Download MBBS (Bachelor of Medicine, Bachelor of Surgery) 1st year (First Year) Biochemistry ppt lectures Topic 78 Nutrition Health Is Priority Of All Human Beings Notes. - biochemistry notes pdf, biochemistry mbbs 1st year notes pdf, biochemistry mbbs notes pdf, biochemistry lecture notes, paramedical biochemistry notes, medical biochemistry pdf, biochemistry lecture notes 2022 ppt, biochemistry pdf.
Induction To Todays Topic
What Is Priority Of Any
Human Being's Life?
Pick One First Most Important Thing
? Health
? Wealth
? Happiness
? Success
? Peace
Answer
Health Is Priority Of Al Human Beings
What is Most Important
Factor For Health?
Energy
Chemical Form Of Energy
ATP
ATP Producing Factors
? Air (Oxygen )
? Food/Diet (Nutrients)
Any Guesses For Todays Topic?
Specific Learning Objectives
? What is Nutrition ?
? Importance of Studying Nutrition
? Nutritional Goals and Guidelines
? Food Nutrients and their roles
? Calorific Values/Energy content
of Food nutrients
? Energy requirement by a body
? Basal Metabolic Rate (BMR)
? Respiratory Quotient(RQ)
? Specific Dynamic Action (SDA)
? Balanced Diet and its Importance
? RDA of various Nutrients
? Nutritional Disorders and Preventive Measures
? PEM- Kwashiorkor and Marasmus
? Obesity
INTRODUCTION
What is Nutrition?
Nutrition is a wide branch of Science
which deals with:
vHuman food its role in human body
vEnergy contents of food nutrients
vEnergy requirement by Human Body
vNutritional Disorders
Importance Of Studying Nutrition
Evidenced Based Eating
(EBE)
Know Do's and Don'ts Of Eating
So That One Can Understand Its Truth of
Significance
Implement Do's and Avoid Don'ts
Of Eating
Evaluate Its Significance in form of
Strength and Health
Spread To Others - Family and Patients
STUDY OF NUTRITION
WILL
ANSWER FOLLOWING
QUESTIONS
? WHY TO EAT FOOD ?
? What and How to Eat Food?
? What are dietary nutrients and their role
in human body?
? What are Macro and Micronutrients?
? What Quality and Quantity of dietary
nutrients to be ingested?
? What happens if food is eaten in a
balanced/imbalanced manner?
vKnowledge Of Nutrition Explores
vHow thoughtful y and rightly one can
choose particular food/ type of diet?
vPlanning of balanced diet in various
phases and conditions for good health
vNutritional Studies Involves
vRelation of Nutrients in health and
disease
vUnderstand and Prevent Nutritional
disorders due to under and over
nutrition
vNutrigenomics- Effect of Nutrients on
Genes
What Is Main Purpose
of Eating Food ?
?Food/Diet is a prime
requisite for human body
health, survival and
existence
Importance of Food Nutrients
What we eat is directly/indirectly
related to
Composition and Function of
Sub Cellular Organelles,
Cells,Organs,System,
Body as Whole
? Main purpose of Food is to:
? Supply basic building blocks, to build
Macrobiomolecules, for structural
composition of Cells,Organs,System and its
function
? Provide Energy (Fuel) for cellular activities
? Enable to ingest and provide accessory
growth factors
? Role Of Human Food
? Build Cel and Subcel ular Structures
? Maintain all body functions
? Regulates Metabolism
? Therapeutic benefits of food
?Healing of diseases
?Prevention of diseases
? Remember Proper Nutrition
? Maintains normal growth, health
and reproduction.
? Rewards healthy and happy life
? Improves life span
Remember
Defective Nutrition
Is Root Cause Of Many Disorders
How Should Be Our Eating?
One Should Eat
To Live
A Healthy and Happy Life
SOP's Of Eating Nutritive Food
? Simple
? Natural
? Balanced (Mixed)
? Appropriate quality and quantity
? Fixed
? Regular
? Timely
? Utilization of unutilized stores (Fasting)
Essentials for Healthy Life
?Ingest food Nutrients
with
?Proportionate Quantity
?Appropriate Quality
?Ignorance and wrong
food habits are
?Responsible for most
il nesses of Human being
? `Prevention Is Better Than Cure'
?Good and Proper diet is a
best way to prevent many
diseases.
? A sound knowledge of nutrition to a
doctor is of paramount importance
?To maintain his/her own good
health
?Advice for planned diets/Moderate,
to patients to maintain their good
health's.
DIETARY GOALS
Phase Wise Diet
? Maintenance of a state of positive health and optimal
performance in populations at large by maintaining
ideal body weight.
? Ensuring adequate nutritional status for pregnant
women and lactating mothers.
? Improvement of birth weights and promotion of
growth of infants, children and adolescents to achieve
their ful genetic potential.
? Achievement of adequacy in al nutrients
and prevention of deficiency diseases.
? Prevention of chronic diet-related disorders.
? Maintenance of the health of the elderly and
increasing life expectancy
Nutritional Goal Is To Accomplish
Structural Composition And Function
Of Every Body Cel To best
? Quantity of food promotes a constant
BMI
? Quality of food promotes functionality
43
DIETARY GUIDELINES
Do's and Don'ts Of Eating Food
? Eat variety of foods to ensure a balanced diet.
? Ensure provision of extra food and healthcare to
pregnant and lactating women.
? Promote exclusive breastfeeding for six months and
encourage continue breastfeeding til two years or
as long as one can.
? Feed home based semi solid mixed foods to an
infant after six months.
? Ensure adequate and appropriate diets for
children and adolescents, both in health and
sickness.
? Eat plenty of vegetables and fruits
? Ensure moderate use of edible oils and animal
foods and
? Very less use of ghee/ butter
? No use of Vanaspati/ trans fats
? Avoid undereating /very less eating to
loose weight.
? Overeating to prevent overweight and
obesity
? Exercise regularly and be physical y
active to maintain ideal body weight.
? Restrict salt intake to minimum
? Ensure use of safe and clean foods with natural
antioxidants
? Adopt right pre-cooking processes and appropriate
cooking methods.
? Drink plenty of clean water and take beverages in
moderation
? Minimize the use of processed foods rich in salt,
refined sugar and trans fats.
? Include micronutrient-rich foods in diets of elderly
people to enable them to be fit and active
? Nutrition Influences on:
? Health
?Appearance
?Behavior
?Mood
48
Mixed Type Of Diet Is A Healthy Diet
Composition of Food
and
Their Role in Human Body
or
Nutritive Value of Nutrients
What To Eat?
And
What Not To Eat?
?Nutrients are organic
or inorganic molecules
?Crucial y required for
human growth & wel -
being.
? Food items derived from
plant or animal sources
contain nutrients.
? ~ 40 nutrients identified and present in
food items.
Chief Nutrients
Of
Food Substances
Six Main Nutrients of Food Items
? Carbohydrates
? Lipids (Fats)
? Proteins
? Vitamins
? Minerals
? Water (Most Important)
Classification Of Nutrients
? There are four ways to classify 6 classes of
nutrients:
I. Essential or Nonessential Nutrients
I . Organic or Inorganic Nutrients
I I. Macronutrient or Micronutrients
IV. Calorific or Non calorific Nutrients
? Essential Nutrients ?
? Nutrients not biosynthesized in body or
cannot make enough of to meet the bodies
need.
? These nutrients must be obtained from foods.
?Examples:
? Vitamins
? Minerals
? Some of the amino acids and fatty acids.
? Nonessential Nutrients ?
? Nutrients readily biosynthesized by
body from other ingested nutrients
Examples:
?Cholesterol
?Non Essential Amino acids
?Non Essential Fatty acids
? Organic Nutrients - contain carbon
? Carbohydrates
? Lipids
? Proteins
? Vitamins
? Inorganic Nutrients - do not contain carbon
? Minerals
? Water
? Macronutrients-
? Required in large quantities
?Carbohydrates
?Lipids
?Proteins
?Water
? Micronutrients
? Required in small quantities.
? Minerals
? Vitamins
? Energy-yielding nutrients /Calorific
Nutrients:
?Carbohydrates
?Lipids
?Proteins
66
? Non energy yielding/Non Calorific
?Vitamins
?Minerals
Main Food Groups
Fruit and Vegetables
Fruits and vegetables grow
on plants: underground, on
Take
the ground or in trees.
5 a day
Every day we should eat at
least 5 portions of fruit and
everyday!
vegetables. (A portion is
about a handful.)
Fruit and vegetables give us
fibre and vitamins and
minerals.
Grains and Pulses
This food group includes
wheat, corn, barley, rice,
lentils, beans etc.
What is..?
These are all from plants
Rice is the staple food in China
and form a staple part of
and much of the East. What is
the diet for people all over
it in the West (UK, USA)?
the world.
Grains and pulses give us
carbohydrates and proteins.
Nuts are another source of
protein.
Dairy Products
Dairy foods are made from milk (usually
cow's milk, but can be from other animals
like goats or sheep). Dairy foods give us
proteins and fats. They are also a good
source of calcium which is good for bones
and teeth.
Weird fact
These foods include:
?Cheese (hard, soft, cottage)
Ourbrainsare
80%fat.
?Yogurt
?Food high in milk or milk products.
Meat, Fish and Eggs
The main nutrients derived from meat are
proteins, but it also gives us fats and some
minerals.
The meat and fish group includes: Foodie fact
?Chicken and all poultry
Sushi (raw fish) is
?Fish and shellfish
now Marks and
Spencer's best-selling
?Beef, pork and lamb
lunchtimesnack.
?Eggs are included in this group too.
Athletes eat lots of protein; they help to
build muscles.
Body Composition
GROUPS OF NUTRIENTS:
?Carbohydrates
?Proteins
?Lipids
?Vitamins
?Minerals
?Water
Carbohydrates
?Nutritional Carbohydrates:
?Sugars-simple Carbohydrates
?Starch-complex Carbohydrates
? Simple Carbohydrates:
? Mono and Disaccharides include:
vGlucose
vFructose
vLactose
vFruits,Milk,Juices and
Sweets
?Complex Carbohydrates
are Present in
?Starches
?Cellulose
vLegumes
vWhole grains
? Simple Carbohydrates
? pop, candy, sweets, fruits
? Recent studies reported Refined sugars are
Brain damaging and Poisons
? Complex Carbohydrates
? pasta, rice, breads, potatoes
80
Dietary Fiber
?Dietary Fiber
?Indigestible complex
Carbohydrate
?Non calorific
Substances As Dietary Fiber
? Cellulose
? Hemicellulose
? Pectin's
? Gum
? Lignin
? Mucilage
? Sources Of Dietary Fibers
? Richly present in plant food
substances.
? Poorly present in refined and
commercial food products.
Types Of Dietary Fibers
? Soluble Dietary Fiber ?
? Decreases Cholesterol levels
? Found in oat bran, fruits and veggies
? Insoluble Dietary Fiber-
? Reduces risk of colon cancer
? Found in wheat bran and grains
? Recommendation of Dietary Fiber:
? 25-40 gm per day
Check
are we getting enough
Dietary Fiber through foods ?
Ways to Get More Fiber
? Eat more fruits
and vegetables
? Eat whole grain
foods
Advantages Of Dietary Fiber
? Act as roughage
? Holds water
? Forms soft and bulky feces
? Increases bowel movement
? Easy defecation
? Prevents constipation
Advantages Of Dietary Fiber Contd---
?Dietary fiber corrects
?Hyperglycemia
?Hypercholesterolemia
Advantages Of Dietary Fiber Contd---
? Fiber Reduces risk of:
?Diverticular disease of colon
?Colon cancer
?Varicose veins
Advantages Of Dietary Fiber Contd---
?Good satiety and non
calorific value of dietary
fiber
?Helps in management of
obesity.
Disadvantages Of Dietary Fiber
? It binds with trace
elements and reduces its
absorption.
? Decreases absorption of fat
soluble vitamins.
A Grain of Wheat
BRAN
- B vitamins
- minerals
ENDOSPERM
- dietary fiber
- starch
- protein
- some iron and
GERM
B vitamins
- Essential fats
- minerals
- vitamins
(B's , E and folacin)
? Germinated legumes have
partial dextrinization of
Starch.
? Which is good for digestion,
absorption and utilization.
Role Of Carbohydrates
v Readily available source
v Supply primary energy needs
v Antiketogenic
v Build structure of cells
v Store calories as Glycogen
v Excess Carbs convert to Fat
v Amino acid synthesis
v Cellulose as roughage
Quantity And Quality Of
Carbohydrates To Be Ingested
? RDA for Carbohydrates-
400-600 gm/day
? An Adult individual with
his/her routine activities
should adjust the
Carbohydrates intake.
? Ingestion of Starchy food is more
preferable.
? Refined sugars have high glycemic
index so quantity should be reduced.
? Excess of Glucose transforms to
Lipids viz Fatty acids,TAG,Cholesterol
? Dietary fiber in form of Celluloses to
be ingested.
Hypoglycemia and Hyperglycemia
Relates To Glycemic Index (GI) of Foods
?Dietary Proteins
?Provide essential amino acids
? Building blocks for tissue
Proteins
?Proteins are of structural and
Functional importance
?Maintain growth, repair and
function of the body cel s and tissues.
Nutritional Classification Of Proteins
? Dietary Proteins nutritional y
classified into two groups:
?Complete Proteins
?Incomplete Proteins
? Complete Proteins/ First Class
Proteins/High Biological y Valued
? Complete Protein contains adequate
amounts of al essential amino acids.
SOURCES INCLUDE:
Animal Origin Proteins
?Fish
?Meat
?Poultry Meat and Eggs,
?Milk, Cheese and yogurt
?Soya Bean products
? Incomplete Proteins
? Incomplete Proteins lack one or more
essential amino acids (limiting amino acid).
SOURCES INCLUDE:
? Beans
? Pulses ( Limit in Met)
? Nuts
? Whole grains (Limit in Lys and Thr)
? Types of Amino Acids (20 AA)
? Nutritional y Nonessential AA (10) ? can be
biosynthesized by body
? Nutritional y Essential AA (8) ? Not biosynthesized
must be made available through diet
? Nutritional y Semi-essential AA (2)- Made in body to
less amount need also from diet
Dietary Protein Requirements
? RDA average = 0.8-1.0 g/kg body weight/Day
? RDA Athlete = 1.2-1.6 g/kg/day
?High levels of Dietary
Protein intake
above 2 g/kg/day
can be harmful
to the body
Evaluating Protein Quality
? Biologic Value (BV) of Protein:
?Amount of ingested Nitrogen
retained in the body
compared with Nitrogen
absorbed.
Biological Value Of Proteins
?Dietary Proteins differ in
their quality i.e
?Efficiency of digestibility
and absorption capacity.
? An effectiveness of dietary
Protein is in
? Providing amount of
essential amino acids for
tissue Protein biosynthesis.
Biological Value = Nitrogen Retained x 100
Nitrogen Absorbed
Biological Value of Protein is
Percentage of Nitrogen
absorbed and retained in the
body.
? Thus BV of Protein
indicates effectiveness
of utilization of dietary
Proteins
? Proteins with high biological
value(B.V) are also termed as:
? Superior Proteins
?Complete proteins
?First class Proteins
?All animal origin Proteins
rich in all essential amino
acids are of high B.V.
? Dietary Proteins with high
biological value
? Support good tissue
biosynthesis and retain the
Proteins in body for their
functional use.
? Net Protein Utilization (NPU):
?Percentage of Nitrogen
consumed that is retained in
the body.
? Biological value of protein affects
Nitrogen balance.
?Low B.V proteins leads to negative
nitrogen balance.
?Increased loss of NPN substance
Urea in urine.
? Plant proteins are of low B.V
? Since deficient in one or two
essential amino acids.
?Complete Proteins with
high biological value
?Maintain Positive/Nitrogen
equilibrium
Source Of
B.V
Limiting Amino
Protein
acid
Egg
94
Nil
Milk
84
Sulfur containing
amino acids
Fish
85
Tryptophan
Meat
75
Sulfur containing
amino acids
Soya Beans
65
Sulfur containing
amino acids
Source Of
B.V
Limiting Amino
Protein
acid
Rice
68
Lysine and
Threonine
Wheat
58
Lysine and
Threonine
Pulses
58
Sulfur containing
amino acids
Mutual Supplementation
Of
Dietary Proteins
Improves Biological Value
Of Proteins
? Eating combination of Pulses and
Grains provides al required
essential Amino acids for tissue
Protein biosynthesis.
? Dal and Roti
?Rice and Dal
? Idli and Sambhar
?Rajma Chanwal
?Chhole Chanwal
Functions Of Dietary
Proteins
? Supply amino acids for growth &
repair of body tissues
? Biosynthesize all tissue Proteins
?Hemoglobin
?Nucleoproteins
?Glycoprotein
?Lipoproteins
? Protein serve as a source of
energy :
?When there is shortage of
Lipids & Carbohydrates in the
body.
? Proteins has role in metabolism
osmoregulation ,transport and
acid-base balance
?Enzymes
?Hormones
?Antibodies
?Receptors
?Transport Proteins
?Osmotic Proteins
?ETC Components
?Collagen (bones)
?Keratin (nails & hair)
? Dietary lipids predominantly
contains Triacylglycerol (TAG).
? TAG to human body serves as a
secondary source of energy on
long term basis.
?TAG stored as reserve food
in adiposecytes
?Provides energy in
between meals , fasting
and starvation condition.
? The other forms of dietary
lipids viz
? Phospholipids and
Cholesterol has structural
and functional role in the
body.
?Fats/Oils are type of
neutral lipids,
insoluble in water.
?Fatty acids are the
building blocks of
various tissue Lipids .
Types of Fatty Acids
? Saturated Fatty Acids
? Animal sources
? Solid at room temperature
? High intake is associated with an increased risk of heart disease
? Unsaturated Fatty Acids (MUFAS and PUFAS)
? Vegetable sources
? Liquid at room temperature
? Associated with a reduced risk of heart disease
? Trans Fatty Acids
? Hydrogenation to alter "state" of fat example Vanaspati Dalda
? Increase shelf-life & market availability
? Repeated heating of Oils
Composition of Oils (%)
Type
Sat
Poly Mono
safflower
09
75
16
sunflower
10
66
24
corn
13
59
28
soybean
14
58
28
sesame
14
42
44
peanut 17
32
51
palm
49
09
42
olive
14
08
78
canola
07
35
58
? Those Fatty acids are
considered as good
? Who on entry in body get
easily metabolized and
give good effect to body.
? Those Fatty acids are considered as
bad
? Which are more stable and get less
metabolized and remain for long
time in the body.
? As the fatty acids remain for long
time it increases the risk of
Atherosclerosis.
Quality and Quantity Of Dietary Lipids
? Quantity of Dietary Lipids 60 gm/day
? Quality of Dietary Lipids:
? TAG with mixture of Fatty acids linked
? Fatty acids in ratio of MUFA:PUFA:SFA 1:1:1
? Zero Trans Fatty acids
? Equal proportion of Antioxidants To protect In
vivo PUFA's
? Adequate Carbohydrate Diet-No too much
excess of Glucose to transform into Fatty acids
and Cholesterol
? Fatty food is associated
?With fat soluble vitamins A,
D, E, and K
?Sources of Linoleic acid-
essential fatty acid that is
needed for growth and
healthy skin.
Recommendations for
Fat Consumption
? Dietary Fat Recommendations
? Less than 30% of calories in diet
from dietary Lipids.
? Less than 1/3 of dietary fat
should be saturated.
? Ways to Decrease Intake of Fat
?Minimize "fast" foods and Snacks
?Minimize processed foods
?Use better cuts of Red meat
?Use low fat alternatives
?No Pork Meat/ Fat
?Choose foods with "Natural Lipids"
Food s Should be rich In
Essential Fatty Acids (EFAs)
? Linoleic acid (LA)
? Linolenic (LNA) or Alpha
Linolenic acid or (ALA)
? Arachidonic Acid
Omega-3 and Omega-6 Fatty acids
?Linolenic Acid (18:3n
-3) belongs to the
omega-3 family of
fatty acids
?Linoleic Acid
(18:2n-6) belongs
to the omega-6
family
Role Of Essential Fatty Acids
(EFAs)
? LA can be converted to both Arachidonic and Linolenic
acids
?Essential FA are necessary for growth, skin &
hair integrity.
?Regulation of Cholesterol metabolism.
?Lipotropic activity
?Decreased platelet adhesiveness and
reproduction.
? Rich Dietary Sources of
Linoleic Acid :
?Soya oil
?Sunflower oil
?Safflower oil
?Sesame seeds
?Corn oil
?Most nuts
? Dietary Sources Of Linolenic
Acid :
? Flax seeds(abundantly )
?Walnuts(Small quantities)
?Cold pressed Canola oil
?Wheat germ
?Dark green leafy vegetables
? Diets with <1-2% EFAs
will affect growth rate,
cause dry scaly rash
and poor wound
healing
? The right ratio of LA to ALA in the
diet
? About 3:1 or 2:1, is important
? An imbalance in the ratio
? May lead to a variety of mental
disorders,
? including hyperactivity,
depression, brain allergies, and
schizophrenia
? Docosa Hexenoic Acid (DHA-C22)
? Is high in the phospholipids of brain gray matter .
? DHA is rich in Algae and Fishes
? It is the main component of CNS importance for its
function
? Depletion of DHA in the brain can result in learning
deficits/Cognitive Function.
?DHA appears to
be important for
visual and
neurological
development
? EPA and DHA
supplementation during
pregnancy
? Has evidenced beneficial
effects on long-term
cognitive development in
children
Functions Of Lipids
v A concentrated & reserve secondary source of
energy
v Physical protection for vessels, nerves, organs
v Insulate against changes in temperature
v Structure of body tissues, cell membranes &
nuclei
v Carry the fat-soluble vitamins (A, D, E, K)
v Give appetite appeal
v Aid satiety (delay emptying time of the
stomach)
v Spare Protein
v Supply Linoleic acid, the other essential fatty
acids.
? High intake of animal origin
food is linked to increased
blood Cholesterol .
? Excess Cholesterol can lead
to an increased risk of
Atherosclerosis and heart
disease.
Vitamins
? Organic substances that are
vital for human body.
? Vitamins are accessory
growth factors to human
body.
? Vitamins are classified into two groups:
? Water-soluble Vitamins:
? Vitamins dissolve in water and pass easily into
the blood during digestion.
? The body does not store these so they need to
be replenished regularly.
? Includes vitamins C, and Vitamin B Complex
members B1 ,B2, B3,B5, B6, Folic acid, and B12.
? Excesses of water soluble
vitamins will be excreted in the
urine.
? However, B-6 and Niacin can be
toxic when ingested in
unusually large amounts.
? Fat-soluble vitamins
? These include vitamins A, D, E, and
K.
? These Vitamins are absorbed,
stored, and transported through
dietary fat.
? Body stores these vitamins in fatty
tissue, liver, and kidneys.
? Excess buildup in tissues can be
toxic.Fat Soluble Vitamins
? Consist of Vitamins A, D, E, and K
? Absorbed at the small intestine in the
presence of bile (and fatty
substances).
? Overdoses can be toxic (A and D)
Vitamin Supplementation?
? Not necessary if diet is healthy
? Multivitamins are safe (100% RDA)
? Not all vitamins are "pure"
? Can be toxic at high doses
Vitamin A Role in vision, growth and Fish Liver
differentiation of germinal
Sweet
epithelial cells,
potatoes,
anticancer
Carrots
Vitamin B
Form Coenzymes, help
Green leafy
enzymes in metabolic
vegetables,
reactions
Fruits, yeast
Vitamin C
Collagen synthesis,
Citrus fruit,
Steroidogenesis, Iron
tomatoes
metabolism, Healing skin,
preventing colds
Vitamin D
Calcium metabolism,
Milk
Strengthen bones
Sunlight
Vitamin E
Potent Antioxidant,
Vegetable
Helps strengthen cells
Oils, nuts
? Most of the vitamins except very few are
not biosynthesized in human body.
? Vitamins are associated with various plant
and animal origin foods of nature.
? Ingestion of foods rich in vitamins is
mandatory for a good health.
? Vitamins helps to maintain growth ,health
and reproduction.
? They do not generate calories/Non calorific
? Most Vitamin B complex members serve as
Coenzymes for Enzyme action.
? Vitamins help to regulate many vital
body processes that include:
? Digestion
? Absorption
? Metabolism
? Bone Ossification
? Vision
? Antioxidant role
?
Minerals
Minerals
? Inorganic elements found in
food that are essential for life
processes
? About 25 are essential Minerals
?Minerals are classified
as:
?Macro minerals
?Trace minerals
? Macro Minerals: Sodium,
Potassium, Chloride, Calcium,
Phosphorus, Magnesium, Sulfur
? Trace Elements: Iron, Zinc,
Selenium, Molybdenum, Iodine,
Copper, Manganese, Fluoride,
Chromium
Macro Minerals
?Calcium
?Is needed for bone
and teeth rigidity
?Helps in blood
clotting,
?Muscle contraction &
normal nerve
functions.
?Phosphorous
?Helps build strong
bones & teeth
?Forms various
Phosphorylated
compounds.
? Sodium, Chloride,
Potassium
? Serve as body Electrolytes
? Work together to regulate
the fluids in the body
? Help regulate the nervous
system, muscle functions
& nutrient absorption in
the cells
? Magnesium
? Helps regulate body
temperature,
? Muscle contractions & the
nervous system
? Helps cells metabolize
Carbohydrates, Fats, and
Proteins
? Sulfur
? Helps in detoxification
reactions (PAPS)
? Is present in sulfur containing
amino acids in proteins
? A component of constituents
of mucopolysaccharides &
essential compounds
Microminerals
? Iron combines with Protein
to form Hemoglobin
? Iodine is needed by Thyroid
gland to produce Thyroxine
? Copper is necessary in
formation of Hemoglobin
? Fluorine helps reduce
incidence of tooth decay
? Zinc plays an important role
in the formation of protein
? Zn assists in wound healing,
blood formation and general
growth & maintenance of all
tissues
? Cobalt is a component of
vitamin B12
? Manganese is necessary for
normal development of bones
and connective tissues
? Chromium maintains normal
glucose uptake into cells &
helps insulin bind to cells
? Selenium along with vitamin E
protects cells from destruction.
? Glutathione Peroxidase
contains Selenium.
? Molybdenum is a component of
Xanthine oxidase and Aldehyde
oxidase
? Functions Of Minerals
? Body cannot manufacture Minerals
but are needed for forming healthy
bones and teeth .
? Regulate many vital body processes.
? Aids in muscle function
? Help transmit messages in nervous
system
Mineral Guidelines
? Dietary supplementation of
Calcium is beneficial for post-
menopausal women
? Salt should be limited in diet
of hypertensives.
Calcium
? Important for preventing osteoporosis
? RDA = 800-1000 mg/day
? Found in dairy products and vegetables
High protein diets leach calcium from
bones and promote osteoporosis
Iron
? Important component of
hemoglobin
? Iron deficiency is known as
anemia
(Symptoms: shortness of breath, fatigue)
Antioxidants
? Antioxidants are chemical substances which
defend free radical activities.
? Antioxidants prevents Peroxidation of
biomolecules ?PUFA,DNA etc
? Antioxidants protect membrane damage.
? Antioxidants prevent Oxidative Stress.
Dietary Sources Of Antioxidants
? Pigmented Fruits and Vegetables
? Broccoli
? Bananas
? Berries
? Cherries
? Cantaloupe
? Carrot
? Mango
? Papaya
? Pumpkin
? Red Pepper
? Spinach
? Strawberries
? Sweet potato
Fresh Fruit and Vegetables
These contain Fibre ,Minerals, Vitamins
and Antioxidants
?Water makes up
around 65% of
body weight
Remember
?It's important to drink
at least 8 glasses of
water a day to
maintain health.
Role Of Body Water
? Water is essential to keep the body
healthy.
? It helps to cook , swal ow and digest
food.
? It keeps the body hydrated.
? Water Helps to Maintain
Many body functions.
? Chief component of blood plasma
which serves as a transport media
? Bodies solvent helps in metabolic
reactions(Hydrolase and Hydratase)
? Lubricates joints and mucous
membranes
? Serve as Shock absorber in eyes,
spinal cord, and amniotic sac (during
pregnancy).
? Absorb , transport and eliminate
nutrients and metabolic wastes.
? Perspiration/sweating helps to
maintain normal body temperature.
Remember
?Man can live for many
days without food,
?But cannot live few
days without water.
Calorific Values Of Food
Constituents
OR
Energy Content Of Food
Nutrients
Calorimetry
?Calorimetry is a term used
to measure energy content
of food nutrients.
? Calorific value of food is defined
as :
? An amount of energy released
by combustion of 1 gram of
nutrient
(Carbohydrate/Lipid/Protein)
Determination
Of
Calorific Values of Food
Instrument Used For
Nutrients Energy Measurement
OR
Computing Calorific Values Of Nutrients
?Bomb Calorimeter is an
instrument used to
determine Calorific values
of food nutrients.
What Is Bomb Calorimeter?
Bomb Calorimeter
? It is a closed metal ic Oxygen
chamber with electrical y heated
platinum wires.
? When food is placed inside it and
operated
? It combust Nutrients placed inside it
and determines calorific value of
foods.
? Nowadays there are highly
automated efficient
combustion Calorimetric
systems available
? To compute an energy
contents of food and body.
Unit For Measuring
Calorific Values Of Food Nutrients
Calorie/kilocalorie
? Calorie /kilocalorie is a Unit
for measuring heat energy, of
food and energy requirement
for body.
? When you hear "Calorie," it is
real y a Kilocalorie
210
Is There Any Difference
Between Calorie and kilocalorie?
? "Calorie" we refer to in food is
actually kilocalorie.
? One (1) kilocalorie is same as one
(1) Calorie(upper case C).
? Calories and kilocalories are used
interchangeably to mean same thing.
Calorie and Kilocalorie
? "Calories" when we're talking about food
? "kilocalories" when we're talking about exercise
Definition of Calorie
? 1 Calorie is amount of heat
required to raise temperature
of 1 gram of water with 1
degree Celsius.
Calorific Values of Nutrients
? Macronutrients ( Calorific Values):
?Fats = 9 Cal/g
?Carbohydrates = 4 Cal/g
?Proteins = 4 Cal/g
( 5.3 Cal/g in Bomb Calorimeter)
?Carbohydrates and
Fats are completely
oxidized in body to
CO2 and H2O.
? Proteins are not completely
oxidized in the body.
? Nitrogenous excretory product
Urea, stil contain oxidizable
carbon and hydrogen in it.
? Micronutrients (Non Calorific)
?Vitamins = 0 Cal/g
?Minerals = 0 Cal/g
?Water = 0 Cal/g
Calculation of Calorific Value
of
Food Stuffs
? Food energy is an amount of
energy liberated by food
nutrients.
? Through digestion absorption
and assimilation of food
nutrients.
Calorific values of Foods
? Food Items contain mixture of
nutrients.
? Calorific value of foods depends
upon an amount of nutrients
present in it.
From Total Energy Content
50-60 % Of Energy
Is Provided By Carbohydrates
Energy is provided by the following
Carbohydrates: (Primary Source)
Energy Provided 60% (45-65%) of the diet
1gm provides 4 kcal
Fats:
Energy Provided 35% (25-45%) of the diet
1gm short-chain provides 5.3 kcal
1gm medium-chain provides 8.3 kcal
1gm long-chain provides 9 kcal
Proteins:
Energy Provided 11% (9-15%) of the diet
1gm provides 4 kcal
How To Calculate
Energy Content Of Foods?
Calculate Calorific Value of
100 gm Wheat Flour?
100 gram of Wheat Flour Contains
? 69.6 gm Carbohydrates
? 12.0 gm Proteins
? 1.5 gm Fat
? Calories of 100 gm Wheat flour=
(69.6x4)+(12x4)+(9x1.5)=340 Calories
? Energy Content of foods is computed as:
? Multiplying amounts of calorific
nutrients in 100 gm of food with their
physiological calorific values.
? Final y adding up their values.
Energy Requirements by
A Human body
? Human body daily requires sufficient
amount of energy to expend on
various body activities.
? This energy need is provided by
combustion/oxidation of food
nutrients of calorific values.
?Usual y Carbohydrates and Fats
?In Emergencies Proteins
Energy Requirement By
Human Body Differs
In Different
Phases Of Life
?Approximately 80-120
kcal/kg body weight for
1st year of life.
?Approximate 2500
Kcal/day for an Adult
individual
An Amount of Energy Needed by a body is
Utilized for Fol owing Factors:
1. Basal Metabolism (BMR)
2. Physical Activities
3. Specific Dynamic Action of foods(SDA)/
Thermic effect of Food Nutrients
RQ for mixed diet is .82
from 40% CHO & 60%
fat.
? Non-protein RQ is
between 0.7 and 1.0.
? Thermal equivalents
of oxygen for different
non-protein mixtures.
BMR > Activity > Dietary Thermogenesis
Basal Metabolic Rate
(BMR)
What Is
? Basal Metabolic Rate (BMR) ?
?BMR is minimum amount
of energy required by a
body to maintain life in
basal condition.
? Basal condition of body is :
1) Post Absorptive Phase
2) Awake condition
3) Thermo neutral
environment
4) Complete physical and
mental rest
?BMR is minimum resting
energy expended by an
individual in an awake,
alert , post absorptive
phase present in
thermoneutral
environment.
? An energy required in basal condition is
consumed for an involuntary actions of
body viz
?Pumping of Heart
?Blood Circulation
?Respiration process by Lungs
?Muscular Twitching and reflexes
?Intestinal Peristalsis
?Metabolic Reactions
?Renal Functions
Determination Of BMR
BMR= Total heat production in Cal/hr
Body surface area in Sq.m
Normal Values Of BMR
? Males= 35-40 kcal/ sq.m /hr
? Females= 30-35 kcal/ sq.m /hr
Preparation Of Patient
For BMR Estimation
? In early morning subject should be
in:
?Post absorptive phase (12 hr Fast)
?Physical y and mental y relaxed
?Lying position, awake condition
?Room Temperature should be
around 21-25 degree centigrade
?Normal humidity
Methods For BMR Calculation
? Direct Method For BMR
Determination Using :
?Benedict Roth Apparatus
?Dubois Apparatus
? Benedict-Roth Apparatus
? Calculates an amount of
Oxygen consumed under a
specific basal condition.
? Oxygen consumption for 2-6
minutes and measure the value
from graph.
? Indirect Method of BMR
Determination:
?Analysis of an expired air
?Determining O2 consumption and
CO2 output.
? Total heat production is determined
and is then
? Calculated per sq.m of body surface per
hour
? Indirect Calorimetry:
Calculates Respiratory Quotient
? Oxygen Consumption
? Carbon Dioxide Production
? Spirometer or Respirometer
apparatus is used to measure
an amount of Oxygen
consumed and Carbon dioxide
produced.
? This helps in calculating an
energy expenditure.
Respiratory Quotient
? Respiratory Quotient (RQ) is
ratio of volume of carbon
dioxide produced to volume of
Oxygen consumed by an
individual in a given interval of
time.
Respiratory Quotient (RQ)
Volume of CO2 Produced
RQ = Volume of O2 Consumed
At the CELL
Each substrate has its own RQ value.
(Carbohydrates (1.0) vs Fatty acids (0.7))
? Respiratory Quotient (RQ)
?Amt of CO2 produced/O2 consumed
?Varies for different Calorific Nutrients
? Amount of CO2 formed does not always
equal amount of O2 consumed
RQ for CHO and FAT
Carbohydrate (Glucose):
C6H12O6 + 6O2 6CO2 + 6H2O + Energy
RQ = 6CO2 / 6O2 = 1.00
Fat (Palmitic Acid):
C16H32O2 + 23O2 16CO2 + 16H2O + Energy
RQ = 16CO2 / 23O2 = 0.70
?R.Q of Protein is 0.8
?R.Q of Mixed diet is 0.85
? R.Q in Heavy work exceeds more than 1.
?During heavy exercise tissue
metabolism is increased.
?CO2 out put is increased by
enhanced pulmonary
ventilation
?Oxygen consumption is not
proportionately increased.
? Thus R.Q is an indicator of metabolic
status.
? R.Q of food stuffs depend upon:
? Type of food Nutrients
?Their varying proportions
?RQ value can be used to
find an amount energy
produced per litre of
Oxygen consumed
? Conditions increasing R.Q
? Violent Exercise
? Fever
? Acidosis
? Conditions Decreasing R.Q
? Starvation
? Diabetes mellitus
? Alkalosis
Significance Of R.Q
? R.Q value helps in:
?Estimation of Basal Metabolic Rate
?Type of food oxidized
?Diagnosis of various pathological
conditions such as Acidosis ,
Diabetes mel itus ,fever etc.
? To estimate Calories needed for
basal metabolism/hour:
?For Men: Multiply body weight
(lbs) by 11
?For Women: Multiply body
weight (lbs) by 10
Average Calories Required for Basal Metabolism is
70 C/hr or 1680 C/day
Factors Affecting BMR
BMR is Influenced By Many Factors.
? Age
? Sex
? Body Surface Area
? Climate/Environmental Temperature
? Nutritional Status
? Hormones-Insulin Therapy
? Pregnancy
? Physical Activity- Exercises
? Circadian Rhythms
? Emotional State
? Smoking and Caffeine
? Body temperature
? Diseases
? Digestive Processing
(Specific Dynamic Action)
? Aquatic Salinity (Osmoregulation)
BMR and Metabolism
? High rate of Metabolism Increased BMR
? Decreased Metabolism Decreased BMR
Age
? Infants and children have much
higher BMR than adults.
? Growth increases BMR.
? Highest BMR is noted at age of 5-6 yrs
(58kcal/sq.m/hr)
? BMR is gradually decreased as age
proceeds
Gender/Sex
? BMR of men is always higher
than women.
? Men possess
? increased lean muscle mass.
? increased physical activities.
Body Surface Area
? Body surface area is related to
height and weight of an
individual.
? BMR is directly proportional to the
body surface area.
?Increased Body Surface
(lean muscle) area has
greater BMR.
?Lean muscle mass is
more metabolical y
demanding than Fatty
tissue(Adipose cytes).
? Lean tal persons with greater
muscle mass has higher BMR.
? Obese short persons with
lower lean muscle mass has
lower BMR.
? Lower body Fat percentage
higher is the BMR.
? Higher body Fat percentage
lower is the BMR.
Climate/Environment Temperature
? BMR is decreased in summer
? BMR is increased in winters
? People living in warmer climates
has lower BMR than living in
colder climates
Nutrition and Metabolic Status
?BMR is lower in
persons with
malnutrition and
starvation.
Endocrine Secretion/Hormones
? Thyroid hormone influences
directly on BMR
?BMR is increased in
Hyperthyroidism
?BMR is decreased in
Hypothyroidism.
? High levels of Growth hormone
and Epinephrine also increases
BMR.
? BMR lower in Diabetes mel itus
? On Insulin therapy BMR is
increased
Pregnancy
?BMR is raised by 5%
in pregnancy.
BMR And Physical Activity
ACTIVITY LEVEL
PERCENTAGE OF BASAL
METABOLISM CALORIES
Inactive: sitting most of the
30%
day; <2 hours moving about
slowly or standing
Moderate: sitting most of
50%
the day; walking or standing
2-4 hours, no strenuous
activity
Active: physically active for
75%
>4 hours a day; little sitting
or standing; some strenuous
activity
Thus BMR Increases With
Rate Of Physical Activity
Circadian Rhythms
? BMR is lower in sleep
? BMR is higher in awake
Emotional State
? Stress increases BMR
Smoking and Caffeine
?Smoking and ingestion
of Caffeine increases
BMR.
Body Temperature
? BMR increases with increasing
body temperature.
? An elevation of body temperature
above 370C will increase BMR by
13% per 0C.
? Thus in Fever BMR is raised.
BMR In Diseased Conditions
? BMR is Increased in
? Fevers
? Leukemia
? Cardiac Failure
? Hypertension
? Metabolic disorders
? Surgery
? Infections
? Anorexia
Factors Affecting BMR
List Of Conditions
Increasing And Decreasing BMR
S.No BMR Increased
BMR Decreased
High Metabolism
Low Metabolism
1
At Growing Age
Infant and Geriatric
2
Active Body
Sedentary Body
3
Exercise
No Exercise
4
Males
Females
5
Winters
Summers
6
Hyperthyroidism
Hypothyroidism
7
More Body Surface Low Body Surface area
Area
S.
BMR Increased
BMR Decreased
No
8
Pregnancy
No Pregnant Women
9
Fevers
Malnutrition
10 After Surgeries
Starvation
11 Lean Body
Obese body
12 Smoking
Non Smoker
13 Day and Night
Only Day workers
Workers
14 Insulin Therapy
Diabetes Mellitus
15 Stress
No Stress
Significance Of BMR Calculation
? BMR values help in calculating
energy requirement of an
individual body which help in
planning of diets.
? To know an effect of food and
drugs on BMR.
? BMR value checks basal
metabolism and disease
conditions.
? BMR values help in assessing
Thyroid function.
Energy Required For
Physical Activities
? Energy requirement for an
individual per day varies from:
vPerson to Person
vMode of life style
vType of Occupation
? Action to Action
?Duration of Action
?Intensity of Action
Energy Requiring Factors For Physical
Activities
? Age
? Sex
? Body Surface Area ?
? Body weight ,Size and Height
Workers
Calories/Day
B.M.R %
Light Workers
2200-2500
30-40%
Teachers, Doctors, Office
Workers
Moderate Workers
2500-3000
40-50%
Students, House wives
Heavy Workers
3000-3500
50-60%
Farmers ,Miners, Athlete
Very Heavy Workers
3500-4000
60-100%
Rickshaw Pullers,
Construction Workers
Activity
Energy Expenditure in
Calories/ hour
Sitting
25 Calories/hour
Standing
30 Calories/hour
Writing
30 Calories/hour
Car Driving
60 Calories/hour
Typing
75 Calories/hour
Walking Upstairs
800 Calories/hour
Every physical activity needs energy above BMR
Energy Cost of Physical Activities
Activity
Cal/KgBW/Hour
Bicycling (fast)
7,6
Bicycling (slow)
2,5
Dancing (foxtrot)
3,8
Dancing (waltz)
3,0
Dish washing
1,0
Driving
0,9
Table tennis
4,4
Marathon run
7,0
Sawying
5,7
Walking 5 km/h
2,0
Writing
0,4
Playing piano
2,0
Sewing
0,6
Specific Dynamic Action
(SDA)
Thermogenic Effect Of Food
(TEF)
Diet Induced
Thermogenesis (DIT)
SDA also termed as
Calorigenic Action Of Food
? SDA is an extra heat produced over and
above calculated calorific value when
food nutrients consumed by a body.
? SDA is referred as an increased heat
production fol owing an intake of food.
Dietary Proteins
Has Highest SDA Values
? 25 gm of dietary proteins when
consumed in body should produce 100
Calories of energy.
? 25 x 4= 100 Calories
? But actual heat produced is 130 Calories
? Thus 30 Calories of energy is extra.
? Protein rich meal eaten in hot
weather feels the body hot
and sweaty.
? Protein rich meal in cold
weather provide cozy and
comfortable feeling.
Significance Of SDA
? Heat of SDA can be utilized
for maintaining body
temperature but not for
muscular activity.
? SDA produced heat is expended
for digestion and absorption of
food.
Conditions with Decreased SDA
? Conditions where amino acid catabolism
decreased
? SDA is decreased
?Starvation
?Growth
?Pregnancy
?Convalescence period (Recovery )
SDA of food is an amount of energy
required to digest mixed food
(Carbohydrate, protein, lipid, fruit &
vegetable).
Approximately 10% of BMR is
required as SDA of food
Adult 60 Kg, requires BMR =24 Cal/kg
BMR
= 1440 Cal
SDA
= 144 Cal
Total = 1584 Cal (BMR+SDA)
Balanced Diet
OR
Prudent Diet
(Wise, Wel Judged,Judicious,Wel Advised)
(Thoughtful, Careful, Right Way Of Eating)
?Human body if considered as a
Machine
?Food is our fuel
? Maintaining General health and
wel being of human body is first
priority
? Nutrition is a first need of human
beings to acquire good health.
? Health and Unhealth of body directly
depends upon
? Nutritional status of an individual
What and How We Build Our Body
Depends On What We Eat ???
Food Nutrients Determines:
?Bodies composition and built of
cells/Organs/Systems
?Bodies capacity to grow, repair and
reproduce
?Bodies strength to cope up with:
? Interacting environmental pol utants
?Multi tasking ability
?Routine Stress
What Is a Balanced Diet?
How Truly We Plan for Our Eating?
Let Us Think for a Moment
Do We??????
Yes /No????????
We Plan and Implement
? Comparatively ? Comparatively
More
Less
?Trips
?Career
?Fests
?Academics
?Parties
?Exams
?Games
Lets Us Well Plan Our Diet
And Implement
For Eating Our Food
For
HEALTH ,HAPPINESS, PEACE AND SUCCESS
Balanced Diet
Planned Diet
at Various Physiological States
Balanced Diet A Healthy Diet
Features of Balanced Diet
? Balanced diet provides the
mixture of al dietary nutrients
in:
?Adequate quantity
(Restrict to RDA values)
?Good quality
? Balanced Diet Provides
?Calorific needs
?Building blocks
?Accessory Growth factors
?Balanced diet does not
al ow an individual
?To ingest any one
dietary nutrient in
excess or less amount.
?Thus Balanced diet
prevents a body
?To suffer from over or
under nutritional
disorders.
? It is especial y important to
take care of eating during
?Growth, Pregnancy and
lactation
?Remember a young plant, not
given proper nutrients grows up
to a poor specimen with less/no
fruits and flowers.
Right Diet wil
Build Human Body Systems Strongly
And Protect Our Gene Functions
?Withstand Stress to carry out multi tasking activities
?Prevent from almost al diseases of any system
?Infection , Immune Disorders
?Depression
?Genetic Disorders
?Metabolic Disorders
?Hormonal Disorders
?Anemia
Points To Consider
While Planning For Balanced Diet
1. Physiological States
2. BMR (Considering al factors)
3. Physical activities of an individual
4. SDA
? Food included during planning of
balanced diet should be local y
available
? Food should be within economic
means of people.
? It should fit with local food habits.
? Balanced diet food items should be
easily digestible and palatable.
? Food eaten should contain al the
chief essential nutrients which
suffice bodies health, growth and
reproduction.
? An individual should eat fol owing food
groups in recommended quantity and
quality and maintain balanced diet.
?Cereals and Pulses
?Milk
?Meat and Fish
?Vegetables and Fruits
? RDA values differ during
different physiological states
of human body
? viz growth, pregnancy,
lactation and convalescence.
Points To Remember
? During growth, pregnancy and
Lactation dietary intake should
be increased
? To develop fetal growth and
maintain reproduction
Indian Balanced Diet
? Nutrition Expert Group
constituted by ICMR
? Taking into account of Indian
available foods
? Has recommended composition
of Balanced diets for Indians.
Indian balanced diet composed of
? Cereals : Rice, Wheat,Jawar
? Pulses
? Vegetables- Roots,Tubers
? Fruits
? Milk and Milk products
? Oil
? Sugar
? Fish
? Meat
? Eggs
Recommended Daily Al owance(RDA)
? RDA of Chief Nutrients for an Adult Individual
? Prescribed by WHO
? Modified by ICMR as per Indian conditions
Nutrient
RDA in Grams
Carbohydrates
400 gm
Fats
70 gm
Proteins
60 gm
Fiber
40 gm
? Carbohydrate content of
Some common foods
Food Item
Carbohydrate Content
Cane Sugar
100 %
Rice
80%
Wheat
70-80%
Bread
50-60%
Potatoes
25%
Vitamins
RDA
Vitamin A
3000- 4000 IU
Vitamin D
200-400 IU
Vitamin E
9 mg
Vitamin K
70 ug
Vitamin C
60 mg
Folate
400 ug
Thiamine (B1)
1.2 mg
Vitamins
RDA
Biotin
30 mcg
Riboflavin (B2)
1.2 mg
Niacin (B3)
15mg
Pantothenic (B5)
5 mg
Pyridoxine (B6)
1.6 mg
Cyanocobalamin (B12)
2.4 ug
Minerals
RDA
Calcium (Ca)
1200 mg
Phosphorus (P)
700 mg
Magnesium (Mg)
370 mg
Sodium (Na)
500 mg
Chloride (Cl)
750 mg
Potassium (K)
2000 mg
Minerals
RDA
150 ug
Iodine (I)
Iron (Fe)
10 mg
Copper (Cu)
1.5 mg
Zinc (Zn)
14 mg
Selenium (Se)
60 ug
Minerals
RDA
Molybdenum (Mo)
75 ug
Manganese (Mn)
2 mg
Fluoride (F)
4 mg
Chromium (Cr)
50 ug
Maintain Balanced Diet By
?Eating items from al food groups
?With appropriate quantity and good quality to
provide all nutritionally essential nutrients.
?Eating properly and regularly (Timely) without
skipping the whole meals.
Eat A Balanced Diet
Guidelines for
Healthy Eating
Fol ow principles in the Food Guide Pyramid
? 75% of a day's
food
? Should come
from grains,
vegetables and
fruits
? Extra servings of green
and yellow vegetables
may be beneficial
? Extra consumption of
citrus and other fruits
may be beneficial
?Its necessary to maintain balanced diet
since:
?What we eat today, will affect our health
in future.
Tips For Eating Wel
Know And Implement
Do's and Don'ts of Eating
Eat More Natural
and
Home Made Food
? Eat regular meals
? Do not skip breakfast
? Eat foods from al food groups
/According to food pyramid
? Limit processed /Junk food
?Prefer meals on starchy
foods
?Eat Egg and Fish
?Eat adequate amounts of
vitamins and minerals
?Eat lots of fruit and
vegetables
? Eat fresh and natural foods
? Cut down saturated fats , trans fats and
refined sugars.
? Try to eat less salt (no more than 5g/day)
? Say No to Alcohol
? Limit Tea and coffee
? Drink plenty of clean water
? Maintain a healthy weight.
? Keep body active- Work/Exercise
Regularly Recal the 8 tips
Energy Balance and Imbalance
?Body weight is stable
when energy consumed
is equal to energy
expended.
?This is termed as
Nitrogen balance.
Energy Balance:
Input vs Output
One pound of body weight is equal to
3,500 kilocalories
?Body weight increases,
when energy consumed
is greater than energy
expended.
?Body weight decreases
when energy consumed is
less than it expenditure.
? Balanced Energy Intake: not losing or
gaining weight
? Negative Energy Balance
?Weight loss: Energy intake < Energy
expended
? Positive Energy Balance
? Weight gain: Energy intake > Energy
expended
Significance Of Balanced Diet
Balanced Diet
Makes Life
Healthy And Happy
? Eating balanced diet right from the
beginning of life builds:
? Organ system of human body with
ful of strength and vital capacity
? This prepares body to face any
critical conditions.
?Metabolic stress
?Infections etc
?Balanced diet Significantly
? Maintains bodies normal growth , health
and reproduction.
? Prevents from suffering of nutritional
disorders.
? Increases span of healthy and happy life.
Nutritional Disorders
Result/Outcome/Punishment
Due to Extreme
Imbalanced/Uncontrol ed
Ingestion Of Nutrients
(Ignorance,Negligence,Nonimplementation,
Disobedience)
Do Reflection Analysis
of Dietary Habits
MALNUTRITION/
DEFECTIVE NUTRITION
q A pathological/diseased state
resulting from
q Relative or absolute
deficiency or excess of one
or more essential nutrients.
Forms of Malnutrition
v
Undernutrition:
Kwashiorkor, Marasmus
Specific Deficiency:
Hypovitaminoses, Mineral Deficiencies
v
Overnutrition:
Obesity, Metabolic Syndrome
Specific Toxicities: Hypovitaminoses
v
Imbalances: Electrolyte Imbalance
Why Human beings suffer from
Nutritional Disorders?
Due to What Factors ?
Do Reflection Analysis
? No Planning and Implementing in of Eating
(Thoughtful and Righteous way)
? Do's and Don'ts of Food Habits
?Ignorance/Il iteracy
?Lack of general awareness
?Negligence
?Disobedience
? Economical Status-
? Low and High
? No proper distribution
? No Regularity and Control on Diet habits
?Wrong food habits
?No Control/Regulation on eating habits
?No Change (quit/adopt) for Good Cause
? Results in Nutritional Disorders
? Availability of food is not uniform due to:
?Unequal distribution of food items
?Unequal economical status of human
population
?No proper planning in Occupations
? Undefined Number of
?Farmers/Food Growers and Distributors
?Doctors
?Teachers
?Engineers
?Other Miscellaneous Professions
ETIOLOGY OF MALNUTRITION
Types Of Nutritional Disorders
? Under Nutritional Disorders
? Over Nutritional Disorders
Under Nutritional Disorders
Under Nutritional Disorders
? It is a type of Malnutrition.
? Less intake of food nutrients.
? Insufficient building blocks and
vital growth factors.
? Insufficient energy sources.
Unhealthy GIT Affects
Absorption Of Nutrients
Leads To
Nutritional Deficient Disorders
Chronic Use of Chemicals, Alcohol,
Drugs Trauma and Infections
Lead To Il -health Of GIT
Protein Energy Malnutrition(PEM)/
Protein Calorie Malnutrition (PCM)
? Protein Energy Malnutrition (PEM)
? Protein and Energy (Carbs and Lipids)
deficiency go hand in hand.
? This combination leads to protein-
energy malnutrition
?PEM is worlds most
widespread malnutrition
problem in developing
countries.
PEM PRECIPITATING FACTORS
? LACK OF FOOD (Famine, Poverty)
? INADEQUATE BREAST FEEDING
? WRONG CONCEPTS ABOUT NUTRITION
? DIARRHOEA & MALABSORPTION
? INFECTIONS (Worms, Measles, T.B)
PEM
EPIDEMIOLOGY & ETIOLOGY
? Seen most commonly in the first year of
life due to lack of breast feeding and the
use of dilute animal milk.
? Poverty or famine and diarrhoea are the
usual precipitating factors
? Ignorance & poor maternal nutrition are
also contributory factor
Development Of PEM
? Majority of world's children live in
developing countries
? Lack of food & clean water, poor
sanitation, infection & social
unrest lead to LBW & PEM
? PEM leads to
? Increased Rates of Infant Mortality
? PEM disorders caused due to lack of
adequate Proteins and Energy in the
diet.
? According to W.H.O PEM is most
important public health problem
prevailing in developing countries.
? PEM most common in Africa, Central
America, South America, Middle
East, SE/E Asia
? Also see in US
?Homeless
?Inner-city
?Rural poverty
? PEM most often affects
children:
?500 mil ion children are
malnourished
?>50% of deaths of <5
children (5 mil ion/year)
? Adults may also be affected with PEM
?Men at greatest risk are:
?Those living in poverty
?Elderly living alone
?Addicted person
?Eating-disorders
?Long-term illness
Forms Of PEM
? Protein Energy Malnutrition (PEM)
includes
? Kwashiorkor
? Marasmus
? Marasmic Kwashiorkar
(Noted during Starvation or Wasting
extreme energy deprivation)
?Kwashiorkor
?Marasmus
? Two Facets of PEM
PEM Forms Kwashiorkor and Marasmus
Il ustrates
Two Faces Of Same Coin
Kwashiorkor
Risk of Development
? Kwashiorkor means sickness of
displaced/deposed /replaced child
? It affects when a first born child, is
replaced by a second born child.
?Kwashiorkar describe
sickness of weaning.
?Weaning- Process of
withdrawl of mothers milk
and replace with adult
diet
KWASHIORKOR Historical Aspects
? Word Kwashiorkor was introduced in
medical literature(1933),by Cecil y
Wil iams, a British Nurse.
? Kwashiorkor is Ghanaian name for
an Evil Spirit
Biochemical Cause
? Kwashiorkar is an extreme
condition of Protein Energy
Malnutrition
? Caused due to ingestion of
Protein deficient diet.
Features of Kwashiorkor
? Age of onset- 1 to 5 years
? Child gets displaced by mothers
attention.
? Ingestion of low dietary Proteins
? Weaning protocol not fol owed
? No milk fed instead low protein diet
like gruel prepared from grains and
potatoes is fed.
Biochemical Alterations
? Amino acid deficiency for tissue
protein biosynthesis.
? Serum Albumin levels markedly
decreased < 2gm%
? Digestive Enzymes lowered
? Overal body Proteins are lowered
? Serum Cortisol levels decreased
Clinical Signs And Symptoms
? Enlarged abdomen
? Pitting edema of trunk, limbs and
eyelids (Low serum Albumin)
? Moon Face
? Anemia
? Growth retardation
? Loss of weight, lethargic
? PSYCHOMOTOR CHANGES
? SKIN DEPIGMENTATION
? Failure of digestion and absorption due to
lack of digestive enzymes.
? Due to indigestion of food
vLoss of appetite and anorexia
vDiarrhea
vWater and Electrolyte imbalance
? Subnormal Immunocompetence
(Low Immunity)
? Mental Changes observed-Low
Neurotransmitters
? Fatty Liver-Low/No mobilization of
Lipids
? Sparse ,soft, thin and curly hairs
? Glossitis
? Conjunctivitis
? One theory says Kwashiorkar is
a result of Liver insult with
hypoproteinemia and oedema.
? Food toxins like Aflatoxin have
been suggested as precipitating
factors for Kwashiorkar.
Kwashiorkor
(Edematous Malnutrition)
? Underweight with Edema
? Stunted growth
? Irritable, difficult to feed
? Highest mortality ?
50 to 60%
Treatment Of Kwashiorkar
? Gradual feeding with good
quality food proteins
?Milk
?Egg
?Legumes /Pulses
Marasmus
? Marasmus means neglected child
? Marasmus is a disorder of PEM
where an infant is virtual y
starving
? Due to lack of both dietary
calories and proteins.
? Term Marasmus is derived from the
Greek word, which means wasting.
? Marasmus involves an inadequate
intake of Protein and Calories and is
characterized by emaciation.
? Marasmus represents the end result
of starvation where both proteins
and calories are deficient.
Causes Of Marasmus
? Age of onset- Below 1 year
? Deficiency of both Calories and
Proteins.
? Marasmus occurs in areas where
there is severe starvation and
famine/draught conditions.
Biochemical Alterations In Marasmus
?Serum Albumin levels 2-3
gm%
?Serum Cortisol levels
increased
Clinical Signs And Symptoms
? Marked growth retardation
? Severe Muscle wasting
? Loss of sub cutaneous fat
? Extreme loss of body weight
? No Edema
? No mental changes
? No characteristic change in hair
? Appetite is normal
? Skin becomes dry and atrophic
? Child looks older than his age
?Feels Hungry
?Diarrhoea &
Dehydration
?Alert but miserable
Differentiation Between
Kwashiorkar
And
Marasmus
Features
Kwashiorkor
Marasmus
Displaced Child
Neglected Child
Age Of Onset
1-5 years
Below 1 year
Cause
Deficiency of dietary
Deficiency Of dietary
Protein
Proteins and Calories
Serum Albumin
< 2gm%
2-3 gm%
Edema
Significantly Present
Absent
Muscle Wasting
Not severe
Markedly sever
Growth Retardation
Present
Markedly noted
Features
Kwashiorkor
Marasmus
Attitude and
Lethargic ,apathetic
Irritable and fretful
Appearance
Face looks plump
Shrunken with skin and
bones
Appetite
Anorexia
Normal
Skin Changes
Crazy pavement
Dry and atrophic
Dermatitis
Hair Changes
Sparse, soft thin and
No characteristic
curly
change
Serum Cortisol
Decreased
Increased
Investigations for PEM
? Ful Blood Counts
? Blood Glucose
? Serum Electrolytes, Ca, P
? Serum Proteins and Albumin
? Septic screening
? Stool & urine for parasites & Microbes
? Mantoux test
NON-ROUTINE TESTS
? Hair analysis
? Skin biopsy
? Urinary Creatinine
? Measurement of trace elements
levels, iron, zinc & Iodine
Complications of P.E.M
? Hypoglycemia
? Hypothermia
? Hypokalemia
? Hyponatremia
? Heart failure
? Dehydration & shock
? Infections (bacterial, viral & thrush)
Treatment
? Slow refeeding
?Small frequent feeding round the
clock
?Patient encouragement of food
? Nutritional rehabilitation
?Play and teaching
?Control infections
In Acute/ life threatening Cases:
?Fluid and Electrolytes
?K and Mg shifts
?Oral rehydration, slowly
70-100 ml/kg
?Infections: Main cause of death
? Aggressive treatment
?Other deficiencies
? Anemia and Heart failure,
? Care with transfusions and no diuretics
? Vitamin A: immediate treatment
? Dietary support:
? 3-4 g protein & 200 Cal /kg body
wt/day + Vitamins & Minerals
? Prevention of hypothermia
? Counsel parents & plan future care
including immunization & diet
supplements.
KEY POINT FEEDING
? Continue breast feeding
? Add frequent smal feeds
? Use liquid diet
? Give vitamin A & Folic acid
? With diarrhea use lactose-free or soya
bean formula
PROGNOSIS
? Kwashiorkor have greater risk of
morbidity & mortality compared to
Marasmus and under weight
? Early detection & adequate treatment
are associated with good outcome
? Late il -effects on IQ, behavior &
cognitive functions are doubtful and not
proven
Over Nutrition Disorders
Obesity
Types Of Adipose Tissue And Roles
Appetite Related Hormones
Obesity
?
Generalized, excessive
accumulation of fat in
subcutaneous & other tissues
? Classification of Obesity
according to "desirable"
standard weight :
? Overweight ~ >10%
? Obese ~ >20%
Obesity Is Identified By
Measurement Of Body Mass Index
(BMI)
What Causes Obesity
? 3 major factors contribute for
development of obesity:
?Genetic background (non-modifiable)
?High Dietary intake (modifiable)
?Low Physical activity (modifiable)
q Psychic disturbances
q Endocrine & metabolic
disturbances (rare)
Obesity Affects Quality Of Human Life
Biochemical Alterations Of Obesity
? Increased stores of TAG in adiposecytes
? Increased biosynthesis of Endogenous Lipids
? Affects receptor structures on cel membrane
? Derangements in endocrine activity
? Increased risk of Diabetes mel itus
? Biochemical Derangements in Glucose and
Lipid Profile
? Increased Risk of Atherosclerosis , CAD ,
Stroke
Dysregulation of Adipocytokines in
Obesity
? Adipocytokines function as classic circulating
hormones
? Communicate with other organs including brain,
liver, muscle, the immune system, and adipose
tissue itself.
? Dysregulation of Adipokines has been implicated
to increases inflammation, insulin resistance , type
2 diabetes, and cardiovascular disease.
Leptin and Adiponectin
Regulate Feeding Behavior and Energy Expenditure
Leptin
? Leptin is a hormone that is produced mainly by
Adiposecytes.
? " Leptin's primary target is in hypothalamus of
brain
? "Leptin is a Master" Hormone that regulates body
weight.
? It is often referred to as "satiety hormone" or
"starvation hormone.
? Leptin dampens/ suppresses appetite
An individual lacking a
functional leptin protein
or receptor manifested
voracious feeding
and leads to obesity
Adiponectin
? ADIPOQ gene
? Produced in adipose tissue
? Protein hormone involved in
? Blood Glucose regulation
? Fatty acid breakdown and oxidation
? Adiponectin reduces inflamation
? Adiponectin inversely correlated with body mass
index
Adiponectin mRNA serum levels are
decreased in obesity
Upper Abdominal Obesity
? Increased abdominal circumference (> 102 cm in men and
88 cm in women)
? Waist to hip ratio (> 1.0 for women and >0.8 for men)
? Visceral fat within abdominal cavity is more hazardous to
health than subcutaneous fat around abdomen
? Also called, `Apple shaped obesity'
? Increased Risk of diabetes mellitus, stroke, coronary artery
disease, Cancer and early death
Complications of
Obesity
Metabolic Syndrome Major
Complication/Consequence Of Obesity
Metabolic Syndrome
X Syndrome
? Affects Receptors on Plasma membrane
? Protein Hormone Receptors altered
? Role of messengers for coordination and
communication disturbed
? Dysregulation of Enzyme activity
? Affects over all Metabolism
? Insulin Resistance
? Hyperlipoproteinemias
Central Obesity is Dreadful
Increases Risk Of Metabolic Syndrome
Clinical Manifestations:
v Fine facial features on a heavy-
looking stout child
v Larger upper arms & thighs
v Genu valgum common
v Relatively small hands & fingers
tapering
v Adiposity in mammary regions
v Pendulous abdomen with Striate
v Psychologic disturbances common
v Bone age advanced
v In boys, external genitalia appear
small though actually average in
size
v In girls, external genitalia normal &
menarche not delayed
Obesity Affects Endocrine System
Obesity And Thyroid Dysfunction
Pickwickian Syndrome/
Obesity Hypoventilation Syndrome
? Pickwickian syndrome is a
condition in which severely
overweight people
? Fail to breathe rapidly enough or
deeply enough
? Resulting in low blood oxygen
levels and high blood carbon
dioxide (CO2) levels
?Rare complication
of extreme
exogenous obesity
Signs And Symptoms
?Severe cardio respiratory
distress & alveolar
hypoventilation
?Includes polycythemia,
hypoxemia, Cyanosis, CHF
?Low Metabolic rate
?Lethargic and Fatigue
? Obesity Hypoventilation
Syndrome have:
?Concurrent obstructive sleep
apnea, a condition
characterized by snoring.
?Interrupted sleep
?Excessive Daytime Sleepiness
Management Of Obesity
Treatment of Obesity
1st principle: Decrease
energy intake
Initial medical exam to
diagnose pathological
causes
Plan right diet
a.Avoid all sweets, fried foods &
fats
a.Limit milk- intake not >2
glasses/day
a.For 10-14 yrs, limit to 1100-
1300 cal diet for several months
2nd principle: Increase energy
output:
I. Obtain an activity history
I. Increase physical activity
I. Involve in hobbies to
prevent boredom
Advise To
? Stop Alcohol
? Cessation of Smoking
Orlistat FDA Approved Drug Inhibits
Pancreatic Lipase ,TAG Digestion In GIT
Thoughtful and Rightful Knowledge
Implementation Wil Prevent Obesity
Over Al Messages
Lets Al Of Us Fight For Malnutrition
Eat Food Cautiously with Awareness
With Good Purpose Than Sensual Pleasure
Our Body Is Precious Gift
Health Is First Priority
THINK AND EAT
Cautiously,Moderately
Careful y and Rightly
Do Not Make Our Body As Dustbin
Eat As Fol ows
Sleep And Food Cycle Affects Health
Change for Positivity
?Adopt Do's
?Quit Don'ts
Best For Human Health
Thoughtful and Rightful
Eating And Living Style
Simple, Natural-
Planned ,Organized ,Regular, Disciplined
Simple , Humble, Care and Share
Yes for Good Stead Fast No For Bad
4/4/2022
540
Questions
? Short Notes
? Food Groups ,their constituents and
their role
? Basal Metabolic Rate (B.M.R.) & its
importance.
? Calorific value of food and its
calculations.
? Respiratory Quotient.(R.Q)
? Specific Dynamic Action (S.D.A.)
? Balanced diet
? Factors affecting BMR
? Biological value of Proteins.
? Nitrogen Balance & types.
? Role of Fiber in diet/Significance of
dietary fibers.
? Protein Energy Malnutrition (PEM) /
? Differentiate between Kwashiorkor
and Marasmus.
? Obesity: Causes and Consequences
THANKS
This post was last modified on 05 April 2022