Lecture 3Respiration,blood,circulation and Nutrition

Entrance Window

SodaLyme

Meter

Oxygen cylinder

Yasuo KAGAWA. “Easy nourishment study” KAGAWA Nutrition publishing, 2006, p.31

A, B

Th

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D M

oto

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the

air

E P

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ditio

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rAtwater-Benedict human calorimeter

Relation among breath on inside, outside breath, circulation, and blood

Cell

Blood

Inside body

Outside body

Breath outside breath and in is connected through the blood circulation

Glucose

Pulmonary alveolus

External respiration(Lung respiration)

Gas exchange between in blooding

and pulmonic

Gas exchange between blood and cell

Internal respiration(Organization respiration)

Internal respiration

Source: A part of "Medical student science that learns one step a step" project (http://physiology1.org) by "Medical student science education sharing group"

Mitochondria

Mitochondria are respiratory organs of the cell

ATP is synthesized by using oxygen. ATP is a source of the activity of the mind and body. Supporter of aerobics

It is few in the white muscle of a lot of sprinters who are in marathon runner's red muscle.

The fault of making the active oxygen also.

Oxygen in lungs － The carbon dioxide exchange the outside breathes. The mitochondrial respiration in the cell breathes on the inside

The first purpose of nourishment, breath, and the circulation is syntheses of ATP. The purpose of confirming the vital sign like consideration, the pulse, the number of breaths, and the temperature, etc. is to know whether ATP of the cell is safely supplied with oxygen and the nutrient.

Oxygen

Carbon

Phosphorus

Nitrogen

Hydrogen

ＡＴＰ＝ Adenosine triphosphoric acid

Energy source of living body

Yasuo KAGAWA. “Easy nourishment study” KAGAWA Nutrition publishing, 2006, p.33

ATP Cycle

Cellu

lar respiratio

n.

Co

mb

ustio

n o

f n

utritio

nal

sub

stance.

・

Ch

em

os

yn

the

se

s

・ Activ

e tra

ns

po

rtM

us

cle

・ contra

ctio

n

Function　 of cell

O2

CO2

＋H2O

Ad － P ～ P ～ P　　 （ ATP)

Ad － P ～ P ＋ P　（ ADP) 　（ Phosphoric acid ）

ATP synthesized with mitochondria is used to act of the mind and body, resolved to ADP and Pi, and synthesized to ATP by mitochondria again.

Amount of basal metabolic rate of healthy adult male (65kg) according to internal organs

－ Amount of ATP generation calculated from oxygen absorbed

Internal organsＯ２＊１ ＡＴＰ＊２

mmol/minute mol/day

mmol/minute mol/day

Liver （ including abdomen ）

BrainHeartKidney

Musculus skeletiOthers

2.631.850.671.021.771.89

3.82.71.01.52.62.7

15.7811.10 4.02

　 6.1210.6211.34

22.716.0 5.8 8.815.316.3

Amount 9.83 14.2(453g)

58.95 84.9(43kg

)*2 ATP generation amount calculated as ATP/O= ３

　 Standard by Dr. CallDuring 120 times of pulsus frequens/minute or more 50 times of the bradycardia/ as follows

Standard by Dr. Call From high blood pressure 180mmHg or more

to low blood pressure 90mmHg or less

24 times of increased breathing rate/minute or moreEight times or less of breath/a minuteFive times of artificial respiration beginning/minute

Vital Day and time

Ｘ

name age

Basis of heart revival method

Airway management

Artificial respiration

Cardiac compression

Except minute movement

Pulmonary artery

Pulmonary

artery

Atrium dextrum

Ventriculus dexter

Ventriculus sinister

Atrium sinistrum

Capillary

Pulmonary vein

Ao

rta

Source: A part of "Medical student science that learns one step a step" project (http://physiology1.org) by "Medical student science education sharing group"

Electrocardiogram of normality : Sinus rate

Normal 　６０～１００ / minute

s

ＲＲ intervalAn electric excitement that happens by nodus sinuatrialis shrinks, and positive Den of order is gotten and shrinks to the entire heart

End of excitement

Sinoatrial node excitement

１mV

The pulse is 60/minute if the R-R interval is one second

約１mV

Ventricular systole

Atrial contraction

Restarting Battuta Ugo of the heart that stopped by using AED ！

Electrocardiogram of ventricular fibrillation (Ventricular fibrillation : VF)Continuousness of curve that cannot distinguish P, QRS, and T without rule at all. Except emergency

⇒ minute movement

Strict fixed quantity of senior citizen's energy metabolism by PEG （ Nami SASAKI, 2007)

stomachOutside of

the body

Abdominalwall

The most basic energy metabolism of the individual variation is large. Amount of metabolizing at rest and each calculation value of PEG of 900kcal during a day

Y = 771. 315 + 0. 136 × X ; R2 = 0. 111

400

600

800

1000

1200

1400

1600

400 600 800 1000 1200 1400 1600

Y = 773. 367 + 0. 171 × X ; R2 = 0. 088

400

600

800

1000

1200

1400

1600

400 600 800 1000 1200 1400 1600Y = 882. 232 + 0. 187 × X ; R2 = 0. 106

400

600

800

1000

1200

1400

1600

400 600 800 1000 1200 1400 1600

ＢＥ

Ｅ

REE （ Actual measurement value ）

ＢM

R

REE （ Actual measurement value ）

Sim

pli

city

BM

RREE （ Actual measurement value ）

B group:Strict amount of energy metabolizingPEG:Transdermal endoscope gastric fistula TsctscjutsThe composition is also constant

P 　 F 　　　 C

18 　 22 　　60 （ % ）

Nami SASAKI (2007) 　 Recommended article

The Ministry of Health, Labour and Welfare, 　“ Inspection examines blood pressure” 　 Available from <http://www.mhlw.go.jp/topics/bukyoku/kenkou/seikatu/kouketuatu/inspection.html>, (accessed 2007-10-23)

Classification of blood pressure

Hypertension

Blo

od

pressu

re systolic

Blood pressure diastolic

Severe

Middle

Slight

NormalHighvalueNormal

Bloodpressure

Healthy

Best

Cause disease of bedridden

Cerebrovascular disease

Heart disease

Weakening by aged

Dementia

Rheumatism ・Arthritis

Cold ・Pneumonia

Fracture ・ Fall

Others

Uncertainty

National Livelihood Survey (1998)

Number of estimates

356,000

Yasuo KAGAWA. “Easy nourishment study” KAGAWA Nutrition publishing, 2006, p.147

Person's of taking medicine ratio(whole country and each age class)There is no country where a lot of consumption of the medicine exists like Japan

05

1015

202530

3540

4550

50-59 60-69 upper 70

Medicine that lowerblood pressure

Medicine that mendsdisorder of pulse

Medicine that lowersinsulin injection or bloodsugarCholesterol- loweringmedicine

The Ministry of Health, Labor and Welfare “The healthy people and nourishment investigation report” 2003

Each age of man and woman total

Ratio of hypertension (men)Hypertension of the slight illness person is more than a normal person

0

5

10

15

20

25

30

35

40

50-59 60-69 above 70

NormalSlight IllnessMiddle SyndromeSerious Illness

National healthy nourishment investigation )2003

It makes it from normal high price

blood pressure 130 to the problem

in “Metabolic syndrome”

Yasuo KAGAWA. “Easy nourishment study” KAGAWA Nutrition publishing, 2006, p.135

Ratio of hypertension (women)

0

5

10

15

20

25

30

35

40

45

50-59 60-69 Above 70

NormalSlight IllnessMiddle SyndromeSerious Illness

National healthy nourishment investigation (2003)

It makes it from normal high price blood

pressure 130 to the problem in “Metabolic

syndrome”

Hypertension and arteriosclerosis

Obesity

HeadacheTinnitus

Evil intention

Multi urineUrine at nighttimeDryness of mouth

Heart painPalpitationBreathing difficulties

Urine protein

Cardiac infarctionCardiac failure

Sclerotic kidney syndromeUremia

Brain hemorrhagecerebral infarction

Heart disease Apoplexy Kidney disease

Yasuo KAGAWA. “Nourishment 　 biochemistry” KAGAWA Nutrition publishing, 1970, p.271

Maintenanceof proper weight

Excessive calorieSaturated fatty acid

Mental tension

High cholesterol

Pressor substance

Essentialhypertension

Arterios-clerosis

Hereditary predisposition

Escape Cholesterol medicine

Essential fatty acidProtein

Excess salt intakeJapanese: 12-15g/ a day

Ca antagonist, AngiotensinSalt limitation, Inhibitor converting enzymeAntihypertensive diuretictranquilizer

Inhibitor converting enzyme

Possibility of getting cardiac infarction

Hypertension

Hyperlipemia

Diabetes

Smoking

ALL

Not to do what had used to doDo

Cerebral infarction appearance of disease rate

MenRate o

f app

earance

Systolic arterial pressureDiastolic phase of uterine contraction

Per 1,000/year

(Research in Hisayama-machi)

Improvement method of hypertension

Low salt and potassium uptake Low salt of 6g→ shrinkage period blood pressure 3mmHg decrease Potassium increase → shrinkage period blood pressure 2mmHg

Correction of obesity1BMI decrease → shrinkage period blood pressure 2mmHg decrease

1 temperance combination (1 glass of beer)shrinkage period blood pressure 5mmHg decrease

Fast walking for 30 minutes a dayshrinkage period blood pressure 5-10mmHg decrease

Frequency of aryl of gene that relates to salt receptivityJapanese becomes hypertension easily being inherited more than Caucasian

45

81Japanese

Caucasian

Angiotenshinorgen　　　　 　Ｔ 235

50

69Japanese

Caucasian

Aldosterone synthetase　　　　 　Ｔ -344

25

52Japanese

Caucasian

G Proteinβ3 （ Na-H pump ）　Ｔ 825

15

57Japanese

Caucasian

α Adushin　　Ｔ rp460

(Ishikawa, Hypertension 2001)

(Ishikawa, Am J Hypertens 1998)

(Tsujita, Hypertens Res 2001)

(Ishikawa, Am J Hypertens 2000)

（ Unit：％）

Amount of meal of blood sugar load and relation of HDL cholesterol

(1349 farm village females of 20-78 years old)

67.265.5

62.1 61.9 60.8

58

60

62

64

66

68

70

Five quantities of amount of meal of blood sugar load (center for each 1000kcal value)

HD

L C

hole

ste

rol

（m

g/d

L）

The value is mean value ± standard error. Tendency P=0.038.Adjusted (Inhabitable area, use of age, state of climacteric, smoking, and supplement, feeding speeds, body activity levels, energy intakes, energy ratio, partaking of alcohol, dietary fiber intakes of fat, present BMI, and

BMI at 20 years old) 　　　　　　　　Murakami et al. Am J Clin Nutr (in press)

Influence that active oxygen (Free radical)exerts on blood vessel

Blood vessel

Arteriosclerosis

The microcirculation

is imperfect

Macrophage of making to bubble

Blood vesselEndodermis Cell Monocyte

Oxidation LDL

Blood vessel slack

Vasoconstrictor

Overoxidation of cell film

Vasoconstrictor

Red blood cell

Endodermis trouble

Other diseases cannot be prevented by improving one symptom

The reduction of the entire iceberg is safe

MetaboriccshindorormInternal organs obesity

Individual treatment Lifestyle improvement× ○

Excessive nourishmentLack of physicalactivityMaking of foodEuropean-style

⇒

Arteriosclerosis

High Cholesterol bloodLow HDL-Cholesterol

Hypertension High blood of sugarObesity

High neutral fat blood syndrome

High uric acid

Glucoseintolerance

⇒

ApoplexyHeart diseaseDiabeticCancer(intestine, breast)GoutLungs flat cuticle cancer

Metabolic syndrome is a kernel of the lifestyle disease. (internal organs obesity, insulin resistance, hypertension, and hyperlipemia)

〇 〇 〇 〇 〇 〇

Administering the medical treatment of present Japan is easy and is earnings Prevention is the best

Yasuo KAGAWA “Prevention of life related disease （ IWANAMI Shinsho ）

. IWANAMI Shoten, 2000, 24p.

Significant decrease in blood pressure because of MS improvement by nourishment and movement guidance of no administering (1968-1980)

Hypertension 283,normal 446

Fall of I-IV is all P<0.01

Kagawa Y, Kagawa A:Nutritional Prevention of CVD

(Lovenberg W et al. eds, Acad. Press, N.Y., 1984, pp.339-348)

この中で追跡可能なものAfter 23 years, average 127/75

“National nutrition survey” 136/79

Bloodpressure

Serum total cholesterol

Comparison of Guidance before and afterby Nutrition clinic (KAGAWA Nutrition University)

Before After Before After

Before After

Before

After

Fat in the serum Glucose toleranceBlood sugar

Normal

Normal

Systolic arterial pressureDiastolic phase of uterine contraction

min

The person who attend “Eiyo (Nutrition) clinic “

maintains health at a long term

Attendant

“Nutrition clinic”Contrast

Present : pObject person

vs

ContrastWhen attend

Present Present

BMI （㎏ /m2 ）

25.7±3.2 24.6±3.9 23.3±0.4 0.0050

SBP （㎜ Hｇ）

119.4±14.5 127.1±18.5 135.5±6.3 0.0006

DBP （㎜ Hｇ）

75.0±9.1 74.9±10.3 79.4±1.4 0.0007

TC （㎎ / ｄｌ）

208.8±34.7 225.2±33.5 211.9±6.5 0.0015

TG （㎎ / ｄｌ）

95.6±46.9 100.2±55.8 134.2±10.9 ＜ 0.0001

(After 23 years on the average attending a lecture, this ages are the national nourishment investigation transitions and are compared )

＊

＊＊

＊

Change in salt intake

13.5

13.7

13.413.4

13.012.9

12.5

12.312.4

12.212.112.1

11.7

12.212.2

12.5

12.912.912.812.8

13.2

13.012.9

12.712.6

12.3

11.0

11.5

12.0

12.5

13.0

13.5

14.0

75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00

National average Nishi-Aizu

13.6

12.4

year

g

Material2002 the Ministry of Health, Labour and Welfare ‘Current state of national nourishment' versionsData for 93 years and 94 years is a meal record and about 200 of the three days.

Heat-and-serve m

eal

Apoplexy suppression of Nishiaizu the districtStudent research by "Food cultural nutrition faculty, Kagawa nutrition university"

Amount of Na exhaust according to prefectureAll dormitory Jichiidai student (urine for 24 hours)

The salt intake is experienced every year because of the biochemistry practice

２０１－２３６ｍ E ｑ　１８１－２００ｍ Eq 　１６１－１８０ｍ Eq 　１４１－１６０ｍ Eq 　１３６－１４１ｍEq

National nutrition survey (1995) 13.2g→(2002) 11.4g

Number of measurements

N=208

　 (Na1Eq=Salt58.5g)The Japanese northeast part coming from student's salt intake is more intentionally more than the southwest coming from student also in the same dining room

One nitric oxide synthetic enzyme gene T786C multi type doesn't become high blood pressure in case of the salt intake 11.7g or less/a day either

115

120

125

130

135

140

145

150

<7.5g 7.5-9.2g 9.2-11.7g >11,7g

TT typeTC/ CC type

Miyaki K et al.: Am J Hypertens. 18: 1556-1562 (2005)

281 Japanese of 45 years on average

TC/CC type that 17% becomes high blood

pressure easily

Hypertension appearance of disease rate and Angeotenshinorgen gene

polymorphism after three years intervention examinations

45

2825

44

3236

32

41

32

0

10

20

30

40

50

Obse

rvation

Only

Low

Salt Mea

l

Weight Los

s

typeＴＴ typeＴＭ typeＭＭH

yperten

sion

app

earance rate

（％） The TT type increases

production of Angiotenshinorgen to maintain the salt in the inside of the body with tropical forests extremely in the region where the salt is a little.

The ape and the black are 100%. A lot of 30% is had as for the Japanese and Caucasian has a lot of MM types

Systolic arterial blood pressure

Improvement of blood pressures of those who attend normal high price blood pressure

(mmHg)p=0.04

Normal high value

Lower bound value

0

20

40

60

80

100

120

140

160

Before After

(mmHg) p=0.02

Before After0

10

20

30

40

50

60

70

80

90

100

Normal high value

Lower bound value

(n=25)

Quotation from master's thesis (Ishii)

Enhancing periodblood pressure