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AOHS Foundations of Anatomy and Physiology ILesson 11The Endocrine SystemStudent ResourcesResourceDescriptionStudent Resource 11.1Anticipation Guide: The Endocrine SystemStudent Resource 11.2Reading: Hormones and the Endocrine SystemStudent Resource 11.3Review: HomeostasisStudent Resource 11.4Reading: Endocrine Feedback LoopsStudent Resource 11.5Glossary: The Endocrine System (separate Word file)Student Resource 11.6Reading: Diabetes and Teens Student Resource 11.7Graphs: Blood Glucose and Insulin Student Resource 11.8Guide: Menu Makeover PamphletStudent Resource 11.1Anticipation Guide: The Endocrine SystemStudent Name:_______________________________________________________ Date:___________Directions: For each of the statements below, underline “I agree” if you think the statement is accurate or “I disagree” if you disagree with it. Write one reason to explain your guess. Fill in the “I learned” section as you watch the presentation Hormones and the Endocrine System.When you're stressed, hormones can change the way your body stores fat.My guess:I agree I disagreeMy reason:I learned:All these processes are controlled by the same body system: the production of melanin in your skin, maturing into an adult, and adjusting the amount of water in your body. My guess:I agree I disagreeMy reason:I learned:Alcohol affects your brain and your nervous system but does not affect the system that controls your hormones.My guess:I agree I disagreeMy reason:I learned:There are two types of diabetes; eating and exercise habits contribute to the cause of one type, but not to the other. My guess:I agree I disagreeMy reason:I learned: Girls produce the hormone estrogen but not testosterone. Boys produce the hormone testosterone but not estrogen. My guess: I agree I disagreeMy reason:I learned:Student Resource 11.2Reading: Hormones and the Endocrine SystemThe endocrine system affects nearly every cell in the human body. But you’re probably more aware of your nervous system because its effects are more immediate: you hear a sound, and you turn your head right away to see what’s there. Your endocrine system, on the other hand, oversees functions that, for the most part, take much longer. For example, the hormone insulin, which allows your body to make use of glucose, takes about a half hour to work, and other hormones, like growth hormone, can exert their effects slowly over a period of years. While the nervous system does its business with electrical signals, the currency of the endocrine system is chemical substances called hormones. Both systems help to maintain homeostasis as we respond to the environment.Using hormones, your endocrine system keeps tabs on many of the processes in your body. These include your blood sugar, digestion, body temperature, how fast you use your food and oxygen, how much water is in your blood, how fast you grow, and your maturation into a man or a woman. Although the nervous and endocrine systems are separate entities in the body, they work closely together and have some similarities. Neurons release neurotransmitters that bind to the cell membranes of other neurons or muscles. Endocrine tissue releases chemicals called hormones that also bind to receptors in other cells. In some cases, these are even the same compound. Both the nervous and endocrine systems are important components of feedback loops, but loops in the two systems have different types of stimuli. In the nervous system, the loops begin with sensory stimuli, and in the endocrine system, the loops begin with chemical stimuli. Via these loops, each system sends signals and communications from one part of the body to another.Some glands, like sweat glands, secrete substances onto the skin. These aren’t endocrine glands, which contain cells that make and release hormones into the body, usually into the bloodstream. Each hormone is produced and secreted by one specific gland, but one single gland can produce many different hormones. There are about 65 different hormones, and each one induces a particular kind of change. The cells that a hormone acts on are called its target cells. Target cells may be very specific, or for some hormones, many cell types can be target cells. When a hormone finds its target cell, it binds to a receptor protein in the cell, and that binding causes a response inside the cell. The response might include a change in activity of the cell, or stimulate the target cell to release yet another hormone. In some cases the response is to activate a gene in the cell’s DNA, which will result in more of a protein or other compound that is needed. Because the conditions in the environment around you are always changing, your body has to constantly adjust your internal environment so that all the functions necessary to keep you alive can keeping going efficiently. That’s a big part of the process of homeostasis, and a major function of the endocrine system. So how does a gland know when to start or stop producing a hormone? Each endocrine gland is part of a feedback loop: the gland will get signals, sometimes from your blood and sometimes from another gland, about how much hormone is already there and what its effect is. The stimuli can be many things: food in your stomach, loss of water from the body, the threat of injury, even just the passage of time. When, for example, you’ve just eaten, glands in your body get signals that it’s time to digest and to move glucose from your blood to your cells, and they release their hormones. Once those tasks are done, the same glands get signals that they can stop. As you grow older, glands in your body release hormones that lead to sexual development: women’s bodies change shape and their breasts begin to grow, and men begin to grow beards and their voices get lower. As you’ll see, these feedback loops can be fairly simple or have many levels of stimulus and response to them.Your body has three different ways of signaling to a gland that it’s time to get into action. The most common is when the level of one hormone or another is the stimulus. This means that when the level of a given hormone rises, it signals a gland that there’s enough hormone, and the gland can stop its production. Then, when the level of that hormone falls, the gland gets another signal that says “time to make some more.” Glands can also be stimulated into action by the presence of certain nutrients in your blood. When the levels of calcium ions in your blood fall, glands in your body release hormones that will take some calcium from your bones. Once calcium levels rise, the glands stop producing those hormones. In rare instances, nerves will stimulate a gland. The most common example of this is when you’re scared or startled. Neurons stimulate glands to release the hormones associated with changes in your sympathetic nervous system, the fight or flight response. A lot of the endocrine activity in your body is overseen by the hypothalamus. The hypothalamus is considered a part of both the nervous system and the endocrine system. It controls the pituitary, which is sometimes referred to as the master gland because it gives orders to many other endocrine glands.The levels of most substances in the body don’t change too much; your body needs to maintain a narrow range of most things in order to keep you running efficiently. The hypothalamus is key to keeping many of your systems in check. It contains special cells that can assess the levels of various compounds in the body by analyzing the blood that flows through it. The hypothalamus also contains cells that produce hormones in response to these assessments. Rather than having a specific, distant target organ, the hormones released by the hypothalamus go to the nearby pituitary gland, which in turn, controls many other glands and organs.The pituitary gland sits just inferior to the hypothalamus. It has two parts, which receive their signals from the hypothalamus in different ways. The hypothalamus releases hormones that travel to the anterior pituitary. Once detected by the anterior pituitary, these hormones prompt the production of other hormones that then travel to target cells of other endocrine organs. Sometimes the target cells are outside the endocrine system. For example, melanocyte-stimulating hormone (MSH) directs the melanocytes to create melanin. In other cases, hormones from the pituitary stimulate the production of hormones by other glands. For example, the anterior pituitary produces a hormone called ACTH, which controls some of the activity of the adrenal glands. In these cases, there are three levels of management involved altogether: the hypothalamus, the anterior pituitary, and the target gland or cell that is involved.These are six of the major hormones produced by the anterior pituitary. The top three act directly on target cells that aren’t part of endocrine tissues. The bottom three act on endocrine glands that then secrete other hormones. The pituitary is prompted to release each of these hormones after getting the signal from the hypothalamus. As you can see just from this short list, hormones act to create many different kinds of changes throughout your body.Whereas the anterior pituitary is separate from the hypothalamus, the posterior pituitary and the hypothalamus are actually connected. Some hormones produced in the hypothalamus travel along the axons of its neurons to the posterior pituitary and from there go directly into the bloodstream. Antidiuretic hormone (ADH) is one released by the posterior pituitary when the hypothalamus detects that the level of water in the bloodstream has fallen too low. The ADH travels from the hypothalamus to the posterior pituitary, where it is released and makes its way to the kidneys. When there’s enough water in the blood, the hypothalamus detects that and stops producing ADH. Alcohol inhibits the hypothalamus from releasing ADH, which means that when you drink, your kidneys may release more water into the urine than they normally would, leaving you dehydrated.When it comes to your overall metabolism, once again, the whole hormonal cycle begins with your hypothalamus. It senses levels of thyroid hormone in your body. You need to maintain your levels of thyroid hormone within a fairly tight range, because thyroid hormone affects the rate at which your cells carry out basic functions using proteins, carbohydrates, fats, vitamins, minerals, oxygen, and water. We call those processes, taken altogether, as your metabolism. When the hypothalamus detects a decrease in thyroid hormones, it produces a hormone that tells your anterior pituitary, “Hey, we’re short on thyroid hormone.” This signal prompts the pituitary to secrete TSH, which targets the thyroid and makes it produce more thyroid hormones. People with thyroid hormone deficiency may feel cold, sleepy, or sluggish or may not be able to think as quickly and clearly as usual. People who have too much thyroid hormone may be agitated or anxious. Thyroid disorders are quite common, especially among women.You have two adrenal glands, each sitting like little caps on top of each of your kidneys. The adrenals each contain two parts, called the cortex and the medulla. First, the cortex: it produces a wide variety of hormones that regulate ion balance, sexual development and sex drive, and how your body metabolizes different nutrients. One of the main hormones produced by the adrenal cortex is cortisol, which is also sometimes called the stress hormone because your body produces it when you’re physically or emotionally stressed. Cortisol affects the way you use and store fats, proteins, and carbohydrates. It can also reduce some activity of your immune system, and researchers are studying whether cortisol and other hormones can make you more susceptible to catching diseases like colds and flu.The hormones of the adrenal cortex have a wide variety of roles in your body. Other hormones besides cortisol include aldosterone, which regulates the concentrations of ions in your blood, especially potassium. If you eat a diet high in potassium, aldosterone is released from the adrenal cortex and stimulates potassium secretion into the urine, lowering blood potassium levels. The sex steroids are responsible for sex characteristics that aren’t directly related to reproduction, like the lower voice that men have or the milk-producing breasts that women have.You can thank your adrenal medulla for the adrenaline rush you get from watching a scary movie, riding a roller coaster, or making that final sprint to be first across the finish line. Unlike most of your other endocrine functions, the action of your adrenal medulla is stimulated by your nervous system, meaning that it can happen in a split second. Which is important, because if you sense yourself in trouble, you need to be able to act fast. The adrenaline rush comes from two hormones. Epinephrine, which we also call adrenaline, tells muscles to use fatty acids for energy, saving the glucose for your brain (you need to think clearly under duress, after all!). Epinephrine also gets your sympathetic nervous system in gear. Norepinephrine constricts your blood vessels, raising your blood pressure and preparing you for action—whether that’s jumping out of your seat or picking up your running pace.Your blood sugar is regulated by two hormones that work in tandem, and which are both produced by the pancreas. The pancreas is a flat, fibrous gland that sits nestled between your stomach and small intestine inside your abdomen. When you’ve eaten, there is a lot of glucose in your blood. In order to use it for fuel, your cells must be able to bring it inside of them. For this, they need the hormone insulin. Once the pancreas secretes insulin into your bloodstream, glucose can move into the cells, lowering your blood sugar. When your blood sugar falls, the pancreas gets a signal that it can stop producing insulin. This is a classic feedback loop. Insulin is the only substance known that can bring glucose into cells, and glucose is the primary fuel that cells use to power their activities. Thus, without insulin, cells can’t carry out their functions, making insulin absolutely necessary for life.If, on the other hand, it’s way past lunchtime and your blood sugar is dipping, the pancreas secretes another hormone, glucagon, which will pull glucose out of the cells in your liver and get it circulating in your blood where it can be used by other cells (such as muscle and brain cells) as it’s needed.Diabetes is a common disease in the United States: over 8% of Americans have diabetes, and experts expect that number to rise. Diabetics are people whose pancreas either doesn’t produce enough insulin or whose cells have developed a resistance to it. The image above shows how insulin works in a healthy person and the difference in insulin function between type 1 and type 2 diabetes. Type 1 diabetics have lost the cells in the pancreas that make insulin and therefore have none. They are dependent on regular insulin injections in order to remain alive and metabolize glucose. Most type 1 diabetics develop the disease early in life as children or young adults. Type 2 diabetes can develop at any stage of life. Many type 2 diabetics also take insulin. But in many cases, the condition can also be managed by eating a healthy diet and exercising regularly. Both forms of diabetes involve some genetic factors, and certain lifestyle choices can put a person at greater risk for type 2 diabetes. Smokers are much more likely to develop type 2 diabetes than nonsmokers, and heavy drinking can cause damage to the pancreas. Still, doctors don’t have a complete picture of why some people develop diabetes and others don’t. They do know that you can lower your risk of type 2 diabetes with a healthy diet and regular exercise. Type 2 diabetes is more common in overweight people, and it’s believed that there are thousands of people in the United States who are at high risk for developing diabetes but are unaware of it. The gonads are the organs in both men and women that produce what you probably think of when you think “hormones”: the sex hormones. The ovaries produce many hormones that play different roles in fertility, pregnancy, and childbirth. The ones that cause the most obvious effects are estrogen and progesterone, which are produced in regular cycles and together bring about menstruation. This cycle is set by the anterior pituitary. Estrogen and progesterone also drive the development of breasts and milk-producing tissue in women. In males, the testes produce a group of hormones called androgens, of which testosterone is the main (and most familiar) one. Testosterone brings about the maturation of the penis and testes as well as secondary characteristics like increased muscle size, facial hair, and a lower voice. Testosterone also plays a role in sex drive. Estrogen isn’t only for women, and testosterone isn’t only for men. Both genders produce estrogen and testosterone, but in smaller amounts than their primary sex hormones.Many teenagers think that hormones are just about sex. But there are at least 50 other hormones in the human body besides the ones discussed in this presentation. Together, they direct digestion, the levels of ions, the color of your skin, blood pressure, your weight, when you sleep, and many other factors. They can even affect your mood and behavior. The notion that women’s moods change when they have their period isn’t a new one. And women are affected by hormones during other parts of their cycle: when a woman is ovulating, she changes the way she walks and talks, and she is sometimes drawn to different types of men than she is at other times of the month. Men are also affected by women’s hormones: various studies have shown that men find a woman more attractive when she is ovulating. Men’s hormones go through fluctuations, too. Researchers have found that male athletes have more testosterone when playing games on their home turf than when they’re a visiting team. And testosterone levels tend to fall in men who are raising children. Researchers have also found that just as hormones can influence behavior, behavior can also affect hormones. Practicing meditation has been shown to lower cortisol levels, and testosterone levels appear to rise when a man hears a baby crying but can’t comfort the child. There is a lot to be learned about the complicated connection between hormones and behavior, and research about hormones will continue to be fertile ground for many years to come.Student Resource 11.3Review: HomeostasisStudent Names:_______________________________________________________ Date:___________Directions: In the space below this diagram, work with your partner to describe the steps in the feedback loop of maintaining homeostasis in the temperature of the house. Student Resource 11.4Reading: Endocrine Feedback LoopsStudent Names:_______________________________________________________ Date:___________Directions: Read through the descriptions of the three endocrine feedback examples independently. Working with a partner, answer the questions and fill in the boxes to identify the components (stimulus, receptor, control center, effector, and response) in each feedback loop. Endocrine Loop 1When the loud “pop!” of a balloon startles you, it sets off a series of events that ultimately result in changes in many functions in your body. It all starts with the sound entering your ears, sending signals to the temporal lobe in your brain. Your brain then integrates that information, and sends the message “unknown threat!” to the hypothalamus. In response, the hypothalamus does an unusual trick: it sends a signal via a neuron directly to your spinal cord. This signal alerts neurons in your spinal cord that are part of the sympathetic nervous system, and they carry the message to the adrenal medulla, “hey, we need to be ready to spring into action here.” In response, the adrenal medulla pumps out epinephrine and norepinephrine, which help maintain your ready-to-fight-or-flee state, keeping your heart beating faster, your blood pressure higher, and maintaining metabolic changes that keep you more alert. This is one of the few hormonal cycles in your body that is stimulated directly by the nervous system, and it is one of the ways in which the nervous and endocrine systems are linked. 0163830How else are the nervous and endocrine systems linked? 00How else are the nervous and endocrine systems linked? Fill in the boxes in the diagram that follows and describe what is happening in each of the steps. Endocrine Loop 2The control of many hormones in the body involves a set of feedback loops that sometimes become quite complicated, involving several organs and substances in the body. One of the simpler and more typical systems is the loop that controls the release of thyroid hormone. Unlike the rush of adrenaline caused by the popping balloon, the release and regulation of thyroid hormone is a continual process that goes on as a cycle rather than having a particular starting point. Therefore, we have to choose a point in the cycle to start describing it, so we’ll begin at the hypothalamus. 7620078740What mechanisms in the body does the thyroid control? 00What mechanisms in the body does the thyroid control? The hypothalamus releases a hormone called TRH (thyrotropin-releasing hormone). TRH goes to the anterior pituitary, where it stimulates the production of TSH (thyroid stimulating hormone). The anterior pituitary secretes the TSH into the bloodstream, where it circulates and finds its target cells in the thyroid gland. The TSH stimulates these target cells to produce thyroid hormones and secrete them into the bloodstream. These thyroid hormones will affect changes in the body, and the levels of thyroid hormone will also be detected by the hypothalamus as blood circulates through it. When the hypothalamus senses that there is enough TSH in the body, it stops secreting TRH, which, in turn, stops the anterior pituitary from secreting TSH. Less TSH means the thyroid secretes a smaller amount of thyroid hormone. When the hypothalamus detects that levels of thyroid hormones have gotten too low, it will start to produce TRH and start the cycle all over again. Fill in the boxes in the diagram and describe what is happening in each of the steps. Endocrine Loop 3In the previous two endocrine loops, the hypothalamus serves as the control center, initiating the cascade of events that leads to a change in physiological function (your heart beating faster or your metabolism speeding up). In the case of your pancreas, the gland itself is the primary regulator of its own activity, deciding which hormone to secrete depending on the level of glucose it detects in your blood. The pancreas produces two separate hormones that have opposing effects on the body as a whole, and each has its own relatively simple feedback loop.When you eat, you bring more glucose into your system. When the level of glucose in your blood rises, your pancreas detects the increase and secretes insulin into your bloodstream. Insulin allows glucose to enter your cells, where it’s used to power basic cell functions or is stored either as fat or a substance called glycogen, which is a polymer of glucose that is similar to starch. As your cells are taking up the glucose, your blood glucose levels fall. When they reach a normal level, the pancreas stops producing insulin.If you have to skip a meal and don’t get to eat when you need to, your blood glucose levels will fall below normal. When your pancreas detects that decrease, it will begin to produce glucagon. Glucagon releases glucose from various energy stores around the body, especially those that have stored extra as glycogen, so that it can enter the bloodstream. Glucose levels then rise, and when they return to a normal level, the pancreas stops producing glucagon.Fill in the boxes in the diagram and describe what is happening in each of the steps. Student Resource 11.6Reading: Diabetes and TeensStudent Name: Date:Directions: Complete this reading independently. Record your answers to the questions at the end of the reading in your notebook.Minnie Ortiz had never even heard of type 2 diabetes when she was diagnosed with it at age 12. She’d been feeling nauseous and tired. She was really thirsty, drinking lots of sugary sodas like Pepsi and sport drinks like Gatorade. She had to go to the bathroom a lot. Her family didn’t know what was wrong with her, either. One day, Minnie’s blood sugar skyrocketed and she fell into a diabetic coma. It took her a week to come out of it, and when she did, she learned that she had type 2 diabetes.Minnie is hardly alone. Nearly one in every four American teenagers may be on a path to type 2 diabetes or already have the disease. Cases of type 2 diabetes have been on the rise in the United States over the last couple decades, but the increase among teens is especially startling. As recently as 2002, researchers estimated that only about 1 in 10 teens was at risk for type 2 diabetes. Now the risk is at least twice that. Before 1990, type 2 diabetes was so rare among children that it was even called adult onset diabetes. What is the difference between type 1 and type 2 diabetes? The symptoms of type 1 and type 2 diabetes are similar, though their causes are different. In type 1 diabetes, which is an autoimmune disease, the patient’s immune system has killed off the cells in the pancreas that produce insulin. In type 2 diabetes, the patient’s pancreas may have lost some or all of its ability to produce insulin because it has been overworked, or important cells in the patient’s body may have become resistant to insulin. For both types, genes appear to play some role. Type 1 diabetes strikes a wide range of individuals, but most patients with type 2 diabetes have two things in common: they are overweight and they get very little exercise. How do people know if they have diabetes?In both types, there is too much glucose in a patient’s blood. This is because the patient doesn’t have enough (or any) insulin. As you know, insulin is the hormone that stimulates cells throughout our bodies to take up glucose for energy. Since their cells aren’t able to bring the sugar in, a person with diabetes will feel really tired and be thirsty all the time even though he or she is drinking lots of fluids. The reason the person feels so thirsty is related to the fact that there is so much glucose in his or her blood. It’s the job of the kidneys to filter certain things out of the blood, add water to the stuff that’s been filtered out, and flush it out as urine (pee). If you have too much glucose in your blood, your kidneys have to work overtime, producing extra urine, which takes extra water out of your body. Plus, a diabetic will keep drinking lots of water, so another symptom of diabetes is having to go to the bathroom a lot. Diabetes for a lifetimeThere is no cure for type 1 diabetes. Although sometimes type 2 can be reversed with appropriate diet and exercise, most people will have it for the rest of their lives. And over time, diabetics experience a range of health complications. Many diabetic patients develop nerve damage and poor circulation, because high blood sugar can harm the tiny blood vessels that bring nutrients to your neurons. The nerve damage may be felt as numbness or tingling in their fingers or toes, or it may mean losing feeling in an entire arm or leg. If you know a diabetic who has had to have their foot in a medical brace or boot, it was likely for this reason. High blood sugar can also damage nerves in the retina of the eye, and cause blindness. Diabetics are at high risk for heart disease and heart attacks, as well as kidney disease. Diabetics are also more prone to skin and mouth conditions, and their wounds and injuries often heal more slowly. It can be difficult for a diabetic to manage his or her blood sugar well enough to avoid these complications, and researchers have recently found that blood sugar—and therefore overall health—is even more difficult to control in teens. They aren’t sure why this is, but some doctors suspect that it might be related to all the growth and hormonal changes that happen during adolescence. Because type 2 diabetes didn’t really exist as a childhood disease until two decades ago, doctors are just now beginning to understand how the disease is different in teenagers. The most common treatment for type 2 diabetes is metformin, an oral medicine that lowers blood sugar. It works well for adults, but a 2012 study of 699 children found that metformin failed to keep blood sugar under control for over half of the children who were using it. Another medication that was also tested had poor results. What that means is that there isn’t currently a good way to keep teens with type 2 diabetes from progressing to the point where they need insulin injections and potentially begin to suffer complications. Doctors are concerned that teens with type 2 diabetes will get sicker faster than adults and live shorter lives. What you eat is criticalA key aspect of managing blood sugar that affects everyone—both diabetics and nondiabetics—is the kinds of foods we eat. Some foods contain a lot of sugar or starch molecules and not much else. When you eat these types of foods, your body converts them to glucose quickly. That means your blood sugar rises quickly and also falls quickly, which is called a blood sugar spike. Foods that cause these spikes have what is called a high glycemic index. The glycemic index (or GI) is a measure of how quickly a food will make your blood sugar rise. A GI below 55 is considered low. A GI above 70 is high.Blood sugar spikes make your pancreas work harder, because it has to produce more insulin in order to process the sudden rise in sugar. Our bodies are not actually designed to deal with constant sugar spikes, since most foods in nature don’t cause them. So over time these constant blood sugar spikes can wear your pancreas out and lower its insulin production. Researchers still have a lot to learn about the link between diet and diabetes, but they have found that eating a lot of high GI foods can increase your chances of developing type 2 diabetes—especially if you have a family history of the disease.Low-glycemic-index foods either don’t have much starch and sugar, or the starch and sugar are balanced with other nutrients, like fats and proteins. When protein, fat, and other nutrients are combined with carbohydrates in a food, that food will cause less of a blood sugar spike. The food requires more than just being broken down into sugar molecules, so glucose enters the system more gradually. Think about orange juice versus an orange. Orange juice is mostly the sugar in the orange, water, and a few nutrients like vitamin C. Orange juice made from frozen concentrate has a GI of 57. An orange, on the other hand, also contains pulp, which is mostly made of a substance called fiber. The GI of an orange varies, depending on the kind of orange, but it can be as low as 33. That’s a big difference!Plants such as whole wheat, brown rice, nuts, beans, and fruits contain fiber. Fiber is made up of molecules in plants that aren’t digested but instead pass through and out of your body. Processed foods often have the fiber removed, which is one reason they tend to have a higher GI. For example, the white rice we’re most familiar with is white because the brown outside of the rice kernel has been removed. That outer layer of rice contains a lot of fiber and protein. Once it’s been removed, all that’s left of the rice is starch—carbohydrate.PreventionThe good news: most people can avoid getting type 2 diabetes. Eating low GI foods is helpful, because they keep your blood sugar from spiking and leave your feeling more full and satisfied. The other important prevention measures are exercising and maintaining a healthy weight. Exercise keeps your weight down, allows you to enjoy more food, and keeps your cells doing their jobs efficiently. Questions:1. What is type 2 diabetes? How is it different from type 1 diabetes?2. What are some symptoms of type 2 diabetes?3. What are four potential complications of type 2 diabetes?4. Why is it more difficult to treat diabetes when someone gets it as a teenager?5. What are three things you can do to prevent getting diabetes?Student Resource 11.7Graphs: Blood Glucose and InsulinStudent Names: Date:Directions: With your partner, study the graphs below and answer the questions that follow them.1. When you eat, your blood sugar level rises. How much your blood sugar goes up depends on how much food you’ve eaten and what kind of food. When your pancreas detects higher blood sugar, it secretes insulin, and the amount of insulin it secretes depends on how much your blood sugar has gone up. The graph below shows a typical pattern of how blood sugar and insulin levels would go up and down over the course of a day.a. What has happened to your blood sugar when you are hungry?b. What happens to the level of insulin as your blood sugar falls?2. Below is a graph that shows how low- and high-glycemic-index foods compare when it comes to their effects on blood glucose and insulin production. Using the graph and what you know about carbohydrates and food, answer the questions that follow.a. How long after you eat does your blood sugar start to rise?b. Why is the insulin curve higher and sharper for the high-glycemic-index foods? c. If your blood glucose is all used up and therefore falls below a detectable level, as it does in the graph on the right, how does your pancreas respond? (Hint: You learned the answer when you completed Student Resource 11.4, Reading: Endocrine Feedback Loops.)Student Resource 11.8Guide: Menu Makeover PamphletStudent Name: Date:Directions: Use this guide to work through the steps of creating your menu makeover pamphlet. Fill in each section as directed. Begin with writing down basic information in the Recording Your Research and Ideas section at the end. Case StudyLawrence is a 10th grader who’s been having a tough year at school, so he has had to study a lot. When he’s not studying, he’s usually working at his part-time office job for a friend’s dad. When he’s got free time, he likes to play Nintendo games. But several months ago, Lawrence started constantly feeling like he was coming down with something. He was tired all the time and felt generally under the weather. At first he just thought he was getting the flu, but the longer he felt bad, the more he started to wonder if maybe something else was wrong. Finally, he went to see a doctor.After the doctor did a check-up, he told Lawrence, “It’s possible that you are developing what we call prediabetes. That’s when a person’s blood sugar is higher than normal, but not high enough to be classified as diabetes.”“Oh…,” Lawrence looked at the doctor. “My aunt has type 2 diabetes. Am I going to get it?”“Well, thankfully for you,” the doctor said, “A person who is prediabetic might be able to fend off diabetes by changing his or her eating habits and lifestyle. But you do have some of the risk factors. Having diabetes in your family already increases your chances of getting it. Between your job and studying and Nintendo, you don’t get to exercise much. That’s probably part of the reason you’re carrying too many extra pounds.”Lawrence looked down. “I know. I don’t like it. My brother lifts weights and stuff and he told me to try some kind of protein shake diet that he does. So I tried it, but it didn’t work.”The doctor smiled. “The good news is that you can lose weight and still eat a lot of tasty things besides protein shakes. And a lot of the changes you’d make to lose weight are also changes that will help stabilize your blood sugar. If you can do both of those things, that will help keep you from developing diabetes.”Lawrence was skeptical. “I don’t know … sounds hard. I don’t really know what to do.”“Tell you what,” said the doctor, “Keep track of everything you eat for three days. Then bring in your list and we’ll have our nutritionists look at it and do a little menu makeover. Then you can try the ideas they come up with and see what you think.”Lawrence was still skeptical, but he agreed to the deal. The next week, he brought his list in to the doctor’s office. Here’s what was on it:Day 1Breakfast: Two chocolate donuts and a bottled mocha coffee drinkLunch: A burger with fries and a CokeSnack: A snack bag of potato chips, a snack bag of pretzels, and a GatoradeDinner: Pepperoni pizza, chocolate ice creamDay 2Breakfast: Bagel with cream cheese, orange juiceLunch: Ham and American cheese sandwich on white bread, a carton of whole milk, three peanut butter cookiesSnack: Snicker’s bar and a can of CokeDinner: Chicken nuggets, mashed potatoes, a brownie, and a glass of milkDay 3Breakfast: Corn flakes with whole milk and orange juiceLunch: Steak burrito and a CokeSnack: Nachos with cheddar cheese, a can of sweetened iced teaDinner: Box of macaroni and cheese, salad with tomatoes, croutons, and blue cheese dressing, can of 7UpCreating the Menu MakeoverYour task is to be Lawrence’s nutritionist. To give his menu a makeover, you can:Use some of the same dishes he ate but write recipes for them that substitute healthier ingredients for some of the unhealthy ones.Find recipes for dishes that are similar but that use ingredients that have fewer calories and a lower GI.Substitute recipes for dishes that are healthier and sound good to you, that you’d like to try, and that you think would appeal to Lawrence. Be sure to include some fresh fruits and vegetables in your menus so that Lawrence gets a wide variety of nutrients.Make sure Lawrence is getting enough calories, even though you want him to be eating fewer. A sedentary teenage boy like Lawrence, who isn’t getting much exercise, needs about 2,200 calories a day. Your recipes should include the following information:Recipe or explanation of what is included in the mealServing size (include the amount of each ingredient)Carbs per serving Calories per servingFor each meal, a one- or two-sentence description of how it is an improvement over Lawrence’s original meal from a diabetes-prevention e up with a varied meal plan; don’t use the same dishes each day. Think of it as creating a set of menus that you’d be willing to try to follow. Finding SubstitutionsUse the chart and URLs below to find values for carbs, GI, and calories in the foods you’ll include in your menu. Think about serving size as you plan your menu and be realistic—does your meal require one serving of a certain food or two? Also, you will have to take each of the three values into consideration. Remember:Consider GI when thinking about whether a food will create a blood sugar spike. If you mix a high GI food with a low GI one in the same dish, that will help balance the glucose spike.Remember that some low GI foods are high in calories. Adding a lot of fat to something with a lot of sugar (like a cake or ice cream) can lower the GI but it sure doesn’t lower the calories. And important part of a diabetes prevention diet also involves losing weight and maintaining a healthy weight. So be sure to keep your meal calorie counts in mind.Keep an eye on total carbohydrates. Carbs need to be balanced with fats and protein to maintain a healthy weight, and total carbs, no matter what the GI, still make a demand on the pancreas.Low GI = a GI below 55Medium GI = GI between 55 and 70High GI – GI over 70If there are foods that you’d like to use that aren’t listed in the chart, use the URLs below the chart to look them up. Food Values ChartFoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingBreads, pastries, and other bakery itemsBagel1 7248245Baguette 4” slice9536185Corn tortilla1 6” tortilla521152Hamburger bun1 6021117Pumpernickel bread1 slice561265Flour tortilla1 10” tortilla3040234White bread1 slice711474100% whole grain bread1 slice511274Waffles1 4” square7615100Doughnut, glazed1 medium 7623192English muffin, white flour1 7725127English muffin, multigrain1 4326133Blueberry muffin1 medium (113 g)5961426Peanut butter cookie1 medium6418143Brownie2.5” square5129180Chocolate cake with frosting1 slice (1/12 of cake)3873537FoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingPasta, grains, and cerealsSpaghetti, white flour, cooked1 cup4243220Spaghetti, whole grain, cooked1 cup3237174Rice, white, cooked1 cup8946205Rice, brown, cooked1 cup5046218Quinoa, cooked1 cup5340222Wheat bulgur, cooked1 cup4834151Barley, cooked1 cup2844193Rice noodles (Chinese), cooked1 cup4644192Bean thread noodles (Thai), dry1/4 cup2630123Corn flakes1 cup9324100Instant oatmeal, maple and brown sugar flavor1 packet8332157Granola1 cup6138215Granola bar, chocolate coated1 bar6215152FoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingBeans and nutsPinto beans, cooked1 cup3945245Black beans, cooked1 cup2040218Lentils, green, cooked1 cup2240230Baked beans, with pork1 cup5651268Cashews1/4 cupVery low9163Peanuts, dry roasted, salted 1/4 cup78214Hummus (chickpea dip)1/2 cup618204FoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingFruits Apple, fresh1 medium362595Apple, dried1 cup2957209Banana1 medium5127105Orange1 medium431869Watermelon1 cup diced761146Grapes1 cup5927104Raisins1/2 cup6465247Pineapple, unsweetened1 cup592282Strawberry jam1 tbsp511456FoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingVegetablesCarrots, fresh1 cup sliced or baby carrots351250Peas, frozen1/2 cup516211Cabbage 1 cup shreddedVery low418Broccoli1 cup choppedVery low631Green beans1 cup of 1/2“ piecesVery low731Tomatoes 1 cup choppedVery low732Mushrooms1 cup slicedVery low215Onions 1 large slice 1/4” thickVery low315Potato, mashed with milk and butter1 cup8735159Potato, baked1 large11163224French fries, frozen20 fries7543255Yam, baked1 cup cubed 5437158FoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingEggs, milk, and dairy productsEgg, hard boiled1 large0178Egg, fried1 large0190Cheese, cheddar1 sliceVery low1113Cheese, American1 sliceVery low269Cheese, cream1 tbspVery low150Cheese, mozzarella1 cup shreddedVery low4341Cheese, Swiss1 sliceVery low2106Cheese, string1 stickVery low080Milk, skim1 cup321291Milk, whole1 cup2712149Yogurt, plain lowfat1 cup1417154Yogurt, lowfat with fruit1 cup3347250Chocolate ice cream1 cup6819143Frozen yogurt, nonfat? cup1223110Orange sherbet1 cup1130107FoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingMeats and meat productsBacon2 slices0186Hamburger1/4-lb. patty00141Chicken breast, roasted1 cup chopped or sliced00276Chicken drummies, breaded1 drumstick06200Hot dog1 hot dog02185Pepperoni1 slice0010Sliced turkey1 slice0015Tuna fish1 cup 00132Salmon6 oz00300FoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingBeveragesCoca-Cola1 can63351367UP1 can6038151Gatorade, orange flavor1 bottle (8 oz.)8939158Orange juice1 bottle (8 oz.)5028122Apple juice1 bottle (8 oz.)4428114Lemonade 1 bottle (8 oz.)5426106Strawberry banana smoothie1 bottle (8 oz.)442091Soy milk, vanilla1 cup710100Hot or iced tea, unsweetened1 box/can (12 oz.)00.672FoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingSnack foods and candiesMicrowave popcorn1 bag6547463Potato chips1 snack-size bag (1.5 oz.)5122230Pretzels1 snack-size bag (3.5 oz.)8379377Tortilla chipsSnack-size bag (3 oz.)7428208M&Ms1 bag (1.7 oz.)4334236Snickers bar1 5114280FoodServing SizeGlycemic IndexTotal Carbohydrates (in grams)Calories per ServingMixed foodsCheese pizza1 slice6036285Macaroni and cheese, box mix1 cup6444310Frozen breaded chicken nuggets6 nuggets4617355Canned beef barley soup1 cupmoderate26202Cliff bar (cookies and cream flavor)1 10145235Steak burrito (fast food)1 3750454Web sites with additional lists of foods:If you want to include other foods in your menu that aren’t on your list, you can use these two websites to get the numbers you need:National Nutrient Database from the USDA: for the food item, click on the link to it. At the top of the page, you can fill in the amount of the food item (2 ounces, 1 cup, etc.) and it will give you details on that amount. You can use this site to give you calories and carbs per serving. Calories are listed as “kcal,” which stands for kilocalories, the technical name for the calories we eat.Glycemic Index of Foods: Use this database to get the GI of a food. Again, type your item into the search box and hit the return key on your keyboard, and you’ll get the GI. Make sure you are using the number for glycemic index (GI) and not glycemic load (GL).Recording Your Research and IdeasUse these charts to make notes and keep track of what you’d like to include in your menus. Day 1BreakfastFoods or dishes from the original menu you’d like to change:Foods and dishes for the new menu:Serving size:Total carbs per serving:Total calories per serving:LunchFoods or dishes from the original menu you’d like to change:Foods and dishes for the new menu:Serving size:Total carbs per serving:Total calories per serving:DinnerFoods or dishes from the original menu you’d like to change:Foods and dishes for the new menu:Serving size:Total carbs per serving:Total calories per serving:Day 2BreakfastFoods or dishes from the original menu you’d like to change:Foods and dishes for the new menu:Serving size:Total carbs per serving:Total calories per serving:LunchFoods or dishes from the original menu you’d like to change:Foods and dishes for the new menu:Serving size:Total carbs per serving:Total calories per serving:DinnerFoods or dishes from the original menu you’d like to change:Foods and dishes for the new menu:Serving size:Total carbs per serving:Total calories per serving:Day 3BreakfastFoods or dishes from the original menu you’d like to change:Foods and dishes for the new menu:Serving size:Total carbs per serving:Total calories per serving:LunchFoods or dishes from the original menu you’d like to change:Foods and dishes for the new menu:Serving size:Total carbs per serving:Total calories per serving:DinnerFoods or dishes from the original menu you’d like to change:Foods and dishes for the new menu:Serving size:Total carbs per serving:Total calories per serving:Putting it all togetherWhen you’ve completed your research, you should have a plan for breakfast, lunch, and dinner for three days. Now you need to put your menus together into a pamphlet. Put each meal on a separate piece of paper—when you are done, you should have nine sheets of paper altogether. You can lay the information out in any way you like, and use pictures, too. Just make sure that you have included all the required information and that the menus are clear and understandable, because you will be sharing them with your classmates. If you are using a computer to create your menus, print them out. If you have time, you can also make a cover for the pamphlet. Then staple the pages together.Assessment CriteriaMake sure your assignment meets or exceeds the following assessment criteria:The pamphlet is thorough and covers all of the required information.The information in the pamphlet follows in a logical order.The pamphlet content indicates an understanding of the information a prediabetic person can use to affect his or her condition.The pamphlet shows an understanding of which foods have a high versus a low glycemic index and how to construct a healthy diabetes-prevention meal.The pamphlet is neat, with no errors, and the information is easy to read. ................
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