REVIEWER IN NUTRITION AND DIET THERAPY

FOOD- any substance, organic and inorganic, when ingested or eaten, nourishes the body by build and
repairing tissue

ORGANIC- absence of pesticides, herbicides, etc. Ex. Fruits, vegetables

INORGANIC- use of synthetic chemicals

QUALITIES OF FOOD

1. SAFE

2. NOURISHING/NUTRITIOUS

3. HAS PALATABILITY FACTORS TO SATISFY CONSUMER

4. SATIETY VALUE

5.

6.

NUTRIENTS- chemical substance, organic or inorganic

NUTRIENT CATEGORIES

 ORGANIC COMPOUND- (carbohydrates, lipids, protein and vitamins)

 INORGANIC COMPOUND- (minerals and water)

NUTRIENT CLASSIFICATION

1. ACCORDING TO FUNCTION

- ENERGY GIVING- furnished energy

- BODY BUILDING- form tissue

- BODY REGULATING- maintain normal functioning

2. ACCORDING TO CHEMICAL STRUCTURE

* ORGANIC NUTRIENTS- carbon containing compounds w/ exception of carbonate cyanide

* INORGANIC NUTRIENTS- minerals and water

3. ACCORDING TO ESSENTIALITY

* ESSENTIAL NUTRIENTS- when body requires nutrients for growth or maintenance but lacks the
ability to manufacture

- Also must be supplied in the diet

- linked to specific deficiency

EX. KWASHIORKOR-protein deficiency

SCURVY- vitamin C deficiency

* NON ESSENTIAL NUTRIENTS- nutrients that body can make on its own

[Not all nutrients are essential for species]

[Study of essentiality is a continuous process]

ESSENTIAL NUTRIENTS

CHO- glucose

LIPIDS- linoleic acid

PROTEIN- amino acids

VITAMINS- fat soluble and water soluble

MINERALS- calcium, phosphorus

WATER

VITAMINS

WATER SOLUBLE FATS SOLUBLE

B1- THIAMINE VIT. A- RETINOL
B2- RIBOFLAVIN VIT. D- CALCIPHEROL
B3- NIACIN VIT. E- TOCOPHEROL
B6- PYRIDOXINE VIT. K- ANTI HEMORRHGIC FACTOR
B9- FOLIC ACID
B12- COBALAMIN
VIT. C- ASCORBIC ACID

4. ACCORDING TO CONCENTRATION

* MACRONUTRIENTS- nutrients which body needed in amount 1 or more per day

*MICRONUTRIENTS- present in small amount less than 1 grams

NUTRITURE OR NUTRITIONAL STATUS- condition how well-nourished the human body

CRITERIA

1. Physical signs and symptoms

2. Medical history

3. Blood and urine tests

4. Anatomical changes

5. History of diet intake

MALNUTRITION- undesirable state of one’s health can either be nourished or undernourished

- Opposite of good nutrition

- Lack or excess or imbalance nutrient

UNDERNUTRITION- lack of one or more nutrients

- Under consumption of energy

RDA- Recommended Daily Allowance

STUNNIN- height

WASTING- weight

OVERNUTRITION- over weight or obesity

FACTORS:

PRIMARY FACTORS

1. Poverty

2. Ignorance

3. Poor food habits

4. Limited supply of food due to overpopulation

5. Poor distribution of food

SECONDARY FACTORS

- Multiple and include all conditions within the body that reduce ultimate supply of nutrients

METHODS

1. DIETARY SURVEY- method of collecting information regarding actual or habitual dietary intake

Ex. 24HR FOOD RECALL- report on what an individual ate

2. ANTHROPOMETRIC MEASUREMENT- measuring the height and weight and limb circumference

Ex. BMI

3. MEDICAL OR CLINICAL HISTORY

- MEDICAL EXAMINATION- from head to toe

- CLINICAL OBSERVATIONS- limited value because overt symptoms would not become apparent

4. BIOCHEMICAL TESTS- analysis of sample of body tissues or how the body uses nutrients

Ex. STAINING

NUTRITIONAL PHYSIOLOGY- deals with biological process or how the structural parts work
 - How the body transform food substances for maintenance of life

CELL- has ENERGY, NUTRIENTS and WATER&OXYGEN

SCOPE OF NUTRITION

1. PHYSICAL SCIENCE- using chemical provided by food

2. BIOLOGICAL SCIENCE- how nutrition relates with the body functioning

3. BEHAVIORAL SCIENCE- how nutrition is interwoven with our unique nature

DIGESTION- process by which body turns food into energy

METABOLISM- chemical process of transforming food into complex tissue

CATABOLISM- breakdown of molecules to obtain energy (large to small)

ANABOLISM- synthesis of all compounds needed (small to large)

QUIZ

1-3. QUALITIES FOOD (3)

4. MACRONUTRIENT MEANING

5. MICRONUTRIENT MEANING

6. RULE- (60%CARBOHYDRATES, 25%PROTEINS, 25%LIPIDS)

7. CELL- ENERGY, NUTRIENTS, WATER&OXYGEN

8. BILE- FOUND LIVER

9. PERISTALSIS MOVEMENT (DIGESTION KEMERUT)

10. BMI FORMULA (WEIGHT IN KG OVER HEIGHT IN M SQUARED)

11. 18.9-24.9 (NORMAL BMI)

12-15- CHO, LIPIDS, FATS, WATER

MACRONUTRIENTS

CARBOHYDRATES- body’s major source of energy

- Composed of carbon, hydrogen and oxygen

2 MAIN TYPES
1. SUGAR- found in milk fruits and table sugar
2. STARCHES- found in grains, breads, crackers and pasta
 * 65% of food in diet are consist of carbs

GLUCOSE- absorbed into blood stream, make the sugar level go up

INSULIN- as sugar level rises the pancreas produce it

- It is needed to move glucose in the blood stream

CELLULOSE- wood in furniture, pages in notebook, and clothing

3 CLASSIFICATIONS OF CARBOHYDRATES

1. MONOSACCHARIDES- simple sugar, simplest form of carbohydrates

- Sweet since they require no digestion

- absorbed directly into the bloodstream from small intestine

*GLUCOSE (DEXTROSE) - fuel the work of the body cells, provide energy to the brain

Ex. Fruits, sweetcorn

*FRUCTOSE (LEVULOSE) – sweetest simple sugar. Ex. Fruits, honey

*GALACTOSE (MILK SUGAR) – produce from lactose, found in dairy products.
Ex. Avocado, sugar beets
2. DISSACCHARIDES- made up of monosaccharides
- They must be charge to simple sugar by hydrolysis before absorbed
* SUCROSE- ordinary table sugar
*LACTOSE- found in milk
*MALTOSE- not found in free foods, most in beverages
3. POLYSACCHARIDES- many simple sugar (COMPLEX SUGAR)
*DEXTRINS- formed as intermediate products
*CELLULOSE- forms the frameworks of plant
*PECTINS- non-digestable, having gel quality
*GLYCOGEN- formed form glucose and stored in liver
CHO DIGESTION
1. MOUTH- salivary amylase
2. STOMACH- uniform mixture called chime
3. SMALL INTESTINE- pancreatic amylase
4. LIVER- first organ receives glucose

FUNCTIONS OF CHO
1. Serves as the major sources of energy
2. Exerts protein spacing action
3. for normal fat metabolism

CHO REQUIREMENTS
1. Size
2. Activity level
3. Age
4. Sex
SOURCE OF CHO
1. Dairy
2. Fruits
3. Grains
4. Legumes
5. Starchy vegetables
DEFICIENCY
1. Body feels cold
2. Body bruises
EXCESS
1. Overweight
2. Fat
CHO REQUIREMENTS
2-4 serving of fruits
3-5 serving of vegetables
6-11- serving of whole grains
Small amount refine sugar

PROTEINS- essential nutrients, building blocks and fuel source of the body
IMPORTANCE
- Essential for growth repair and maintenance for good health
- Provide body with app. 10-15% dietary energy

TYPES
1. COMPLETE PROTEINS- all are essential
2. INCOMPLETE PROTEINS- at least one are essential
3. COMPLEMENTARY PROTEINS- two or more food containing incomplete proteins

PROTEIN DIGESTIONS
1. MECHANICAL DIGESTION- physical digestion
2. CHEMICAL DIGESTION- by digesting enzymes

DEFICIENCY
1. Malnutrition
2. Eating disorder
3. Last stages cancer
SYMPTOMS
1. Bed sores
2. Weak and sore
3. Nausea
4. Weight loss
DISEASES
1. Marasmus
2. Kwashiorkor
3. Cachexia
4. Mental retardation
TREATMENTS
1. Protein supplement
2. Protein rich food
BENEFITS
1. Prevent diabetes
2. Saves from cardiovascular diseases

LIPIDS (FATS)
GOOD FATS- monounsaturated and polyunsaturated fats (heart healthy)
BAD FATS- saturated fat and Trans fat (harmful to health)

TYPES OF FATS
1. SIMPLE-CHAIN FATTY ACIDS- aliphatic tails
2. MEDIUM-CHAIN FATTY ACIDS- 6-12 carbons
3. LONG-CHAIN FATTY ACIDS- 13-21 carbons
4. VERY LONG-CHAIN FATTY ACIDS- 22 or more carbons
IMPORTANCE
1. Provide energy
2. Maintaining skin and hair
3. Important in dietary requirements
4. Insulating body organs against shock
HEALTH PROBLEMS
1. Hurts your heart
2. Ups male hormones
3. Triggers diabetes
4. Ruins sleep

QUIZ
1. SUGAR- ex.
2. STARCHES- ex.
3. GLYSEMIC INDEX- sugar content, how it affect on our blood sugar
4. GLUCOSE- provide energy to the brain
5. FUNCTION OF CHO
6. 4 Cal=1 gram protein (4cal= 1 gram carbs & 9cal= 1gram fats)
7. MUSCLE, BLOOD, SKIN- protein
8-9. example of protein deficiency
10-11. benefits of protein
12-13. GOOD FATS/ HEART HEALTHY
14. TRANS FAT- most harmful fat
15. HEART- protein

MICRONUTRIENTS
- Plays a central part in metabolism and in maintenance of tissue function
- Vitamins and mineral

VITAMINS- organic substance that are essential for several enzymatic functions in metabolism

 Compound is called vitamins when it cannot be synthesized in sufficient quantities

 Acts as hormones (VITAMIN D)
 Acts as antioxidant (VIATMIN E)
 Acts as mediators and regulators of cells (VITAMIN A)
 VITAMIN classification- fat soluble(4) and water soluble(9)

WATER SOLUBLE- dissolves easily in water

FAT SOLUBLE- absorbed through the intestinal tract with help of lipids

VITAMIN A- retinol, retinal

Functions:

- Immunity
- Vision
- Regulation of gene expression
- Growth and development

RDA:

- Infants- 300-400
- Children- 400-600
- Adolescents- 900-700

DEFICIENCY

- Ocular changes
- Extra ocular changes

VITAMIN D- comprises group of sterols which are cholecalciferol (VIT. D3) and ergosterol (VIT. D2)

FUNCTIONS:

- Calcium metabolism
- Cell differentiation
 - Immunity

SOURCES

DEFICIENCY

- Rickets in small children

- Osteomalacia
- Osteoporosis

TOXICITY

- Nausea & vomiting

- Excessive thirst & polyuria

TREATMENT

- Administered orally

VITAMIN E- anti oxidant, free radical scavenger, antineoplastic, transported in the body by lipoprotein

SOURCES:

- Nuts, seeds and whole wheat grain

RDA

DEFICIENCY

- Observed in low birth weight infants

- Anemia
- Prophylaxis- reduces retinopathy of prematurity

VITAMIN K- cofactor of enzyme that catalyzes one step

SOURCES

- Green leafy vegetables

DEFICIENCY

- Coagulation defect

WATER SOLUBLE VITAMINS

B VITAMINS (THIAMINE)

SOURCES:

- Fish liver, legumes, nuts, whole grain

IMPORTANT:

- Producing energy from carbs

- Proper nerve function
 - ATP production

WARNING:

- B1 is nontoxic even at high dosage

DEFICIENCY

- Beri beri

DIAGNOSIS

- Functions primarily in the metabolism of carbs

- RDA- 0.4mg/1000kcal consumed

TREATMENT

- Resolution of neurologic and cardiac symptoms

DEFICIENCY OF VIT. C

- SCURVY:
- in infant- clinical features (anorexia, diarrhea, pallor)
- In older children- hemorrhagic sign (bleeding of gums, conjunctiva)

DIAGNOSIS

- Physical findings
- X-ray

TREATMENT

- Supplementation of vit.c

FOLIC ACID

- Essential for the normal growth of all cells of the fetus

SOURCES

- Leafy vegetables- spinach, turnip, lettuce

DEFICIENCY

- Megaloblastic anemia
- Memory problems

B2 RIBOFLAVIN

IMPORTANT:

- Energy production
- Formation of antibodies
- Maintenance of good vision, hair, skin, nails
 SOURCES:

- Large amount in dairy, eggs, meats

- Small amount in leafy green vegetables, enriched in grains

DEFICIENCY:

- Itching and burning eyes

- Dermatitis
- Oily skin

WARNINGS:

- Non-toxic at supplemental and dietary levels

AT RISK:

- People with cataracts

- People with sickle cell anemia
- Alcoholics

B3 NIACINAMIDE&NIACIN

IMPORTANT:

- Energy production
- Maintenance of skin and tongue
- Improves circulation

NIACINAMIDE (NICOTINAMIDE): not regulate cholesterol

NIACIN (NICOTIN ACID): highly toxic in large doses

WARNINGS:

- Nicotinic can cause dilation of blood vessels and potentially painful tingling “niacin flush” ,
liver damage
- Nicotinamide is safe to take, few cases of liver damage

DEFICIENCY

- PELLEGRA
- Gastro intestinal disturbance

AT RISK:

- Added white flour

B6 PYRIDOXINE

IMPORTANT:

- Production of red blood cells

- Nervous system functions
 - Maintaining proper balance

WARNINGS:

- Treat carpal syndrome and sleep disorders

- Pregnant women should consult before taking this supplement

DEFICIENCY:

- Nervousness, insomnia
- Loss of muscle control
- Arm and legs cramps
- Skin lesion

AT RISK:

- Very rare
- Alcoholics
- Px with kidney failure

B12 COBALAMIN

IMPORTANT:

- Proper nerve function

- Metabolizing fats and protein
- Prevention of anemia

WARNINGS:

- Vegetarians need to look for fortified sources

- Elderly trouble absorbing

DEFICIENCY

- Anemia
- Nerve damage
- Hypertensive skin

AT RISK:

- Pernicious anemia
- HIV
- Chronic fatigue syndrome

CALCIUM- most abundant mineral in the body

- Located primarily in bone tissue (98%)

- Absorption depends on intake of vit. D

SOURCES:
 - Milk, dairy products, grains and fruits

DEFICIENCY

- Vegetarians
- Steatorrhea
- chronic malabsorption syndromes

DEFICIENCY

- Tetany- muscle cramps, numbness, and tingling

- Rickets
- Osteoporosis

MAGNESSIUM- essential for bioenergic reactions controlling fuel oxidation

- 80% in bone and muscle

SOURCES:

- Legumes
- Nuts
- Banana
- Renal tubular absorption

DEFICIENCY:

- Secondary intestinal malabsorption

- Excessive gastrointestinal losses

MANIFESTATION

- Irritability
- Tetany
- Hypo or hyper reflexia

TRACE ELEMENTS

ZINC COPPER

SELENIUM CHROMIUM

IODINE IRON

ZINC- intracellular hormone contributing to the regulation of cellular growth

Metabolizes in liver

DEFICIENCY:

- Poor physical growth

- Delayed sexual maturation
- Eye lesions- photophobia, blepharitis, corneal opacities
COPPER- component of several metalloenzymes that are required for oxidative metabolism

- Transport to the liver attached to albumin

SOURCES:

- Meats
- Liver
- Seafood
- Seeds

DEFICIENCY

- Secondary deficiency- malabsorption syndrome, liver disease

IODINE DEFICIENCY can result:

- Stillbirth
- Spontaneous abortion
- Congenital abnormalities

IN NEONATE: neonatal goiter, hypothyroidism, endemic mental retardation

IN CHILD & ADOLESCENT: goiter, subclinical hypothyroidism

DAILY INTAKE:

90 microgram- preschool children 0-59mth

120 microgram- school children 6-12yrs

150 microgram- adults above 12yrs

200-250 microgram- pregnant and lactating women