Nutrition and food hygiene

Dr. Quanjun Lu
Department of nutrition and Food hygiene
TEL:67781923
Email:lqjnutr@zzu.edu.cn
2006.11.15
Nutrition and food hygiene
1.Nutrition
2.Food Hygiene
 Introduction
1.Concept of nutrition
2.Content of nutrition
3.Classification of nutrients
4.Research methods
 What is nutrition
• The word 'Nutrition" comes from a Latin word which
means to 'nourish" or to "to feed".
• Nutrition covers many areas including:
 the science of food
 why people choose certain foods
 what foods are made of
 the nutrients in foods
 how the body uses food
 food digestion
 food functions
 Nutrition is
• “the science of food, the nutrients and the
substances therein, their action, interaction,
and balance in relation to health and
disease, and the process by which the
organism ingests, absorbs, transport,
utilizes, and excretes food substances”----The
Council on Food and Nutrition of the American Medical Association
 Physiology of Nutrition
• Nutrition is the process by which the body
metabolizes and utilizes the nutrients from
food.
• Nutrients are digested, absorbed by the
blood or lymphatic system, and transported
to the body’s cells.
 Physiology of Nutrition
• Digestion is the process by which ingested
foods are broken down in the GI tract to
smaller segments in preparation for
absorption.
 Physiology of Nutrition
• Absorption is the process by which the end
products of digestion pass through the
epithelial membranes in the small and large
intestines into the blood or lymph systems.
 Physiology of Nutrition
• The end products of digestion are
monosaccharides (simple sugars), amino
acids, glycerol, fatty acid chains, vitamins,
minerals, and water.
 Physiology of Nutrition
• Metabolism is the aggregate of all chemical
reactions and process in every body cell,
such as growth, generation of energy,
elimination of wastes, and other bodily
functions as they relate to the distribution of
nutrients in the blood after digestion.
 Physiology of Nutrition
• Metabolic rate refers to the rate of heat
liberation during chemical reactions.
 Metabolism
• Energy
– A calorie is the unit of measurement used to express
the quantity of energy released during metabolism.
– Energy is expressed in terms of kilocalories.
– Basal metabolic rate (BMR) represents the energy
needed to maintain essential physiological functions.
 Metabolism
• Excretion
– Digestive and metabolic waste products are
excreted through the intestines and rectum.
– Other excretory organs are the kidneys, sweat
glands, skin, and lungs.
 Nutrients Come from Food

• Provide energy to fuel our bodies

• Provide building blocks for new tissue
• Vital for growth and maintenance
• Some are essential i. e. we can’t make
them (or enough) and so must get them
from our diets
 Nutrition and Health
• Poor diet and sedentary lifestyle increase
the risk for chronic diseases
– Disease of the heart (31% of all deaths)
– Cancer (23%)
– Cerebrovascular disease (~7%)
– Diabetes (3%)
 The Six Classes of Nutrients
• Carbohydrates
• Fats
• Proteins
• Vitamins
• Minerals
• Water
Essential nutrients
Nonessential nutrients
 Nutrients Come from Food

FOOD DIGESTION / ABSORPTION

NUTRIENTS PROCESSING / METABOLISM
(converts the basic nutrients into many other needed
chemicals / biochemicals)
 DIGESTION, ABSORPTION

Large molecules: Polysaccharides, proteins, triglycerides

Enzymes (digestion)

Small molecules: Monosaccharides, amino acids, fatty acids

Absorption

Small molecules in the blood, to liver, muscles, neurons etc.

ESSENTIAL NUTRIENTS
 Energy Yielding Nutrients
• Carbohydrates: 4 kcal/gm
• Protein: 4 kcal/gm
• Fat: 9 kcal/gm
• (Alcohol: 7 kcal/gm)
• Adjusted for digestibility
• Account for substances (in food) not
available for energy use
 Carbohydrates
• Composed of C, H, O
• Provide a major source of fuel for the body
• Basic unit is monosaccharide (glucose)
• Simple and Complex CHO
• Energy yielding (4 kcal /gm)
 Nutrients
• Nutrients are essential dietary factors, such
as vitamins, minerals, essential amino acids,
and essential fatty acids, that cannot be
synthesized by the body at a sufficient rate.
• Sources of energy are not classed as
nutrients and neither is water nor dietary
fibre.
 Classification of nutrients

• Energy
• Macro-nutrients:
Protein,Fat,Carbohydrates
• Micro-nutrients: Inorganic salt(minerals)
and Vitamins
• Other compositions: Water,Fibre,
Phytochemicals
 Nutrients
• Water
• Vitamins
• Minerals
• Carbohydrates
• Proteins
• Lipids
 Nutrients
• Water
– Accounts for 60% to 70% of an adult’s total
body weight and 77% of an infant’s weight.
– Water and electrolytes are substances that must
be acquired from the diet.
– Body water requirements are met through
consumption of liquids and foods and the
oxidation of food.
 Water
• Vital to life
• Requirement about 8 cups/day***
• Is a solvent, lubricant, medium for transport,
chemical processes, and temperature regulator
• Makes up majority of our body (60%)
*** not necessarily as glasses of water – can be any
food/drink containing water
(varies with size, activity, temperature)
 Nutrients
• Vitamins
– Organic compounds that aid in the regulation of
cellular metabolism and assist in the
biochemical processes that release energy from
digest food
– Vitamins are classified as fat-soluble or water-
soluble.
 Vitamins
• Fat-soluble vitamins:A,D,E,K
• Water-soluble
vitamins:Thiamin,Riboflavin,Niacin,Folic
Acid etc.
 Vitamins
• Composed of various elements
• Essential for life
• Enable chemical reactions
• Needed in tiny amounts
• Fat soluble or Water soluble
• Yield no energy
 Nutrients
• Minerals
– Serve as catalysts in biochemical reactions.
– Classified according to daily requirement:
• Macrominerals (quantities of 100mg or greater)
• Microminerals (trace elements, quantities less than
100 mg)
 Minerals
• Inorganic substances
• Function in cellular process, nervous system,
water balance, bones
• Needed in tiny amounts
• Not destroyed in cooking
• Trace minerals/Major minerals
• Yield no energy
 Inorganic salt

• Macro-elements: content >0.01%Body weight

e.g. Calcium,Phosphorus, Sulfur,Potassium,
Magnesium, Chloride, Sodium
• Micro-elements(trace elements):
content<0.01%Body weight
e.g Iron,Zinc, copper,Selenium,Fluoride,
Chromium,Manganese, Iodine,Arsenic, Boron,
Molybdenum, Nickel, Silicon,Vanadium,
 Nutrients
• Carbohydrates
– Organic compounds composed of carbon,
hydrogen, and oxygen
– Primary source of energy for the brain and the
preferred fuel for the body
 Nutrients
• Carbohydrates
– Monosaccharides (simple sugars) include
glucose, galactose, and fructose.
– Disaccharides (double sugars) include sucrose,
lactose, and maltose.
– Polysaccharides (complex sugars) include
glycogen, cellulose (fiber), and starch.
 Nutrients
• Proteins
– Organic compounds that contain carbon,
hydrogen, oxygen, and nitrogen atoms
– Essential for almost every bodily function
 Proteins
source of amino acids for growth & new proteins (for tissues,
antibodies, enzymes, hormones etc.), can provide energy, are
important structural and functional components of bodies

• Composed of C, O, H, N
• Basic unit is amino acid (string of beads)
• Make up bones, muscles, other tissues, and
components
• (9) Essential amino acid
• (11) Nonessential amino acid
• Energy yielding (4 kcal /gm)
 O
ll
-HN-CH-C-O-
|
R (20 different side chains)
Space-filling model of the protein hemoglobin
Fig. 1.1c
 Nutrients
• The end products of protein digestion are
amino acids.
• Nonessential amino acids can be
synthesized in the cells.
• Essential amino acids must be ingested in
the diet because they cannot be synthesized
in the body.
 Nutrients
• Proteins are also classified as complete or
incomplete.
– High-biological-value proteins (complete
proteins) contain all the essential amino acids.
– Low-biological-value proteins (incomplete
proteins) lack one or more essential amino acid.
 Nutrients
• Protein Deamination is the process of
removal of (degradation) amino groups
from the amino acids.
 Nutrients
• Other physiological processes occur during
protein deamination.
– Gluconeogenesis
– Ketogenesis
– Nitrogen balance
– Positive nitrogen balance
– Negative nitrogen balance
– Obligatory loss of proteins
 Nutrients
• Lipids (fats)
– Organic compounds are the only essential
nutrients that cannot mix with water and
therefore, must be emulsified by molecules to
be absorbed.
 Lipids
The other major energy source (higher energy content/weight than
carbohydrate). Supplies essential fatty acids, necessary for
adsorption of fat soluble vitamins, vital components of membranes.

• Composed of C, H and fewer O

• Basic unit is fatty acid
• Triglyceride is the major form of lipid
• Fats and oils
• Unsaturated Fatty Acids
• Saturated Fatty Acids
• Trans fatty acids
• Essential Fatty Acids
• Energy yielding (9 kcal /gm)
 Nutrients
• Fatty Acids
– Simplest form of lipids and the basic components of more
complex lipids
– Saturated fatty acids form fats, which are glycerol esters of
organic acids whose carbon atoms are joined by single bonds.
– Unsaturated fatty acids form glycerol esters of organic acids
whose carbon atoms are joined by double or triple bonds.
• Monounsaturated Fatty Acids
• Polyunsaturated Fatty Acids
 Nutrients
• Fatty Acids
– Monounsaturated fatty acids are formed esters with one
double or triple bond.
– Polyunsaturated fatty acids form esters that have many
carbons unbonded to hydrogen atoms.
– Hydrogenated or trans-fatty acids are another category of fat
that is not naturally occurring but man made.
 Nutrients
• Most Important Lipids
– Triglycerides are composed of three fatty acid cells
attached to a glycerol molecule.
– Phospholipids are composed of one or more fatty
acid molecules and one phosphoric acid radical; they
usually contain a nitrogenous base.
– Cholesterol is produced by the body and is
considered a fat; it is also found in whole milk and
egg yolk.
 Promoting Proper Nutrition
• Recommended Daily Allowances (RDAs)
• The Food Guide Pyramid outlines six
groups of food and the number of servings
based on dietary guidelines and the basic
four food groups.
 Promoting Proper Nutrition
• Societal Concerns
– One-third of the U.S. population is considered
overweight.
– Obesity is becoming an epidemic.
– Undernutrition is a specific problem for the
elderly and for people with eating disorders.
 Weight Management
• Overweight is an energy imbalance in
which more food is consumed than needed.
• An underweight person expends more
calories than are consumed.
 Weight Management
• Anorexia nervosa (self-starvation) disrupts
metabolism because of inadequate calorie intake.
• Bulimia nervosa refers to food-gorging binges
followed by purging of food, usually through self-
induced vomiting or laxative abuse.
 Factors Affecting Nutrition
• Age
• Lifestyle
• Ethnicity, Culture, and Religious Practices
• Economics
• Gender
 Contents
• Basic nutrition
• Community Nutrition
• Nutrition and Diseases
• Food Hygiene
• Food Poisoning
 Methods of estimating an
individual’s dietary intake

• Dietary recall
• Food diary
• Complete chemical analysis
 References
• American J.of Nutrition
• British J.of Nutrition
• Food Science
• Food Chemical Toxicology
• Nutrition Abstract & Review
• J.of Nutrition
Chapter 1 Energy
requirements
• Under-nutrition(malnutrition) remains a
leading cause of mortality and morbidity in
developing countries worldwide. In
industrialized countries, the major
nutritional problem is one of surfeit, with
excess dietary energy and fat contributing
to the disproportionate increase in
metabolic disease prevalent in our society.
Dietary Reference Intakes (DRIs)
• DRIs are reference values that are
quantitative estimates of nutrients intakes to
be used for planning and assessing diets for
healthy people. They include RDAs as goals
for intake by individuals, but also present
three new types of reference values. These
include the Adequate Intake(AI ),the
Estimated Average Requirements(EAR), and
the Tolerable Upper Intake Level(UL)
 Recommended Dietary
Allowance(RDA)
• RDA is the dietary intake level that is
sufficient to meet the nutrient requirement
of nearly all(97 to 98 percent) healthy
individuals in particular life stage(life stage
considers age and when applicable,
pregnancy or lactation) and gender group.
 Estimated Average
Requirements( EAR)
• EAR is the amount of nutrient that that is
estimated to meet the nutrient requirement
of half the healthy individuals in a life stage
and gender group. A requirement is defined
as the lowest continuing intake level of a
nutrient that will maintain a defined level of
nutrient in an individual.
 The Adequate Intake(AI)
• AI is provided instead of a RDA when
sufficient scientific evidence is not
available to calculate an EAR. The AI is
based on observed or experimentally
determined estimates of nutrient intake by a
group(or groups) of healthy people.
• The primary use of the AI is as a goal for
the nutrient intake of individuals.
Tolerable Upper Intake level (UL)

• UL is the highest level of daily

nutrient intake that is likely to pose
no risk of adverse health effects to
almost all individuals in the general
population.As intake increase
above the UL,the risk of adverse
effects may increase.
• ULs are useful because of the increased
availability of fortified foods and the increased
use of dietary supplements in the world. ULs
may be based on total intake of a nutrient from
food, water, and supplements if adverse effects
have been associated with total intake.
However, if adverse effects have only been
associated with intake from supplements or food
fortificants, the UL is based on nutrient intake
from those sources only, not on total intake.
This is specified for each nutrient for which a
UL is given.
 If the standard deviation(SD)of the EAR is available
and the requirement for the nutrient is
symmetrically distributed, the RDA is set at 2 SDs
above the EAR;
RDA =EAR + 2 SDs
• If data about variability in requirements are insufficient to
calculate a SD, a coefficient of variation for the EAR of 10
percent is ordinarily assumed (the coefficient of variation
[CV]is equal to the SD÷ EAR.The resulting equation for the
RDA is then
RDA=1.2× EAR. If the estimated coefficient of variation
is 15 percent as it is for niacin, the formula would be
RDA=1.3 × EAR.
• The RDA for a nutrient is a value to
be used only as a goal for dietary
intake by healthy individuals.
• The RDA is not intended to be used
to assess the diets of either
individuals or groups or to plan diets
for groups.
 Energy sources
• Dietary macronutrients-carbohydrates, fat,
protein and alcohol all provide energy.
• Energy values are about 4kcal/g(16kJ/g) for
carbohydrates(starch and sugar)and
protein,9kcal/g(37kJ/g) for fat, and
7kcal/g(29kJ/g) for alcohol.
 Basics
• ATP (Adenosine Triphosphate)
– Storage molecule of chemical energy used in
most metabolic processes
– ATP ↔ ADP + Pi + Energy
• Kilocalorie (Kcal or C)
– Energy value of food
– 1kcal = energy required to raise 1kg of water
1oC
 Functions
• Energy is required by all living organism to
support life.Plants use the energy of
sunlight to create complex carbohydrate, fat
and protein. All animals including humans ,
then consume and digest the constituents to
extract energy.
 Food energy
• The total energy content of food is the
amount of energy released when food is
completely burnt in air to CO2 and H2O,that
is the heat of combustion.
• The total energy is equal to the sum of the
digestible and the non-digestible energy.
 Total energy
• Digestible energy is the amount of energy
that can be absorbed from food and usually
accounts for about 95% of the average
Western diet.
• Non-digestible energy is the energy in food,
for example in cellulose, that we cannot
break down and is last in faeces.
 Human energy requirement
• Human energy requirement is defined as the
energy intake that will balance energy
expenditure when the individual has a body size,
composition and level of physical activity
consistent with long-term good health. Energy
requirements therefore vary according to body
size, body mass,nature of diets, age, sex, state of
health, and climate, as well as genetic
differences.
 Metabolizable energy
• Metabolizable energy is the energy available to the
body for use ;it has three fates:
• 50% is lost as heat;
• 5-10%of energy is used up in digestion,
absorption,and transport of food.This is as ether
thermic effect of food,diet-induced thermogenesis,
or post-prandial thermogenesis (they all mean the
same thing)
• Only about 25-40%of energy is trapped as
ATP,that is ,the body is only 25-40% efficient.
 Energy expenditure
• Energy expenditure includes several
components; Basal metabolism, the thermic
effect of exercise(TEE), the thermic effect of
food (TEF,formerly known as specific
dynamic action, and facultative
thermogenesis (also known as adaptive
thermogenesis)
 Basal metabolic rate(BMR)
• The BMR is the energy used to carry out
normal body functions such as blood flow,
breathing,and so on,that is ,it is the energy
expended doing nothing!
• At rest,lying down but not asleep;
• At a constant,warm temperature.
• Assessed about 12h after the last meal or
any exercise.
 Resting Metabolic Rate:
• RMR is usually the greatest contributor
(60%~70%) to total energy expenditure.
RMR is a measurement of the energy
expended for maintenance of normal body
function and homeostasis plus a component
for activation of the sympathetic nervous
system.
 RMR
• RMR is measured with the subjects in a
supine and sitting position in a comfortable
environment several hours after a meal or
significant physical activity. The basal
metabolic rate, originally defines by Boothby
and Sandiford,is measured in the morning
upon awakening, before any physical activity,
and 12-18 hours after a meal.It may be
slightly lower than RMR,but the difference is
small and RMR is now the more commonly
used measurement.
The calculating formula of RMR suggested by WHO(1985)
Age(years) Formula(male) Formula(female)
0~ (60.9×W)-54 (61.0×W)-51
3~ (22.7×W)+495 (22.5×W)+499
10~ (17.5×W)+651 (12.2×W)+746
18~ (15.3×W)+679 (14.7×W)+496
30~ (11.6×W)+879 (8.7×W)+829
>60 (13.5×W)+487 (10.5×W)+596
 Body composition
• An average 72kg man is composed of
15%fat
85%fat-free mass
• Fat-free mass or lean body mass(LBM) is made up
of
72% water
20% protein
8% bone mineral
Thermic effect of exercise(TEE)
• (TEE) is second largest component of
energy expenditure. It represents the cost of
physical activity above basal levels. In a
moderately active individual it comprises
15%~30% of total energy requirements. Of
all the components of energy
expenditure,TEE is most variable and
therefore most amenable to alteration.
 Physical activity ratio
• The PAL can be measured for where
activity is expressed as a multiple of the
BMR(i.e BMR=1)
• PAL =metabolic rate during
exercise÷ BMR
• Activity lying sitting standing football
• PAL 1.0 1.2 1.7 7.0
 Thermic effect of food(TEF)
• (TEF) refers to the increase in energy
expenditure above RMR that occurs for
several hours after the ingestion of a meal.
TEF is the results of energy expenditure to
digest ,transport, metabolize, and store
food.On average TEF accounts for about 10%
of daily energy expenditure and varies
depending on the metabolic fate of ingested
substrate.
 Facultative thermogenesis
• Facultative thermogenesis is readily demonstrable
in animals but is less well described in humans.It
appears to account for less than 10%-15% of total
daily energy expenditure but may have significant
effects on long-term weight changes. Facultative
thermogenesis is the change in energy
expenditure induced by changes in ambient
temperature,food intake, emotional stress,and
other factors.
• The energy requirements of individuals in good
health can vary from about1 450 kcal/day
(6MJ/day) for small sedentary women, to 4 250
kcal/day(18MJ/day) for large very active men.
• The requirements of population groups vary
from 1 900kcal/day (8MJ/day) in some African
countries to 2 150 kcal/day(9MJ/day) in some
Asia countries, to 2 300-2 350kcal/day(9.6-
9.8MJ/day) in Europe and North America.
These variations are largely a reflection of
average body size.
• Expressed as kilocalories per kilogram of body weight,
the requirements of more active populations in the
developing world are greater than those of typically
sedentary people in the developed world.Figures are
approximately 38kcal/kg(160kJ/kg) in Africa,
40kcal/kg(170kJ/kg) in Asia,and 33kcal/kg(140kJ/kg) in
Europe and North America.
• Absolute and relative energy requirements in the
developed world have decreased remarkably in the
second half of the twentieth century,reflecting the
increased use of machines to replace human physical
effort at work,at home and for transport.
• Human energy metabolism includes energy
intake and energy output.Energy balance
(intake minus output)can be in a state of
equilibrium,negative(where energy intake is
less than energy output) or positive (where
energy intake is more than energy
output).Positive energy balance,leading to
weight gain as excess energy intake is
converted to adipose and lean tissue,may be
caused by high energy intake,by low levels of
energy output,or by a combination of the two.
 Influence factors

• Nutritional status
• thyroid function
• sympathetic nervous system activity
 Other factors
• Environmental temperature changes
• Pregnancy and lactation
• Growth
• Age
 Energy deficiency
• Chronic energy deficiency leads to negative
energy balance and weight loss as body tissues
are broken down(catabolised) to meet the
body’s requirement for energy.Public health
problems associated with energy intake and
output have been identified as problems of
deficiency in the developing world and
problems of excess in the developed world.
 OBESITY
• Obesity results from an imbalance between the
input,storage and expenditure of energy ;that
is energy intake is greater than energy
expenditure.
• Obesity can be defined or graded in term of
the body mass index(BMI)
• BMI(kg/m 2)=weight÷ (height)2
 The grading of BMI
• 20-25 ideal weight
• 25-35 obesity grade I(over weight)
• 30-35 obesity grade II (obese)
• 35+ obesity grade III
Obesity
Definition:
Medical term for overfatness frequently resulting in a significant impairment of health.
Difference of overweight and obesity
Overweight—excess weight for height by standards, such as actuarial
tables.
Ob—refer to excess body fat.
*some football player: overwt due to lean body mass, but not Ob.
*some inactive individuals w/little muscle may be obese but not overweight.
The normal proportion of BWt as fat is:
15-20%----------M
20-25%----------F
NIH (National Institute of Health)
BWt. of 20% over desirable weight has adverse effects on
health.
Pattern of fat distribution throughout the body is more impt. factors than
total adipose tissue mass. Fat in abdominal region is greater risk of some
chronic disease than others.
Classification of Ob:
1.base on the number and size of adipose cells:
hypertrophic Ob.: normal number of adipocytes but large quantities of
fat in each cell. Often w/mild,moderate ob, beginning in middle age.
Hyperplastic Ob: too many adipocytes, each containing fat reasonably normal in quantity.
Marked ob dating to early childhood.
 Normal adipocytes

After Wt. loss

Hypertrophic Ob. Hyperplastic Ob

 2. the regional fat distribution
a) android (male): apple shaped, upper body Ob

b) gynoid (famale): pear shaped, lower body Ob

To determine the two types of Ob:
Waist/hips ratio
Normal-----0.7
Lower body ob---<0.7
Upper body Ob--->0.7 fat below the waist is more difficult to lose wt. even under
strict dieting.
Causes of Ob. :
1.calories:
2.genetics: two ob parents—73% chance of having ob offspring
one ob parent—41.2% chance of having ob offspring
two lean parents—9% chance of having ob offspring
3.brown fat: in adult, only located around neck and chest, rich mitochondria, can
burning up calories. Ob—fewer brown fat cells or dysfunction
4.LPL:
5.ATPase: help to burn off 15-40% off all calories not used during physical
activity. Ob has 20-25% less ATPase vs. a person of normal wt.
6.leptin: hormone secreted by fat cells only, response to an increase in fat mass
and acts on the hypothalamus of the brain to through the control of appetite and
energy expenditure.
Feeding  leptin secretion ⊕ starvation
 ⊕
Hypothalamus
⊕ 
Neuropeptide Y synthesis, secretion
⊕ 
appetite
Assessment of Ob:
1.BWt: ideal BWt. （ kg ） = height （ cm ） 105
>10% ideal BWt—overweight
>20%----------------Ob
2.BMI: BWt. (kg)/height (m)2
20-24.9----normal
25-29.9----low risk
30-40------moderate risk
>40--------Ob. High risk
3.Skinfold thickness:
triceps skinfold
for age 25-45: M—18mm
F—23mm
Medical complications:
Diabetes, hypercholesterolemia, high plasma TG,
hypertension, heart disease, cancer, gallstone, arthritis.
*DM: 2.9 x in Ob than normal wt , fasting blood glucose
increase 2 mg/dl for each kg of excess BWt.
Wt. reduction: diet, exercise, behavioral modification,
appetite suppressants, surgical treatment.
Major components of caloric expenditure:
1) basal metabolic rate: 60-70%
2) dietary thermogenesis 5-10%
3) physical activity 25-35%
Caloric requirement:
F-------12-14× ideal BW(lb)
M------14-16× ideal BW(lb)
To lose 1 lb/w, must take in 3500 calories fewer than he/she expends.
e.g. to lose 1 lb/w, has to maintain a  energy balance of 500
calories/day dieting, or increase activity (running 45’, tennis
60’,walking75’, bike 90’, golf 120’).
In normal diet:
CHO:50-55en% (min.100g/d); Pr: 10-15en% (min. 0.8mg/kg.d); Fat: 30-35en%
 Chapter 2 Protein and Amino Acid

• Proteins form the major cellular structural

elements, are biochemical catalysts,and
important regulators of gene expression.
• Protein may be classified as of plant or
animal origin, or by its constituent amino
acids.
 SOURCES
• Protein makes up 20-36% by weight of pulses
(legumes), 8-25% of nuts and seeds, 8-16% of
cereals, 10-20% of meat and fish, 15% of eggs,
3.5% of milk and 1-3% of vegetables.
• Plant protein sources provide 65% of the world
supply of edible protein of which cereals (grains)
(47% of total protein supply) and pulses, nuts and
oil seeds (8%) are the major sources.
• Intakes of plant protein vary little with economic
development. Intakes of animal protein generally
increase with increasing economic prosperity.
 COMPOSITION
• Protein is an essential human nutrient.
Specifically, certain of its constituent amino
acids are identified as essential, meaning that,
like vitamins, the body is unable to manufacture
them from other dietary constituents.
• Proteins are complex molecules containing up to
several thousand amino acids. Twenty-one
amino acids are distinct;others are chemically
modified during protein synthesis.
• Structural or fibrous insoluble proteins provide the
framework for animal tissues and organs (hair, skin,
cartilage, bone and tendons). Others include the semi-
soluble contractile proteins of muscle, enzymes,
peptide hormones, proteins of blood (including
haemoglobin and albumin), milk (casein and whey
proteins), cell membrane proteins, the plasma lipid-
transport system, other transport proteins, and proteins
involved in DNA replication, transcription, and repair.
 The functions of Protein
• They are the components of body
composition
• Form some important substances such as
Hemoglobin, Enzyme and some hormones
etc.
• Produce energy.1g protein can produce
16.7kj(4.0kcal)
 FUNCTIONS
• The characteristic functions of proteins are
determined by the relative amounts and
sequence of their constituent amino acids. All
proteins turn over, that is they break down to
constituent amino acids and are then re-
synthesized, although for the structural proteins
this process is slow or minimal.
• Individual amino acids also serve as precursors for
a range of metabolites such as neurotransmitters,
pigments, amines, nucleic acids and various
cellular metabolites. Many amino acids can be
easily interconverted, and are dispensable and
replaceable by other amino acids or nitrogen
sources.
• However eight (in adults) or nine (in infants) have
structures that cannot be synthesized by humans;
these are the essential amino acids.
 Amino acid and essential amino acid

• The distinction between dispensable

(nonessential) and indispensable (essential)
amino acid is strictly nutritional,inasmuch as
am indispensable amino acid must be part of
the diet,while a dispensable amino acid need
not necessarily be present in food. By
definition,an indispensable amino acid cannot
be synthesized by the organism in question.
 Indispensable amino acids
• Isoleucine(Ile),
• Leucine(Leu),
• Lysine(Ly),
• Methionine(Met),
• Phenylalanine(Phe),
• Tryptophan(Trp),
• Threonine (Thr),
• Valine(Val).
• Histidine(His) is essential amino acid for infant.
Cysteine(Cys) and Tyrosine(Tyr) are conditionally
essential amino acid or semiessential amino acid.
 Reference protein
• Reference proteins contain all the amino
acids in the exact proportions needed for
protein synthesis.Albumin (found in egg
white) and casein (milk) are the closest
examples.Other proteins are compared with
these reference or perfect proteins.
 Limiting amino acid

• A limiting amino acid is the essential amino acid

present in a protein in the lowest amount relative to
its requirement for synthesis.Examples of proteins
and their limiting amino acid are
• Wheat limited by lysine
• Meat and fish limited by methionine and cysteine
• Maize limited by tryptophan.
• Combining different protein-containing foods such
as meat and the pulses ensures an adequate intake of
all amino acids,that is protein complementation.
 Metabolic need
• This is a direct reflection of rates of
metabolic pathways (e.g., protein
deposition) that consume the nutrient
in question and is fundamentally a
function of genotype as well as the
developmental and physiological state
of the individual.
 Dietary requirement
• This is the quantity of the nutrient
that must be supplied in the diet in
order to satisfy the metabolic need;
it includes factors associated with
digestion, absorption, and cellular
bioavailability.
Recommended dietary allowance(RDA).
• This is the practical expression of nutritional
recommendations. An RDA is designed explicitly
to be applicable to populations rather than to
individuals and thus attempts to account for
variability among subjects in need and dietary
requirement. RDAs are intended to prevent
nutrient deficiency, and are often expressed as
"safe levels." An RDA, so defined, is the intake
that reduces the prevalence of nutrient deficiency
to some desired proportion of the population while
avoiding excessive intakes.
• Metabolic need <Dietary requirement <RDA
• The daily basal nitrogen excretion of adults,
analogous to the minimal metabolic need, is about
50% mg N/kg.The mean nitrogen intake necessary
to maintain nitrogen equilibrium is about 75mg
N/kg and is equivalent to the dietary requirements
Current RDAs or safe levels of intake of high
quality protein for adults are 96-125 mg
N/kg(600-800 mg /kg protein)
 High-quality protein
• The use of the term "high-quality protein" in the
RDA indicates that dietary proteins differ in their
nutritional quality. This reflects the differences in
amino acid composition of proteins and the fact
that the protein need is, in many respects, a
surrogate for the sum of the needs for each amino
acid.
• In theory, the term "high quality" should reflect
how closely the amino acid composition of
dietary protein and the individual's needs for
different amino acids match one another.
• This has led those concerned with farm animal
nutrition to develop the concept of the "ideal
protein," an ideal protein being defined as one with
an amino acid composition that maximizes its
productive utilization by the recipient animal.
• In human nutrition, the term "high quality" is often
taken to be synonymous with proteins of animal
origin, usually milk or whole egg. However,
assessment of the quality of a given dietary protein
should start with a consideration of the amino acid
needs of the individuals to whom it will be fed.
• The equation of "high quality" and
"animal origin" is not necessarily correct
for any stage of life other than perhaps
early infancy. For example, it has been
shown that relative requirements for
different amino acids of preschool
children are not the same as relative
quantities of amino acids in egg and milk.
• The requirements of this population can be
readily satisfied with mixtures of foods of
vegetable origin. Indeed it is possible to
prepare mixtures of proteins of plant origin
(e.g., a cereal and a legume) that, for
school-age children, have a higher
biological value than mixed egg and milk
diets.
 Protein Digestion and Absorption
• Digestion of dietary protein begins in the
stomach with the action of the protease pepsin,
which is secreted as an inactive proenzyme
(zymogen). Activation occurs autocatalytically
with the release of a small peptide fragment
from the inactive precursor. The contribution of
the gastric phase to overall protein digestion is
mainly cleavage of dietary proteins to smaller
polypeptides and accounts for <10% of total
protein digestion in humans.The major site
protein digestion is the small intestine.
• Here proteins of dietary origin (exogenous) as
well as those of endogenous origin are cleaved to
small peptides and free ammo acids. Endogenous
proteins are secretions of the oral cavity (saliva),
stomach, intestine, liver (bile), and pancreas. They
include hydrolytic enzymes and proteins of cells
desquamated during the normal turnover of
intestinal mucosa. Endogenous protein may
account for up to 50% of the total protein
digested.14 The proportion will depend upon
dietary protein intake.
• The intestinal proteases are also secreted as proenzymes
from the pancreas. A brush border enzyme, enterokinase,
which is released from the intestinal mucosa by the action
of bile acids, activates trvpsinogen to trypsin by cleaving
a hexapeptide. Trypsin in turn activates the other
pancreatic proenzymes producing an array of activated
proteases including endopeptidases, such as trypsin and
chymotrvpsin, and exopeptidases,such as the
carboxypeptidases. The end result of the action of these
enzymes coupled with that of aminopeptidases from the
brush border is mixture of free amino acids and short
peptides, mainly dipeptides and tripeptides, which are
readily taken up by the enterocyte.
• A number of transport systems exist for ensuring
efficient absorption of the products of protein
digestion. Well-defined carriers for the transport
of acidic, basic, and neutral amino acids have been
identified;
 REQUIREMENTS
• Humans require dietary protein to provide amino
acids both for the synthesis of proteins during
tissue growth and turnover and for conversion to
the various metabolites that are derived from
amino acids. Dietary amino acids need not match
the composition of tissue proteins exactly.
However, diets must provide the essential amino
acids as well as sufficient amino acids or nitrogen
sources to allow synthesis of the non-essential
ones.
• Traditionally, the nutritional value (quality) of dietary
proteins has been classified in terms of their ability to
provide for tissue growth in rapidly growing rats; marked
differences are observed between most animal proteins
and individual plant-protein sources. With the exception
of gelatin (from collagen), most animal dietary protein
sources have an amino-acid composition similar to that of
tissue protein. Cereal proteins tend to have lower levels of
the amino acids lysine and tryptophan, and pulses contain
lower levels of sulphur-containing amino acids. In
combination, these differences tend to cancel each other
out, so that mixtures of plant proteins allow similar body
growth rates as animal proteins through provision of the
appropriate balance of essential amino acids.
• Human growth is very much slower. so the
nutritional demand for essential amino
acids is much lower; moreover, contrary to
the older view, there is little if any
difference between the quality of protein of
animal origin and that from plant sources
when these include both cereals and pulses.
• There are currently no generally agreed
values for the requirements for essential
amino acids in the human diet (FAO/WHO,
1991). National agencies now stress that, in
most mixed, nutritionally balanced diets,
sufficient essential amino acids will be
provided irrespective of the relative amounts
of plant or animal protein sources
(Department of Health, 1991).
• Recommendations for adults are
specified as 0.75 g/kg in the UK (the
RNI) and 0.8 g/kg in the USA (RDA),
which is equivalent to about 9% total
energy intake, with an upper limit
recommended at 1.5 g/kg (about 18%
total energy).
 Functional and Metabolic
Basis for Amino Acid Needs
• Minimal needs for growth
• Minimal needs for maintenance of body
nitrogen equilibrium
• Nonprotein aspects of maintenance amino
acid needs
 Minimal needs for growth
• The composition of body protein should
provide a firm basis for defining the quantities
of individual indispensable amino acids
obligatorily needed for protein deposition.The
relative requirements of different essential
amino acid,as measured by nitrogen balance
trials,show a commonality among species and
are similar to the composition of body protein
Minimal needs for maintenance
of body nitrogen equilibrium
 CONSUMPTION PATTERNS

• The amount and type of protein consumed

varies widely in different parts of the world.
The most notable difference is in the ratio
between protein of plant origin and protein of
animal origin.
• Throughout the world, protein intake varies
between 10% and 18% total energy. The
average in Africa is 58 g (10% total energy) of
which 79% is of plant origin. Consumption in
Japan is 79 g (15.5% total energy), of which
47% is of animal origin. In a UK nutrition
survey, intakes were 73.2 g (13% total energy),
of which 64% came from meat, milk, eggs and
fish, and 31% from cereals and vegetables.
Consumption in North America is 110 g (16-
17% total energy), of which 66% is of animal
origin.
• Intakes of total protein above 2 g/kg are rare,
although some athletes consume up to 3 g/kg
(30% total energy). Low intakes of protein are
more common among vegetarians. For
example, in the UK, 32% of female and 20% of
male vegetarians, compared with only 5.8% of
female and 3.0% of male omnivores, consume
less protein than the RNI of 9% total energy
(Jackson and Margetts, 1993). The amino-acid
composition of mixed lacto-ovovegetarian
diets is not markedly different from that of
meat eaters.
Nutritional evaluation of protein
in foods
• Amount
• Digestibility
• Protein protein utilization (NPU)
• Chemical score or Amino acid
score(AAS)
 Protein quality
• Chemical score
• Biological value
• Net protein utilization
Protein energy malnutrion(PEM)

• Kwashiorker
• Marasmus
• Kwashiorkor in an african child showing edema
and dermatosis (left) skin lesions (right)
Nutritional marasmus.
showing extreme wasting
in a child
 Chapter 3 Lipids
• Dietary fat consists mainly of a heterogeneous
mixture of triacylglycerols (triglycerides) and
makes up a substantial but variable portion of total
energy intake.
• many European countries, fat accounts for 40--
45% of total energy in the diet. In the United
States, ranging between 30% and 40% in Asia and
Africa, fat provides only l5--25% of energy.
• A widely held belief is that excess dietary
fat contributes importantly to several
chronic diseases, such as coronary heart
disease (CHD), stroke, diabetes mellitus,
cancer, and obesity.
• Fat is a major nutrient and an important
source of body fuel, and fat consists of a
complex mixture of triacylglycerol
molecules that can differ greatly from one
another in their chemical and physical
properties.
 Classification of Lipids
• Triglycerides
• Phospholipids
• sterols
 Lipids
Definition: a wide variety of chemical substances such as
fat (TG), FA, and their derivatives, phosphalipids,glycolipids,
sterols, and fat-soluble vits.
Dietary lipids:Fat constitutes ~90% .
Function:
Provide energy, carrier for fat-soluble vits, EFA as essential
nutrients, cell structures, precursors of PG.
 Property:
Insoluble in water, soluble in organic solvents. The chemical and
physical properties of fat are influenced by the FAs they contain.
SFA<=10 C liquid
SFA> 10 C solid RT
PUFA liquid RT
Insolubility: important for storage as energy and participation in

membrane structure.
 Function of Lipids
• Maintain body temperature
• Storage of fat
• Components of body
• Satiety
• Improve the properties of food such as color,
flavor,smelling etc.
• Produce energy:1g fat produce
39.7kJ(9.46kcal)
 FAs:
Basic formula: CH3[CH2]nCOOH
n can be any number from 2 to 22 and is usually an even
number.
Classification:
A) Chain length:
Short chain: C2-4
Medium chain: C6-10
Long chain: C12-24
B) Saturation: (# of D.B.)
Saturated : no D.B.
Unsaturated: one D.B.
Polyunsaturated: 2 or more D.B.
 Essential Fatty Acid(EFA)
• linoleic acid
• linoleni acid
 Function of EFA
• Component of phospholipids,cell member
• Precursor of prostaglandins
• It is related to metabolism of cholesterol
 Nomenclature:
The DB in all of naturally occurring FAs are in cis configuration (H
atoms are on the same side of the DB)
e.g. H-C-(CH2)nCH3 CH3-(CH2)n-C-H

H-C-(CH2)nCOOH H-C-(CH)nCOOH
Cis trans
The C atoms of FA are numbered from the carboxyl group
(∆ numbering system) or lettered (ω or n numbering system)
 numbering system (carboxyl side)
16 4 3 2 1 C16:1 or C16:1, 9
CH3(CH2)11 CH2CH2CH2COOH CH3(CH2)5 C=CH CH2 (CH2 )6COOH
1 13 14 15 16 C16:1, ω 7
ω or n numbering system (ω -side)
 Digestion and absorption
Mouth: little or no lipid digestion
Stomach: some lipase, but acidic environment w/o bile salt →no
significant digestion
Duodenum: the forceful contraction of stomach breaks up lipids into

fine droplets (Ave D~100 Å) which are exposed to the

solubilizing effects of BS.
BS –powerful emulsifying agents, hydrophobic & hydrophilic sides
Pancreas procolipase

Trypsin ⊕
Colipase
Lipase bind to BS and Droplets [allow lipase to hydrolyze the TG droplets.

(covered by PL which displacing lipase from the droplets)]

 Factors involved in lipid digestion:
* Contraction of stomach
* Enzyme from pancreas ( lipase
and colipase)
* Bile salts
 Digestion and absorption
• Dietary triacylglycerols enter the gastrointestinal
tract,where they come into contact with gastric and
intestinal lipases. The latter is the major lipase, and it
hydrolyzes the fat into free fatty acids and
monoacylglycerols.
• Fatty acids in positions sn-l and sn-3 are
removed,whereas that at position sn-2 remains attached
to glycerol. The solubilization of fatty acids in the gut is
enhanced by the polar lipids of bile: bile acids and
phospholipids, which promote the formation of
expanded,mixed micelles that solubilize fatty acids and
monoacyglycerols. These lipid products then pass by
monomolecular diffusion into the mucosal cells of the
small intestine.
 Lipid Transport:
Lipoprotein:
Absorbed lipids are made water-soluble for transport by blood
plasma by their incorporation into lipoproteins
CM : produced by intestinal mucosa , rich in TG &Chol
VLDL: secreted by the intestinal mucosa
HDL: liver , small intestine muscle
LDL: VLDL heart
energy kidney
TG LPL FAs passive cell re-esterified CE platelets
(in LP) diffusion TG (energy storage)
phospholipids cell membrane
Most circulating FAs are from lipolysis of TG in adipose
tissues during fasting, FAs transported in the form of complex
w/albumin.
 Fatty acid
• Saturated Fatty acid;
• Monounsaturated fatty acid
• Polyunsaturated fatty acid
cis-fatty acid and trans-fatty acid
 Saturated Fatty acid
• Stearic acid( 18:0)
• Palmitic acid(16:0)
• Myristic acid(14:0)
• Lauric acid(12:0)
• Medium-chain fatty acid(8:0 and 10:0)
 monounsaturated fatty acid
• Oleic acid(cis-18:1)
• Elaidic acid (trans- 18:1)
 polyunsaturated fatty acid;
• n-6 fatty acids:Linoleic acid(18:2)
• n-3 fatty acids:Linoleic acid (18:3)
Eicosapentaenoic acid (EPA)(20:5)
Docsahexaenoic acid (DHA)(22:6)
• The predominant monounsaturated fatty acid is
oleic acid (cis-18:l n-9). The term "cis-”indicates
that the double bond is in the cis cofiguration, and
the term "n-9" means that the double bond is
located nine carbon atoms from the terminal
carbon.Another monounsaturated fatty acid is
elaidic acid (trans-l8:1n-9). The trans
configuration of the double bond forms during the
catalytic hydrogenation of poIyunsaturated fatty
acids. Other trans monounsaturates having double
bonds at other locations along the carbon chain are
also produced by hydogenation.
 Phosphorous
• Lecithin
• Cephalin or kephalin
CH2-OOCR2

CHCH2-OOCR1

CH2-OOCR3
 Sterols
• Cholesterol
 Cholesterol
Metabolism :
Ch found in all animal tissues. Eggs—only common food rich on ch
(252mg/large egg).
Body chol present all kind of cells of body. Esp. Brain, nervous system,
connective tissue, muscle
Blood chol only ~8% of total body chol.
Function :
★ Major constituent of all cell memb.
★ ~50% of myelin which surrounds the nerves is ch (ch is necessary
for proper nerve conduction and brain function)
★ precursor of BS
★precursor of steroid hormones
★ essential components of plasma LP
★ precursor of vit D
 Synthesis:
Except the mature red blood cells, all cells can synthesize ch in
human.
Site: liver & intestine
C source: AcCoA (CHO,FA,PRO.)
In human de novo synthesis of chol >dietary intake (>30 steps)
AcCoA HMG CoA * mevalonate phosphomevalonate
farnesylpyrophosphate chol
HMG CoA reductase—rate limited enzyme can be inhibited by
dietary chol in liver (not in small intestine).
Chol homeostasis: Bile acids
Dietary chol steroid hormones
De novo synthesis Chol excretion in the feces
Dietary factors affect ch metabolism: dietary ch, fat, cal , pro,
CHO, fiber etc.
 EFAs
Definition: EFAs are those that cannot be biosynthesized in
adequate amounts by animals and humans and which are
required for growth, maintenance, and proper functioning of
many physiological processes. They have one or more DB
situated within the terminal seven carbon atoms (counting
from the ω end ) and can not be made de novo. Therefore
must be supplied in the diet.
* Linoleic acid (C18:2, ω 6,9)--n-6
 Linolenic acid (C18:3, ω 3,6,9)--n-3
 Arachidonic acid (C20:4, ω 6,9,12,15) –can be converted from
linoleic acid
*only EFA
 Functions
a).Stimulation of growth
b).Maintenance of skin and hair growth
Maintains the integrity of epidermal water barrier,.
w/o EFAs severe water loss from the skin;
c).Regulation of chol metabolism
Formation of bile acids from chol require EFA;
synthesis of phosphatidyl choline—a constituent of HDL, which in turn break
down the chol transport process prevent TG & chol accumulation in liver.
d).Maintenance of cell membrane integrity
Cell secretion, signal transmission depend on memb. fluidity;
n-3 FAs-- important components of structural lipids in many tissues, e.g. brain,
retina.
Deficiency:
Most common cause of EFAs deficiency in human in all age
group—long term of fat free;
Parenteral nutrition (PN);
Low birth weight infants have limited body stores of EFAs
easy to be deficiency.
Dietary requirements:
U.S. linoleate in diet 10 g/d
Food source:
Vegetable oil, e.g. corn oil, soy bean oil, safflower oil,
sunflower oil.
Arachidonic—foods animal origin
 Fat consumption and balance of FAs in the diet
There is close relation between dietary fat and obesity, heart
disease, cancer.
Plasma [chol] >5.17 mmol/L risk for AS
…………….. >6.20 mmol/L high risk for AS
for them , the recommended fat consumption:
Total fat <30 en%
SFAs <10 en%
PUFA <=10 en %
MUFA 10~15 en %
the ratio of P:M:S should be 1:1:1
 Sources of Lipids
• Animal
• Plant oil
Chapter 4 Carbohydrates (CHO)
• General
formular:
(CH2O)n
 Definition
• CHO are polyhydroxy aldehydes,
polyhydroxy ketones, or compounds
that can be hydrolyzed to them.
 Classification of carbohydrates
• saccharide （ 1-2monosaccharide ）：
monosaccharide(glucose,fructose and
galactose,ribose,deoxyribose,xylose etc.);
disaccharide(sucrose,lactose,maltose etc.)
• oligosaccharide （ 3-9monosaccharide ）
： raffinose and stachyose)
• polysaccharide （ 10monosaccharide ）
： starch,glycogen and fibre 。
 Classification

A).Monosaccharides—are simple sugars which

cannot be broken down into smaller molecules
by hydrolysis.
B).Disaccharides—can be hydrolyzed to give two
monosaccharide units.
C).Oligosaccharides—are polymers made up of
three to ten monosaccharide units.
D).Polisaccharides are polymers with many
monosaccharide units.
Major CHO in the human diet:
Disaccharides:
Sucrose (cane sugar)
lactose (milk sugar)
Polysaccharides starches:
amylose : consists of 250-300 glucose units linked
by α -1,4 glucosidic bonds, straight chain.
amylopectin:α -1,4 glucosidic bonds, about one α -1,6 glucosidic
bonds, for thirty α -1,4 glucosidic bonds,(branched
type, 80-90%of dietary starch).
* Starches (glucose polymers) and their derivatives are the only
polysaccarides that are digested to any degree in the human
GI tract.
* Glycogen resenbles amylopectin in structure but has a higher
degree of branching.
 Digestion:
Starch: salivary amylase (begins in the mouth)
pancreatic amylase (the bulk of starch digestion in the small
intestine )
intestinal amylase (minor contribution )
This process yields glucose as well as three oligosaccharides—
maltose, a disaccharides, maltotriose, a trisaccharides, and α -limit
dextrins, which contain 8 glucose moieties on the average.
Oligosaccharides: from above or diet;
Oligosaccharidases: lactase, maltase, sucrase, α -dextrinase--
epithelial brush border
Undigestible CHO: metabolize by the Bacteria are present in the lower ileum and colon; products:
hydrogen (H2), methane (CH4), and CO2, SCFA. May cause--diarrhea, cramps (“gas pains”),
bloating.
Principal end products of CHO digestion in the intestinal lumen:

α -limit dextrin

G
maltotrioseG sucrose

G maltose G F
G G
lactose
G G G

G G

Ga G
 Digestion of CHO

Source Enzyme Substrate Catalytic function or products

salivary α -amylase starch hydrolyzes 1,4α -
linkage,produing α -limit
dextrins, maltotriose and
maltose.
Exocrine
Pancreas α -amylase starch same as above
Intestinal maltase maltose glucose
Mucosa maltotriose
Lactase lactose Ga & G
Sucrase sucrose F&G
α -limit α -limit
dextrinase dextrins G
Mechanism of absorption:
Glucose and other monosaccharides are hydrophilic, to pass through
the hydrophobic lipid cell membrane of the intestinal epithelial cell, need
the carrier molecule in an active energy-consuming process:
1.Glucose and galactose, for example, share a carrier
transport system and compete for access to it. This
system is Na+-dependent, and for this reason, has been
termed the Na+ co transport mechanism.
2.Fructose is absorbed along concentration gradient. Although this
mechanism does require a specific carrier, it does not consume
energy and, thus, is termed facilitated diffusion.
Factors determining the blood glucose level:
The balance between the amount of glucose entering the blood stream and
the amount leaving it.
The principal determinants :
dietary intake;
the rate of entry into the cells of muscle, adipose tissue, and others;
the glucostatic activity of the liver;
Ingested glucose :
5% → glycogen in the liver.
30-40% → fat.
the remainder→ metabolized in muscle and other tissues.
 Blood glucose homeostasis

Diet amino acids glycerol

liver
intestine lactate
Blood
glucose

Muscle and
kidney other tissues
brain fat

Urine
(when BG>180mg/dl)
 Function of dietary
• Improve intestine
• Control body weight and lose weight
• Decrease glucose and cholesterol in serum
• Prevent from cancer
 Functions of CHO
• Provide and store energy
• Components of bogy
• Sparing protein action by gluconeogenesis
• Antiketogenesis
• Provide dietary fiber
 Function:

1. to provide a source of energy; (~50-60 en % in the US).

Esp. Brain& RBC
2.body component; e.g.glycolipid, DNA, RNA, lycoprotein.
3.Sparing protein;
4.Antiketogenesis;
 Source of CHO
• Plant :corn, wheat, rice
• Amimal :liver
Major source: plant food, diary food, meat,

food additives.
RDA: minimum 50-100mg/d
50mg/d can antikosis;
100mg/d can prevent dehydration.
*short term CHO free diet is not harmful.
 CHO intolerance
It is characterized by malabsorption that leads to symptoms,
particularly diarrhea, with excretion of acidic stools and carbohydrate
in the feces following ingestion of sugars. It can be due to a defect in
digestion and/or absorption of dietary carbohydrate. Di-, oligo-, and
polysaccharides that are not hydrolyzed by amylase and/or small
intestinal surface (brush border) enzymes cannot be absorbed; they
reach the lower tract of the intestine which contains bacteria.
Microorganism can break down and anaerobically metabolize some
CHO resulting in the formation of SCFAs, lactate, H2, CO2, and CH4.
The presence of osmotically active CHO and fermentative products
within the lumen is associated with intestinal secretion of fluid and
electrolytes until osmotic equilibrium is reached. These products on
the intestinal motility and cramps, because of intraluminal pressure and
distention of the gut, or because of the direct effect of degradation
products on the intestinal mucosa. Some intestinal mucosal cells along
with disaccharidases may be lost.
Disaccharidases deficiency:
Common in human, due to a single or several enzymes for a variety of
reasons :
e.g. genetic defect, injuries to mucosa, or physiological decline with
age.
Patients suffering or recovering from a disorder cannot drink or eat
significant amount of dairy products (lactose) or sucrose without
exacerbating the diarrhea.
Lactase deficiency most commonly observed in human
(milk intolerance)
a) inherited deficiency, which is relatively rare;
b) secondary low lactase activity, damage of the small intestine
c) primary low-lactase activity is a relatively common syndrome, age-
related decline in lactase activity
Nutriton therapy:
◆ reducing or avoiding lactose intake (milk and dairy products);
◆ pretreating milk with lactase derived from bacteria
◆ ingesting only lactose-treated dairy products such as Lactaid or Dairy
Ease.

!!! Individuals who avoid all products containing lactose will not
meet their daily calcium requirement. Calcium supplementation of
800 to 1200 mg/d is necessary for these patients. Pregnant and
lactating women and the elderly require higher levels , depending on
their intake of nondairy calcium sources.
 Dietary Fibre
• Soluble fibre :pectin,gum ,mucilage and
hemicellulose
• Insoluble fiber:cellulose,some
hemicellulose, lignin
 Dietary fiber:
Definition: those plant constituents which are resistant to digestion by
secretions of the human GI tract.
Food sourses:
All food of vegetable origin, but in variable quantities.
Whole grain cereals are a major source. Average contents:
Whole wheat:12.8%; White flour: 3.3%; Wheat bran 42.4%;
Corn bran 88.8%;White rice 4.1%;
Dry bean, soy bean >4%; Roasted nuts 2.3-6.2%
Most fruit & vegetables 0.5-1%;
Components of DF
Major nonstarch polysaccharides (including celluloses, hemicelluloses,
pectins, etc.).
Cellulose (unbranched polymers of β 1,4 bond) most abundant and best
known component of fiber, in all pant cells, rich in oats and barley.
 Physicochemical and biologic actions of fiber

Type of fiber Chemistry Physical property Biologic action

Cellulose linear G polymers hydrophilic, ↓ transit time,
β 1,4 bond H2O insoluble ↑stool bulk
Hemicelluloses branched polymers hydrophilic, ↓ transit time,
of pentose & hexoses H2O insoluble ↑stool bulk
Pectins mixture of colloidal can form, ↓rate of small Polysacharides,
viscous solutions intestinal absorption
galacturonic acid water soluble, (glucose, bile acids,
linked to sugars gel-forming plasma Chol)
binds bile salts
transit time—the time necessary for a substance to move through the
entire GI tract and pass out in the feces. It is shorten by ingestion of
increased dietary fiber.
 Fiber and disease

• Constipation
• Colon cancer
• Hyperlipidemia
• DM
• Obesity
1. Constipation—elderly people,
Hemicelluloses and cellulose hydrophilic
property→
↑stool bulk and weight. 1 g of extra DF
→↑ stool weight by 3-9g.
The stool weight in low fiber intake population is 80-200g/d;
……………………high………………………….400-500g/d.
Insoluble fiber especially wheat bran has the greatest effect on
stool wt.
 2. Colon cancer—the 2nd cause of cancer mortily
in the U.S.
Protect against cancer in several ways.
1). ↑Water content and fecal bulk→dilute the potential carcinogens or cocarcinogens in the
colon.
2). ↓the transit time→↓time of mucosa exposed to the toxic materials.
3). ↓the production of carcinogen by altering the bacterial flora or their functional activities.
4).absorb the toxic material →↓their availability to the lining of the colon.
5). The production of SCFA→↓colonic pH→conversion of bile acids to potential carcinogens;
→limit the uptake of ammonia by epithelial
cells
→energy for bacterial growth→help inactive
toxic substances.
→antineoplastic.
 3. Hypolipidemia

Hypolipidemic effect: soluble fiber.

Fiber → ↓transit time →↓fat, chol absorption
→binding bile salts, chol →↓ fat, chol digestion, absorption
→ binding bile salts→↑ chol excretion.
 Diabetes

DF →↓glucose absorption and levels of blood glucose and insulin.

1). ↑the peripheral sensitivity to insulin
2). ↑ The number of insulin receptors on circulating monocytes
 Obesity

Obesity—high fiber →↓bw.

1). Displace available nutrients from the diet.
2). It requires chewing which slows down food intake and
promotes a feeling of satiety→↓food intake
3). ↓absorption efficency of the small intestine.

Overconsumption of fiber
↓vit. Mineral (Zn, Fe, Mg, Ca) absorption.
Fig 1 Annual Ratio Trends for Old People Aged at 65 and Over
(Management and Coordination Agency, September 2002)

%
30

25

20

15

10

0
1970 1980 1990 2000 2010 2020 2030

Year
Fig 2 A Number of Old People who Need Assistance
(Health and Welfare White Paper 1997)

600
x ten thousands

500
400 bed-ridden
300 dementia
200 infirmity

100
0
1,993 2,000 2,010 2,025
year
Chart 1 Lifestyle-Related Disease
Life-style related disease in England
Maladie de comportement in France
Zivilisationskrankheit in German
Valfardssjukdomar in Sweden
 Table 1 Living Practices concerning Lifestyle-related Diseases

Eating habits Hypertension followed by cerebral apoplexy;

Obesity followed by hyperlipidemia, hyperglycemia;
Type II diabetes; Colon cancer; Hyperuricemia
Exercise Obesity; Hyperlipidemia; Type II diabetes; Hypertension
insufficient
Smoking Lung squamous cell carcinoma; Lung emphysema; Chronic
bronchitis; Periodontosis; Circulatory diseases; Stomach cancer
Drinking Alcoholic liver disease; Esophagus carcinoma 　
 Diagnostic Standards for Obesity, Hypertension,
Table 2
Hyperlipidemia, Hyperglycemia, Osteoporosis and Uricemia
Diseases Unit Item Normal Marginal Pathological

Obesity BMI 19.8-24.2 24.2-26.4 > 26.4

Hypertension mmHg diastolic 90-140 140-160 > 160

systolic < 90 90-95 > 95

Hyperlipidemia mg/dl total chol. < 200 200-220 > 220

LDL chol. < 140 no disease > 140
total fat < 150 no disease > 150

Hyperglycemia mg/dl fasting glucose < 126 126-160 > 160

Osteoporosis SD bone mineral < -1.5 -1.5- -2.5 > -2.5

Hyperuricemia mg/dl <6 6-8 >8

 Table 3 Worse Following Lifestyle-Related Disease

Lifestyle Mild symptoms Severe symptoms Intense pain After effect

High salt diet mild hypertension *severe *cerebral *hemiplegia

hypertension haemorrhage *phasia
*atherosclerosis *cerebral *dementia
infarction

High fat diet hyperlipidemia *hyperlipidemia *coronary *restricted activity

obesity infarction *recurrence
Less exercise obesity *hyperlipidemia *fracture *restricted
less bone density *osteoprosis excercise
hyperglycemia *type II diabetes

Hyperalimentation obesity *type II diabetes *necropathy *dismember

hyperglycemia *diabetic *hemodialysis
hyperuricemia nephropathy *blindness
*diabetic
retinopathy

Drinking hyperuricemia *gout *gouty attack *gouty attack

*nephropathy *nephropathy

Smoking early neoplasm *malignant neoplasm *intense pain *extirpation and

terminal care
 Table 4 Primary, Secondary and Tertiary Care for Disease Prevention
Goals Target Care aiming at prevention Guidance for exerciseParticipant in medical care
& nutrition
Primary Normal Hypercholesterolemia; Public health guidance; Managerial nutritionist; Public
(lifestyle- Hypertension; Community and school health nurse; Health and
related Hyperglycemia; guidance; Control of exercise instructor
disease):healt Osteoporosis; Diabetes; exercise; Control of
hy life span Obesity; Early neoplasm school lunch;

Secondary Mild case Cerebral apoplexy; Guidance of meals for Doctor; nurse; Expert of
(adult Coronary infarction; outpatient; Diet clinical examiner; Hospital
diseases): Diabetes; Cancer; Fracture; guidance by dietitian
early Derangement educational
detection & hospitalization
treatment

Tertiary Serious Cerebral apoplexy; Diet guidance for Doctor; Orderly; Physical
(inpatient): case Infarction; Cancer; Diabetes; inpatient; End stage therapist; Terminal orderly
prevention of Diabetic nephropathy; diet supplementation
death Blindness; Bed-ridden
 Fig 3 A Number of Hospitalized and Ambulant Patients per
100,000 (Health, Labour and Welfare, Patient Survey)

700

600 Hypertension
500 Derangement
Neoplasm
400 Heart disease
300 Diabetes
Liver disease
200 Tuberculosis
100 Cerebrovascular

0
1950 1960 1970 1980 1990 2000 2010
 Fig 4 Striking Increase of Diabetes

250

200

150

100

50

0
1960 1970 1980 1990 2000
 Fig 5 Annual Distribution Trends for Obese People (BMI> 25)

Men Women

35
35
30 30
25
25
20
%
20
15
%

15 10
10 5
0
5
1970 1980 1990 2000
0
1975 1980 1985 1990 1995 2000 2005 age at 20 age at 30
Fig 6 Annual Distribution Trends for Leptosomatic People
(BMI< 18.5)

Men Women

20 30
25
15
20
10 15
%

%
10
5
5
0 0
1970 1980 1990 2000 2010 1970 1980 1990 2000 2010
age at 20 age at 30 age at 20 age at 30
age at 40 age at 50 age at 40 age at 50
 Fig 7 Blood Pressure with Age
Men

70
64.5

60
55.6

50
43.7
41.4
40
34.8
%

30

20.7
20
11.5
10
2.5
0
Total 15-19 20-29 30-39 40-49 50-59 60-69 age over
70

Women

70

60.7
60
51.7
50

40 36.9
%

31.9
30

20 17.5

10
4.4
0 0.7
0
Total 15-19 20-29 30-39 40-49 50-59 60-69 ageover
70
 Fig 8 Distribution of People Having High Blood Cholesterol (>220
mg/dl)

Men Women

35 33. 2 35 33. 2
30 29. 9 30 29. 9
2525. 1 26 25. 7 26 25. 7
2525. 1
20 20
% 17. 3
% 17. 3
15 13. 9 15 13. 9
10 10
5 5
0 0
Total 30- 39 50- 59 over Total 30- 39 50- 59 over
70 70
Fig 9 Distribution of People Having High Blood Glucose Level (> 110
mg/dl)

50 41. 7
% 22. 67 .9 15. 3 29. 4
16.8
8. 1
0
Tot al 30- 3950- 59 over
70
M en
50 41. 5
33. 4
% 22. 3 2 2 .7
4 .5 8. 29. 6
0
Tot al 30- 39 50- 59 over
70
Fig 10
 Fig 11 Distribution of People Having Exercise Twice a Week, More Than
30 Min per Once and Continuing More Than One Year

45 42. 940 38. 3

40 39. 5 35
35 30 30. 1 31. 3
31. 9 27. 4
30 28. 9 29 25
22. 6
25 23. 222. 6 % 20 19. 7
%
20 15
15
15
10
10
5
5
0
0 total 30- 39 50- 59 over
total 30- 39 50- 59 over
70
 Fig 12 Distribution of People Smoking Regularly

70 70
60 60. 8 60
56. 6
55. 1
54. 1
5047. 4 50
40 37 40
30 29. 4 30
20 20 20. 9
18. 8
11. 5 13. 6
10 10 10. 4
6. 6 4
0 0
Tota 30- 39 50- 59 over Tota 30- 39 50- 59 over
70 70
Fig 13 Distribution of People Drinking Alcohol Three Times
a Week, and More Than 180 ml Sake and 650 ml Bear a Day

Men Women

70 70
61.5
60 55.8 56.9 60
53.3
50.8
50 50

40 38.4 40
%

%
30 27.8 30

20 20
14.1
11.5
9 8.4 9.8
10 10 7.3
3.3

0 0
Total 20-29 30-39 40-49 50-59 60-69 age over Total 20-29 30-39 40-49 50-59 60-69 age over
70 70
Fig 14 Annual Distribution Trends for People who Do not
Have Breakfast

Total Men Women

12

10

8
%

2
Fig 15 Annual Distribution Trends for Fat-Derived Energy in
Total Energy Intake

100%

90%

80%

70%63.1 61.5 60.4 59.2 57.6 57.5 57.4 57.7 57.5 57.5

60%
Carbohydrate
50% Fat
Protein
40%

30% 25.3 26.4 26.5 26.6 26.3 26.5 26.5

22.3 23.6 24.5
20%

10% 16 16 16 16 16 15.9
14.6 14.9 15.1 15.5
0%
1975 1980 1985 1990 1995 1996 1997 1998 1999 2000
Fig 16 Annual Distribution Trends for Animal-, Plant- and
Fish-Derived Fat Intake

Animal Plant Fish

60
5. 8 5. 8 6. 1 5. 9
5. 6 5. 6 5. 7 6
50 6

40 29.3 29.6
30.2 29.7 29.6 28.7 28.9
28.3 28.7

30
g

20

10 20. 9 21. 3 22 21. 6 24 23. 5 23. 6 23. 2 23.

0
 Fig 17 Annual Calcium Intake Trends

700
600
500
400
300
200
100
0
1940 1960 1980 2000
 Fig 18 Annual Salt Intake Trends

15

14
13. 5 13. 2
13 12. 9 12. 9
g/day

13 12.
12. 5 12. 7 12
12 12. 1

11

10
 Table 5 Annual Food Intake Trends (g/d/capita)
1975 1980 1985 1990 1995 1998 1999 2000

Cereals: rice 248 225 216 197 167 164 162 160
:wheat 90 91 91 84 93 90 89 94
Potatoes 60 63 63 65 68 71 67 64
Fats & Oils 15 16 17 17 17 16 16 16
Pulses 70 65 66 68 70 72 70 70

Green vegetables 48 51 73 77 94 87 94 95
Other vegetables 198 200 187 173 196 186 196 194
Fruits 193 155 140 124 133 115 119 117
Algae 4 5 5 6 5 6 5 5
Sugars 14 12 11 10 9 9 9 9

Beverages & spices 119 109 113 137 190 193 185 182
Confectionaries 29 25 22 20 26 24 23 22
Fish & Shellfishes 94 92 90 95 96 95 94 92
Meats 64 67 71 71 82 77 78 78
Eggs 41 37 40 42 42 40 40 39
Milks 103 115 116 130 144 135 37 127
 Chart 2 Comparison of Health and Welfare
Statistical Survey with Epidemiological Study

Statistical Survey:
Data of birth, death, diseases etc reported to municipals
and wards from medical facilities.

Epidemiological Study:
Investigation on health condition, diet
, exercise and etc in freely living
people.
 Fig 19 Epidemiological Studies in Hisayama on Vascular Diseases

Population: 7,50
Occupation: farmer
Start of study: 1961
Aim: prevention from
lifestyle-related
diseases
Age of participant > 40 Hisayama-machi,
Analyses of data Fukuoka

Group I: 1961-1969
Group II: 1974-1982
Group III: 1988-1996
Autopsies: > 80%
 Table 6 Annual Crisis Trends for Vascular Diseases
(number/1,000 per year)

Vascular diseases I group II group III group

1961-1969 1974-1982 1988-1996

Cerebral apoplexy 10.5 5.0* 4.7*

infarction 7.0 3.7* 3.1*
hemorrhage 2.3 0.8* 1.0*
subarachnoid hemorrhage 0.9 0.5 0.7
Ischemic heart diseases 2.1 1.9 2.3
infarction 2.0 1.6 1.7
sudden death 0.1 0.3 0.6

*P< 0.05 vs I group

 Table 7 Incidence of Hypertension, Use of Antihypertension
Drug and Annual Blood Pressure Trends

Group Number of Incidence of Antihypetension Blood pressure

subjects hypertension (%) drug user (%) (mmHg)

Men
I 705 28 10 175/96
II 855 24* 37* 167/91*
III 1110 23* 62** 157/87**
Women
I 913 24 11 179/94
II 1183 24 35* 173/89*
III 1527 22 70** 161/82**

Age is adjusted. *P<0.05 vs Group I. **P<0.05 vs Group II.

 Fig 20 Annual Incidence Trends for Metabolic Diseases
(Obesity, Hypercholesterolemia HC, Impaired Glucose Tolerance IGT)

M en
W omen
1961 1974 1988 1961 1974 1988

50 50
40 40
30 30
% %
20 20
10 10
0 0
O be se HC IG T O bese HC IG T

Obesity BMI> 25; Impaired glucose tolerance IGT> 220 mg/dl

 Fig 21 Annual Incidence Trends for Hypercholesterolemia
accompanied with or without obesity

Men W
omen
60
60
50

40 50

Obese (-)
% 30 40
Obese (+)
20
%30
10
20
0
1961 1974 1988
10
1961 1974 1988 1961 1974 1988
0
Obese (-) 654 829 951 Obese1961
(-) 778 1010 1974
1210 1988
Obese (+) 19 51 126 Obese (+) 62 131 205
Fig 22 Comparison of Annual Intakes Trends for Selected Foods between
National Nutrition Survey and Hisayama Study

Ri ce Meats
120
400
100
80 300
60 200
40 100
20
0
0
65 85 94
65 85 94 Nati onal Hi sayam
An intake from obtained from the National Nutrition Survey in 1965 is taken as 100.
a
Nati onal Hi sayam a
Fig 23 Polymorphism of Aldehydedehydrogenase gene (ALDH2) and its
Effect on Alcohol Consumption

Wild type (ALDH2·1)

ACT GAA GTG AAA ACT GTG AGT GTG G…..
Thr Glu Val Lys Thr

Defficient type (ALDH2·2)

ACT AAA GTG AAA ACT GTG AGT GTG G…..
Thr Lys Val Lys Thr

Metabolism of alcohol

Alcohol Acetoaldehyde Acetic Acid TCA Cycle

Alcohol dehydrogenase ALDH

 Table 8 Inheritance of a Particular Single Nucleotide
Polymorphism Due to Lifestyle during Evolution

Genes & polymorphism Characteristics during evolution

Alcohol sensitive gene Black: consumed fruits fermented in tropical area.

*Aldehydedehydrogenase
(ALDH2·1) (ALDH2·2)
Starvation resistant gene
*Leptin receptor (exon 6, N223R etc)
*Uncoupling protein
β 3 Adrenergic receptor (W64R)
Salt sensitive gene
*Angiotensinogen (T173K)
*Angiotensin converting enzyme (R173K)
*Aldosteron synthetic enzyme
Caucasoid: depended on a fermented food during a long
winter.
Mongoloid: consumed fresh fruits.
Caucasoid: depended on house hold animals during
starvation.
Mongoloid: depended on plant foods.
Ape, Black and Mongoloid: lived in salt-poor area.
Caucasoid: obtained salt from animals.
 Fig 24 Starvation Resistant and Hypertension Sensitive Genes
in Response to Lifestyle

LERP

leptin Thyroid gland

noradrenalin
T3

β 3 leptin β 3 AR
AR UCP3
Brown
UCP2
adipocytes UCP1 PPAR2
PPAR2γ γMuscle
White
adipocytes
angiotensinogen
Pancreas TNFα
insulin adiponectin Hypertension
Obesity

Diabetes
Atherosclerosis
 Table 9 Different Lifestyles between Japan and the West

Items Japan USA, Europe etc

Adequate energy intake 2,200 Kcal 3,000 Kcal
Major foods rice, fish wheat, meats, milks
cereals 459 g 258 g
meats 91 g 305 g
milks 162 g 659 g
fish & shell 187 g 50 g
Eating habits boiling, cooking, bread, meats, milks
fermentation
Agriculture rice, root vegetables Wheat, vegetables,
Hypertension, stock-farming
Type of disease stomach cancer Coronary infarction, lung
cancer
Mongoloid Caucasoid
Genes
 Table 10 Effect of Walnut Consumption on Serum
Cholesterol in Japanese, Spanish and American

Country Subjects Background diet Results References

Japan Healthy men & women Average Japanese Lowering LDL Europ. J. Clin.
diet cholesterol Nutr. 2002

Spain Mild hyperlipidemic men Mediterranean diet Lowering LDL Ann. Intern. Med.
& women cholesterol 2000

USA Healthy men NCEP Step I diet Lowering LDL New Eng. J. Med.
cholesterol 1993
 Conclusion
• Lifestyle differs among countries, so that any
recommendations related to health-promoting diet
that was obtained in the West should be evaluated
carefully to meet each countries demand.
• It is urgent to examine systematically a role of diet
and genetic polymorphism in prevention from
lifestyle-related diseases.
• It is necessary to increase consumption of rice to
approximately 220 g/day.