FUNDAMENTALS OF NUTRITION Minerals Regulate body

processes
Nutrition - Science of food; the nutrients and substance
therein; their action, interaction and balance in relation Water Regulate body
to health and diseases; and the process by which processes
organism (i.e., body) ingests, digests, absorbs,
transports, utilizes and excretes food substances Nutrient deficiency – occurs when person lacks one or
Malnutrition – poor nutrition (undernutrition and more nutrients over a period of time
overnutrition) – Primary - caused by inadequate dietary
intake
Characteristics of Good Nutrition – Secondary – caused by something other
 Alert expression than diet
 Shiny hair Individual at risk from poor nutrition
 Clear complexion with good color a. Infants and Toddlers – depend on their
 Bright, clear eyes mother’s selection of food
 Pink, firm gums and well-developed teeth b. Adolescents – they are subject to peer pressure;
 Firm abdomen may eat at an unusual hours
 Firm, well-developed muscles c. Elderly – often alone and may be unwell; lack of
 Emotional stability companionship, depression, illness
 Good stamina; seldom ill d. Pregnant women – makes a woman’s appetite
 Healthy appetite and need for certain nutrients increase
 Healthy, normal sleep habits DEFICIENCY NUTRIENT(S) LACKING
 Normal elimination DISEASE
 Well-developed bone structures
 Normal weight for height Iron deficiency Iron
 Erect posture anemia
Beriberi Thiamin
Food - Provides energy and nutrients needed to build
Night blindness Vitamin A
and maintain all body cells. Food intake depends upon
the appetite (psychological) and the hunger (physical) Goiter Iodine
of a person Kwashiorkor Protein

Nutrients - Chemical substances in food that contribute Marasmus All nutrients

to health Osteomalacia Vitamin D, Calcium
Osteoporosis Vitamin D, Calcium, phosphorus,
NUTRIENTS FUNCTIONS magnesium, and fluoride
Macronutrients Carbohydrates Provide energy Pellagra Niacin

Fats Provide energy Rickets Vitamin D, Calcium

Proteins Build and repair Scurvy Vitamin C

body tissues, Xeropthalmia Vitamin A
Provide energy
Micronutrients Vitamins Regulate body Nutritional Assessment
processes  Evaluation of one’s nutritional condition
  Process of determining the nutritional status of • Nutritional Guidelines For Filipinos – general
the individual goals for optimal nutrient intake
1. Anthropometric – height, weight, head DIGESTION, ABSORPTION, METABOLISM
circumference, upper arm and skinfold • Digestion – process whereby food is broken
2. Biochemical tests – urine, blood and feces down into smaller parts
– Serum Albumin Level Two types
– Serum Transferrin Level 1. Mechanical digestion – requires mechanical
– Blood Urea Nitrogen movement as chewing, swallowing and
– Creatinine Excretion peristalsis
– Serum Creatinine 2. Chemical digestion – chemical change in foods
3. Clinical examination – signs of nutrient caused hydrolysis, involving enzymes
deficiencies are noted
4. Diet history – 24-hr recall, food diary
5. Economic assessment
6. Body Mass Index
Body weight (kg) or Body Weight (lbs) x
703.1
Height 2 (meters) Height 2 (inches)

• Below 18.5 – underweight

• 18.5 – 24.9 – normal weight
• 25 – 29 – overweight
• 30 – 39 – 0bese
• 40 + - morbid obese

Why do we need to have a sound knowledge of

Nutrition?
• Would help eliminate many health problems
caused by malnutrition
• Can relieve patients’ anxieties by providing
simple and clear explanations
• We can recognize the fad and distinguish it
from the fact
Functions of the Stomach
• The health professional will be an effective
1. Temporary storage of food
professional and will also be helpful to family,
2. Mixing of food with gastric juices
friends and self
3. Regulation of a slow, controlled emptying of
food into the intestine
Basic Tools In Nutrition
4. Secretion of the intrinsic factor for Vitamin B12
• Food Guide Pyramid
5. Destruction of most bacteria inadvertently
• Dietary Standards (RDA) – minimum
consumed
requirements needed for nutrients
• Food Composition Tables
• Food Exchange List – grouping of common
foods that have practically the same amounts of
protein, fats and carbohydrates
 absorbed in the stomach, small intestine and large
intestines. The major tasks of the large intestine are to
absorb water, to synthesize B vitamins and Vitamin K,
and to collect food residue
Metabolism – it is the use of food as fuel, resulting in
energy
Aerobic metabolism – combining nutrients with oxygen
within the cells; oxidation
Anabolism – building up
Catabolism – breaking down
Anaerobic metabolism – reduces fat without oxygen

Metabolism is governed primarily by triidothyronine

(T3) and thyroxine (T4).

Energy - It is needed for the maintenance of body tissue

and temperature and for growth, as well as for
Enzymes and Foods Acted upon
voluntary activity.
SOURCE ENZYME FOOD ACTED • Kilocalorie (Kcal) – used to measure energy
UPON • 1 Kcal = 4.18 Kjoule
1. Carbohydrates – 4 kcal/g
Mouth Salivary Amylase Starch
2. Proteins – 4 kcal/g
(ptyalin)
3. Fats – 9 kcal/g
Stomach Pepsin Proteins 4. Alcohol – 7 kcal/g
(hormone Rennin Proteins in
gastrin – Gastric Lipase Milk Basal Metabolic Rate
gastric juices) Emulsified Fat • The rate at which energy is needed for body
maintenance (respiration, circulation,
Small Intestine Pancreatic Amylase Starch
regulation of body temperature, and cell
(hormone Pancreatic Proteases Proteins
activity and maintenance); referred to as
secretin) (trypsin) Fats
Resting Energy Expenditure (REE)
Gall bladder (chymotrypsin) Lactose
• Factors that affect BMR
(hormone (carboxypeptidases) Maltose
1. Lean body mass
Cholecystokini Pancreatic Lipase Sucrose
2. Body size
n) (steapsin) Proteins
3. Sex
Lactase Emulsifies fats
4. Age
Maltase
5. Heredity
Sucrase
6. Physical condition and climate
Peptidases
7. BMR = Body Weight [kg] x 24 hrs = _____ x 0.9
Bile
(female)
Body Weight [kg] x 24 hrs = _____ x 1
Absorption – passage of nutrients into the blood
(male)
(capillaries) or lymphatic system (lacteals). To be
absorbed, nutrients must be in their simplest forms
Harris-Benedict equation
(simple sugars, amino acids and fats and glycerol). Most
Female: REE = 655 + (9.6 x weight in kg) + (1.8 x height
absorption of nutrients occurs in the small intestine,
in cm) – (4.7 x age)
although some occurs in the large intestine. Water is
Male: REE = 66 + (13.7 x weight in kg) + (5 x height in  Cellulose – primary source of dietary fiber,
cm) – (6.8 x age) found in skins of fruits, leaves and stem veggies
 Hemocellulose – found mainly in whole grain
Calculating Total Energy Requirements cereal
TEA/TER =Wt (kg) x activity  Lignins – woody part of vegetables such as
ACTIVITY KCAL/KG DBW/DAY those found in asparagus and carrots

Bed rest but mobile 27.540 Classification

Sedentary mostly sitting 30 I. Monosaccharides
a. Glucose/Dextrose – fuels RBC and the
Light (tailor, nurse, 35
brain
doctor)
b. Galactose – product of milk digestion
Moderate (carpenter, 40 c. Fructose/Fruit sugar (levulose)– found
painter) in most fruits and honey
II. Disaccharides
Very active (swimmer, 45
a. Maltose – from the hydrolysis of starch
lumberman)
found in beer (less sweet than glucose
or sucrose)
Energy Balance
b. Lactose – sugar found in milk and helps
• Caloric value of food ingested must be equal to
in calcium absorption
the calories expended.
c. Sucrose – table sugar, brown sugar,
Tanhauser’s Method: Desirable Body Weight
molasses, sugar cane, sugar beets
DBW = Ht in inches x 2.54cm = _____ cm – 100
(glucose+fructose)
[Deduct 10% Filipino unless frame size is known]
III. Polysaccharides
a. Starch – found in grains and vegetables
Hamwi Formula:
b. Glycogen/animal starch – storage from
Females : Allow 100 lbs for the 1st 5 ft (add 5 lbs for
glucose in the body; mostly stored in
each additional inch)
the liver and muscles
Males : Allow 106 lbs for the 1st 5 ft (add 6 lbs for
c. Fiber/roughage – cannot be broken
each additional inch)
down by digestive enzymes; primary
source is cellulose
Carbohydrates
 Principal source: plant foods
 Cereal grains
 Provides the major source of energy in people
 Vegetables
 Composed of carbon, hydrogen and oxygen
 Fruits
Functions:
 Nuts
 Provides energy
 Sugars
 Protein sparer
• The only substantial animal sources of
 Normal fat metabolism
carbohydrate is Milk
 If there is a low supply of
carbohydrates, fat will be metabolized
to meet the body’s demand for energy
 During emergency needs of energy, fat
oxidation in the cell is not complete and
substances called ketones are
produced.
 Providing fiber
  Corn
 Peanuts
 Peas
 Navy beans
 Soy beans
 Grains
 Nuts
 Sunflower seeds
 Sesame seeds

Amino Acids

 When more glucose is ingested than the body ESSENTIAL NONESSENTIAL

can either use immediately or store in the form Arginine* Phenylalanine Alanine Glutamine
of glycogen, it is converted to fat and stored as
adipose (fatty) tissue Histidine* Threonine Arginine* Glycine
 Glucose metabolism is controlled mainly by the Isoleucine Tryptophan Asparagine Histidine*
hormone insulin
Leucine Valine Aspartic Acid Proline
 Hyperglycemia
 Hypoglycemia Lysine Cysteine Serine
 Half of one’s energy requirement should come Methionin Glutamic Tyrosine
from carbohydrates, preferable complex e Acid
carbohydrates. Ten (10%) of it will come from
simple carbohydrate. *Essential during childhood only
 One needs a minimum of 50 – 100 grams of
carbohydrates  Mechanical digestion begins in the mouth
 Chemical digestion begins in the stomach
Proteins  Pepsin – reduced proteins into peptides
 From the Greek derivation and means “of first  Pancreatic enzymes (trypsin,
importance” chymotrypsin, carboxypaptidase)
 Contain carbon, hydrogen, oxygen and nitrogen  Intestinal peptidases – finally reduce
 Composed of chemical compounds called amino the proteins in amino acids
acids  Deamination – the nitrogen containing amine
Functions: group is stripped off from the amino acid
 Build and repair tissues
 Play a role in regulating body functions
 Provide energy

 Animal food sources (complete proteins)

 Meats
 Fish
 Poultry
 Eggs
 Milk The average adult’s daily requirement to be 0.8 gram of
 cheese protein each kilogram of body weight.
 Plant food sources (incomplete proteins)
 1. Divide body weight by 2.2 (the number of Kwashiorkor
pounds per kilogram)
2. Multiply the answer obtained in step 1 by 0.8
(gram of protein per kilogram of body weight)
Determined by:
 Size
 Age
 Sex
 Physical condition
 Emotional condition

 Affects children as well as adults

 Protein intake represent no more than 15 to
 Caused by extreme lack of protein
20% of one’s daily calorie intake and not double
 Causes fat accumulation of fat in the liver
the amount given in the table of DRI’s (Daily
 Edema
Reference Intake)
 Painful skin lesions
 Nitrogen balance – when nitrogen equals
 Changes in skin and hair pigmentation
nitrogen excreted
 Positive nitrogen balance – nitrogen intake
exceeds the amount excreted Differentiating Marasmus and Kwashiorkor
 Negative nitrogen balance – more nitrogen lost
MARASMUS KWASHIORKOR
than taken in
Total surface fat (TSF)* and TSF and NAC within
Protein deficiency midarm circumference normal limits
 Muscle wasting will occur (MAC) decreased
 Edema Weight decreased Weight possibly within
 Wounds heal very slowly normal limits
 People may lose appetite , strength and weight
 Mental retardation Visceral proteins (albumin) Visceral proteins
within normal limits or decreased
Protein Energy Malnutrition (Marasmus) decreased
Immune function within Immune function
normal limits decreased
Dull, dry hair Reddish-color hair
Emaciated, wrinkled Puffy appearance
appearance
Lack of protein and total Edema
energy
 Afflicts very young children
 Lacks both protein and energy-rich foods as
wells as vitamins and minerals
Lipids
 Emaciated
 From the Greek derivation lipos and means
 Irritability
“fat”
 Hair is dull and dry
 Greasy substances that are not soluble in water
 Skin is thin and wrinkled
but are soluble in some solvents such as ether,
benzene and chloroform
 They are organic compound that includes fats • Essential fatty acids – Linoleic, Linolenic, and
and oils (chemically called triglycerides), lecithin Arachidonic – must be supplied by the food
(phospholipids), and cholesterol (sterol)
 Lipids in food, 95% are fats and oils and 5% are Cholesterol
other lipids • A sterol fat like substance found in animal foods
 Present in both animals and plants and body cells
• Essential for the synthesis of bile, sex
Functions: hormones, cortisone and Vitamin D
 Provide energy • The human body manufactures 800-1000 mg of
 Essential for the functioning and structure of cholesterol a day in the liver
the body tissues • Normal daily allowance is 200mg/dl
 Carrier of fat-soluble vitamins (A,D,E,K) • Lipoproteins - caries fat in the blood
 Protects organs and bones from injury to CHYLOMIC VERY LOW LOW HIGH
serving as protective padding and support RONS LIPOPROTEI DENSITY DENSITY
 Serve as insulation from cold NS LIPOPROTEIN LIPOPROTEIN
 Provide satiety (satisfaction) after meals S S

Classification: Largest Produced by Bad Good

1. Visible fats – used and purchased as fats lipoprotein the liver cells cholesterol cholesterol
– Butter s (55-65% (45%
– Margarine (80-90% triglyceride) cholesterol
– Lard triglyceri and some
– Cooking oil de) triglyceride
2. Invisible fats – not immediately noticeable s)
– Meat, fried foods, egg yolk Lightest They carry Carry most Carries
– Olives, nuts, avocados triglycerides blood cholesterol
– Cream, salad dressing and other cholesterol from the
– Whole milk, cheese lipids to the from the liver cells to the
cells to the cells liver for
Triglycerides eventual
Saturated fats (SFA) – usually solid at room excretion
temperature (i.e. meat, poultry, bacon, sausages,
Lipoprotei As they lose Greater than 40 mg/dl is a
egg yolk and milk)
n lipase triglycerides, 130 mg/dl major risk
Mono-unsaturated fats (MUFA) – fats that are
acts to they pickup contributes for heart
neither saturated nor polyunsaturated and are
break cholesterol to disease
thought to play a role in atherosclerosis (i.e. olive
down the and then atheroscleros 60 mg/dl
oil, canola oil, avocado, chicken fat and cashew
triglyceride become LDL is or more is
nuts)
s into free considered
Polyunsaturated fats (PUFA) – found in both plant
fatty acids protective
and animal fish oil (i.e. Omega-3 and Omega-6 fatty
and against
acids)
glycerol heart
• Omega-3 fatty acid – helps lower risk for heart
disease
disease (tuna, pink mackerel, king crabs)
• Omega-6 fatty acid – Linoleic acid, has
cholesterol lowering effect (sunflower, • High in cholesterol – egg yolk, internal organs,
safflower, corn oil, sesame oil, and soybean) mayonnaise
• Moderate amount –crabs, lobster, shrimps, Covering the pan (except for the 1 st few minutes
meat, powdered milk, cheese, creams, cakes when cooking strongly flavoured veggies and
and pastries cooking as short time as possible
• Cholesterol-free – all types of vegetables, all Saving cooking liquid for later use as in soups,
vegetable oils, avocado, cereals, and nuts stews and gravies
Storing fresh veggies and fruits in cool dark
Lecithin places
• Fatty substance classified as phospholipid which Classifications
is found in both animal and plant sources and is Fat soluble vitamins Water soluble vitamins
synthesized by the liver.
• Helps transport fat in the blood stream and can be Can be dissolved in
used to make commercially made food products dissolved in fats water
smooth Vitamins A, D, E, Not stored in the
• 95% of ingested fats are digested K body
• Chemical digestion occurs in the small intestine Not easily lost in
where bile emulsifies fats cooking
• Enzyme pancreatic lipase reduces them to fatty Excess amounts
acids and glycerol are stored in the
• The liver controls fat metabolism. It hydrolyzes liver
triglycerides and forms new ones from this
hydrolysis as needed
• Metabolism occurs in the cells, where fatty Fat soluble vitamins
acids are broken down to carbon dioxide and
water, releasing energy Name/Fo Functions Deficiency/toxicity
od
Vitamins sources
Organic compounds that are essential, potent
Vitamin A • Maintenance Deficiency
and non caloric that is needed by the body in
Retinol – of vision in Night blindness
small amounts for body processes
animal dim light Xeropthalmia
Enable the body to use the energy provided by
foods • Maintenance Respiratory infections
carbohydrates, proteins and fats
(liver, egg of mucus Bone growth ceases
Deficiency can occur and result in disease
yolk, membranes Toxicity
Avitaminosis – without vitamins
cream, and healthy Birth defects
Hypervitaminosis – excess of one or
fortified skin Bone pain
more vitamins
or • Growth and Anorexia
Vitamin supplement – concentrated
irradiated development Enlargement of liver
form of vitamins
milk and of bones
Megadoses can be toxic or poisonous
cheese, • Reproduction
margarine • Healthy
How to preserve vitamins in food
) immune
Purchasing the freshest, unbruised fruits and
Beta- system
veggies and using them raw whenever possible
carotene • Helps prevent
Heating canned veggies quickly and in their own
– plant cancer
juice
foods
Following package directions when using frozen
(green
fruits and veggies
and butter, normal
yellow margarine, bones and
veggies, cereal, egg, teeth
deep liver and • Prevention
orange oily fish like of tetany
fruits and sardines
veggies)
Rickets
Xerophthalmia

Name/Food Functions Deficiency/toxici

sources ty

Vitamin E • Antioxidant Deficiency

Tocopherol/tocot • Considered Destruction of
rienols – (Alpha, essential for the red blood
beta, delta, protection of cells
A mother seeking medical attention for her child, gamma) cell structure, Toxicity
who is suffering from Vitamin A deficiency, PUFA rich plant especially of Kidney stones
blindness and malnutrition (photo from ) - oils, leafy green red blood Calcification of
Australian Doctor, 29 October 1993, p.57. veggies, wheat cells soft tissues
germ, nuts, seeds
Name/Foo Functions Deficiency/toxicity and whole grain
d sources products

Vitamin D • Regulation Deficiency Vitamin K • Essential for blood Deficiency

Ergocalcifer of Rickets Phylloquin clotting Bleeding
ol/ absorption Osteomalacia/Osteoporo one/ • Formation of a protein tendencies
Cholecalcif of calcium sis Menaquin that binds calcium in Hemorrhagi
erol – and Poorly developed teeth one/ bones c diseases
synthesis phosphoru and bones Menadion Toxicity
with s Muscle spasms e Anemia
sunlight, • Building Toxicity Bacterial
fortified or and Kidney stones synthesis
irradiated maintenan Calcification of soft in the
milk, ce of tissues digestive
tract; liver
milk,
green
leafy
vegetable,
vegetable
oils, eggs,
meats
Name/Food Functions Deficiency/toxicity
sources
Water soluble vitamins
Name/Food Functions Deficiency/toxicity Vitamin B1 • Helps burn Deficiency
sources Thiamine – carbohydrates Beri-beri
present in into energy Loss of appetite
Vitamin C • For healthy Deficiency all • Support Mental confusion
Ascorbic Acid and strong Scurvy , Anemia nutritious normal Muscle weakness
– citrus blood vessel Tendency to bruise foods appetite Nerve damage
fruits, ripe walls easily • Supports Toxicity
papaya, raw • Iron Pinpoint normal Nausea
cabbage, absorption hemorrhages functions of Anorexia
tomatoes, • Antioxidant Poor wound healing the heart, Lethargy
Leafy veggies • Provides the Frequent infections nerves and Ataxia
matrix for Bone fragility and muscles
bone growth joint pain
• Promotes Toxicity
healing Birth defects
• Strong Bone pain
resistance Anorexia
infection Enlargement of liver

Scurvy
Beri-Beri

Pinpoint hemorrhages, corkscrew hair

 Name/Food Functions Deficiency/toxicity
sources

Vitamin B • Helps the Deficiency

Niacin body release Pellagra
Nicotinic energy from Diarrhea
Acid/ carbohydrate Weakness and loss
Name/Food Functions Deficiency/toxicity Nicotinamid s, proteins of appetite
sources e – meats, and fats Glossitis
peanuts, • For healthy dementia,
Vitamin B2 • Helps the Deficiency whole grains skin Confusion
Riboflavin – body produce Ariboflavinosis and enriched • Keeps normal Toxicity
Milk, yogurt, energy from Cheilosis breads, activity of Heartburn
meats, carbohydrate Sore throat unrefined stomach, Nausea and
cottage s, proteins Swollen red tongue cereals, milk, intestines vomiting
cheese, and fats Magenta tongue fish, poultry, and nervous Ulcer irritation
enriched • Supports Skin rashes nuts and all system Abnormal liver
cereals and normal vision Eye irritation protein function
green and skin containing Low blood pressure
veggies health food
Pellagra
Cheilosis

Name/Foo Functions Deficiency/toxicity

d sources
Glossitis
Vitamin B • Helps the Deficiency
Biotin body turn Unknown green and nerves
Widesprea food into leafy • Release of
d in foods energy veggies glucose from
• Required in glycogen
the making
Vitamin • Helps the Deficiency
of fatty acids,
B12 formation of Megaloblastic/Pernicio
amino acids
Cobalamin new cells us Anemia
and purines
– animal including Nerve paralysis
• Needed for
foods like RBCs Hypersensitivity of the
the
liver, • Helps skin
formation of
meat, fish, maintain
glycogen in
poultry, nerve cells
muscle and
eggs, none • Folate
liver
in plants metabolism
Vitamin B • Helps Deficiency • Treatment of
Pantotheni release Vomiting pernicious
c Acid energy in the Intestinal distress anemia
Widesprea body Insomnia
Vitamin B • DNA Deficiency
d in foods • Helps make Fatigue and muscle
Folic Acid synthesis Megaloblastic Anemia
fatty acids cramps
Folacin/Fol • Protein mental confusion
and
ate – metabolism Heartburn
cholesterol
chicken • Essential in Glossitis
• Essential for
liver, the Depression
synthesis of
breakfast formation of Neural tube defects
neurotransm
cereals, new cells Anencephaly
itters
spinach, • Supports Toxicity
Vitamin B6 • Helps the Deficiency asparagus, normal Masks Vit B12
Pyridoxine body use Anemia black maturity of deficiency
/ amino acids Irritability beans, RBCs
Pyridoxal/ to form Depression baked • Required for
Pyridoxam tissue Convulsion beans with the release
ine proteins Greasy dermatitis pork, of energy
- whole • Helps Muscle twitching tomato from food,
grains, convert Toxicity juice, especially
poultry tryptophan Bloating orange, amino acids,
meat, fish to niacin Depression fortified work with
and • Helps make Fatigue white Cobalamin to
shellfish RBCs Impaired memory bread protect and
seeds, • Supports in Nerve damage develop the
liver and the synthesis nervous
kidney, of system
milk, eggs, neurotransm
fruits, itters coating Folic acid deficiency
legumes, around