3. The Complete Course Agenda
15 Min Introduction
15 Min Food Guide Pyramid
60 Min Nutrition “What is it ?" - Water & Protein
30 Min Nutrition “What is it ?” - Carbohydrates & Fats
10 Min Review/Activities/Group
20 Min Break
10 Min Human Physiology – Introduction
60 Min Cells and Cell Physiology
Cell Structure
Cell and energy
Fat Metabolism
Protein Metabolism
Glucose Metabolism
20 Min Revision
Total: 240 mins
4. The Complete Course Agenda
10 MIN Summarize previous day learning
20 MIN Opener/Activity
50 MIN Digestive System
Stomach
Liver
Pancreas
40 MIN Urinary System – Kidney
20 MIN Tea / snacks BREAK
10 MIN Review/Activity/Group
50 MIN Respiratory System - Nose & Nasal Passages;
Pharynx ; Trachea; Bronchioles; Lungs
50 MIN Cardiovascular System – Heart; Blood Flow (Heart) ;
Blood Vessels; Blood Pressure; Blood as Delivery System
10 MIN Review/Activity/Group
5. The Complete Course Agenda
10 MIN Summarize previous day learning on Nutrition
15 MIN Central Nervous System - Brain
15 MIN Peripheral Nervous System - Autonomic Nervous
System ; Sensory Somatic Nervous System
15 MIN Musculature System – Skeletal; Cardiac; Smooth
15 MIN Integumentary System – Skin; Hair; Nails
10 MIN Human Physiology Review
20 MIN Tea / snacks BREAK
10 MIN Activity: Short quiz on Physiology
120 MIN Water Soluble Vitamins – Vitamin C; Vitamin B; B1-
Thiamin; B2- Riboflavin; B3- Niacin; B5- Pantothenic
Acid;B6- Pyridoxine B12- Cobalamin; Biotin; Folic Acid
10 MIN Review/Activity/Group
6. The Complete Course Agenda
10 MIN Summarize previous day learning
60 MIN Fat-Soluble Vitamins – Vitamin A ; Vitamin D
60 MIN Fat-Soluble Vitamins – Vitamin E ; Vitamin K
15 MIN Review/Activity/Group
20 MIN Tea / snacks BREAK
10 MIN Opener / Activity
60 MIN Minerals - Calcium, Chromium; Copper; Iron;
Selenium
60 MIN Mineral – Zinc; Potassium; Sodium;
Magnesium; Phosphorus
10 MIN Short class test/ Review/Activity/Group
7. The Complete Course Agenda
10 MIN Total Nutrition Review
10 MIN Diet and Disease Introduction
90 MIN Cardiovascular Disease - Pathophysiology;
Diet Therapy
20 MIN Tea / snacks BREAK
60 MIN Diabetes - Pathophysiology; Diet Therapy
50 MIN Cancer - Pathophysiology; Diet Therapy
10 MIN Review/Activity/Group
8. The Complete Course Agenda
10 MIN Review/Activity/Group
60 MIN AIDS/HIV - Pathophysiology; Diet Therapy
20 MIN Tea / snacks BREAK
60 MIN Food Science & Technology - Agriculture and food
products; Alternative agriculture methods; Integrated pest
management; Organic farming; Pesticides; Food safety
and food borne illness; Food irradiation; food additives;
Biotechnology
60 MIN Organic farming –Cd; Supplementation
30 MIN Short class test/Review/Activity/Group
Date will be announced: FINAL TEST
1 1/2 Hours
12. What is Nutrition?
Metabolism of Foods
Nutritive Value of Foods
Qualitative and Quantitative
Requirements
Changes in Nutrient
Requirements
Cultural Factors
13. Six Classes of Nutrients
Carbohydrate Vitamins
Fat Minerals
Protein Water
*The Human Body Like Food is Composed
Largely of Nutrients
14. Nutrition
Composition Composition
of Foods of Body
70% Water 60% Water
1% Fat 20% Fat
4% Protein 20% Protein,
24% Carbohydrates Carbohydrate
1% Vitamins & , Vitamins,
Minerals and Minerals
15. Macro Nutrients
These nutrients are required in a large amount
by the body.
Carbohydrates
Energy Rich
Fat Foods
• Proteins
• Dietary Fiber Body Building
foods
• Water
16. Micro Nutrients
These nutrients are required in a very
small quantity, However are extremely
critical for the normal functioning of the body.
Vitamins
Minerals Protective
foods
18. Elements of Nutrients
Carbon Hydrogen Oxygen Nitrogen Minerals
Inorganic Nutrients
Minerals
Water
Organic Nutrients
Carbohydrates
Fats
Proteins a
Vitamins b
a Proteins also contain the mineral sulfur
b Some vitamins contain nitrogen, some contain minerals
19. Energy
Capacity to do Work
Energy in Food is Chemical
Energy
Body Converts Chemical
Energy mechanical
energy
21. Measurement of Energy
Energy is measured in Calories
Calorie: A Unit by Which Energy is Measured
Food Energy is measured in Kilocalories
1000 Calories = 1 Kilocalorie
1 Kilocalarie of Heat is needed to raise the
Temperature –
1 Kilogram of Water 1 Degree Celsius
23. Energy in the Body
Nutrients to Fuel Metabolic and Physical Activities
Heart -Beating
Brain- Thinking
Legs -Walking
Breathing
Eliminating Wastes
24. Excess Nutrient Consumption
Excess Consumption of
Energy-Yielding Nutrients
Converted to Fat and Stored in the Body
25. Classification of Nutrients
Macronutrients (Macro = BIG)
Protein, Carbohydrate, Fat, and
Water
Micronutrients (Micro = small)
Vitamins and Minerals
28. Water in Body Fluids
Intracellular Fluid: Fluid Within Cells
– Approximately 2/3 of Body Water
– High in Potassium and Phosphate
Interstitial Fluid: Fluid Between Cells
Approximately 1/3 of Body Water
Large Component of Extra Cellular Fluid
Usually High in Sodium and Chloride
30. Water's Role
Carries Nutrients and Waste
Helps form Structure of Molecules
Participates in Chemical Reactions
Solvent for Small Molecules
31. Water Sources
Beverage and Water
Foods Contain Water
Fruit and Vegetables = Up to 95% Water
Meats and Cheese = Up to 50% Water
Object 7
32. Water content in foods
Dry seeds, such as the grains and legumes were intentionally left of the following list as they should have a common moisture
content of 10% or less. All pure fats and oils contain no water. The water content of each of the foods below is shown by the
number following the food. After these foods have been dehydrated, their weight will be reduced by close to the following
percentage:
Almonds 7% Collards Boiled 91%
Apples 85% Corn Sweet Fresh 74%
Apricots 85% Cucumbers Raw 96%
Bananas 76% Eggs Raw Whole 74%
Bean Sprouts 92% Egg Plant Raw 92%
Bread Whole Wheat 35% Fruit Cocktail 80%
Broccoli 91% Pickles Dill 93%
Butter 20% Pineapple Raw 85%
Cabbage Raw 92% Plums Raw 87%
Carrots Raw 88% Potatoes Raw 85%
Olives 80% Pumpkin Canned 90%
Onions 89% Radish Raw 95%
Oranges 86% Spinach Raw 92%
Papayas Raw 89% Squash Boiled 96%
Parsley Raw 86% Grape Fruit Raw 88%
Peaches Raw 90% Grapes 82%
Peanuts Shelled Trace Honey 15%
Peanut Butter Trace Jams / Preserves 30%
Pears Raw 82% Lettuce Head 91%
Peas Raw 81% Macaroni/Spaghetti Cooked 72%
Pecans 7% Margarine 20%
Peppers Green 94% Okra Boiled 91%
Cauliflower Raw91% Straw Berries 90%
Celery 94% Sweet Potatoes Boiled in Skin 71%
Cherries Raw 80% Tomatoes Raw 93%
Chicken Broiled Turkey Roasted 62%
Coconut Dried 7%
33. Water Balance
Water Sources Amount (ml) Water Excretion Amount (ml)
Liquids 550 to 1500 Kidneys 500 to 1400
Foods 700 to 1000 Skin 450 to 900
Metabolic Water 200 to 300 Lungs 350
Feces 150
1450 to 2800
2450 to 2800
34. Water Recommendations
t Recommendations:
Diet
Activity
Environmental Temperature
Humidity
Adult Recommendations
*Amount of Water = Amount of Energy Expended
35. Water Recommendations
Person Expending 2,000 Kcal per Day
2 to 3 Liters of Water
7 To 11 Cups
Best Sources: Water, Milk, and Juice
Not Substitutes: Alcohol, Caffeine-
Beverages
*Act as Diuretics
36. What are Proteins?
The name Protein was suggested
by Mulder in 1838 to the complex,
organic, nitrogeneous substances
found in animal and plant tissues.
37. What are Proteins?
• Proteins are the foremost & forefront nutrients
Important constituents of tissues and cells of the body
These are present inside the cell as well as in the
plasma
They form 16% wet weight of the cell
As enzymes and hormones they are concerned with
vital metabolic processes
As antibodies they help defend against infections
38. Classification of Proteins
Structural proteins
Proteins which form part of the body
structure
• Collagen - gives tensile strength to the
body
• Elastin - provides elasticity to the skin
• Keratin – helps formation of nails & hair
They have a slow turnover and therefore a long
half life
39. Classification of Proteins
Functional proteins
Proteins which regulate the various functions in the
body.
- Enzymes acts as catalyst for various metabolic
functions
- Hormones trigger some specific reactions e.g.
Insulin which regulates the glucose metabolism in
the body, has half life of 0.5 second and if not so
will result in hypoglycemia
They have a faster turnover and shorter life span
40. Classification of Proteins
Depending upon the combination in which they
exist in the body, Proteins can also be classified
as :
• Muco protein: Protein when combined with
carbohydrates .eg saliva mucos.
• Lipo protein: Protein when combined with
lipids eg. cholestrol, triglyceride in emulsion
form.
• Transport protein: Protein when used as
carrier eg . Iron is transported in the form of
haemoglobin in the body
41. Structure of Protein
Proteins are made up of Amino acids
Dietary proteins provide amino acids
for the synthesis of body proteins
Amino acids are composed of carbon,
hydrogen, oxygen, nitrogen, sulphur
and sometimes phosphorus
42. Amino Acids
• There are 22 naturally occurring amino acids.
• Of these 22 amino acids,
9 amino acids are known as essential since they
cannot be synthesized in the body
Rest are non essential as they can be
synthesized in the body by inter conversion of
compounds already present in the body
43. Types of Amino Acids
Depending upon the chemical structure Amino
Acids can also be classified as under :
• Aliphatic : Glycine, Alamine, Threonine, Serine
• Acidic : Aspartic, Glutamic
• Branched Chain : Valine, Leucine, isoleucine
• Aromatic : Phenylalanine, Tyrosine, Tryptophan
• Basic : Lysine, Arginine, Histidine
• Sulphur containing amino acids : Cystine, Cystaine,
Methionine
• Iminoacid : Proline
44. Limiting Amino Acids
Essential Amino Acid
A Protein from Plants (Usually Limiting)
Corn: Deficient in Tryptophane and
Lysine
Legumes (Beans): Deficient in
Methionine
Grains (Wheat): Deficient in Lysine
46. Digestion and Absorption of Protein
Protein in Food Do Not Become
Body Proteins
Protein in Food Supply Amino
Acids
47. Digestion and Absorption of Protein
Hydrolysis of Protein Begins in the Stomach
Acted upon by Gastric juices
HCL ( in the Stomach)
Amino Acids Blood Stream
48. Various Sources of proteins
• Cereals and Millets
• Pulses, legumes
• Milk and milk products
• Egg and Flesh Foods
• Soya
49. Functions Of Dietary Proteins
Provide AA for the formation of
tissues during growth.
To provide AA for the growth of
fetus in pregnancy and for the
production of milk proteins
during lactation.
50. Functions Of Dietary Proteins
• To replace the daily loss of
body protein.
• To provide AA for the
formation of enzymes, blood
protein and certain hormones
of protein nature.
53. Experimental assessment of Protein sources.
Protein Digestibility Corrected Amino Acid
Score
– Measures the nitrogen content of undigested
protein to indicate the digestibility of protein
present in a particular source.
– Measured on a scale of 0 - 1
- where 0 represents least digestibility and 1 represents
maximum digestibility.
64. Lipid Family
Triglycerides (Fats and Oils)
a Glycerol (1 per Triglyceride)
Fatty Acids (3 per Triglyceride)
Saturated
Monounsaturated
Polyunsaturated
Omega-6
Omega-3
Phospholipids (Such as Lecithin)
Sterols (Such as Cholesterol)
65. Saturated Fats
Hydrogenated Fatty Acids
Chemical Process:
• Hydrogen Atoms + Mono or
Polyunsaturated Fats
– Fats More Stable
– Prolongs Shelf Life
– Protects Against Oxidation
– Sources: Margarine, Shortening, Baked
Goods
66. Effects on Health
Saturated Fats Elevate Blood Cholesterol
Heart Disease
Hydrogenated Fats Trans Fatty Acid
Heart Disease
Unsaturated Fats Lower Blood Cholesterol
Heart Disease
67. Role of Triglycerides and Fatty Acids
Provide Energy
Enhance Palatability
Influence Texture of Foods
Enable Absorption of Fat Soluble Vitamins
Insulate the Body
Protect Organs Against Shock
Help Body Use Carbohydrates and Proteins
68. Essential Fatty Acids
Body Can Make All But "2" Fatty Acids
Linoleic Acid
Linolenic Acid
Indispensable to Body Function
Supplied by Diet
70. Linoleic Acid: Omega 6
Arachidonic Acid
Structure and Function of Cell Membranes
and Inflammation Reactions
71. Linolenic Acid: Omega 3
Body Can Produce
EPA - Eicosapentaenoic Acid
DHA - Docosahexanenoic Acid
• Development and Maintenance:
– Brain and Retina of Eye
– Integrity of Skin, Kidney, Liver,
Reproductive Organs
72. Linolenic Acid: Omega 3
Essential for Normal Growth and
Development
Regulates:
Blood Clotting
Blood Pressure
Lipid Concentrations
Inflammation Responses
73. Linolenic Acid: Omega 3
Important Role in Prevention
and Treatment of:
Heart Disease
Hypertension
Arthritis
Cancer
74. Sources of Omega Fatty Acids
Omega-6
Linoleic Acid Leafy Vegetables, Seeds, Nuts, Grains, Vegetable Oils
(Corn, Safflower, Soybean, Cottonseed, Sesame,
Sunflower)
Meats (or can be Made from Linoleic Acid)
Arachidonic Acid
Omega-3
Fats and Oils (Canola, Soybean, Walnut, Wheat Germ,
Linolenic Acid
Margarine, and Shortening Made from Canola and
Soybean oil)
Nuts and Seeds (Butternuts, Walnuts, Soybean Kernels)
Vegetables (Soybeans)
Human Milk
EPA and DHA Shellfish and Fish* (Mackerel, Tuna, Salmon, Bluefish,
Mullet, Sturgeon, Menhaden, Anchovy, Herring, Trout,
Sardines) (or can be Made from Linolenic Acid)
75. Phospholipids
Similar to Triglyceride
Choline and Phosphate Group
Lecithin - Used as an Emulsifier
Emulsifier: Promotes the Mixture of Two
Substances such as Oil and
Water, that are not Mutually
Soluble
76. Role of Phospholipids
Constituents of Cell Membranes
Lipid Transportation
Fat Soluble Substances: Vitamins
and Hormones
Emulsifiers
95. Digestive System
Tongue
Propels Food
Taste Buds (Sweet, Sour Salt)
• Salivary Glands (Saliva)
– Moisten Food
Begin Digestion - Starch
• Tonsils
– Part of Immune System
96. Digestive System
Epiglottis
Muscles to Prevent Food
Entering Lungs
Directs Food to Esophagus
and Blocks Trachea
Coughing
• Esophagus
– Muscular Tube to Stomach
97. Digestive System
Stomach
Sphincter-Muscle Closes Stomach
• Reflux
Churns Food-Chyme
• Mixes With Acid and Pepsin
– Mucus Protects Stomach
– Intrinsic Factor
101. Digestive System
Accessory Organs
Liver - Largest Organ
Liver Stomach
Metabolism
Bile Production
Vitamin Storage
Remove Chemicals
Cholesterol Production
Essential for Life
102. Digestive System
Accessory Organs
Pancreas – 5 inches long Pancreas
Digestion Picture 5
Blood Sugar Levels
Diabetes - Type I and Type II
Duodenum
103. Urinary System
Kidney Urinary Ducts
Urinary Bladder
Filtration System Kidney
Urine
Chemical Waste Urinary
Salts duct
Water
Bladder
104. Urinary System
More Sweat = Less Urine
Kidney Plays Role in Blood Pressure
– Urine Production Blood Pressure
– Salt Balance
• Chemicals Metabolized in Liver
Excreted in Kidney
105. Respiration
Nose Trachea Bronchioles
Lungs
Picture 9
Nose nasal area
Filter
Warm trachea
Moisten
lungs
107. Respiration
Nose Trachea Bronchioles
Lungs
Alveoli
Gas Exchange
Surface Area
• Inhalation/Exhalation
– Brain
– Gas Exchange
– Surface Area
108. Respiration
Nose Trachea Bronchioles
Lungs
Hemoglobin
Protein
Oxygen/Carbon Dioxide
110. Cardiovascular System
Body Left Heart Lungs Right Heart
Body
Artria Contract Ventricles Contract
Heart Rhythm Pacemaker
60-80 Beats/Minute
111. Cardiovascular System
Blood Vessels
Arteries
Blood from Heart
Muscular
Systole/Diastole
Blood pressure (Pulse)
• Feel Your Wrist
Capillaries
Tiny (Feed Body)
112. Cardiovascular System
Blood Vessels
Venuoles
– Tiny (Take Blood to Veins)
Veins
Blood to Heart
Little Muscle
Smooth Blood Flow
113. Cardiovascular System
Blood Pressure 120/80 mmHg
Heart Pump
Blood Vessels
Amount of Blood
• Need to Move Blood
– Too Much Bad Hypertension
– Too Little Bad Hypotension
114. Cardiovascular System
Blood Red Cells/White Cells/Plasma
Red Cells -
Hemoglobin/Oxygen
Lungs
Metabolism + Oxygen
Metabolism and Carbon
Dioxide
Anemia
115. Cardiovascular System
Blood Red Cells/White Cells/Plasma
White Cells
Immunity
Infection
• Platelets
– Blood Clot
124. Nervous System
Peripheral Nervous System (PNS)
Autonomic Nervous System
We Do Not Control This System
Sympathetic/Parasympathetic
Blood Pressure
Digestion
Intestines
Lungs
"Fight or Flight"
138. Vitamins
• Solubility:
Hydrophilic: (Water-Soluble)
Carbohydrate, Protein
Vitamins B and C
– Hydrophobic: (Fat-Soluble)
• Fat
• Vitamins A, D, E, K
170. Fat Soluble Vitamins: A, D, E, K
*Differ From Water-Soluble Vitamins
Found in Fat and Oily Parts of Foods
Insoluble in Water
Lymphatic System
171. Fat Soluble Vitamins: A, D, E, K
*Differ From Water-Soluble Vitamins
Greater Risks for Toxicity
Stored in Liver and Adipose Tissue
Not Readily Excreted
172. Vitamin A and Beta-carotene
First Fat-Soluble Vitamin Recognized
Beta-Carotene, Precursor to Vitamin A
Three Forms of Vitamin A (Retinoids)
Retinol (an Alcohol)
Retinal (an Aldehyde)
Retinoic Acid (an Acid)
173. Beta Carotene as an Antioxidant
Protects the Body Against Disease
Free Radicals
Heart Disease
Cancer
Arthritis
Cataracts
174. Retinol-Vitamin A
Functions
– Vision
– Maintenance of Cornea
– Mucous Membranes
– Skin, Bone, and Tooth Growth
• Food Sources
175. Retinol-Vitamin A in Vision
Cornea
Transportation of Light Energy
Nerve Impulses at Retina
Supports Growth of Bones
Remodeling of Bone
176. Retinol-Vitamin A
Deficiency Disease
– Hypovitaminosis A
• Deficiency Symptoms
177. Retinol-Vitamin A Deficiency
Vitamin A Stores: 90% in Liver
Adequate Protein
Vitamin A Food Sources
Global Nutrition Problem
Night Blindness
100 Million Children with Deficiency
179. Calciferol-Vitamin D from the Sun
Natural Exposure to Sunlight
Sun Imposes No Risk of Toxicity
• Prolonged Exposure Degrades the
Vitamin D Precursor
180. Calciferol-Vitamin D from the Sun
Ultraviolet Rays of the Sun
Dark Skinned People Prone to Rickets
Deficiency More Likely in Elderly
Vitamin D Fortified Foods or Supplements
181. Calciferol-Vitamin D
Functions
Raises Blood Calcium and
Phosphorus
Hormone
Organs: Intestines, Kidneys, Bones
Stimulates Absorption from GI Tract
Bone Growth
182. Calciferol-Vitamin D
Deficiency Disease
Rickets
Osteomalacia
Deficiency Symptoms
183. Tocopherol-Vitamin E
1922, Discovery in Vegetable
Oils
Anti sterility Factor = Tocopherol
Compound Named Vitamin E
Alpha Beta
Gamma Delta
184. Tocopherol-Vitamin E
Food Sources
20% = Vegetable Oils
20% = Fruits and
Vegetables
15% = Grain Products
• Animal Fats: Meat and Milk Fat
Contain Little or No Vitamin E
186. Vitamin E as an Antioxidant
Oxidation
Transformation of Energy Fuels to ATP
Oxidation of Polyunsaturated Fatty Acids
Protection of Lungs
• Air Pollutants (Nitrogen or Ozone)
– Protects Red Blood Cells
187. Tocopherol-Vitamin E Deficiency
Rare in Humans
Fat Malapsorption
Cystic Fibrosis
• Causes of Vitamin E Deficiency
– Erythrocyte Hemolysis
188. Vitamin K
Blood Clotting
“K” = Danish Word Koagulation
(Coagulation or Clotting)
13 Different Proteins and Calcium
Vitamin K Essential Synthesis of Protein
Blood-Clotting Process
Calcium and
thromboplastin Fibrinogen
Vitamin K (a soluble
(a phospholipid)
from blood platelets protein)
Prothrombin Fibrin
Thrombin
Precursor (an inactive (a solid
(an active
protein) clot)
enzyme)
198. Body’s Handling of Minerals
Amount of minerals absorbed
Ease of absorption, transportation and
excretion
Carriers to be absorbed and
transported
Increased risk of toxicity
199. Variable Bioavailability
Binders
– Phytic Acid: calcium, iron, zinc
• Legumes and grains
– Oxalic Acid: calcium and iron
spinach and chocolate
200. Sodium
Principal cation (+) of extracellular
fluid
– Cation: positively charge ions
– Extracellular fluid: fluid outside cell
• Maintain acid-base balance
• Essential to nerve transmission
• Essential to muscle contraction
201. Sodium Roles in the Body
Foods provide more sodium than the
body needs
Intestinal tract absorbs sodium readily
Sodium travels freely in the blood
Kidneys filter all sodium out of the blood
Kidneys return to bloodstream exact needs
Excretion = Consumption
202. Sodium Recommendations
Diets rarely lack sodium
Committee on dietary allowances
– Minimum: adults = 500 mg per day
– Maximum: (NaCl) less than 6 g per day
203. Sodium Recommendations
Salt (sodium chloride) is about 40%
sodium
1 g salt = 400 mg sodium
5 g salt = 1 tsp
1 tsp salt = 2,000 mg sodium
204. Sodium and Hypertension
Majority of people with HTN, salt restriction
does not lower blood pressure
Most effective dietary treatment
for HTN is weight loss
205. Sodium in Foods
Processed foods high
amounts of sodium
Fresh fruits and vegetables low sodium
75% sodium added to foods at table or
during preparation
15% sodium added during cooking
10% natural sodium in foods
206. Chloride Roles in the Body
Major anion (-) in extracellular fluids
Association with sodium (NaCl)
Moves freely across membranes
Critical for fluid and electrolyte balance
207. Chloride Roles in the Body
Chloride ion is part of hydrochloric acid
(HCL)
Strong acidity of gastric juice
Proper digestion
Protein digestion and iron absorption
Vomiting loss of HCL
208. Chloride Recommendations
and Intakes
Abundant in foods (especially processed)
No RDA set
Estimated minimum requirement 750 mg per
day
210. Potassium Roles in the Body
Maintaining fluid and
electrolyte balance
Maintaining cell integrity
Homeostasis (steady
heartbeat)
*If cells were to give up to the blood only 6% of the K(+) they contain,
it would stop the heart
211. Potassium Recommendations
and Intakes
Abundant inside all living
cells
Richest sources are fresh Canned
foods vegetables
Luncheon
Fruits
meats
Processed foods: more Ready to eat
sodium less potassium cereals
212. Potassium and Hypertension
Potassium
– Prevent or help to correct HTN
Low potassium diets raise blood pressure:
– Hypertensive
• High potassium intake protects against stroke
215. Calcium Roles in the Body
99% of body’s calcium in bones
Bone structure
• Rigid frame
• Attachment point for muscles
Calcium bank
Readily available source
Readily to body fluids
217. Calcium in Bones
Birth to 20 years:
– Actively growing in
length, width, shape
12 to 29 years:
Peak bone mass
Bones growing thicker
and denser
• 30 to 40 years:
– Bone loss exceeds new
bone formation
218. Calcium in Body Fluids
1% circulates as ionized
calcium
Ionized calcium is vital to life
Regulation in muscle
contraction
Clotting of blood
Transmission of nerve impulses
219. Calcium in Body Fluids
Ionized calcium is vital to life:
Secretion of hormones
Activation of some enzyme reactions
Cofactor in a protein (calmodulin)
Conveys signals to the inside cells
Helps maintain normal blood pressure
220. Calcium and Disease
Prevention
Preventing and treating hypertension
– Epidemiological studies show low
dietary calcium correlates with high
prevalence of hypertension
• Relationship between dietary calcium
• and blood cholesterol, diabetes,
and cancer
221. Calcium Balance
Blood calcium falls too low,
3 organ systems may raise it:
– Intestines: absorb more calcium
– Bones: release more calcium
– Kidneys: excrete less calcium
222. Factors Influencing Calcium Absorption
Factors that Promote Factors That Interfere
Calcium Absorption with Calcium Absorption
Hormones that Diminished absorption
promote growth with aging
Ingestion with a meal; Lack of stomach acid
stomach acid Vitamin D deficiency
Vitamin D High phosphorus intake
Lactose High-fiber diet
Phosphorus in an Phytates and oxalates
optimal ratio
High protein intake
224. Calcium Recommendations
and Intakes
Internationally, recommendations vary
Calcium intakes are low in most of
world
WHO recommends:
– 400-500 mg per day (adults)
• Protein intakes are also low in most of
world
225. Calcium Sources
Most abundant in milk and milk products
Recommended daily milk servings:
Children 2 cups
Teenagers 3 cups
Adults 2 cups
Pregnancy (women) 3 cups
Pregnancy (teens) 4 cups
226. Absorbability of Calcium
Foods Ranked According to
Absorbability of Calcium
Excellent Cauliflower, watercress, brussels
sprouts, mustard greens, broccoli,
turnip greens, carrot, dates
Milk, soy milk, tofu*
Good
Almonds, sesame seeds, pinto beans
Fair
Spinach
Poor
*Calcium-set tofu
228. Calcium Deficiency
Bone mass peaks = skeletal maturity (30)
Dense bone mass is best protection against
age-related bone loss and fracture
Low calcium intake during growing years
impairs acquisition of optimal bone mass
Adults lose bone as they age (40)
229. Phases of Bone Development
Age in Years
Bone
10 20 30 40 50 60 70 80
Density
Time of
Peak Bone Mass
Bone Loss
Active Growth
230. Phosphorus Roles in the Body
Found in blood plasma as phosphorus
salts (Phosphates)
In all body cells as part of buffer
system
Phosphoric acid
Salts
Maintains acid-base balance
231. Phosphorus Roles in the Body
Phopholipids help transport other lipids
in the blood
Phospholipids are
major structural Cell Membranes
components of cell membranes
Effect transport of nutrients into and out of cells
Proteins, casein, contain phosphorus
in
232. Phosphorus Roles in the Body
Part of DNA and RNA
Genetic code material in every cell
necessary for all growth
• Assists in energy transfer
during cellular metabolism
– Enzyme and B vitamins activity
– ATP, uses three phosphates
233. Phosphorus Recommendations
Same as calcium, except
during infancy
Diets that provide adequate
energy and protein also supply
adequate phosphorus
236. Magnesium
1% in the extracellular fluid
Bone magnesium is reservoir to
ensure availability
Remaining magnesium found in
muscle and tissue
237. Magnesium Roles in the Body
Important to 300+ enzyme systems
Energy metabolism
Catalyst reaction - the reaction of ATP
Essential to the body's use of glucose
Synthesis of protein, carbohydrates
and nucleic acids
Cell's membrane transport system
238. Magnesium Roles in the Body
Muscle contraction and blood clotting
Calcium promotes processes
Magnesium inhibits processes
Regulates the functioning of the lungs
Prevent dental caries
Supports normal functioning of
immune system
239. Magnesium Deficiency
*Even when average magnesium intakes are below
RDA, symptoms are not apparent except with
disease
Protein malnutrition
Renal or endocrine disorders
Prolonged vomiting or diarrhea
Extensive use of diuretics
240. Magnesium and Hypertension
Magnesium ion is critical to heart
function
Protects against hypertension
protects against heart disease
deficiency causes walls of arteries and
capillaries to constrict- possibly contributing
to hypertension
Studies on magnesium show
intakes are lower in men who have
heart attacks
241. Sulfur
Part of some amino acids
Body does not use sulfur by itself
Methionine, and cysteine
Skin, hair, and nails
Severe protein deficiency will lack
sulfur containing amino acids
Thiamin and Biotin also contain sulfur
242. Trace Minerals: Overview
Body requires them in small, minuscule
quantities
Function similarly to minerals
– Assists enzymes in diverse tasks all over body
• Each has special duties that only it can
perform
243. Trace Mineral Food Sources
Content in foods unpredictable:
Soil
Water quality
Processed foods
Factors in diet and body affect
absorption and bioavailibility
Abundant in a variety of foods, whole
foods
244. Trace Mineral Deficiencies
Severe deficiencies of common
minerals more easily recognized
Mild deficiencies are easy to
overlook
Common result of deficiency
Children failure to grow and
thrive (GI tract, heart, bones, blood
muscles, CNS)
245. Trace Mineral Interactions
Excess of one trace mineral may cause
deficiency of another, e.g., Manganese
overload iron deficiency
Iron deficiency makes the body
much more susceptible to lead
poisoning
246. Trace Mineral Interactions
Deficiency of one may exacerbate problems
associated with deficiency of another
– Combined iodine and selenium deficiency
thyroid hormone production
Factors that enhance absorption of one may
decrease absorption of another
Vitamin C enhances absorption of iron but
depresses that of copper
247. Iron
Essential nutrient that is vital for energy
Accumulation in body causes harm
Iron is found in two ionic states:
Ferrous ion (reduced): Fe++
Ferric ion (oxidized): Fe+++
248. Iron Roles in the Body
Most of body’s iron found in two
proteins
Hemoglobin in the red blood cells
Myoglobin in the muscle cells
Iron helps accept, carry and
release oxygen
249. Iron Roles in the Body
Found in many enzymes that oxidize
compounds
Required by enzymes involved in
making part of all cells' metabolism
Amino acids, hormones,
neurotransmitters
250. Heme and Nonheme Iron
Heme iron found flesh of
animals
Meats, poultry, fish (40% heme,
60% nonheme)
10% of the average person’s intake
Well absorbed by the body at a constant rate
of 23%
Iron deficiency absorption
251. Heme and Nonheme Iron
Nonheme iron found in plant
and animal foods
Vegetables, fruits, milk
90% of the average person’s
intake
Absorption rates 2% - 20% and
influenced
by:
Dietary factors
Body iron stores
252. Heme and Nonheme Iron in Foods
From all
foods From
meats
only
me
He
Heme
Nonheme Nonheme Nonheme
Only foods derived All the iron in foods Dietary iron intake,
from animal flesh derived from plants daily average
provide heme, but is nonheme iron
they also contain
nonheme iron
253. Absorption Inhibitors
Phytates and fibers in whole
grain cereals and nuts
Calcium and phosphorus in milk
EDTA in food additives
Tannic acid (tea, coffee, nuts,
fruits, vege)
254. Adaptability of Absorption
10% -15% dietary iron is
absorbed
Absorption varies from person to
person
2% in person with GI disease
35% in a rapidly growing, healthy child
255. Adaptability of Absorption
Absorption adjusts to supply
and to need
Iron absorption is increased:
If the need increases (pregnancy)
If a person’s iron intake diminishes
256. Iron Recycling
Spleen
Average red blood cell live
3 months
Liver and spleen
Remove iron from blood, take it apart,
prepare for excretion or recycling
Liver
Iron is salvaged liver attaches it to
blood transferrin transports back to
bone marrow for new RBC
257. Iron Recycling
Body loses some iron daily
Via the GI tract
If bleeding occurs
Tiny amounts in urine, sweat,
shedded skin
258. Prevalence of Iron Deficiency
Worldwide, most common deficiency
Affects an estimate 15% of world’s
population with highest
prevalence in developing countries
Young children and pregnant
women
Iron deficiency Anemia.
259. Zinc
Cofactor by more than 100 enzymes in
every organ of the body
DNA and RNA
Manufactures heme for hemoglobin
Essential fatty acid metabolism
Releases Vitamin A from liver stores
260. Zinc
Cofactor by more than 100 enzymes in
every organ of the body
Metabolizes carbohydrates
Synthesizes proteins
Metabolizes alcohol in the liver
Disposes of damaging free radicals
261. Iodine
Iodine is indispensable to life
Needed in trace amounts
Iodine in foods is converted to
iodide ion in the GI tract
262. Selenium
Essential mineral that is an antioxidant.
Antioxidant effect may also benefit the
CVS and give protection against
Cancer.
Enzyme that converts thyroid hormone
to its active form
Not commonly found in food.
263. Copper
Body contains about 100 mg of
copper
1/3 is in the muscles
1/3 is in the liver and brain
1/3 is in the bones, kidneys,
blood, and other tissues
264. Copper Roles in the Body
Copper serves as a constituent of
enzymes
Enzymes catalyze oxidation of ferrous to
ferric ions
Iron metabolism makes it a key factor in
hemoglobin synthesis
Functions as an antioxidant
Formation of Myelin
265. Copper Roles in the Body
Copper serves as a constituent of
enzymes
Helps manufacture collagen and heal
wounds
Helps in the formation of Myelin sheath.
Mild Anti- Inflammatory effect
Oxygen Free Radical Metabolism
267. Chromium Roles in the Body
Helps maintain glucose homeostasis
Works with hormone insulin to facilitate
glucose uptake into cells and energy
release
Diets low in chromium may impair glucose
tolerance, insulin response, and glucagon
response
Glucose tolerance factor (GTF) enhances
insulin's action
268. INTER RELATIONSHIP BETWEEN
VARIOUS NUTRIENTS
NUTRIENTS ASSOCIATED WITH
VITAMIN A Requires ZINC for its release from the
Liver; needs FAT for its proper
absorption
VITAMIN D Works along with CALCIUM &
PHOSPHORUS ; together they ensure
proper Bone development needs FAT for
its proper Absorption
VITAMIN E Works synergistically with SELENIUM as
potent antioxidants . Needs FAT for its
proper absorption.
VITAMIN K Works in association with CALCIUM
thereby helping in Blood clotting. Needs
FAT for its proper Absorption
269. INTER RELATIONSHIP BETWEEN
VARIOUS NUTRIENTS
NUTRIENTS ASSOCIATED WITH
VITAMIN C Crucial for IRON Absorption
FOLIC ACID Aids in IRON Absorption;
Also ↓ Homocystein levels
COPPER Aids in IRON Absorption
MAGNESIUM Works with CALCIUM to Promote
Bone Growth & Muscle
Contraction
PHOSPHORUS Associated with VITAMIN B1, B2
B3, B6 for their Co-enzyme
Activity
270. Diet & Disease
SOME FACTS
By 2020, scientists
expect 40 million
Americans will suffer
from Osteoarthritis.
1 in 8 people living in
Indian metros suffer
from diabetes!
271. Causes of Death
Infectious diseases
– TB, diarrhea, malaria,
AIDS
Cardiovascular
– Heart, coronary,
cerebrovascular
• Cancer
• Respiratory
272. Leading Causes of Death in 2004
Deaths in India per 100,000 population in Year 2004
14.9 (2%) 12.3 (2%)
Diabetes Nutritional
72.6 (11%) 113.6 (17%)
deficiencie
Perinatal conditions s Infections diseases
(tuberculosis, diarrhea, HIV/AIDS, malaria)
)
Infectious Diseases
Circulatory disease
Cancer
Respiratory
Perinatal
Diabetes
Nutritional Deficiencies
107 (16%)
Respiratory 267.7 (41%)
71 (11%)
Circulatory diseases
Cancer disease/conditions
(coronary heart, cerebrovascular)
)
(lung, stomach, colon and rectum, liver, breast)
273. Diet and disease
Obesity
1.2 billion people in the world are
overweight
300 million of them are Obese
274. Diet and disease
How to calculate BMI
BMI = weight in kg /height (mts x mts)
BMI > 18.5 is underweight
18.5- 24.9 is normal weight
25.0 – 29.9 is overweight
30.0 – 39.9 is Obese
40.0- and higher is severely obese
275. Hazards of Obesity
Adult Children
Pre mature deaths Bowing of legs because of
Maturity onset diabetes weight
Pain in the hip joint Sever headache can lead to
vision loss
Heart disease
Suffer daytime sleepiness
Hypertension
Breathing difficulty during
Cancer
sleep
Fatty Liver disease
Obese female may develop
Vascular disorders polycystic ovary disease
Thrombosis chances of diabetes
Obstructive Sleep Apnea Hypertension
Musculoskeletal problems Gall bladder disease
Gastro esophageal reflux Raised blood cholesterol
276. Obesity may lead to……..
Hypertension
Heart diseases
Diabetes
Increased blood cholesterol levels
Breathing difficulty
Stroke
High rate of certain type of cancer
Fatty liver
Vascular diseases.
Reproductive problems in females
277. Childhood Obesity ……..
Obesity among Children is on the rise
from 1998 to 2006
2-5 yrs prevalence increased 5%- 13.9%
6-11yrs prevalence increased 6.5%- 8.8 %
12-19yrs prevalence increased by 5%-17.4%
279. Childhood Obesity ……..
Factors that lead to childhood obesity.
Genetic factors or some genetic Disorders
Underlying illness (Hypothyroidism)
Eating Disorders
Certain Medication
Sedentary lifestyle
Psychological/Emotional Disturbances
281. Preventing Obesity ……..
Tips to parents
• Children do not need to finish every
bottle or meal.
• Avoid prepared and sugared foods when
possible
• Limit the amount of High calorie foods
kept in the home
• Provide a healthy diet with 30% or fewer
calories derived from Fat
282. Preventing Obesity ……..
Tips to parents
• Provide ample fiber in the child’s diet
• Skimmed milk may safely replace whole
milk at 2 yrs of Age
• Do not provide food for comfort or as a
reward.
• Limit the amount of T.V. viewing
• Encourage active Play such as walks,
ball games etc
298. Major Risk Factors for CVD
Cigarette smoking
High blood pressure
High levels of cholesterol
and fat in blood
Family history of heart
disease
Male gender
Increasing age
300. Compounding Risk Factors
Cigarettes
and
Cholesterol
and
Cigarettes High Blood
and Pressure
Cigarettes Cholesterol
None
301. Coronary Risk Factors
Modifiable Fixed
Hypercholesterolemia Family history
Hypertension Age
Smoking Menopausal
females without
Physical inactivity hormone
Diabetes mellitus replacement
Low LDL
Obesity
302. To Reduce Your Risk
• Control High Blood
Pressure
• Do NOT smoke
• Follow proper diet
303. ALSO: To Reduce Your Risk
Exercise regularly
Have regular
medical check-ups
Identify and treat
diabetes
304. Triglycerides
Triglycerides are the fat in food
we eat
Our bodies manufacture and
store triglycerides when we eat
more calories than we need
305. Saturated Fatty Acids
Saturated fatty acids are the
main culprit in raising blood
cholesterol levels
306. Dietary Recommendation
Total fat intake should be less than
30% of calories
Saturated fatty acid intake should
be less than 10% of calories
307. Dietary Recommendation
Monounsaturated fatty acids should
make up 10% - 15% of total calories
Monounsaturated fatty acids seem to
lower blood cholesterol if the diet is
low in saturated fats but still provide
fat-dense calories
308. Proper Mix of Fat in Diet
Up to 10% polyunsaturated
Less than 10% saturated
Balance from monounsaturated
309. Trans Fatty Acids
Tend to raise LDL cholesterol
levels
Major sources:
Margarine
Vegetable shortening
Fast foods
Baked products
311. Dietary Treatment for Coronary Heart
Disease
Less than 7% of calories as saturated fat
Less than 200 mg per day cholesterol
30% or less of calories as total fat
55% or more of calories as carbohydrate
15% of calories as protein
312. Dietary Treatment
3 to 4 teaspoons servings of fat
and oils per day
Use cooking methods with little
or no fat (bake, broil, roast,
steam, poach,
sauté, or
microwave)
Trim visible fat before cooking
meat and poultry, drain
313. Dietary Treatment
Limit use of organ meats
Choose skim or 1% fat
milk, nonfat or low-fat
yogurt or cheese
Limit intake of saturated
fatty acids
Read labels for amount and
type of fat
315. Salt/Sodium
Use less salt at the table and
in cooking
Use herbs, spices instead of
salt
Limit intake of foods high in
added sodium
Look for unsalted varieties of
foods
316. Lifestyle Modification
For Control of Hypertension
Reduce weight if necessary
Limit daily intake of alcohol
Reduce daily sodium intake to
<6 grams NaCl (salt) or <2.4
grams sodium
Exercise regularly
320. Diabetes Mellitus
A clinically and genetically
heterogeneous group of
disorders that is characterized
by elevated blood glucose.
321. What Causes Diabetes?
Causes and cures remain unknown
Researchers believe tendency is
present at birth
Who is most likely to get diabetes?
People over 40
Women with a high birth weight baby
Overweight
Family History
322. Types of Diabetes
Diabetes Mellitus
Type I (IDDM: Insulin dependent)
Type II (NIDDM: Non-insulin
dependent)
Diabetes Insipidus
Gestational Diabetes
323. Type I (IDDM) Diabetes
Juvenile diabetes
Pancreas makes little or no insulin
Insulin dependent diabetes
Appears suddenly and worsens
rapidly
325. Type II (NIDDM) Diabetes
Makes enough insulin but the
body does not use it effectively
Usually occurs in adults after age
40
Non-insulin dependent diabetes
Develops slowly and can go
undetected for years
327. Diabetes Insipidus
Kidney’s inability to conserve water
Failure of the hypothalamus to release
ADH
Large amounts of urine
Change in appetite
Loss of strength
Emaciation
328. Classification of Diabetes
Type I ~5%
~6% of population
Type II ~95%
GDM ~2% - 4% pregnant women
IGT ~11% of population
329. Screening for Diabetes
Fpg* (MG/DL) Significance Action
<115 Normal Retest in 3 years
116 - 140 IGT 1. Additional testing
2. Check risk factors
3. Medical nutrition therapy
>140 Diabetes likely 1. Confirm by second FPG
2. Treat diabetes
*Fasting plasma glucose
330. What Problems Face a Diabetic?
• Maintaining blood sugar levels
- Measuring blood - Diet
Insulin injections Medications
Exercise Weight
• Organ failures:
- Eyes - Kidneys
Nervous system Blood vessels
Heart disease Stroke
331. How Do We Treat Diabetes?
Type I
Exercise
Diet
Injected insulin
Fast acting
Moderate
Long acting
332. How Do We Treat Diabetes?
Diabetes insipidus
Usually patient is comfortable
except with annoyance of
frequent:
Need to drink
Need to urinate
333. Type II Diabetes
Non-insulin dependent
Insulin secretion insufficient or excessive
Tends to occur after age of 40
80% are above ideal body
weight
334. Benefits of Weight Loss
Reduces blood pressure
Reduces serum
triglycerides, total
cholesterol
Increases HDL-cholesterol
Reduces blood glucose
levels
335. Obesity
Object 10
Obesity is the most important,
modifiable risk factor for type 2
diabetes
BMI greater than 35
risk for type 2 diabetes
by 93-fold in females
BMI greater than 35
risk for type 2 diabetes
by 42-fold in males
336. Indications for Insulin in Type II
Ineffectiveness of:
Meal plan
Physical activity
OHAs
Endogenous insulin
As therapy for an acute
medical condition
337. Treatment Obese, Non-Insulin
Dependent
Meals coordinated with insulin
Weight reduction*
Regular exercise
*May eliminate or reduce need for insulin
339. Benefits of Exercise
Improved fitness
• Flexibility, endurance, strength
• Reduces cardiovascular risk factors
• Dyslipidemia, hypertension, obesity
• Lowers blood pressure
• type II and IGT
• psychological well-being
340. Goals of Medical Nutrition Therapy
Achieve blood glucose goals
Achieve optimal lipid levels
Provide appropriate calories for:
Reasonable weight
Normal growth and development
Pregnancy and lactation
Prevent, delay, or treat nutrition-
related complications
Improve health through optimal
nutrition
345. Nonnutritive Sweeteners
Aspartame, acesulfame-K, saccharin
Safety based on Acceptable Daily
Intake
ADI: amount of a food additive that can be safely
consumed on a daily basis over a person’s lifetime
without any adverse effects
Includes a 100-fold safety factor
Average intake of aspartame ~4% ADI
Safe for use, including pregnancy
347. Oral Hypoglycemic Medication
Increases sensitivity of
receptor to insulin
Stimulates pancreas to
increase production of insulin
Picture 4
348. Effects of Adequate Insulin on
Protein Metabolism
Anticatabolic
– Proteolysis
– Gluconeogensis
Anabolic
– Protein synthesis
• Amino acid transport
349. Diabetes-Related Conditions Requiring
Medical Nutrition Therapy
Hypertension
Nephropathy
Gastroparesis
Diabetes complicated by
surgery
Macrovascular complications
Obesity
350. Nephropathy
Type I diabetes ~35%
Type II diabetes ~ 20%
Accounts for ~35% of
new cases of end-
stage renal disease
(ESRD)
351. Syndrome X
Obesity Genetics
(Upper Body)
Insulin Resistance
Hyperinsulinemia
Dyslipidemia Hypertension
Glucose Intolerance
(IGT and Type II)
352. Lipoprotein Abnormalities
Related to Diabetes
• TG and VLDL (type II)
• HDL-C
• Cholesterol and LDL-C
similar to general public
• Chylomicron clearance
353. Select Meal Planning Approaches
General guidelines
Menu planning systems
Exchange systems
Counting systems
355. Menu Planning Systems
• Benefits:
Gives specific
instructions
Simple to use
Variety of choices
May include recipes
356. Exchange Lists
• Benefits:
Groups foods with similar nutrition
content
Teaches portion control
Can adjust calories
Teaches about CHO, fat, and protein
Cookbooks based on exchanges
358. Factors Affecting
Blood Glucose Levels
• Insulin deficiency • Too much insulin
or resistance or OHA
• Food • Not enough food
• Glucagon or other • Unusual amount
CRH of exercise
• Stress • Skipped or
• Illness delayed meals
• Infection
373. What Can We Do to Decrease
Environmental Risks?
Remove radon and
asbestos
Better chemical
control
374. What Roles Does Diet Play in Cancer?
Difficult to determine
Causation versus correlation
Salt
Fats*
Food preparation and storage
Microbes and cancer
375. How Can We Use
Diet to Decrease Cancer Risk?
Fiber*
Good nutrition
Preservatives
Antioxidants
376. Why is Cancer So Deadly?
Detection
Invasion
Metastasis
377. What Makes Detection
So Important?
Currently a cancer may be
in the body for up to 20
years
Kills normal cells
Goes elsewhere in the
body
378. What is Invasion?
Benign tumors
Cysts: displace normal tissue
Malignant tumors
Invade normal tissue
Disrupt organ function
Invades blood vessels and lymph
379. What is Metastasis
Spread of cancer
throughout the body
Blood vessels
Lymph system
The real killer
383. Cancer Prevention
60-70% of all cancer cases
could be prevented through:
Sensible dietary choices
Maintaining a healthy body
weight
Keeping physically active
Not smoking
387. Antioxidants
¢ Population studies show that high
intake of Plant foods (fruit and
vegetables) is associated with reduced
risk of cancer and heart disease
¢ Plant Foods are rich in antioxidants as
flavonoids, Vitamins E and C, and
Carotenoids
391. Phytochemicals
Chemicals in plants that have
nutrient or other functions.
Dietary Sources
• soy, oats, tea, grapes, garlic, tomato
Supplements Sources
ginseng, echinacea
392. Activities of
Phytochemicals
Antioxidants Genetic
Enzyme Modulation Anti-Inflammatory
Cell Proliferation Endocrine function
Angiogenesis Platelet aggregation
Vascular Reactivity
403. How Does Virus Affect Us?
Targets immune
cells
Kills lymphocytes
Stored in macrophages
Lose immune
system
404. How Do We Lose Our Immune System?
Virus invades lymphocyte (helper)
Moves to cell nucleus
Takes over cell DNA
Cell makes too
much virus
Cell dies
Virus spreads to more lymphocytes
405. What Kills an AIDS Patient?
Infections:
"opportunistic
infections"
Diet problems
Organ failure
406. How Can We Prevent AIDS?
"Safe sex"
Clean needles
Common sense
414. Why Nutrition?
Optimize immune function to
minimize disease progression
Manage symptoms to reduce risk
weight loss and wasting
Component team-based approach
to managing HIV/AIDS disease
415. Wasting; A Definition
Involuntary weight loss greater than
10% baseline body weight + either
chronic diarrhea or chronic weakness
and documented fever in the absence
of concurrent illness or condition other
than HIV infection
416. Link between Malnutrition and HIV/
AIDS
Malnutrition
wasting
Increased requirements Decreased
Decreased Intake Immunity
Increased losses
HIV
Opportunistic Infections
Increased risk of mortality
417. Causes of Malnutrition
Calorie intake
Nutrient absorption
Altered energy
expenditure
Hormone and nutrient
dysregulation
Malabsorption
Change in physical
activity
418. Dietary Changes to Treat:
Increased lipids
Weight loss
Diarrhea
Increased triglycerides
Increased blood glucose
Taste changes, nausea,
swallow difficulties
419. Nutrition Goals
Preserve BCM
Adequate nutrients and fluid
Manage side effects of
medications
Address symptoms to avoid
nutritional consequences
Nutrition and exercise are key
factors to maintaining and
restoring lean tissue stores
420. Malabsorption
Signs and symptoms
Weight loss
Nutrient deficiency
Abdominal distention, gas, discomfort
Fullness, early satiety
• Consequences
– Compromised immune function
and metabolism
– Reduced medication tolerance
421. Common Nutrient Deficiencies
Total Calories Vitamin E
Vitamin A Folic Acid
Vitamin B6 Magnesium
Vitamin B12 Selenium
Zinc
422. Possible Interventions
Exercise intervention
Food supplements
Vitamin, mineral, protein
supplement
Appetite stimulants
423. Other Concerns/ Early Interventions
Lack of appetite Chronic diarrhea
Taste changes Nausea and
Mouth sores, vomiting
dryness GI discomfort
Lactose Swallow
intolerance difficulties
Lipo-dystrophy
425. Supplement Tips:
Natural versus synthetic
conclusive research remains
to be done
Fat soluble stored by liver
Absorbed better with food
Part of a healthy diet not to
replace a bad one
426. Food Sources Antioxidants
Vitamin E
Foods
Vegetable oils
Fortified cereals
and breads
Almonds
Avocado
whole grains
427. Food Sources Antioxidants
Selenium
Foods
Seafood
Eggs
Organ meats
Chicken
Cereals and breads
Lean meats
Beans
whole grains
429. Food Sources Antioxidants
Vitamin C
Foods
Citrus fruits Green peppers
Strawberries Mango
Broccoli Kiwi
Fortified cereals
Brussels sprouts
430. FOOD SCIENCE AND TECHNOLOGY
Food Science:
Knowledge and understanding of the
nature and composition of food
material.
431. Food Science
• It integrates various
Contributory sciences to
the application to food
• Chemical composition of food material
• Human nutritional requirements and the
nutritional factors in foods
• Nature and behavior of enzymes
• Microbiology of foods
• Pharmacology and toxicology of food
materials
• Additives and contaminants
• Effects of various manufacturing
processes and storage conditions
432. Food Technology
Integrates application to foods
and other technology such as
tinplate, steel, plastic,
aluminum, electronics,
biotechnology, agriculture
Factors important to safety
levels of food
Effects of globalization
Effect on agriculture
433. Role of Agriculture in Food production
• Almost everything we eat starts with
planting of a seed .
– Plants that we eat or livestock eat
• Alternate agricultural techniques.
Reduction in the use of chemical pesticides and
fertilizers
Impact of Agrichemicals on environment and foods
434. Alternate Agriculture Methods
Integrated Pest Management
Pesticides used when pests
reach predetermined
threshold levels
Pest resistant plant varieties
are used
Planting time adjusted
Crop rotation
Biological controls – lady
bugs , parasitic wasps to
control pests
437. Organic Farming
Minimal use of Chemical
fertilizers and pesticides
Standards for allowable,
restricted prohibited
material
438. FOOD SAFETY
Protection of food from
Microbial, Chemical hazards
are Contamination.
ROLE OF FOOD SAFETY
AGENCIES:
Establishment of Safety Standards
Monitoring and Inspection
Enforcement
Tracking Food safety problems
Hinweis der Redaktion
Nutrition begins with food.
Nutrition is a science as it has its roots in the research of many fields including medicine, physiology, chemistry etc. It is not static. It is a growing science which is changing & expanding with the findings of research on which it feeds.
Similar foods are grouped in one food-group.
Food pyramid is a guide to good eating. It recommends having fewer portions of food near the top and more of the foods near the bottom of the pyramid.
Break down of food from complex molecules to simple molecules The nutritive value of food relates only to the edible portion of the food stuff Nutritional requirements differs with age & sex & physiological conditions like pregnancy, lactation, adolescent. When cultures are old and tradition rules the way of life.
On the bases of similarities of content and function it has been classified as under six classes.
Comparison of different nutrients of foods and of body are given here.
Carbohydrates- Rice, Chapattis, Sugars, Potatoes, all Cereals such as Maize, Ragi Fats - Butter, Ghee, Cooking oils, Magarine Proteins - Milk and Milk products, Eggs, fish, poultry, pulses,meats Dietary fibers - Whole grains, fruits, green leafy vegetables Water - Water is an important nutrient since it acts as an emulsifier
Vitamins and Minerals are abundant in fruits and vegetables, Milk and egg , sprouts These very fruits and vegetable have a very important Nutrient which is called Phytonutrients. These Nutrients are present in the colours of the skin of the fruits and Vegetables. They say that a person will benefit if he consumes food comprising of all the colours.
Vitamins and Minerals are abundant in fruits and vegetables, Milk and egg , sprouts These very fruits and vegetable have a very important Nutrient which is called Phytonutrients. These Nutrients are present in the colours of the skin of the fruits and Vegetables. They say that a person will benefit if he consumes food comprising of all the colours.
Minerals are inorganic substances. Their form remains same. While CHO, proteins, fats & vitamins are organic substances.
The body uses energy in 3 ways--- Body uses energy for external activities- every voluntary move requires energy For internal activities- involuntary processes such as heart beat, breathing & circulation etc. For storage of energy- yielding materials chiefly during childhood & pregnancy.
Carbohydrates, fats & proteins & other nutrients are released from food during digestion, then absorbed into the blood stream and converted into glucose/blood sugar.
Calorie is not a nutrient. It is served as a convenient measure of the energy. One calorie is the amount of energy needed to raise the temperature of one gram of water by one degree celcius.
When food is burned in our body cells provides our bodies with energy, which is utilized for internal & external activities of the body.
What food will give energy? Ans – Fats, sugar, Carbohydrates (CHO) Excess consumption of the above will convert into Fat and stored in the body. Excess energy is stored as fat in adipose tissues and as glycogen in liver.
Water is clear, colourless, tasteless, odourless, liquid. It gives no calories yet it is fundamental to all life on earth.
The delicate organs like heart, lungs, brain are covered by double layer which has fluid in it & protect them from external shocks. Heat is eliminated by means of evaporation of water from the lungs & from the surface of the skin. Water is an important constituent of blood. It also gives volume to the blood. All lubricants in the joints has water as the major portion.
Water is the chief solvent of the nutrients. Nutrients are reduced to a liquid state in digestion, in preparation for absorption. Water brings digestive- juices or enzymes into the digestive tract and carries the product of digestion from intestine into the blood, which is largely composed of water. The blood distributes nutrition to the cells and finally some of the waste products from the cells are removed from the body in the urine which is largely water.
Keeping the water balance is more important for staying healthy than food, sleep, or anything else. If you run low on water, salt, or other fluids or have much to much of any– the body is in serious danger.Intake of water in various forms as shown in left colomn is almost 2800 ml per day. But body excretes almost the same amount ( shown in right colomn) This means that one needs to take more water to maintain a healthy body.
We consume water along with meals. Our meals are cooked in water medium. Water is consumed according to the activities, like vigorous or moderate activities. Water consumption is also directly proportionate to the temp. around us and so is the humidity. Among adults men need more water than females.
Body needs water even if you do not feel thirsty. Any beverage can full-fill the requirement but this cannot be compensated with alcohol, tea, coffee as caffeine act as diuretics (diuretics means that make you urinate more frequently).
Plants are the original source of all food proteins. Plants make their own proteins by combining raw materials like nitrogen, carbon, hydrogen, oxygen & energy for the task is obtained from the Sun. Animals eat these plants and build their body proteins.
Structural proteins include the collagen of connective tissues, the fibrin of a blood clot and the myosin of muscles. Elastin is found in the protective and supportive tissues of animals such as skin. Keratin contains 11% of the sulphur-containing amino-acid.
The tissues of the body are under constant repair. The rate at which they are broken down and replaced very greatly. It is impossible to give a reliable figure for the rate of proteins replacement of the entire body. Amino-acids liberated by the break down of old proteins can be re-utilized to synthesize new proteins.
All amino-acids are characterised by the presence of a carboxyl (COOH) group with acidic properties and an amino(NH2) group with basic properties, attached to the same carbon atom.
Histidine is believed to be essential for children which is one of the essential amino acid.
The adult human body can maintain nitrogenous equilibrium on a mixture of 8 pure amino-acids as its sole source of nitrogen.
Food protein is acted upon by number of digestive juices and enzymes then converted into amino-acids, the simpler form of it, then is absorbed by the body.
Protiens are digested to form Proteoses,Peptones,Polypeptides and Amino Acids. Digestion of Protiens in fried foods is slower because of delayed gastric emptying and the fat envelope requires digestion in the small intestine before the protein splitting enzymes act. In the stomach the enzyme Pepsin breaks down proteins into Proteoses and Peptone in the presence of HCL. This Proteoses and Peptones are further acted upon by the other enzymes and releases small Peptide chains and Amino Acids. These Amino acids are taken up by the blood stream and transported to the different parts of the body.
In this chart we see that Soya bean has the highest amount of Nitrogen which signifies that it is the richest source of Protiens among Pulses and Legumes.
The carbohydrates are a class of chemical compounds composed of C,H,& O. They contain 2 atoms of hydrogen and 1 atom of oxygen.
Monosaccharides- contains 3-6 atoms of carbon in each molecule. Disaccharidies- It is derived from 1 mole. Of glucose combined with 1 mole. of fructose which can split by hydrolysis in the process of digestion.
Glucose (grape sugar) Starch consists of glucose in combined form.
This is the animal equivalent of starch and is found in human tissues. The glycogen mole. Is composed of 3000-60,000 glucose units. Like starch this also dissolves in water and readily broken down by the enzyme to yield glucose.
Fibers are not considered a nutrient but it is still a component of food that promotes good health. It is a complex mixture of indigestible CHO material.
This can be explained and can be used later as an exercise at the end of “Vitamin” chapter as part of revision. There are play cards available for the same or chart paper can be used by each team,
Fats contain C, H, & O. They supply more energy than CHO & Proteins because they contain more combustible carbon & hydrogen. Thus they are the concentrated source of energy.
TG is the form in which fats chiefly occur in food stuffs and in the fat depots of most animals. TG are the esters of glycerol and FA. FA- over 40 different FA are found in nature. The natural fats are or TG are formed from 1 mole. of glycerol and 3 mole. of FA. These are 3 naturally occurring types of fats. After TG the next largest lipid component of the body are the Phospholipids. They form the important part of the structure of the cell-membrane. Sterols are the important biological substance.
Vegetable oils can be hardened and turned into solid fats by the action of hydrogen in the presence of a catalyst. This hydrogenation converts most of the unsaturated FA into saturated FA.
EFA are necessary for growth. Like AA they cannot be synthesized by the body and have to be supplied in the diet. Linoleic & Linolenic acid are of vegetable origin. (linoleic-omega 6 FA, linolenic-omega 3 FA).
Arachidonic Acid is a Essential Fatty Acids( EFA) with 4 double bonds. This EFA is synthesized from linolenic acid in fish and animals.
Linoleic and Linolenic Acids are of vegetable origin and are present in Cotton seed, groundnuts and Linseed oils, while Arachidonic acid is synthesized from Linolenic in Fish and animals. Oils from Fatty fish are rich in the long chain n-3 PUFAs and EPA and DHA. The n-3 PUFA Linolenic acid can act as a precussor for EPA and DHA. Linseed oil is particularly rich in this nutrient.
They form part of the structure of cell membranes and are concerned in the transport of fat about the body. Phosphatidyl choline is the predominant substance of lecithin. Lecithin is also the predominant phospholipid in plasma.
Sterols are impt. & widely distributed class of biological substance, all of them have the same basic ring structure. Ex. Cholesterol, Bile salts, Ergosterol.
These are the rich sources of cholesterol.
Physiology tells us how organs and cells function and is further divided into-----------
At simplest level all living beings are made up of atoms such as O,N,C,& P. When atoms are grouped they form molecules like water, salt, fats, proteins, sugars. Molecules associates to form the organization called cells. There are different types of cells. We say cells are the functional unit of the body. Cells are unified into units called as tissues. Similar type of tissues are organized in functional unit called organs and organs work together in a unit called system. Thus we see the organizational unit of cell and increasing with complexity– this is the process of physiology.
Cell membrane is the outer most component of the cell. This membrane is made up of proteins & fats. It does not allow the unwanted material to get in and the required material to g out. Thus acts like a guard.
Most materials get into the membrane by two methods. 1--- Passive diffusion 2--- Active transport.
Cytoplasm is found in the inner part of the cell. Organelles are found in cytoplasm which perform different functions. Mitochondria- The power houses of the cell. Endoplasm- Converts the amino acids into proteins Lysosomes- Its main function is to collect the cell waste & remove it.
Nucleus contains chromosomes, GENES, DNA & RNA. It contains the information of our physical characteristics.
The energy is produced from food that we eat. Mitochondria is responsible for producing energy that cells need.
The food releases energy through a series of chemical reaction through a process called METABOLISM. Metabolism is of two types--- Anabolism & Catabolism.
In case of catabolism (catabolic metabolism) the large complex chemicals are broken down into smaller chemicals which releases energy and then stored as ATP. The main site of catabolism is mitochondria and ATP’s are stored here.
Glycogen is a complex molecule consisting of many glucose units. Its main site of storage is liver.
Digestion of food starts from mouth. It has to pass through various organs of our body where it is acted upon number of digestive juices and enzymes before it is assimilated in the body.
Chewing breaks down the cellulose envelope and make starch and sugar available for subsequent digestion.
Saliva contains a starch splitting enzyme (ptyalin) which converts starch into dextrin and liberates some maltose. This food is passed by the epiglottis and enters into the esophagus and then to stomach.
Epiglottis is a muscular piece of tissue that blocks food from going into our lungs when we swallow food.
Esophageal sphincter separates the esophagus from stomach. This keeps the content of the stomach from going back into the esophagus. The stomach churns the food into a liquid called chyme. At this stage the stomach produces acid, mucus & pepsin. Acid– important for the digestion of the food. Mucus– protects the stomach from eating itself up. Pepsin– important in the digestion of proteins.
When the peristaltic movement occurs in opposite direction it is said to be reflux or regurgitation, i.e; removing of food from stomach back to esophagus and mouth. If it occurs too frequently it can be damaging to the esophagus or mouth. Bulimia--- Forced vomiting done to loose weight---- this can severely damage both the esophagus and teeth. Gastrectomy----- removal of some part of the stomach due to some reason. In such case stomach cannot hold much of food and produce chyme and digestion is also not as good as it should be.
Liver is the largest organ in our body. It is also called the master organ. It plays an important role in the absorption of fats, vitamins, production of bile-salts, proteins such as albumin, globulin and synthesis of cholesterol.
Its main role is the regulation of blood sugar by producing insulin in the body. It produces number of enzymes which helps to digest the food efficiently. Insulin is a hormone. Lack of insulin results in a disease called Diabetes. There are two types of diabetes---- type I & type II.
The primary function of the urinary system is the regulation of water and minerals in the body. The kidneys are been shaped which acts as a filter of our body. First water and minerals are taken out of the nephron and sent back into the blood. The unwanted chemicals, water & salts are excreted out as urine. We produces about 1500 ml of urine every day.
When we sweat more kidneys respond by producing less urine and reabsorbing more water and minerals. When a person has high BP, increasing water excretion can decrease the BP by the kidneys. As the kidneys produces more urine, more water is removed from the body and BP will go down. When we take drugs or are exposed to chemicals our body must get rid of them. In that case liver and kidneys usually work together. The chemicals first go to liver where it is processed and then sent to the kidneys to be excreted.
The process of exchange of oxygen and carbon dioxide between the atmosphere and the body cells during inspiration and expiration is called respiration. Respiratory system consists of nose, trachea, bronchioles and lungs.
Pharynx connects the nasal passage with the larynx. Larynx has tonsils in it, which filters out bacteria in the air and removing them before they get into the body. At the end of the tube the larynx divide into two tubes--- the trachea and esophagus which has epiglottis that works like a lid. The trachea is a stiff tube that runs from the pharynx to the bronchia. Trachea is connected to bronchioles. These bronchioles separate and deliver air to each lung. Lining the bronchioles are mucus coated flaps of skin called cilia. Their function is to trap particles before they reach the alveolus.
Lungs has tremendous surface area equivalent to a tennis court. The lung functions as a gas exchange process. The exchange of gases takes place in alveolar sacs. The exchange of atmospheric oxygen with the carbon dioxide of the body cell occurs during inhalation and exhalation.
The oxygen that enters the lungs are taken up by the hemoglobin, trapped inside the RBC in the blood. Oxygen is required for cellular metabolism which releases energy for cellular activities. As the cell produces the energy it also produce carbon dioxide that must be removed from the body. The blood carries this carbon dioxide to the lungs from where it is removed
Blood leaves the heart in a series of vessels called the arteries and returns to the heart in a series of vessels called the veins. Blood leaves the heart through aorta which divides further into smaller and smaller blood vessels till they form capillaries. Arteries and arterioles have smooth muscles around them which give them elasticity. When heart contract the blood is forced out into the arteries (systole) and the arteries expand. When the heart relaxes (diastole) the blood stops entering the vessels by the blood vessels relax.
The capillaries of the arterial system join with the smallest vessels of the venous system called venules. These venules give rise to veins which bring back deoxygenated blood back to heart. The venous system has much less muscles & less pulsing pressure compared to the arterial system. Blood also flows smoothly in veins as the pulsing pressure is less.
The pressure of the blood with in the arteries primarily maintained by the contraction of the left ventricle of the heart. When we measure the BP we get two values the systolic and the diastolic blood pressure. When the heart contract we get systolic pressure & and when the heart relax we get diastolic pressure.
Blood is a liquid which contains RBC, WBC, Platelets, Plasma, oxygen etc. The hemoglobin of the RBC is responsible of carrying oxygen to tissues. The lower count of hemoglobin results in anemia. As the blood travels through out the body the level of oxygen falls & as the blood goes to the lungs oxygen is left very little. When this deoxygenated blood goes through lungs again oxygen binds back to the hemoglobin.
White cells are members of our immune system & protect us from infections before they cause disease. Platelets are important for our survival. It helps in the clotting of blood. If there is any cut, platelets accumulate at the cut and plug it.
Plasma is the fluid portion of the blood. It constitute about 55% of the total blood volume. Plasma is a solution of water, proteins, sugar, salts, hormones and vitamins.
These are the two major divisions of nervous system, CNS– The brain and spinal cord. PNS--- 12 pairs of cranial nerves and 31 pairs of spinal nerves.
The spinal cord serves as a coordinating center for reflexes and connects the PNS with the CNS. The brain is the primary center for regulating and coordinating body activities. In an adult it weighs about 3 pounds and has many different parts performing different functions.
Spinal nerves come from the top and the bottom of the spinal cord. The top nerves controls our senses and the bottom nerves controls our muscle actions. White & gray matter are the two regions. Spinal cord and the brain are covered by 3 layers called meninges.
Spinal nerves come from the top and the bottom of the spinal cord. The top nerves controls our senses and the bottom nerves controls our muscle actions.
Brain– Site of consciousness, sensation, memory and coordination. It receives the information from the spinal cord and cranial nerves and prepares a response to the information. The brain can also formulate a plan of action without the external stimulus. The outer portion of the brain has gray matter and the inner portion has white matter.
These are the 3 major portions of the brain. Cerebrum-- is the largest part. It is the center of reasoning and memory and defines a persons intelligence and personality. It also controls all five senses, muscle action, learning, logic, creativity. Cerebellum– is a large mass of gray and white tissues that serves as the coordinating center for motor activity. Brain stem– connects the cerebrum with spinal cord. Brain stem is a complex of several smaller parts such as pons & medulla oblongata.
PNS stands for peripheral nervous system and is sub-divided into two components------1- Autonomic nervous system. 2- Sensory somatic nervous system. ANS- We have no control over this system. ANS has two sub units sympathetic and parasympathetic nervous system. The sympathetic nervous system function is to maintain our ability to have an effective fight or flight response, while parasympathatic nervous system serves to keep our body in calm state.
Sensory nerves carries information from our five sense organs and the responses of our CNS back to skeletal muscles & the organs in the body. Somatic muscle nerves (spinal nerves) control much of our skeletal activity.
Muscles connect with bones through tendons. When muscles contract or relax the bones move and our body moves. We can control the information going to the skeletal muscles and thus called voluntary muscles. Skeletal muscles are also called voluntary muscles. The red muscle fiber contains myoglobin similar to hemoglobin and can work for a long time without becoming tired. White fibers respond quickly but tires rapidly. Somatic nerves cells respond most rapidly to nervous stimulation.
Smooth muscles are involuntary . These muscles are most frequently found in Visceral Organs and Blood vessels. No conscious control over these muscles. These cells contract and relax in a group and not as individual cells. These muscles make the heart work as a pump.
For contraction and relaxation of muscles they need energy, ATP and certain minerals like Ca, K for proper muscle function.
This system is made up of skin, hair, nails and glands. Epidermis is the outer layer, tightly packed cells and no blood vessels. Dermis is the second layer and has blood vessels Skin serves the barrier in three ways.
Melanin is a skin pigment that protects our skin from sunlight. Skin allows us to lose heat from our body by sweating & evaporation & from blood by dilating blood vessels close to skin surface.
Synthesizing vit.D from sunlight is one of the important function of the skin. Skin is a sense organ that tells us about pressure, touch, pain, heat and send the information to the CNS for the body to respond.
Vitamins are special chemicals found in food.
Vitamins are organic substances which the body require in small amounts to perform specific functions that promote growth, normal metabolism, reproduction and normal maintenances of health and life.
Vitamins do not supply energy but are essential to metabolic activities and help in the utilization to the proximate principles. They are also involved in the utilization of the major nutrients like proteins, CHO & fats.
Substances that occur in foods which are not themselves vitamins, but are capable of conversion into vitamins in the body e.g; carotens are the pro-vitamin of vitamin A.
Vitamin is a precursor of two enzymes—Flavin-mononucleotide & Flavin adenine di-nuleotied. Release of energy from foods as it effects growth and cellular metabolism Needs in normal vision and may help against cataract. Sources– Milk, eggs, organ meat, mushrooms, shellfish, cereals and pulses.
NAD & NADP- are the active form of niacin named as nicotinamide adenine dinucleotide and nicotinamide adenine dinucleotide phosphate. -These coenzymes are involved in more than 50 different metabolic reactions. -Extracts energy from CHO and glucose. -proper nervous system functioning. Sources- Organ meats, liver, poultry, fish, milk, eggs, wheat germ, whole wheat, yeast.
-A clinical condition due to niacin deficiency, characterized as 3Ds. -Weakness, irritability, burning tongue as the mucous membrane of the mouth is inflamed. -High doses results in irritation of the gastrointestinal tract.
Originally called vitamin H. Egg, liver, kidney, yeast, pulses, nuts, chocolates, cauliflower and green vegetables.
--Biotin coenzyme participate in the metabolism of fat and CHO in the synthesis of fatty acids and amino acids. --Helps metabolize proteins, fats and CHO & thus helps to produce energy in body cells. --Assists in the synthesis of FA. --Incorporate AA into proteins & help with the formation of DNA & RNA.
Sources– Whole grain cereals, vegetables, peanuts, cheese, eggs-yolk, organ meats.
This vitamin is a constituent of co-enzyme A and is present in all living matter. Important for cellular metabolism of CHO & fats to release energy.
Pyridoxine and its co-enzymes have a wide variety of metabolic functions especially— -AA metabolism and its transportation. -Production of antibodies, RBC, synthesis and functioning of both DNA & RNA. - Fish, poultry, egg yolk, soya- bean, bananna, potatoes, cauliflower.
Due to the deficiency of B6 , the RBCs are pale and small and the Anemia is said to be Hypochromic and Microcytic.
-Deficiency leads to impaired RBC production. -Megaloblastic anaemia If the maturation of the RBCs in the bone marrow is impaired by lack of Folic acid or Vitamin B12, the cells which enter the blood stream are irregular in size and shape, but usually on average larger than normal. Such anemia is orthochromic and megalocytic. It is usually referred to as Megaloblastic Anemia.
Bulk of body stores of vitamin B12 is in the form of coenzyme B12.
This vitamin has cyanide group and cobalt group. From animal foods like goat liver, fish, eggs & milk.
Variations in the size and shape of the blood cells. Results in peripheral neuropathy. Loss of mental energy, depression, tingling, numbness, diminished or absent sensation in extrimities.
Also helps to maintain healthy blood vessels.
Amala, guava, oranges, all citrious fruits, dark green leafy vegetables, tomatoes, etc.
--General manifestation of scurvy are fever, rapid pulse, and susceptibility to injection and wound healing is delayed. --Bleeding gums, common cold, delayed wound healing. --Gastrointestinal disturbances, dysuria, skin sensitivity.
Circulates in the plasma with the specific retinol binding protein. This combination is called halo-RBP.
-Encourages immune system to produce the cells you need to fight off infection and promotes rapid recovery. -As anti-oxidant and may aid in reducing the risk of cancer. -Also promotes the growth of healthy bones.
-It is a vision vitamin. -Keeps skin and mucous membranes smooth and supple. -Promotes the growth of bones and teeth. -Sources- Eggs, liver, fish liver oil, milk and milk products & green leafy vegetables.
It may be affected in severe vitamin A deficiency. It becomes dull and then corneal scar occurs. Takes part in the formation of bony matrix.
Changes in the eyes like night blind ness, xeropthalmia, skin changes ,effects the mucous membrane of the respiratory tract, alimentary tract and genito-urinary tract. Toxicity– Fatigue, loss of appetite, nausea, vomiting, weight loss, irritability, cracking lips, dry skin and hair loss, swelling over long bones.
In liver it is stored in the form of retinyl esters.
Also called Sun shine vitamin. Skin prepares vitamin D in the presence of sunlight.
-as it reduces the production of vitamin D. -Osteomalacia is more common in adults. The calcium deficiency results in de-mineralization of bones. -should be taken carefully.
Maintain the blood (plasma) Ca & P levels. Acts like a hormone. Vitamin D main site of action is in the small intestine where promotes Ca & P absorption from the gut & also has direct action on the gut. Raises concentration of plasma Ca & P to promote bone deposition.
Deformity of the weight bearing bones, knock knees, bowing of legs. Loss of bone mineral. Pain in bones. Excessive thirst, diarrhea, nausea, weakness & headach.
Alpha-Tocopherol is the most common and the most active of the seven mentioned forms.
-Natural antioxident. It helps to reduce oxidation of lipid membranes, USFA & breakdown of other nutrients by oxygen. -Protect the cell membrane destruction. -It reacts with free radicals & oxidizing agents. -Found in cell membrane that contain PUFA. It inhibits the reaction involving oxygen. -It protects both vitamin A & carotene from oxidation.
-prevents the oxidation of USFA -protects lungs from oxidative damage from environmental substances. -protects RBC membrane from oxidative damage.
Deficiency– low fat diet, malabsorption syndrome or after gastric surgery. RBC hemolysis occur more easily in vitamin E deficiency.
Originally called Koagulation vitamin.
K1 is the naturally occurring form of vitamin K. Bacteria in GI synthesis vitamin K. Normal synthesis is inhibited by the intake of oral antibiotics– K2 vitamin.
Bile production is impaired if there is sever damage to liver as secretion of bile salts is necessary for normal absorption of vitamin K. In steatrrhoea, ulcerative colitis fats are not absorbed effectively, bleeding due to vitamin K deficiency may occur. Sulfa drugs and antibiotics spoils the GI bacterial flora.
New born babies has sterile GI tract for about a week & hence a low blood prothrombin level. Due to prolonged antibiotic therapy, prevents the growth of intestinal bacteria. Deficiency of vitamin K produces a lowered prothrombin time. Vitamin K deficiency involves abnormal bleeding as in nose bleeding and internal hemorrhage which can be sever.
Successful building of a human body depends upon ability of his body to accept or reject the elements that the food provides After digestion the food is absorbed in the form of a simple, soluble compounds or ions. Once absorbed they are freely excreted. Some essential metals are largely bound to proteins and cannot be excreted by kidneys. To some extent nature also controls the toxicity of metals.
Phytates the salt of phytic acid bind with Fe, Ca, Zn, Mg. In presence of Ca & Mg it forms insoluble complexes with iron & thus makes unavailable to body. Oxalates the salt of oxalic acid interferes with Ca absorption by forming insoluble salts with Ca.
Sodium forms 90% base (cation) of the extracellular fluid. 95% sodium is excreted through kidneys.
Na is very soluble in water & thus easily absorbed from the stomach and small intestine. Jejunal Na absorption is stimulated by the presence of actively transported glucose or amino acid.
Chloride is an acidic anion. Cl is closely associated with Na in the extracellular fluid. Cl is taken into the body largely as Nacl. It may be lost to the body in urine in association with NH4. This leads to acid base balance.
Plasma chloride is required for the secretion of HCL by the stomach. Very few foods are never as acidic as gastric juices. However in vomiting due to gastric outlet obstruction chloride is lost as HCL without the corresponding loss of Na.
K is also necessary for the maintenance of acid base balance. K is the main base of the cellular compartment just as Na is of the extra-cellular compartment.
K is lost from cells due to dehydration, acidosis and tissue breakdown. Persistent vomiting. There is considerable loss of K through urine when diuretics are administered. When liquid stool is passed with laxatives an appreciable amount of vitamin K is lost. Continuous diarrhea results to deficiency. Prolonged use of steroids produces retention of Na & excretion of K which may produce clinical manifestations.
Besides the above it also maintains Neuro-muscular functions
Ca constitutes 2% of the total body weight. Most of the body Ca is stored in bones and teeth. The skeleton is the dynamic reservoir where Ca is continuously deposited & reabsorbed. Bones are the Ca bank. When ever required the Ca from the bones are mobilized to maintain the normal serum levels.
An equilibrium exists between the calcium coming and going from the bones. Osteoblast cells lay down fresh Ca cells. Osteoclast are constantly eroding redundant Ca deposit.
After the bones have stopped growing in length at about the age 18 years they may continue to get more dense for a few years. By the age of 30 bones begin to atrophy. In old people there is no change in the quality of bones.
Ionized Ca is vital to life as it affects the neuromuscular excitability of both voluntary & involuntary muscles.
Ionized Ca is more diffusible. It is controlled by parathyroid hormone. Serum Ca is bound to protein.
Calcium along with Magnesium and Potassium can help prevent high blood pressure and help make clotting possible. Calcium deficiency can cause an over production of the hormones Portisone and Aldosterone which in turn causes the Kidneys to hold salt and water. The blood volumes swells and results in Hypertension. Calcium actually lowers the blood Cholesterol. In research it was found that Calcium combines fatty acids in the intestines and forms a calcium soap which is eliminated in body waste as calcium intake increases the amount excreted is increased. Studies have shown that increased intake of calcium in combination with Vitamin B particularly from supplements may lower the risk of Type II Diabetes by 33%. Studies have also shown that Calcium has protective effect against Colon and Rectum Cancer. Increasing intake of dietary Calcium or decreased dietary fat foods significantly reduces colon cells proliferation.
Parathyroid hormone also enhances intestinal Ca absorption. More is the concentration of Ca in intestine more will be the absorption.
Osteoporosis is the result of negative calcium balance. It occurs due to low Calcium intake , hormonal. Physical and circulatory factors. Lactose increases absorption of instestinal Calcium and Phosphorus. There is a normal daily bone loss of of approx. 30-40 mg. After menopause in women it is accelerated by 17% or more.
The volume of the bone does not change with age but as it atrophies bone mass is reduced and its density falls.
P is widely distributed in all the cells, tissues and body fluids. P is present both in blood red cells & plasma. P is an important anion with in the cells.
P is an important element in the phospholipids cell membrane, nucleic acid and phosphoproteins required for mitochondrial function. Many of the B vitamins are effective when combined with phosphate in the body. Certain proteins like casein contains P in there structure & called phosphoprotein.
As P is part of Nucleic acid. P is the source of high energy bonds of ATP. Some enzymes and vitamin of B group become efficient when combined with P.
Take care of calcium and phosphorous will take care of itself.
It is the second most abundant intracellular Cat-Ion in the body. Enzymes which supplies the energy required for the Na pump. 65% of Magnesium is in the bones, 34% in the intracellular space and only 1% in the extracellular fluid.
It is essential part of many enzyme system responsible for the transfer of energy. Ex. Co-carboxylase and Co-enzyme A only act in the presence of Mg. -Mg activates enzymes that are important for protein, CHO metabolism & needed in DNA production. -Mg helps to transfer phosphate molecule to ATP an energy source generated by the cytochrome system.
-Mg is present intracellular in heart muscle cell that helps in contraction. -Ca stimulates muscle contraction. -Mg relaxes the muscle. Thus also called as anti-stress mineral.
-High alcohol intake produces Mg deficiency. -Metabolic syndrome. -Alimantry loss of Mg may occur in vomiting or diarrhea.
All living matter contains proteins and all proteins contain some sulfur. This element is therefore essential for life. Sulphate ions are present in the cells and sulphate also occurs bound to various molecules e.g. heparin. -Greater part of sulfur is present in the two sulfur containing aminoacid.
Trace minerals are concerned in some way with enzymatic action.
Example : Magnesium deficiency produces Sodium accumulation in the cells and causes loss of potassium out of the cell. This cannot be corrected by supplement alone unless magnesium is also administered. It is also reported that cobalt is required for optimum utilization of low doses of Iodine,
Mg deficiency produces Na accumulation in the cells and causes loss of potassium out of the cell. This cannot be corrected by potassium supplements alone unless Mg is also administered.
Fe is important component of hemoglobin which transports oxygen to the various tissues of the body. Life & Fe are inseparable. Vit C reduces Ferric iron to Ferrous iron which remains soluble even at neutral PH and is better absorbed.
There is about 4 gm. Of iron in an healthy adult. Major portion is present in hemoglobin.
Most tissue enzyme contain iron. There are intracellular enzymes which contain iron prophyrins.
Iron absorption decreases on a cereal diet occur with phosphate & phytates by precipitating ionized iron. Fiber in wheat and maize decreases iron absorption. Tea, coffee forms insoluble iron tannate that is not absorbed. Iron absorption is considerably decreased on a soya bean diet compared to a diet of egg albumin or casein of milk.
In small intestine iron absorption is by a process of diffusion.
Iron is absorbed into the blood stream and not into the lymph. In blood iron gets bound to a plasma protein belonging to beta globulin. The total binding (TBC) is increased when the need for iron is increased for iron is increased as in the later stages of pregnancy or in anemia. Iron absorption is increased with iron deficiency anemia, low plasma iron.
The normal lifespan of RBC is 120 days. About 20 mg of iron is released daily from the breakdown of Hemoglobin. It is oxidised to Ferric form and incorporated into ferritin or Hemosiderin until it is re utilized for the formation of RBC. Iron binding Protien are Tranferrin. Transferrin transports protien and binds 2 atoms of iron. Mucosal transferrin binds iron in the lumen of the gut to transport it across the brush border of the intestinal mucosa.
The body conserve iron well. The normal body losses in the bile, faces and sweat are small and the urinary excretion.
Znic is used as a cofactor in more than 100 enzymes involved with digestion, metabolism, reproduction & wound healing. Zinc is essential in the synthesis of DNA, RNA. Maintains the body levels of vitamin A.
In alcoholic chirrosis of the liver zinc concentration in the plasma is reduced
Iodine is contained in the hormones stored & secreted by the thyroid gland. Iodine in food & water is quickly absorbed from alimentary canal mostly as inorganic iodide.
Active form of selenium is selenocystein which slows the biological aging process.
For the availability of Iron for the formation of RBC Formation of Myelin by allowing Phospolipid synthesis
Coper plays vital role in number of metallo-enzymes, is concerned in the metabolism of catecholamines and ascorbic acid. - oxidation of ferrous to ferric ions for the availability of ironfor the formation of RBC. - concerned in the formation of myelin by allowing Phospholipid synthesis. - copper deficiency leads to Leucopenis and anemia.
It exist in trivalent & hexavalent forms. Only trivalent chromium is biologically active.
Chromium acts as a cofactor for Insulin. Insulin is activated by Chromium thus prevents continued elevation of blood sugar. The growth in some protein deficient children is enhanced by chromium.
These were the percentages of leading causes of death in Dec. 2004 by WHO. CVD, stroke, & cancer, are believed to remain the leading cause.
According to WHO Obesity is one of the 10 most preventable health risk.
Obesity is bad news for both body and mind. It not only makes a person feel tired and uncomfortable, it can also wear down joints and put extra stress on other parts of the body. It is also associated with the above mentioned problems. Obesity affects all age groups.
Childhood overweight is a serious health concern for children and adolescents. Data from the surveys show that the prevalence of overweight is increasing for children aged 2-5 yrs . Over weight children and adolescents are at risk for health problems during their youth and as adults.
Over weight children and adolescents are more likely to become obese as adults . One study found that approx. 80% of children who were overweight at aged 10-15 yrs were obese adults at 25yrs.. Another study found that 25% of obese adults were overweight as children. The latter study also found that if overweight began before 8 yrs of age, obesity begins before 8 yrs of age , obesity in adulthood is likely to be more severe.
Small parts of the DNA that people inherit from their parents that determine s trait. Some of the genes tell the body how to metabolize food and how to use the extra calories or stored fat. Some people burn calories faster or slower than others do because of their genes. Certain illness like Thyroid gland problems or unusual genetic disorders, are uncommon causes for people gaining weight. Sometimes emotions can fuel obesity as well. Some people tend to eat more when they are upset, anxious, sad, stressed out or even bored. Another factor is sedentary life style.
Doctors and nutritionists plays important role in preventing & controlling CVD.
When not enough oxygen is supplied by the blood, part of the heart muscle dies. It may heal or may lead to death.
In all the four cases the normal functioning of the heart is impaired.
The part of the heart muscle that die due to failure of blood supply may heal leaving a scar in the heart. Such patients are severely disabled or may be able to return to restricted physical activity, but carry an increased risk of another infarct. Thus when scar tissue is more there is less percentage of functional heart.
High blood pressure is recognized as the greatest of CV risk factors because it is initially largely symptom less. Atherosclerosis refers to the deposition of yellowish plaques of cholesterol, lipids and cellular debris that builds up in the inner layer of the walls of large and medium sized arteries. This makes the arteries walls thick and less elastic, thus increases their resistance and pressure and makes heart work harder.
High Blood pressure is recognized as the greatest of cardiovascular risk factors and because it is initially largely symptom less, has often been dubbed the ‘silent killer’. It can cause the heart muscles to enlarge and weaken and it is a powerful promoter of atherosclerosis in the coronary arteries.
Some times thrombus forms in an atherosclerotic coronary artery and blocks the lumen. Sometimes there is no thrombus and the infarct arises because the lumen of a coronary artery has been so narrowed by atherosclerosis that the blood flow is insufficient to supply the oxygen needed to maintain a hyperactive cardiac muscle. Which can wear down this vital muscle to starve.
When narrowing of vessels occurs, serious impairment of the blood supply to important structures may result. Untreated hypertension may lead to further other complications such as cerebrovascular accident or stroke.
If kidneys are unable to excrete water from body due to some damage. They control how much sodium your body contains and thus how much water stays in your blood (Na retains water). More water means more fluid trying to get through the blood vessels– and higher blood pressure. Obesity is also one of the predisposing factor. Stress and strain. In some diseases, endocrine disorder, pregnancy are some of the undetermined causes.
Damage to arteries actually begins at blood pressure levels. Untreated hypertension leads to cerebrovascular accident (stroke). Diseases of heart. Retina. Kidneys or peripheral arteries. Hypertension accelerates the on set of IHD.
Taking a well balanced diet. Drinking plenty of water. Meditation. Avoiding stress and tension.
Cholesterol is a waxy substance produced from the fats you eat. Sources—The exogenous, from food and endogenous synthesis by liver and intestine.
Small, dense LDL is especially lethal as they can penetrate artery walls with ease laying the foundation for the plaque build up of atherosclerosis. HDL actually fuses with LDL and remove their cholesterol. HDL also works as antioxidants, blocking LDL from causing plaque promoting damage.
Cigarette smokers has 3 times higher risk of heart diseases than non- smokers. The risk increases with no. of cigarettes particularly in those over 50 years. -as in high blood pressure heart has to work harder, may results in increase risk of CVD. High levels of cholesterol and fats increases the risk of CVD. Heredity- short, stocky and short-necked subjects are more likely to develop CVD than tall, thin people. -Hormones- males in general are more predisposed to CVD than females. It is possible that female sex hormones have an inhibitory effect on coronary artery disease. -CVD usually manifests itself after the age of 50 yr.
-Atherosclerotic patients have diabetes or a tendency to high blood sugar and increased insulin secretion. Obesity is related to coronary heart disease. Those with a punch, i.e. higher waist to hip ratio are more prone to CVD and death. Moderate exercise is beneficial in middle aged persons. Vigorous exercise produces neuromuscular injuries and ventricular fibrillation specially in those with coronary heart disease.
Fixed risk factors we cannot change but can control to some extent by modifying our life style and developing good eating habits.
This is a key factor for good health if we also include exercise.
The exogenous plasma TG are derived from the ingestion of fatty acids. Endogenous TG are produced mainly by the liver from free fatty acids and CHO. TG combining in the liver with phospholipids, cholesterol and proteins form VLDL, which are transported to the tissues for use as fuel or to the fatty tissues for storage.
The following fats have a higher proportion of fatty acids– butter, ghee, cream, hydrogenated oils, egg yolk.
MUFA posses the ability of lowering the levels of lipoproteins in plasma. Use olive oil or rapeseed oil for salad dressings. MUFA in nuts make them excellent snack. But to guard against overeating, limit yourself to one serving and put the rest away. Choose unsalted nuts to keep your blood pressure under control.
There are 3 naturally occurring types of fats– MUFA, PUFA, & SATURATED FA. A fourth type of fat-Trans fats, are man made. It is advisable to cut down trans fats from your diet
Be careful while using oils, type of oil, quantity of oil. Use cooking methods which require little or no fat.
The epidemiological studies which attempt to relate high blood pressure with high intake of salt have not been convincing. Of various possibilities genetic factors are certainly important. An excessive intake of energy leads to obesity is often associated with hypertension. A low salt diet causes a marked reduction in blood pressure.
These are the best way to control blood pressure.
Losing just 10% of your body weight could lower your high blood pressure down to a normal range without drugs. Physical activities flushes out your arteries, cleaning them and keeping them clear and supple. Exercise will raise the levels of HDL cholesterol, thus reducing total cholesterol levels.
Fiber plays vital role in controlling bad cholesterol, regular bowel movement and decreasing the risk factor of heart diseases.
Obesity is responsible for no. of these health problems.
Diabetes Mellitus is a clinical syndrome characterized by hyperglycemia, due to deficiency or diminished effectiveness of insulin.
Typical inactivity and in rare cases certain medication, pregnancy, diesease, or accidents that has damaged the Pancreas also cause diabetes.
-- pancreas fails to produce insulin, which is necessary for survival. -- results from the body’s inability to respond properly to the action of insulin produced by the pancreas. --Diabetes Insipidus is a rare disease in which there is passage of large amounts of urine, that is caused by a disorder of the pituitary gland. --Gastational diabetes refers to the hyperglycemia which may occur temporarily during pregnancy in women.
Juvenile diabetes is a chronic metabolic condition. Type I diabetes onset of it begins in childhood. This diabetes usually develops before the age of 40 years of life in patients of normal or less than normal weight. The majority develops sever symptoms of diabetes over a period of several weeks.
In the absence of insulin the blood sugar is raised & liver glycogen is depleted, liver converts amino acids to glucose that increases nitrogen excretion. This reduces protein synthesis, serum lipids increases and ketone bodies accumulate in the blood. Insulin is the only hormone that promotes storage of fatty acids in the cells against many hormones which tend to release cellular fatty acids.
Many patients with type II diabetes have a long history of mild symptoms which may come and go. May not require insulin shots daily. Instead a healthy diet and exercise can control it.
Diabetes insipidus is a condition associated with the kidney’s inability to conserve water. It is caused by the failure of the hypothalamus to release anti diuretic hormone, resulting in the passage of large amounts of urine this is often accompanied by a change in appetite, loss of strength, and emaciation.
Type I - juvenile onset type. Type – maturity onset type. GDM – gestational diabetes. IGT – increase glucose tolerance.
A good metabolic control can delay the onset and progression of diabetic retinopathy, slow down the progress of renal damage and may delay or prevent heart disease in people with diabetes.
To manage young insulin dependent diabetics a careful balance has to be maintained between diet for adequate growth, weight regulation, exercise and insulin dosage.
Characterized by the chronic excretion of large amount of pale dilute urine which results in dehydration.
This is usually associated with obesity and is not prone to ketosis.
Controlled clinical trials has shown positive response of weight loss on fasting blood glucose and fasting insulin levels, reduced cholesterol levels.
Increasing weight is always a danger signal. The association of obesity and diabetes has long been recognized, but it is still uncertain. Diabetics should be encouraged to maintain a healthy body weight with a BMI in the range of 18.5-25 kg/m2. Regular physical activity improves insulin resistance and lipid profile.
When controlled diet, physical activity and drugs are ineffective then it becomes necessary to give insulin.
The effective management of these adjustment depends on the individual’s knowledge and motivation. Weight reduction and exercise has been already discussed. Meals should be coordinated with type of insulin recommended, if insulin dependent. Weight reduction will help to reduce blood glucose and cholesterol levels. Exercise has the potential to control the diabetes by non medical means.
In the absence of insulin the blood sugar is raised and liver glycogen is depleted. Insulin is the only hormone that promotes storage of FA in the cells against many hormones which tend to release cellular FA. Some hormones are antagonistic to the action of insulin.
Exercise can help control weight and lower blood cholesterol & sugar levels, raises HDL levels, reduces the severity of the disease & reduce the risk of long term complications.
A dietary plan is designed around an individual’s life style and eating habits. Any dietary program is complicated by the fact that the same food may be eaten by different people and produce different responses in blood sugar levels. There is two-to-four fold increase in the prevalence of macrovascular diseases in persons with diabetes. Each person with diabetes should know their individualized blood glucose goal ranges, which may differ from normal. For persons with type 2 diabetes ,moderate weight loss, regardless of starting weight, has been shown to reduce hyperglycemia, dyslipidemia and Hypertension. Calories should be prescribed to provide for normal growth and development in children and adolescents. The meal plan is not a Restriction of calories but is intended to ensure resonable consistent food intake and a nutritionally balanced diet.
Proportions of calories, CHO, proteins and fat are estimated for each individual based on the need to maintain, lose or gain weight. Proteins are broken down to amino acids. They are transport fats in the body via lipoproteins. CHO converts glucose to cellular fuel. CHO causes release of insulin. CHO are the raw material the liver need to manufacture triglycerides, monounsaturated fatty acids & cholesterol.
Same as we have already studied. More portions of food to be consumed from bottom and less from top.
High fiber foods, the body digests the food over time, slowly releasing chunks of glucose into the system. When glucose is released, it triggers a rise in the hormone called insulin, which uses the glucose. If the insulin rise is gentle, the body does well. But if the rise is sudden and very sharp, which typically happens with the consumption of refined food, then the side effects of high insulin levels emerge– weight gain, cholesterol problems, imbalanced blood sugar and irregular cycles in women.
Soluble fiber slow down the digestion of CHO, which results in better glucose metabolism.
Sugar substitutes are so much sweeter than sugar that very small amount are needed to create a sweet taste. That is what keeps the calories of the substitute at a minimum. They also contribute almost no CHO to foods, so diabetics can enjoy more sweet food without affecting blood.ss
In diabetes insipidus there is increased blood sodium and if the diabetic is suffering from hypertension. Then sodium is restricted.
Sulphonylureas lower blood sugar by stimulating pancreatic insulin secretion and increasing insulin receptors on cells. Dietetic control is still essential even with the tablets.
-Good metabolic control can delay the onset of diabetic retinopathy. -Diabetes is among the leading cause of renal failure and is related to the severity and duration of the disease. -Diabetic neuropathy is probably the most common complication of diabetes. Major risk factors of this condition are the level and duration of elevated blood glucose. The first is the management of a stabilised diabetic who has to undergo an operation. -Macrovascular complications produce coronary heart disease, thrombosis or hemorrhage in the brain and gangrene in the limbs. -Obesity is a strong predisposing factor in middle age diabetes. Increasing weight is always a danger signal.
Nephropathy can complicate both type I and type II diabetes. The clinical features are micro-albuminuria in the first stages, then progressing to proteinuria, hypertension, and progressive CRF.
The chief abnormality present in syndrome X is insulin resistance. That is, the body’s tissues do not respond normally to insulin. As a result, insulin levels become elevated in the body’s attempt to overcome the resistance to insulin. The elevated insulin level leads , directly or indirectly to other metabolic abnormalities seen in these patients. When diabetes occurs, the high risk of CV complications goes even higher. The characteristic disorders present in metabolic syndrome X include : Insulin resistance, Hypertension,, abnormalities of blood clotting, Low HDL and High LDL Cholesterol level, High TG levels.
The degree of which increased lipolysis occurs is proportional to the degree of insulin deficiency. In such condition the plasma concentration of FFA may remain 3-4 times the normal.
Dietary instructions for diabetic must be simple. Greater flexibility should be offered so that it is easer to follow the instructions. The word MEAL denotes breakfast, lunch and dinner. The exchange plan, the counting CHO plan & the continuous CHO plan are the 3 main meal plans that people with diabetes use to manage their eating. It is important to eat the same amount of CHO, proteins & fats every day to maintain better control of blood glucose level. Find the one that fits your life.
A dietician gives specific instructions, gives wide choices in food and also give some sample menu to understand easily for the patient.
Exchange list is given to the patients so that on there on they can create variety in their meals.
--Hyperglycemia arises from two main sources- a reduced rate of removal of glucose from the blood by the peripheral tissues and an increased rate of released of glucose from the liver into the circulation. --Decreased glucagon secretion produces hypoglycemia. --The excessive breakdown of fats in an attempt to provide energy results in an accumulation of ketone bodies which the tissues are not able utilize rapidly. Ketone bodies are thus accumulated in the blood and lead to the withdrawal of water from the cell. They are strong acids which release hydrogen ions into the body fluids and thus an increase in plasma CO2 in the arterial blood. This state is called ketoacidosis.
Decreased glucagon produces hypoglycemia these symptoms which may disappear in a short time. It can happen even during those time when you are doing all you can to manage your diabetes.
Hyperglycemia is a major cause of many of the complications that happen to people who are diabetic. Glucose level increases after a meal, but quickly returns to normal as cells remove excess glucose from the blood stream. This normal process for energy falls apart in diabetes. Either the pancreas cells do not make insulin or cells of the body cannot use the insulin properly. Without insulin cells are unable to take up glucose. These are the consequences of hyperglycemia.
Diabetic ketoacidosis is a serious condition where the body has dangerously high levels of ketones or acids that build up in the blood and it can lead to diabetic coma or even death.
When the clinical symptoms are present, the diagnosis is often beyond reasonable doubts then it may be confirmed by the findings of GTT and urine test. In that case a doctor should be consulted. The aim for treatment---- -- the abolition of symptoms while avoiding hypoglycaemia. -- the correction of hyperglycemia and glycosuria. -- the attainment and maintenance of an appropriate and body weight.
Cancer is a condition that can affect nearly every organ system in the body. Its prognosis is enormously variable with nearly 100% survival to almost 100% mortality depending on the site of the cancer.
All these factors play role in precipitating cancer. Cancer is caused more specifically by both external (chemicals, viruses, radiation) and internal factors (hormones, immune conditions, inherited mutation).
More than 80% of the cancer cases are attributed to cigarette smoking.
These are the external factors which has proved to cause cancer. Asbestos has been banned in no. of other countries.
Some of the external causes can be controlled to prevent cancer.
The evidence from research has shown that about 1/3 of the 500,000 cancer deaths that occur in united states alone each year are due to dietary factors. Thus we can say that it is of more importance. Many dietary factors can affect cancer risk:--types of foods, food preparation methods, portion sizes, food variety and over all caloric balance. Western diets are very deficient in Vit . C due to inadequate amounts of fresh fruits and vegetables. Vit C is essential for building and maintaining collagen, for proper utilization of oxygen in cells, for integrity of the immune system. .
There are strong evidence that increase consumption of fruits and vegetables reduce the risk of colon cancer. Some foods like soya bean, broccoli have anticarsinogenic property. Excess fat in the diet definitely increase the incidence of breast, uterine, ovarian, colon & prostat cancer. Antioxidents give protection from free radicles which may give rise to cancer. Gerson diet- based on raw fruits and vegetables , low in sodium and high in Potassium, has proven most effective in restoration of Cancer patients and patients with all types of metabolic diseases. This diet also includes supplementary enzymes , forms the basis of all successful cancer therapy. Enzymes of many kinds derived from both plant and animal sources are now available in powdered or tablet forms.
If the detection is done at the early stage then there is 100% survival. Cancer prevention means early detection, so that necessary surgery, drugs and radiation can be applied sooner to prevent its prognosis. Cancer develops when cell in a part of the body begins to grow out of control. Although, there are many types of Cancer, they all start because of out of control growth of abnormal cells. Cancer cells develop because of damage to DNA. Often Cancer cells travel to other parts of the body where they begin to grow and replace normal tissues. This process is called Metastasis. Invasion – Solid tumors develop initially as a single mass of cells. Cancer invasion is the process in which cells break away from the primary tumor and crawl through surrounding tissues. This enables the cells to move into a blood vessel and be transported through the body possibly establishing a secondary tumor at another site.
Family history and genetic susceptibility also are an important factor. Sometimes cancer cells are dormant in the body for many years. Thus in that stage early detection is helpful.
There are two types of tumors. Benign tumors are non cancerous & Malignant tumors are cancerous.
Metastasis means to spread from one organ to another. The abnormal growth of new tissues and cells tend to invade surrounding tissues and cells and metastasize to different body tissues.
In some cases surgery is the best option. Radiation therapy and chemotherapy is given as a part of treatment. A strong healthy immune system is also an essential part of this plan.
In spite of knowing people do not want to follow.
Cancer of these organs are common.
The majority of patients can maintain nutritional status with normal or fortified diets with or without the need of oral nutritional supplements, by remaining physically active and no smoking.
With years of studies and research we have been able to lay down certain protective and risk factors. When protective factors are followed, the risk factors are covered.
All these vegetables has anti carcinogenic property and rich source of antioxidants. These vegetables contain flavones which are thought to have anti- cancer activities
Fiber fights Cancer particularly Colon Cancer. Fiber moves food more quickly through the instetines, helping to eliminate carcinogens. It also draws water into the digestive tract. The water and fiber makes the fecal matter bulkier so carcinogens are diluted.. Fiber also binds with bile acids and evicts them from the instetines.
---have the potential to decrease LDL cholesterol by 20% equivalent to a first line statin drug.
antioxidents
Ginseng– it is an herb that has been used to stimulate the adrenal gland and there by increase energy, a stress reliver also. Soya has a greater cholesterol lowering effect.
Studies have shown that fruits and vegetables phytochemicals extracts exhibit strong antioxidant and anti proliferative activities. The major part of total antioxidant activity is from the combination of Phytochemicals. Phytochemicals of strawberry , Blueberry contains angiogenesis inhibitors. Inhibition of angiogenesis will result in reduced tumor growth. Modulation of Breast Cancer resistance protein by Flavonoids. Flavonoids are diverse and include their ability to modulate enzymes required for metabolic activation of procarcinogens and detoxification of carcinogens and potent antioxidant activities. Phytochemicals helps in platelet aggregation reduction thus preventing angina myocardial infarction and ECG evidence of ISCHEMIC HEART disease. Phytochemicals significantly lowers cholesterol, reduces stickiness of blood.
An imbalance of caloric intake and output can lead to overweight, obesity and increase risk for cancers at several sites like colon, rectum, prostat, breast and kidney.
Excess dietary fats increases the risk of cancer such as breast, colon, uterine and ovarian. The fats of more concern include saturated animal fats as found in meats and dairy products.
Foods are preserved by these very methods Salts inhibits growth of spoilage – causing micro – organism by causing osmosis. Nitrates / Nitrites not only kills bacteria , but also produces characteristic flavor. Smoking adds chemicals to the surface of an item which affect the ability of bacteria to grow, inhibit oxidation and improve flavor.
Alcoholic beverages along with cigarette smoking and chewing tobacco may cause cancers of the oral cavity, esophagus and larynx. Cancer increase with the amount of alcohol consumed and may start to rise with intake of as few as two drinks per day.
AIDS are commonly associated with wasting. Increased nutrient intake is the key to the treatment although drug management also required. As the immune system worsens no. of complications start to take over. For many people the first signs of infection are large lymph nodes or swollen glands which may last for more than 3 months. Other symptoms are lack of energy, loss of weight, frequent fevers and sweats, short term memory loss.
People with advanced HIV infection are vulnerable to infection & malignancies that are called opportunistic infections because they take advantage of the opportunity offered by a weakened immune system. Symptoms significant in altering nutritional status include diarrhea, anorexia, nausea & vomiting and malabsorption severely reduce oral intake.
Although nutritional interventions have not been effective in reversing advanced HIV infection or mortality, early nutritional assessment, intervention, successful symptoms management, & muscle-strengthening exercises improve health and quality of life and may improve response to treatment.
HAART (Highly Active Anti-Retroviral Therapy) can reduce the amount of HIV in someone’s body & restore their immune system. The introduction of HAART has dramatically reduced the infection of opportunistic infections among HIV + ve people who have received the drugs. Yet the prevention & treatment of opportunistic infection remains essential.
This treatment is very expensive with complex schedule, and the poor resistance of the person.
Auto immune disorders occurs when the immune system confuses normal body tissues ”self” with a foreign intruder & attacks. As a way to avoid being attacked by the immune system, some infectious organisms such as bacteria & viruses learn to expose only those parts of themselves that mimic “self” tissues. Thus when immune system becomes weakened the opportunistic infections occurs.
Providing prevention & treatment of opportunistic infections not only help HIV +ve people to live longer, healthier lives but can also help prevent TB & other Transmissible opportunistic infections from spreading to others. The therapeutic approach may be done by prevention of disease progression & treatment of complications that arises.
Eating well can help strengthen the immune system. This disease has profound effect on nutritional status. Involuntary weight loss is a common feature. An enriched diet can slow the progression of the disease. This disease is accompanied by malnutrition so careful attention to diet is important. Optimal nutrition influences tolerance and response to treatment. It is important to establish goals for intervention and are to identify client at risk, to intervene early to maximize nutritional status and body mass and to minimize loss of lean body mass if or as the disease progress. The client, family, others as well as the health care team must discuss and agree on goals, e.g. when and how to give aggressive nutrition for the client.sss
The main goal of nutrition for a HIV infection person is to maintain the body’s weight and muscles. This will help the individual stay as strong as possible and live an active life.
Malabsorption leads to malnutrition. There is inadequate dietary intake due to loss of appetite. There poor nutritional absorption due to gastrointestinal complications like nausea, vomiting, early satiety, delayed gastric emptying , abnormal taste and dental problems. Side effects of medication results in Diarrhoea.
Due to malabsorption, poor appetite, frequent diarrhoea and other complications aggrevates the loss of water and fat soluble vitamins and certain minerals also.
AIDS may make it difficult to eat & digest food properly because of poor appetite, diarrhea, nausea, mouth sores are often the result of poor immune system. At that time supplements are good. Researches have also indicated that increase intake of certain vitamins and minerals and essential fatty acids can boost the immune system and helps the body to fight AIDS.
Some of these conditions can be treated without pharmaceutical intervention based on the general principles of Nutritional Healing. Maintain normal body weight Build muscles/ maintain lean body mass( avoid wasting) Optimize digestion. Eating 4-6 small meals and chewing food carefully can make its job easier. Eat more healing foods, fewer processed foods. Drink 8-10 cups of non caffeinated fluids daily Use Supplements rationally and consistently
Better to take one multivitamin and mineral tablet daily.
Supplements may help to meet the increased nutritional requirements but nutritional supplements cannot replace eating a balanced diet. Dietary supplements boost the immune system. Use supplements consistently for 6-8 weeks in order to see results. Never take supplements on empty stomach. Absorption will be better if supplements are taken along with food.
Selenium is directly related to improved mortality in HIV INFECTION.
Food science is a discipline concerned with all technical aspects of food beginning with harvesting and ending with cooking and consumption. It is considered one of the agriculture science and usually considered distinct from the field of nutrition.
In simple words we can say this part of science deals with the use of preservatives, means of preserving food, increasing the shelf life of the food, different methods used to retain maximum nutritive value, also taking care of toxins, there packaging and handling, attractive color and texture of the food, and carried to different locations.
Almost everything we eat starts with the planting of a seed that grows into a plant & consumed by humans or a crop that is used as livestock feed. The advancement in the agriculture science has progressed to produce seed verities, resulted in improved production . Many farmers globally are beginning to implement alternate agricultural techniques in an effort to reduce their use of chemicals inputs from pesticides and fertilizers for a variety of reasons.
IPM Works in partnership with nature to produce foods efficiently. This is gaining popularity as it reduce the potential risk to farm workers and the impact on environment, and to promote public confidence in food safety.
The word pesticides refers to a broad class of crop protection chemicals, including 4 major groups. If improperly used these may reach the final food products un amounts which may be toxic to the consumer.
Encouraging organic farming which needs functional group of species and essential ecosystem process as its main “input” to compensate for the restriction on synthetic input use. In organic farming, bio-diversity is both instrument and aim. Natural ecological balance, below and above ground is key to its success. A healthy soil is the base of food production and diversity of plants and animals on land prevents pest and disease out breaks.
The regulatory system for ensuring food safety and quality consists of various local. state, federal and international agencies that may also vary from country to country. The system that these agencies form is responsible for 4 main functions mentioned.
Food born illness generally refers to illness caused by microorganisms consumed by eating any type of food. Food born illness are the greatest food safety threats. Bacteria can also spread from unclean knife, chopping board, dirty napkins and utensils. There are many pathogenic organisms which may gain entrance to the body through infected water or food and cause various types of illness.
Food irradiation is only one tool for improving food safety by killing pathogenic microorganisms. This process is often called cold pasteurization because it kills harmful bacteria without the use of heat.
Any substance added to food to look good, preserve, flavor, thick or blend, is called an additive. These preservatives have been in usad in home for generations.
Common preservatives in use are sulphur, sulphite and benzoic acid. Many synthetic substances mimic the flavour of fruits and vegetable. Many synthetic substances mimic the flavour of fruits and vegetables.
Now a days it is difficult to sell food products unless the color is pleasing. This especially applies to sweets and cakes. Large number of organic dyes have been used to color foods.
Parsley and tomatoes are now a days much used to give color to a dish.
Water is added to milk In tea caffeine and theobromine. Pesticides residues in fruits & vegetables Some antibiotics/drugs given to cattles Heavy metals in soil, utensils
Maximum adulteration is done these products as they are maximum consumed by the society In tea –used tea residue, other leaves with added color. Coffee- starch, roasted dates, tamarind seeds.
In milk water is added. Synthetic milk is prepared by mixing urea to detergents/soap water. All these adulterants are white. Caustic soda, sodium, sugar and hydroxide, starch, gelatin and pesticide residue are added. When milk is transported the milk stock churns inside the containers, churning separates the fat, which is again extracted. More fat extraction means more profit.
Khesari dal alone mixed causing Lathyrus Sativus.
Added to oils
Physical contamination— Whole turmeric coated with lead chromate or coal tar dye. Turmeric power has yellow earth, starch or talc colored yellow with coal tar dye. Cumin seeds artificial cumin seed like product. Black pepper with dried papaya seeds.
Animal fat and other high melting fats, edible oils- palm oil, argemone oil, non edible olis.
Protection of food from flies. these important features are especially for mothers.
All foods that are eaten raw should be carefully washed immediately before consumad.
Raw and ready to eat foods should be kept separate.ssss
Thawing or defrosting foods in a critical control point to prevent food born illness. During thawing take care of cross contamination and to minimize time in the temperature danger zone. Thawing food properly can be done in any of these 4 ways— In a refrigerator at 41 degree F Use microwave As part of the cooking Under running water.
As it kills the germs.
Foods that is cooked should be maintained at a sufficient temperature long enough to ensure the death of any pathogens that it may contains. This time & temperature varies very much from one food to another.
Do not keep raw foods along with cooked foods.
Foods kept in danger zone allows bacteria to grow fast.
Chopping board should be smooth and without pores so that bacteria don’t grow in those cracks.
Biotechnology is a technology based on Biology, especially when used in agriculture, food science and medicine. Biotechnology means any technological application that uses biological systems, living organisms or derivatives thereof, to make or modify products or processes for specific use. It combines disciplines like genetics, molecular biology, bio-chemistry embryology and cell biology ,which are linked to practical disciplines like chemical engineering, information technology and robotics
The answer depends on your eating habits, lifestyle and some factors beyond your controlsuch as your age. Dietary supplements may be needed if You do not eat well. You are a vegetarian You consume less than 1200 kcal a day. You have a medical condition which affects how your body absorbs, uses or excretes nutrients You are a post menopausal woman Heavy bleeding during menstural cycle You are pregnant or lactating You drink alchohol or smoke
Nutrition: Dietary changes are of paramount importance . These comprise of I) reduction of salt intake to an average of not more than 5 g per day ii) Moderate fat intake iii) avoidance of alcohol iv) restriction of carbohydrate intake to just the daily body needs The word nutrient is used for dietary constituents like proteins, carbohydrates, fats vitamins and minerals. The subject of nutrition is very extensive. Nutrition gained recognition as a scientific discipline, with roots in physiology and biochemistry. Specific nutritional diseases were identified and technologies developed to control them as for example protein energy nutrition, nutritional anemia, diarrhea. It is of significance that the science of nutrition has move out of he laboratory and linked itself to epidemiology. This association has given birth to newer concepts in nutrition such as epidemiological assessment of nutritional status of communities, nutritional and dietary surveys, nutritional and growth monitoring,nutritional interventions - all parts of the nutritional epidemiology. Epidemiology methods are now increasingly used not only in the elucidation of disease and identification of risk factors of disease and eliminating the same. All countries should develop a National nutrition and food policy . The dietary goals recommended by WHO are as below: 1) Dietary fat should be limited to approximately 20-30 percent of total daily intake 2) saturated fats should contribute no more than 10 percent of the total energy intake 3) Excessive consumption of refined carbohydrate should be avoided Food means not only proteins fats minerals , vitamins and other nutrients . Nations and civilization are linked together not only by ideas but also nutrition. In the more developed countries of the world nutrition problems are somewhat different. Over nutrition is encountered much more frequently than under nutrition. The health hazards from over nutrition are a high incidence of obesity, diabetes, hypertension, cardiovascular disease , renal disease etc.