES ( Lower Esophageal Sphincter) – band of muscle around
esophagus where it enters the stomach closes to prevent backing
up of food
STOMACH – receives food from
esophagus ; adds gastric juices and grinds
food into semi-liquid mass – CHYME
 CHYME is then released to the

PYLORIC SPHINCTER – which opens
to small intestine

 SMALL INTESTINE – 10 ft. tubing
where most of the absorption take place
3 segments: duodenum, jejunum, ileum
 COLON – or Large Intestine withdraws

water from chyme leaving a semisolid
waste

RECTUM – carries semisolid waste; the
rectal muscles relax and the ANUS,
opens to allow wastes to pass

INVOLUNTARY MUSCLES AND GLANDS
GASTROINTESTINAL MOTILITY- 2 types of

movement: PERISTALSIS AND SEGMENTATION
PERISTALSIS – GI tract has circular and longitudinal
muscles that tighten and relax to push intestinal contents
through the tube
SEGMENTATION – forces contents back to mix them

and promote contact with digestive juices and the
absorbing cells of the intestinal walls before they move
along
PROCESS OF DIGESTION
• 5 different body organs secrete digestive
juices
1. salivary glands
2. stomach
3. small intestine
4. liver (via the gallbladder)
5. pancreas
• 1. Digestion in the mouth
– SALIVARY GLANDS – secrete SALIVA
for the digestion of carbohydrates
– SALIVA: contains water, salts, enzymes –
SALIVARY AMYLASE, that break down
bonds of starch
– Saliva protects the tooth surfaces and linings
of mouth, esophagus and stomach

• 2. DIGESTION IN THE STOMACH
- GASTRIC JUICE: water, enzymes and HCL
- the strong acidity of the stomach prevents
bacterial growth and kills most bacteria that
enter the body with food
- MUCUS – secreted by the cells in the
stomach that coats and protects the stomach
lining

 DIGESTION OF PROTEIN – major digestive
event in the stomach; the acid helps to uncoil the
protein’s tangled strands so stomach enzymes can
attack the bonds
PEPSIN AND STOMACH ACID – act as catalysts

in protein digestion
 Minor events: digestion of fat by GASTRIC

LIPASE, digestion of sucrose ( very small extent) by
stomach acid and attachment of a protein carrier to
vitamin B12
• 3. DIGESTION IN THE SMALL INTESTINE
AND LARGE INTESTINES
-Digestive enzymes: PANCREATIC JUICE –

digest fats, proteins and CHO
- BICARBONATE – found or contained in the
Pancreatic juice; Neutralizes the acidic chyme
as it enters the small intestine

• BILE – secreted by the liver and stored in
the Gallbladder ; emulsifies fat so that
enzymes can digest them and be absorbed
• BIOTIN AND VITAMIN K – defenses

against infection

• 4. FINAL STAGE
– Absorption of the macronutrients (CHO,
CHON, fats)
– Vitamins, minerals and water are absorbed
as they are
– Undigested residues such as fiber are not
absorbed but continue thru the tract to form
a semisolid mass that stimulate peristalsis

Fiber also retains water, keeping stools soft,
and carries bile acids, sterols and fat with it
out of the body
COLON – water, undissolved salts and body

secretions, fiber enter the large intestine
- water and dissolved salts are
reabsorbed or recycled until the WASTE is
excreted
THE ABSORPTIVE SYSTEM
SMALL INTESTINE : where major
absorption takes place
- VILLI – finger-like projections
- MICROVILLI – microscopic hairs found
in a single villi
- villi are in constant motion so that any
nutrient will be absorbed

IMAGE OF VILLI- SMALL
INTESTINE

• Small intestine duodenum with numerous
tongue-shaped projections (villi)
protruding from the gut wall. The
duodenum is the first part of the small
intestine, extending after the stomach to
the jejunum. As a major secretory region
of the gut, the duodenum also receives
secretory products from other organs to
aid in digestion. As in other parts of the
small intestine, digestion and absorption
are maximized by the large surface area
conferred by the presence of villi.
• The villi are composed mainly of
columnar epithelial cells, each of which is
covered with many microvilli to increase
cell absorption. Goblet cells are present
among the epithelial cells. They secrete
mucus that lubricates the lining of the
intestine.

• Release of absorbed nutrients:
- 2 Transport systems: BLOODSTREAM
AND LYMPHATIC SYSTEM
- the many folds and villi of the small
intestine increase surface are to facilitate
nutrient absorption.

- nutrients pass through the cells of the villi and
enter either BLOOD (if they are water soluble
or small fat fragments) or the LYMPH (if
they are fat soluble)
- CHYLOMICRONS: lipoproteins that transport

lipids from the intestinal cells in the body. The
cells of the body remove the lipids they need
from the chylomicrons, leaving remnants to be
picked by the LIVER cells

TRANSPORT OF NUTRIENTS
1. THE VASCULAR SYSTEM –
- blood is carried to the digestive system
by ARTERY, which branches to
capillaries to reach every cell.
- blood leaving the digestive system goes
by way of VEIN and into the LIVER;
- blood leaving the liver returns to the
heart by way of another vein
• 2. THE LYMPHATIC SYSTEM

- One way route for fluids to travel
from tissue spaces into the blood
- lymph collects in a large duct behind the
heart
- materials from the GI tract enter the
lymphatic system before entering the
bloodstream

• 3. TRANSPORT OF LIPIDS:
LIPOPROTEINS – clusters of lipids
associated with proteins that serve as
transport vehicles for lipids in the lymph
and blood
- VLDL , LDL and HDL

• The more lipid in the lipoprotein molecule, the

lower the density; the more protein, the higher
the density
• LDL – deliver cholesterol and triglycerides
from the liver to the tissues
• HDL – scavenge excess cholesterol and
phospholipids from the tissues and return them
to the liver for metabolism or disposal

Health implications of LDL AND HDL

- though there is only one kind of
cholesterol; the difference between LDL AND
HDL reflect PROPORTIONS of lipids and
proteins within them
- LDL “bad cholesterol”
- HDL “good cholesterol”
FACTORS TO IMPROVE LDL – HDL
RATIO
• 1. weight control
• 2. polyunsaturated or monosaturated,
instead of saturated, fatty acids in the diet
• 3. soluble fibers
• 4. physical activity

CHAPTER 6:
METABOLISM AND
ENERGY BALANCE

THE ORGANS AND IT’S
METABOLIC ROLES
• Principal Organs of Metabolism:
1. digestive organs
2. liver
3. pancreas
4. circulatory system
5.kidneys

• ENERGY METABOLISM – all the
reactions by which the body obtains and
spends the energy from food or body
stores

METABOLIC ROLES
DIGESTIVE ORGANS
- physical processes for food
transportation thru out the GI tract
- production of digestive juices and
enzymes
- Absorption of nutrients
- re-absorption of water and salts
METABOLIC ROLES
• THE LIVER
- MOST ACTIVE METABOLIC
FACTORY
- metabolizes and stores most vitamins
and minerals
- manufactures bile (emulsifies fat)
- manufactures and detoxifies drugs,
prepares waste products for excretion
- Iron recycling and blood cell manufacture
- Makes proteins necessary for health,

including immune factors, transport
proteins and clotting factors

• THE PANCREAS
- Contributes digestive juices
- metabolic fxn: produces hormones,
INSULIN AND GLUCAGON which
regulate the body’s use of glucose

•HEART AND BLOOD VESSELS
- Conduct blood with nutrients and
oxygen to all other body cells and carry wastes
from them
- MAKING AND TRANSPORT OF
LIPOPROTEINS : metabolic reactions that
affect the heart and BV the most bec. of the
deposition of cholesterol in the artery walls
• THE KIDNEYS
- Filter waste products from the blood to
be excreted in the urine and reabsorb
needed nutrients to maintain balance
- regulate blood pressure
- convert a precursor compound to active
vitamin D for bone maintenance

ENERGY OF METABOLIC WORK
• HEAT ENERGY AND BODY

TEMPERATURE
- As cells do their metabolic work, the
chemical reactions release heat, and this
heat keeps the body warm
- regulation of metabolism and body heat
helps maintain normal body temp. of 98.6
degrees farenheit
ENERGY OF METABOLIC WORK
• ACCELERATED METABOLISM
- SEVERE STRESS : metabolism speeds
up, fever develops
- inc. in metabolism : signifies that fuels
are burned at a rate more rapid than
normal
- this may lead to wasting of body organs,
loss of weight

BODY’S ENERGY METABOLISM
• ENERGY METABOLISM – defined as
the sum total of all chemical reactions
that manage energy nutrients in the body
• ENERGY METABOLISM FOCUS ON:
1. From CHO to glucose
2. from lipids to glycerol and fatty
acids
3. from proteins to amino acids
• Terms to remember:
- ANABOLISM – reactions in w/c small
molecules are put together to build larger
ones. Anabolic reactions consume energy
- CATABOLISM – reactions in which
large molecules are broken down to
smaller ones. Catabolic reactions usually
release energy

• GLYCOLYSIS – metabolic breakdown
of glucose to PYRUVATE
PYRUVATE – pyruvic acid, a 3 carbon
compound derived from glucose, glycerol
and certain amino acids in metabolism

• BUILDING UP BODY COMPOUNDS
- ANABOLISM – building up of body
compounds
- examples: glucose can be strung
together to make GLYCOGEN CHAINS
- Glycerol and fatty acids into
TRIGLYCERIDES
- Amino acids to make PROTEINS
• BREAKING DOWN NUTRIENTS FOR
ENERGY
- CATABOLISM
- examples: glycogen can be broken
down to glucose, triglycerides to fatty
acids and glycerol, protein to amino acids

• GLUCOSE BREAKDOWN
- GLYCOLYSIS
-Glucose is broken down to PYRUVATE
- Pyruvate is converted to smaller compound,
acetyl CoA
acetyl CoA – compound made up of acetic
acid (formed from the breakdown of pyruvate)
w/ a molecule CoA attached to it

• FAT BREAKDOWN
- TRIGLYCERIDES: primary form of fat
in the body, cannot be converted to glucose,
bec. It consists of fatty acids
- instead, glycerols are broken down into 2-
CARBON FRAGMENTS that combine with
CoA to form acetyl CoA
-By product of fatty acid metabolism is ketone
bodies

FAT BREAKDOWN
• Thus, fat is inefficient source of glucose
• 95% of it cannot be converted to glucose
therefore, it cannot provide energy for the
organs (BRAIN, AND NERVOUS SYS.)
• the task for fueling the nervous system is
left mainly to CHO and CHON

AMINO ACID BREAKDOWN
• If amino acid is needed for energy they
first undergo, DEAMINATION- removal
of nitrogen (removal of amino group
from a compound such as amino acid)
• When nitrogen is removed, half of amino
acid can be converted to PYRUVATE –
w/c can provide glucose
• By product of CHON metabolism is
ketone bodies.
• UREA – principal nitrogen – excretion
product of metabolism
• GLUCONEOGENESIS – making of
glucose from protein or fat. 5% of fat
(glycerol portion) and about 50% of
protein (the glucogenic amino acids) can
be converted to glucose

THE BODY’S ENERGY BUDGET
• Economics of Feasting
- excess energy from alcohol is stored as
FAT
- Excess CHO: excess glucose is first
stored as glycogen ; once filled any
additional CHO is routed to fat

• Excess Fat: excess fat contributes to
body’s fat stores
• Excess Protein: if not needed, amino
acids will loose their nitrogens and will
be converted to Triglycerides – w/c will
swell fat cells and add to body weight

When a Person overeats : FEASTING
• CHO GLUCOSE LIVER AND

MUSCLE GLYCOGEN STORES
• FAT FATTY ACIDS BODY FAT
• PROTEIN AMINO ACIDS

NITROGEN lost in urine

ECONOMICS OF FASTING
• Glycogen used first – glucose from the
liver’s stored glycogen and fatty acids
from the body’s stored fat both flow in
cells to fuel their work
- Low Blood glucose signals further

fat breakdown

• GLUCOSE FOR BRAIN – nervous
system (brain and nerves) and RBC
cannot use fatty acids ; they need only
GLUCOSE for energy
- 2/3 of total glucose / day – 400 to 600

kcalories worth is consumed by nervous
system

• PROTEIN BREAKDOWN AND
KETOSIS
- In the 1st few days of fasting, body
CHON provides 90% of needed glucose
and GLYCEROL provides 10%
- if fasting continues, body finds a
way to use FAT to fuel the brain by
producing KETONE BODIES

• KETONES – condensation of acetyl CoA
from fatty acids and CHON ; ketones can
serve as fuel for some brain cells

When a person draws on stores:
FASTING
• LIVER AND MUSCLE GLYCOGEN
STORES  GLUCOSE  ENERGY
FOR BRAIN AND NERVOUS
SYSTEM
• BODY FAT  FATTY ACIDS 

ENERGY FOR OTHER CELLS

If fasting continues beyond glycogen
depletion
• BODY PROTEIN AMINO ACIDS
-glucose (energy for brain and other
cells) , nitrogen lost in urine and ketone
bodies (energy to some brain cells and
other body cells)
• BODY FAT FATTY ACIDS

KETONES

• SLOWED METABOLISM – if fasting
continues, body shifts to partial
dependence on ketones for energy
- this reduces energy output
(metabolic rate) and conserves both fat
and lean tissue
- fat loss is lessened in fasting
compared to when some food is supplied

• Hazards of Fasting
1. wasting of lean tissues
2. impairment of disease resistance
3. lowering of body temp.
4. disturbance of body’s F and E

* Diet only moderately restricted in energy
can promote greater rate of WEIGHT
LOSS, a faster rate of Fat Loss, and
retention of more lean tissue than a
severely restricted Fasting

ENERGY BALANCE
• Statement of Energy balance:
change in fat stores (kcal) = energy in
kcal (-) minus energy out (kcal)
-Energy intake (food oxidation)=

Energy output (heat, activity, stored fat)

BASAL METABOLIC RATE
• BASAL METABOLIC RATE- rate at
w/c body spends energy for maintenance
of activities
• Varies from person to person
• Eg. Infant’s metabolic rate relative to
body weight is faster than an adult’s to
support the infant’s extraordinary growth
rate

• BMR is fast in :
- people with lean body mass (growing
children, physically active people, pregnant
and males)
– tall people bec. of large surface are for their
weight

• BMR is fast in:
- ppl w/ fever or under stress
- ppl taking medications
- and those w/ active thyroid glands
- high and low temp. / hot or cold

• SLOWING OF BMR:
- loss of lean tissue
- depression of thyroid activity
- inactivity
- fasting, or malnutrition

BASAL METABOLIC NEEDS
• A person whose total energy needs are
2000 kcal/ day spends 1200 to 1400 to
support basal metabolism

CHAPTER 7: OVERWEIGHT,
UNDERWEIGHT, WEIGHT
CONTROL

BODY WEIGHT AND BODY
COMPOSITION
• BODY MASS INDEX – has replaced
weight-for – height tables in clinical
settings. The margin provides the
calculation to demonstrate how BMI
values are derived.
weight in lbs. x 705
• BMI = height (in)2

• CENTRAL OBESITY
- excess fat on the abdomen and around the trunk of
the body ; higher risk of death
• Intra-Abdominal Fat: fat stored within the abdominal

cavity in association with the internal abdominal organs,
as opposed to the fat stored directly under the abdominal
skin (subcutaneous fat) ; when mobilized goes directly to
the liver making LDL.
• Fat fold measure
• Waist circumference- >35 inches female, >40 inches

male = high incidence of central obesity.
Indicators of Obesity
• BMI
• Waist circumference
• Disease risk profile
• Normal fat= female- 20-30%, male-

12-20%

Causes of Obesity
• Genetics
• Lipoprotein Lipase (LPL)-promote fat
storage
• Leptin- obesity gene (ob), contains code
for leptin, hormone produced and
secreted by fat cells that in proportion to
amount of fat stored.
• Fat cell development

Causes of Obesity
• Set point Theory- proposes that body
weight is physiologically regulated.
• Environmental Stimuli
• Learned Behavior
• Physical Inactivity

Health Risk of Obesity
• CVD
• Sleep apnea
• Osteoarthritis
• Gallbladder dse.
• Pickwickian syndrome-sudden death
• Complicated pregnancy

AGGRESSIVE TREATMENTS OF
OBESITY
• OBESITY DRUGS
a. Sibutramine – appetite suppressant
that works on the brain’s neurotransmitters
-enhances food satiety and elevates energy
expenditure but caution HPNive takers.
b. Orlistat – inhibits production of fat

digesting enzymes in the pancreas and so
reduces fat absorption by about 30%
Sibutramine

Xenical

• Surgery
– Gastroplasty – surgery that partitions the stomach
by stapling off a “pouch” or otherwise modifying
the stomach, thereby reducing total food intake
– GASTRIC BYPASS : reroutes food from the
stomach to the lower part of the small intestine;
creates a chronic, lifelong state of malabsorption
by preventing normal digestion and absorption of
nutrients

Gastroplasty

Gastric Bypass

Gastric Bypass

Billroth 1

Billroth 2

• GASTRIC BANDING – new procedure ;
restricts stomach size with a constricting
band or pouch; used in people whose
severe obesity brings extreme health risks

GASTRIC BANDING

STRATEGIES FOR WEIGHT LOSS
• Adopt reasonable expectations about
health and weight goals and about how
long it will take to achieve them
• Be involved in planning
• Keep in mind that you will want to
maintain your lost weight. Practice
needed behaviors as you go
• Adopt a realistic plan

• Make the diet adequate by emphasizing
nutrient-dense foods
• Limit concentrated sweets and alcoholic
beverages
• Drink plenty of water
• Learn, practice and follow a healthful
eating plan for the rest of your life

UNDERWEIGHT
• Becomes more hazardous when
accompanied with undernutrition
• Leaves the body underprepared to handle
its many metabolic and physical tasks
• Common eating disorders:
– Anorexia nervosa
– Bulimia nervosa

Strategies for Weight gain
• Physical activity to build muscles
• Energy dense foods – eg. Milk shakes
instead of fat-free milk, peanut butter
instead of lean meat, avocados instead of
cucumbers, blueberry muffins instead of
whole-wheat bread
• Three meals a day

• Large portions
• Extra snacks
• Juice and milk

Digestive System

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DIGESTION

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 Digestion begins in the mouth ; SALIVA – mixes and

ESOPHAGUS – tube wherein BOLUS( food that is

 CHYME is then released to the

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 COLON – or Large Intestine withdraws

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GASTROINTESTINAL MOTILITY- 2 types of

SEGMENTATION – forces contents back to mix them

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PEPSIN AND STOMACH ACID – act as catalysts

 Minor events: digestion of fat by GASTRIC

-Digestive enzymes: PANCREATIC JUICE –

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• BIOTIN AND VITAMIN K – defenses

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COLON – water, undissolved salts and body

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- CHYLOMICRONS: lipoproteins that transport

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• 2. THE LYMPHATIC SYSTEM

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- VLDL , LDL and HDL

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• The more lipid in the lipoprotein molecule, the

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Health implications of LDL AND HDL

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- Makes proteins necessary for health,

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• HEAT ENERGY AND BODY

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• CHO GLUCOSE LIVER AND

• FAT FATTY ACIDS BODY FAT

• PROTEIN AMINO ACIDS

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- Low Blood glucose signals further

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- 2/3 of total glucose / day – 400 to 600

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• BODY FAT  FATTY ACIDS 