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Principles of Nutrition




Nutrilite Health Institute certification course
                           By
                     Amway India
Introduction




 AGENDA
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
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
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
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
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
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
Nutrition “What is it”


     Nutrition “What is it”
Nutrition
Food Guide Pyramid




     FOOD PYRAMID
What is Nutrition?


Metabolism of Foods
Nutritive Value of Foods
Qualitative and Quantitative
Requirements
Changes in Nutrient
Requirements
Cultural Factors
Six Classes of Nutrients


 Carbohydrate           Vitamins
 Fat                    Minerals
 Protein                Water



*The Human Body Like Food is Composed
 Largely of Nutrients
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
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
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
Video 1- Micro Nutrients




       Click to Start
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
Energy



Capacity to do Work
Energy in Food is Chemical
Energy
Body Converts      Chemical
Energy       mechanical
energy
Energy -yielding Nutrients



         Carbohydrate
         Fat
         Protein
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
Energy in Foods


Carbohydrates =   4 kcal/gram
Protein       =   4 kcal/gram
Fat           =   9 kcal/gram
Alcohol*      =   7 kcal/gram*
Energy in the Body

Nutrients to Fuel Metabolic and Physical Activities


               Heart -Beating
               Brain- Thinking
               Legs -Walking
               Breathing
               Eliminating Wastes
Excess Nutrient Consumption



     Excess Consumption of
     Energy-Yielding Nutrients

     Converted to Fat and Stored in the Body
Classification of Nutrients


     Macronutrients (Macro = BIG)
          Protein, Carbohydrate, Fat, and
     Water
     Micronutrients (Micro = small)
     Vitamins and Minerals
Water


Indispensable Nutrient
Fundamental to All Life on
Earth
Principles of Nutrition By NHI
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
Water's Role


Shock Absorber
Body Temperature Regulation
Maintains Blood Volume
Lubricant and Cushions Joints
Water's Role

Carries Nutrients and Waste

Helps form Structure of Molecules

Participates in Chemical Reactions

Solvent for Small Molecules
Water Sources


Beverage and Water
Foods Contain Water

  Fruit and Vegetables = Up to 95% Water
  Meats and Cheese = Up to 50% Water
                            Object 7
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%
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
Water Recommendations


     t Recommendations:
          Diet
          Activity
          Environmental Temperature
          Humidity
       Adult Recommendations

 *Amount of Water = Amount of Energy Expended
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
What are Proteins?


The name Protein was suggested
by Mulder in 1838 to the complex,
 organic, nitrogeneous substances
 found in animal and plant tissues.
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
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
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
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
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
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
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
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
Complete Proteins


Essential Amino Acids
Nonessential Amino Acids
Animal Sources = Essential Amino Acids
  Meat               Cheese
  Fish               Eggs
  Poultry            Milk
Digestion and Absorption of Protein




        Protein in Food Do Not Become
        Body Proteins
        Protein in Food Supply Amino
        Acids
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
Various Sources of proteins


      •   Cereals and Millets
      •   Pulses, legumes
      •   Milk and milk products
      •   Egg and Flesh Foods
      •   Soya
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.
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.
RDA of Protein ….. contd
Experimental assessment of Protein sources.
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.
Count What You Eat
Count What You Eat
    Protein Value Of Cooked Preperations
   Preperation      Weight(gm) Proteins ( gm)

     SNACKS
      Samosa           65            3
     Sandwich          65            3
       Sevian          80            3
         Idli          115           5
       Dosa            85            6
       Vada            45            6
     Dahi vada         165           11
       Upma            130           5
  Masala omlettee      100           7
     CHUTNEY
      Coconut          55             2
     Coriander         20             1
        Mint           18           trace
      Tomato           50             1
    NON - VEG
   Handi Chicken       125           26
    Fish cutlet        80            14
     Fried fish        85            18
        Liver          140           22
      Mutton           145           18
    Prawn curry        145           18
Carbohydrates


Compounds composed of carbon,
oxygen and hydrogen molecules

  Carbo = Carbon
  Hydrate = With Water (H2O)
Carbohydrate Family
         Simple                          Complex
  Carbohydrates (Sugars)               Carbohydrates

    Monosaccharides               Starch (Polysaccharides)*
       Glucose (Blood Sugar)
                                  Fibers (Nonstarch
       Fructose (Fruit Sugar)
                                  Polysaccharides)
       Galactose (Milk Sugar)
                                      Soluble
 S Disaccharides                      Insoluble
     – Sucrose (Table Sugar)
     – Lactose
     – Maltose

*Glycogen is a Complex Carbohydrate (a Polysaccharide), but
            not a Dietary Source of Carbohydrate
Starch


Glucose Molecules Linked
Plants Store Glucose as
Starch
Humans Eat Plants
Body Hydrolysis
Starch to Glucose    Energy
Glycogen


Animal Polysaccharide
Manufactured and Stored in Liver
Not Significant Source of
Carbohydrate
Not Complex Carbohydrate in
Foods
Food Sources
Fiber


 Structural Part of Plants
  – Vegetables, Fruits, Grains,
    Legumes
• Non-Starch Polysaccharides:
  – Cellulose, Hemicellulose, Pectins,
    Gums, Mucilages
• Non Polysaccharides:
    Lignins, Cutins, Tannins
Fiber: Sources, Actions, Structures


                  Soluble Fibers              Insoluble Fibers


  Food Sources    Fruits (Apples, Citrus),    Wheat Bran, Whole-Grain
                  Oats, Barley, Legumes       Breads and Cereals,
                                              Vegetables


                  Delay GI Transit            Accelerate GI Transit
  Action in the
                  Delay Glucose Absorption    Increase Fecal Weight
  Body
                  Lower Blood Cholesterol     Slow Starch Hydrolysis
                                              Delay Glucose Absorption


                  Gums, Pectins, Some         Cellulose, Many
  Type of Fiber
                  Hemicelluloses, Mucilages   Hemicelluloses, Lignins
Video 2: Good Fats




        Click to Start
Fat




Definition
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)
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
Effects on Health


Saturated Fats Elevate Blood Cholesterol
              Heart Disease

Hydrogenated Fats        Trans Fatty Acid
       Heart Disease

Unsaturated Fats Lower Blood Cholesterol
  Heart Disease
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
Essential Fatty Acids


  Body Can Make All But "2" Fatty Acids
     Linoleic Acid
     Linolenic Acid
  Indispensable to Body Function
  Supplied by Diet
Comparison of Dietary Fats
Linoleic Acid: Omega 6



 Arachidonic Acid
 Structure and Function of Cell Membranes
 and Inflammation Reactions
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
Linolenic Acid: Omega 3


   Essential for Normal Growth and
   Development
   Regulates:
     Blood Clotting
     Blood Pressure
     Lipid Concentrations
     Inflammation Responses
Linolenic Acid: Omega 3


    Important Role in Prevention
    and Treatment of:

      Heart Disease
      Hypertension
      Arthritis
      Cancer
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)
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
Role of Phospholipids


  Constituents of Cell Membranes
  Lipid Transportation
  Fat Soluble Substances: Vitamins
  and Hormones
  Emulsifiers
Sterols


Liquid Compounds
Multiple Ring Structure
Cholesterol
Cholesterol


Animal Foods
  Meats
  Eggs
  Fish
  Shellfish
  Poultry
  Dairy Products
  Organ Meats (Liver, Kidneys)
HUMAN
PHYSIOLOGY
Physiology


  Organism
  Cellular
  Molecular
Structural Organization
  Atoms


  Molecules
              •   Organ
  Cells


  Tissues     •   Systems


                  Organism
Cells

Cells: Building Blocks of Our Body

    Membrane
      Fat
      Holds Cell Together
      Separates Cells
Cells

Cells: Building Blocks of Our Body


          Passive Diffusion
          Active Transport
Cytoplasm


Liquid Inside "Cell Membrane"
Organelles "Tiny Organs"
 Mitochondria
 Endoplasm
 Lysosomes
Nucleus


Brain of Cell
DNA
Ribosomes "RNA"
Protein Synthesis
Energy


Food = Energy
ATP = EnergyObject 2




Mitochondria
Metabolism


 Anabolic - small       large
    Amino Acids     Proteins
    Uses ATP
• Catabolic Fat     Acetyl CoA   ATP
  – Proteins   Amino Acids
  – Make ATP
Fat


Anabolic - Triglycerides
Fat
Catabolic - Fat Acetyl
CoA ATP
Protein


Anabolic - Amino Acids Protein
Catabolic - Protein  Amino Acids
  Essential Amino Acids
  Non-Essential Amino Acids
Sugar


Anabolic - Sugar       Glycogen

Catabolic - Glycogen     Sugar
            ATP
PHYSIOLOGY


Digestive System
Digestive System

Picture 3




              Esophagus


              Stomach
              Small intestine
                   21 ft long

              Large intestine –
                    5 Ft long
              Appendix
Digestive System

Digestion: Breaking Complex
 Food Into Smaller Particles

          Mouth
          Teeth
          Breakdown Food
Digestive System

             Picture 4




  Teeth

 Tongue

 Salivary
  gland

Epiglottis

Esophagus
Digestive System


  Tongue
    Propels Food
    Taste Buds (Sweet, Sour Salt)
• Salivary Glands (Saliva)
  – Moisten Food
    Begin Digestion - Starch
• Tonsils
  – Part of Immune System
Digestive System


 Epiglottis
   Muscles to Prevent Food
   Entering Lungs
   Directs Food to Esophagus
   and Blocks Trachea
   Coughing
• Esophagus
  – Muscular Tube to Stomach
Digestive System


Stomach
  Sphincter-Muscle Closes Stomach
   • Reflux

  Churns Food-Chyme
   • Mixes With Acid and Pepsin

– Mucus Protects Stomach
– Intrinsic Factor
Digestive System


Stomach
 Vomiting
  • Reflex
  • Bulimia - Esophagus, Teeth

– Ulcers
– Gastrectomy
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Digestive System

    Accessory Organs
Liver - Largest Organ
                       Liver   Stomach
  Metabolism
  Bile Production
  Vitamin Storage
  Remove Chemicals
  Cholesterol Production
  Essential for Life
Digestive System

              Accessory Organs
Pancreas – 5 inches long                      Pancreas

  Digestion                       Picture 5




  Blood Sugar Levels
  Diabetes - Type I and Type II




                          Duodenum
Urinary System


Kidney      Urinary Ducts
Urinary Bladder
Filtration System Kidney
Urine
  Chemical Waste    Urinary
  Salts              duct
  Water
                    Bladder
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
Respiration

Nose    Trachea        Bronchioles
Lungs
                                Picture 9




        Nose       nasal area
         Filter
         Warm       trachea
         Moisten
                   lungs
Respiration

Nose       Trachea           Bronchioles
Lungs
         Trachea
            Stiff Tubes       pharynx

            Larynx             larynx
        • Bronchioles
          – Tubes to Lungs
                              trachea
          – Cilia
          – Mucus
Respiration

Nose      Trachea      Bronchioles
Lungs
         Alveoli
           Gas Exchange
           Surface Area
        • Inhalation/Exhalation
          – Brain
          – Gas Exchange
          – Surface Area
Respiration

Nose     Trachea      Bronchioles
Lungs

        Hemoglobin
         Protein
         Oxygen/Carbon Dioxide
Principles of Nutrition By NHI
Cardiovascular System

Body   Left Heart       Lungs   Right Heart
Body
 Artria Contract        Ventricles Contract

 Heart Rhythm           Pacemaker
   60-80 Beats/Minute
Cardiovascular System

       Blood Vessels
      Arteries
        Blood from Heart
        Muscular
        Systole/Diastole
        Blood pressure (Pulse)
         • Feel Your Wrist

        Capillaries
           Tiny (Feed Body)
Cardiovascular System

        Blood Vessels
     Venuoles
      – Tiny (Take Blood to Veins)
     Veins
        Blood to Heart
        Little Muscle
        Smooth Blood Flow
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
Cardiovascular System

Blood   Red Cells/White Cells/Plasma
          Red Cells -
          Hemoglobin/Oxygen
            Lungs
            Metabolism + Oxygen
            Metabolism and Carbon
            Dioxide
            Anemia
Cardiovascular System

Blood   Red Cells/White Cells/Plasma

             White Cells
               Immunity
               Infection
           • Platelets
             – Blood Clot
Cardiovascular System

Blood   Red Cells/White Cells/Plasma

           Plasma - Liquid
             Proteins
Nervous System




      Nervous System
Nervous System


  Central Nervous
  System (CNS)
  Peripheral Nervous
  System (PNS)
Nervous System

Brain  Spinal Cord Nerves
Nerves Spinal Cord  Brain

Coordinates Body Actions +
Functions
Processes Information
  External
  Internal
Nervous System

       CNS

Spinal Cord
 Gray Matter
 White Matter
 Meninges
 Backbone
Nervous System

          CNS

Connects PNS with Brain
Coordinates Reflexes
Spinal Nerves
 Senses
 Movement
Nervous System

                 Brain
Computer
Coordinates + Processes All
Information
Prepares + Coordinates Responses
Gray Matter/White Matter
Nervous System

                  Brain

Cerebrum (Memory, Reasoning,
Intelligence, Personality, Senses, Logic)
Cerebellum (Physical Activity)
Brain Stem
   Brain   Cord
   Cord    Brain
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"
Nervous System

                       PNS

    Sensory Nerves
     – (Taste, Smell, Sight, Touch, Hearing)
•   Somatic Muscle Nerves (Movement)
Musculature

Skeletal Muscles
 Movement Connected to Bones
 Voluntary
 Red Fibers       Slow
 White Fibers     Fast
 Everywhere
 Somatic Nerves
Musculature

Smooth Muscles
– Involuntary
– Blood Vessels, Visceral organs
– Autonomic Nerves


Cardiac Muscles
  Heart
  Involuntary
  Autonomic nerves
Musculature



Consume ATP to do Work

Need Calcium, Sodium, Potassium
Integumentary System


  Skin
     Epidermis (Barrier)
     Dermis (Blood, Muscles, Connection)
• Barrier
   – Infection
   – Waterproof
   – Mechanical
Integumentary System


    Pigment
    – Protect Against
      Sunlight
    Heat Regulation
      Sweating
      Blood Flow
Integumentary System


    Vitamin D from Sunlight
    Touch
    Pain
    Pressure
    Heat
    Nerve Fibers
Vitamins
Vitamins


Vita   = Life

Amine = Containing Nitrogen

  The First Vitamin Discovered
  Contained Nitrogen
Vitamins


Organic
Essential Nutrients
Requirements Minute (Small)
Perform Specific Functions
  Growth
  Reproduction
  Maintenance of Health and Life
Vitamins


Vitamins Differ from Energy-Yielding Nutrients such as
            Carbohydrate, Proteins and Fat

• Structure

• Function

• Food Contents
Vitamins

Vitamins Similar to Energy-Yielding Nutrients:
                     Carbohydrate, Protein and Fat

• Vital to Life

• Organic
Vitamins

Available in Foods

Organic
 – Destructible:
   • Light:   Riboflavin (B2)
   • Oxygen: Vitamin C
   • Heat :   Thiamin (B1) and Vitamin C
Vitamins


• Solubility:
    Hydrophilic: (Water-Soluble)
      Carbohydrate, Protein
      Vitamins B and C

  – Hydrophobic: (Fat-Soluble)
     • Fat
     • Vitamins A, D, E, K
Precursors


Provitamins Inactive Vitamin
Form

Chemically Changed to Active
Form of Vitamins
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Riboflavin-Vitamin B2


 Functions
   Coenzymes FMN and FAD
   Energy Metabolism
   Supports Normal Vision
   Supports Skin Health

 Food Sources
Riboflavin-Vitamin B2


  Deficiency Disease
  – Ariboflavinosis

  Deficiency Symptoms
   Skin Rash
   Cracks and Redness of
   Mouth
   Sensitivity to Light
Niacin-Vitamin B3


Functions
 Coenzymes NAD
 and NADP
 Energy Metabolism
 Nervous System
 Digestive System

Food Sources
Niacin-Vitamin B3


 Deficiency Disease
  – Pellegra

• Deficiency Symptoms
Biotin


Food Sources
Biotin


Functions
 Coenzyme
 Energy Metabolism
 Fat Synthesis
 Amino Acid Metabolism
 Glycogen Synthesis
Biotin


Deficiency Symptoms
 Loss of Appetite and Nausea
 Abnormal Heart Action
 Depression
 Muscle Pain and Weakness
Pantothenic Acid-Vitamin B5




          Food Sources
Pantothenic Acid-Vitamin B5


          Functions
            Coenzyme A
            Energy Metabolism
Pantothenic Acid-Vitamin B5


        Deficiency Symptoms


          Insomnia
          Fatigue
Pyridoxine-Vitamin B6

                          Object 6




Functions
 Coenzymes PLP and
 PMP
 Amino Acid Metabolism
 Fatty Acid Metabolism
 Converts Tryptophan to
 Niacin

Food Sources
Pyridoxine-Vitamin B6


   Deficiency Disease
    Anemia (small-cell type)
Folate-Folic Acid-Folacin


     Functions


      DNA Synthesis
       New Cell Formation

   • Food Sources
Folate-Folic Acid-Folacin


    Deficiency Disease
    – Anemia (large-cell type)

  • Deficiency Symptoms
     Diarrhea
     Depression/Mental Confusion
Cobalamin-Vitamin B12


    Functions
     Coenzymes
     New Cell Synthesis
     Fatty Acids
     Amino Acids
     Maintain Nerve Cells
Cobalamin-Vitamin B12



  Food Sources
Cobalamin-Vitamin B12


  Deficiency Disease
   – Pernicious Anemia

 • Deficiency Symptoms
    Fatigue
    Degeneration of Peripheral
    Nerves
    Hypersensitivity
Ascorbic Acid-Vitamin C


   Functions
     Collagen Synthesis
     Antioxidant
     Amino Acid Metabolism
     Absorption of Iron
     Resistance to Infection
Ascorbic Acid-Vitamin C



   Food Sources
Ascorbic Acid-Vitamin C


     Deficiency Disease
     – Scurvy
   • Deficiency Symptoms
Fat Soluble Vitamins



     Fat-Soluble Vitamins
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
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
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)
Beta Carotene as an Antioxidant



   Protects the Body Against Disease
     Free Radicals

       Heart Disease
       Cancer
       Arthritis
       Cataracts
Retinol-Vitamin A


  Functions
  – Vision
  – Maintenance of Cornea
  – Mucous Membranes
  – Skin, Bone, and Tooth Growth
• Food Sources
Retinol-Vitamin A in Vision


Cornea
Transportation of Light Energy
 Nerve Impulses       at Retina
Supports Growth of Bones
  Remodeling of Bone
Retinol-Vitamin A


  Deficiency Disease
  – Hypovitaminosis A
• Deficiency Symptoms
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
Calciferol-Vitamin D


Significant Sources
  Food
  Sunlight
Calciferol-Vitamin D from the Sun



   Natural Exposure to Sunlight
     Sun Imposes No Risk of Toxicity
     • Prolonged Exposure Degrades the
       Vitamin D Precursor
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
Calciferol-Vitamin D


Functions
  Raises Blood Calcium and
  Phosphorus
  Hormone
  Organs: Intestines, Kidneys, Bones
  Stimulates Absorption from GI Tract
  Bone Growth
Calciferol-Vitamin D


  Deficiency Disease
   Rickets
   Osteomalacia
  Deficiency Symptoms
Tocopherol-Vitamin E


 1922, Discovery in Vegetable
 Oils
 Anti sterility Factor = Tocopherol
 Compound Named Vitamin E
     Alpha      Beta
     Gamma      Delta
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
Tocopherol-Vitamin E


Functions
 Antioxidant
 Stabilization of Cell Membranes
 Regulation of Oxidation Reactions
 Protection of PUFA
 Protection of Vitamin A
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
Tocopherol-Vitamin E Deficiency



    Rare in Humans
      Fat Malapsorption
      Cystic Fibrosis
  • Causes of Vitamin E Deficiency
     – Erythrocyte Hemolysis
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)
Vitamin K


Significant Sources
  Food
  Non-Food
    Bacteria in GI
    Bacterial Synthesis
Vitamin K


Functions
 Blood-Clotting Synthesis
 Bone Growth
Vitamin K Deficiency


    Deficiency is Rare
      Bile Production
      Diarrhea
      Malabsorption Diseases
      (Crohn’s)
      Sulfa Drugs
      Antibiotics
Vitamin K Deficiency


Surgery: Blood Clotting Time Checked
Newborn Babies: Sterile Digestive Tract
 Vitamin K-Producing Bacteria
 Plasma Prothrombin Concentrations
 Hemorrhagic Disease
Principles of Nutrition By NHI
Minerals

• Major Minerals: Macrominerals
  – Essential nutrients in larger amounts
  – Amounts larger than 5 grams

• Trace Minerals: Microminerals
  – Essential nutrients in smaller amounts
  – Amounts smaller than 5 grams
Minerals in 60kg Human Body
Inorganic Elements

Minerals are inorganic elements
Retain chemical identity
Cannot be destroyed by:
– Heat
– Acid
– Air
– Mixing
Inorganic Elements



Preservation of minerals
Ash from food remains
Minerals lost through leaching in water
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
Variable Bioavailability

   Binders
    – Phytic Acid: calcium, iron, zinc
       • Legumes and grains
    – Oxalic Acid: calcium and iron
         spinach and chocolate
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
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
Sodium Recommendations

Diets rarely lack sodium

Committee on dietary allowances
– Minimum: adults = 500 mg per day

– Maximum: (NaCl) less than 6 g per day
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
Sodium and Hypertension


 Majority of people with HTN, salt restriction
 does not lower blood pressure

   Most effective dietary treatment
    for HTN is weight loss
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
Chloride Roles in the Body


 Major anion (-) in extracellular fluids
 Association with sodium (NaCl)
 Moves freely across membranes
 Critical for fluid and electrolyte balance
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
Chloride Recommendations
        and Intakes

Abundant in foods (especially processed)
No RDA set
  Estimated minimum requirement 750 mg per
  day
Potassium


Positively charged ion (+)
Body’s principal Cat-Ion inside the cells
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
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
Potassium and Hypertension

     Potassium
     – Prevent or help to correct HTN
     Low potassium diets raise blood pressure:
     – Hypertensive
 •   High potassium intake protects against stroke
Potassium Deficiency

Dietary deficiency rare
Excessive losses versus deficient
intake:
 - Diabetic acidosis    - Dehydration
 - Prolonged vomiting   - Diarrhea
 - Diuretics            - Steroids
 - Laxatives
Calcium


Most abundant mineral in the body
Found primarily in:
  Bones
  Teeth
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
Calcium in Bones


Formation/dissolution
simultaneously
State of constant flux
  Osteoblast cells build bone
  Osteoclast cells break down
  bone
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
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
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
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
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
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
Calcium-Binding Protein

Body regulates calcium absorption
  Average calcium absorption
  •   Adult            = 30%
  •   Pregnant women   = 50%
  •   Growing child    = 50-60%
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
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
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
Osteoporosis

Osteoporosis: bone loss reaches point
when bones fracture under common
everyday stress
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)
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
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
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
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
Phosphorus Recommendations


 Same as calcium, except
 during infancy
 Diets that provide adequate
 energy and protein also supply
 adequate phosphorus
Phosphorus Recommendations


    Age                Nutrient



    0 – 6 months       400 mg Calcium
                       300 mg Phosphorus


    6 months – 1year
                       600 mg Calcium
                       500 mg Phosphorus
Magnesium


Cat-Ion (Mg++) within body's cells
Active in many enzyme systems
Over half of body's magnesium is in
bones
Magnesium


1% in the extracellular fluid
Bone magnesium is reservoir to
ensure availability
Remaining magnesium found in
muscle and tissue
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
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
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
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
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
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
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
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)
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
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
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+++
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
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
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
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
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
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)
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
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
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
Iron Recycling


Body loses some iron daily
  Via the GI tract
  If bleeding occurs
  Tiny amounts in urine, sweat,
  shedded skin
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.
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
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
Iodine


Iodine is indispensable to life
Needed in trace amounts
Iodine in foods is converted to
iodide ion in the GI tract
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.
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
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
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
Chromium


Essential mineral
Participates in
carbohydrate and lipid
metabolism
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
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
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
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!
Causes of Death


  Infectious diseases
  – TB, diarrhea, malaria,
    AIDS
  Cardiovascular
  – Heart, coronary,
    cerebrovascular
• Cancer
• Respiratory
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)
Diet and disease


Obesity
 1.2 billion people in the world are
 overweight
  300 million of them are Obese
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
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
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
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%
Childhood Obesity ……..
  Object 5
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
Video 4: Childhood Obesity…..




            Click to Start
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
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
Diet and Heart Disease
Why Does the Heart Quit?



  Not enough oxygen and nutrition
  Poisons build up in the heart
  Muscle dies
What happens Then?


Heart gets bigger
Heart works harder
Heart tires out
Heart fails
When Heart Muscles Die What
        Happens?



  Muscle replaced with scar tissue
  Scar tissue does not work
  More scar tissue less muscle
  Heart quits
What Causes Heart Failure?



    High blood pressure
    (Hypertension)
    Coronary blood
                 vessel
    disease
    Atherosclerosis
How Does High Blood Pressure Affect
            the Heart?



        Heart must work
        harder
        Uses more energy
        Muscle starves
What Does Coronary Vessel Do?



   Blocks blood through heart
   muscle
   Less food and oxygen to
   heart
   Muscle starves
What Does Atherosclerosis Do?



      Blocks blood flow to
     brain
      Brain does not get
     food and oxygen
      Brain cells die
What Causes High Blood Pressure?



   Sometimes water
   balance problems
   Obesity
   Other diseases
   Undetermined causes
High Blood Pressure Leads To


    Stroke
    Congestive heart failure
    Heart attack
    Kidney disease
    Blood vessel damage
How Can We Treat High Blood
        Pressure?


   Exercise, diet, stress
   reduction
   Increase urine flow
   Make the heart work less
   hard
   Relax blood vessels
Cholesterol


Is a fat-like waxy substance
essential to body chemistry
Is manufactured by our bodies
Contained in foods we eat
Cholesterol


• LDL
   “Bad” cholesterol
   Lower is better
• HDL
  – “Good” cholesterol
  – Higher is better
Saturated Fats



DECREASE
 YOUR
    SATURATED
        FATS!
Athersclerosis Leads To


   Heart attack
   Stroke
   Sudden death
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
Major Risk Factors for CVD


         Diabetes
         Overweight
         Lack of exercise
Compounding Risk Factors



                                  Cigarettes
                                     and
                                  Cholesterol
                                     and
                      Cigarettes High Blood
                         and       Pressure
           Cigarettes Cholesterol
    None
Coronary Risk Factors


Modifiable               Fixed
  Hypercholesterolemia     Family history
  Hypertension             Age
  Smoking                  Menopausal
                           females without
  Physical inactivity      hormone
  Diabetes mellitus        replacement
  Low LDL
  Obesity
To Reduce Your Risk


   • Control High Blood
     Pressure
   • Do NOT smoke
   • Follow proper diet
ALSO: To Reduce Your Risk


       Exercise regularly
       Have regular
       medical check-ups
       Identify and treat
       diabetes
Triglycerides


Triglycerides are the fat in food
we eat
Our bodies manufacture and
store triglycerides when we eat
more calories than we need
Saturated Fatty Acids


 Saturated fatty acids are the
 main culprit in raising blood
      cholesterol levels
Dietary Recommendation


  Total fat intake should be less than
  30% of calories
  Saturated fatty acid intake should
  be less than 10% of calories
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
Proper Mix of Fat in Diet


   Up to 10% polyunsaturated
   Less than 10% saturated
   Balance from monounsaturated
Trans Fatty Acids


Tend to raise LDL cholesterol
levels
Major sources:
  Margarine
  Vegetable shortening
  Fast foods
  Baked products
Coronary Heart Disease


       1% drop        2% drop
    cholesterol =     coronary
                        heart
                    disease risk
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
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
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
Sodium


Epidemiological evidence
Individual response
Patients likely to have the greatest
response to sodium:
  Older persons
  Those with high initial blood pressure
  Those with a family history of hypertension
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
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
Fiber



 Eat        Fib
More            er
Fiber
Obesity

Blood pressure
Atherosclerosis
Heart
Gall bladder
Diabetes
Pregnancy and
surgery
Joint disease
Diet and Diabetes
Diabetes Mellitus


A clinically and genetically
heterogeneous group of
disorders that is characterized
by elevated blood glucose.
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
Types of Diabetes


Diabetes Mellitus
 Type I (IDDM: Insulin dependent)
 Type II (NIDDM: Non-insulin
 dependent)
Diabetes Insipidus
Gestational Diabetes
Type I (IDDM) Diabetes


Juvenile diabetes
Pancreas makes little or no insulin
Insulin dependent diabetes
Appears suddenly and worsens
rapidly
Type I Diabetes
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
Type II Diabetes
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
Classification of Diabetes

     Type I    ~5%
                 ~6% of population
     Type II   ~95%


     GDM       ~2% - 4% pregnant women


     IGT       ~11% of population
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
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
How Do We Treat Diabetes?


       Type I
         Exercise
         Diet
         Injected insulin
           Fast acting
           Moderate
           Long acting
How Do We Treat Diabetes?


  Diabetes insipidus
    Usually patient is comfortable
    except with annoyance of
    frequent:
      Need to drink
      Need to urinate
Type II Diabetes


Non-insulin dependent
  Insulin secretion insufficient or excessive
  Tends to occur after age of 40
  80% are above ideal body
  weight
Benefits of Weight Loss


 Reduces blood pressure
 Reduces serum
 triglycerides, total
 cholesterol
 Increases HDL-cholesterol
 Reduces blood glucose
 levels
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
Indications for Insulin in Type II



   Ineffectiveness of:
     Meal plan
     Physical activity
     OHAs
     Endogenous insulin
   As therapy for an acute
   medical condition
Treatment Obese, Non-Insulin
        Dependent


     Meals coordinated with insulin
     Weight reduction*
     Regular exercise

   *May eliminate or reduce need for insulin
Regulation of Blood Glucose Levels



               Blood            Counterregulatory
                        Insulin
              Glucose              Hormones


     Fed



    Fasting
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
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
Nutrition Recommendations
For Persons With Diabetes



   Protein          • Fat
   Carbohydrate     • Fiber
Diabetes Food Pyramid


            ~6% of population
High-Fiber Foods

Legumes
                 Contains guar and pectin
Fresh fruit

Raw vegetables
Whole grains:
                 Contains cellulose
  Oats, wheat,
 brown rice
Consuming High-Fiber Foods


    Consuming high-fiber foods
    may:
      Lower post-meal blood
      glucose
      Lower fasting blood glucose
      Lower insulin requirements
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
Sodium


• To choose low sodium in food:
Oral Hypoglycemic Medication



     Increases sensitivity of
     receptor to insulin

     Stimulates pancreas to
     increase production of insulin
          Picture 4
Effects of Adequate Insulin on
     Protein Metabolism



     Anticatabolic
      –   Proteolysis
      –   Gluconeogensis
     Anabolic
      –   Protein synthesis
    • Amino acid transport
Diabetes-Related Conditions Requiring
      Medical Nutrition Therapy


         Hypertension
         Nephropathy
         Gastroparesis
         Diabetes complicated by
         surgery
         Macrovascular complications
         Obesity
Nephropathy


Type I diabetes ~35%
Type II diabetes ~ 20%
Accounts for ~35% of
new cases of end-
stage renal disease
(ESRD)
Syndrome X

  Obesity                           Genetics
(Upper Body)
               Insulin Resistance


               Hyperinsulinemia

Dyslipidemia                    Hypertension
           Glucose Intolerance
            (IGT and Type II)
Lipoprotein Abnormalities
   Related to Diabetes


•   TG and VLDL (type II)
•    HDL-C
• Cholesterol and LDL-C
  similar to general public
•   Chylomicron clearance
Select Meal Planning Approaches



      General guidelines
      Menu planning systems
      Exchange systems
      Counting systems
General Guidelines


• Benefits:
   Easy to understand
   Good “first step” tool
   Inexpensive
   Allows patient to make
   choices
Menu Planning Systems


    • Benefits:
       Gives specific
       instructions
       Simple to use
       Variety of choices
       May include recipes
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
Acute Complications of Diabetes



        Hypoglycemia
        Hyperglycemia
        Diabetic ketoacidosis
        (DKA)
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
Hypoglycemia


     Causes
     Symptoms
      Shakiness
      Sweating
      Confusion
      Irritability
Hypoglycemia


Treat blood glucose < 70
mg/dl
  15 g CHO
  Wait 15 minutes
  Retest and monitor symptoms
Hypoglycemic unawareness
Hyperglycemia


     Symptoms
      Polyuria
      Polydipsia
      Dry mouth
      Weight loss
      Fatigue
Hyperglycemia


  Can lead to DKA,
  coma, and death
  DKA
   Blood glucose > 250 mg/dl
   Urine ketones
Treatment Plan for Hyperglycemia



        Test urine or blood
        Call physician or health
        care team
        Report results and
        symptoms
        Follow doctor’s advice
Diet and Cancer
Burden of Cancer in India

             Estimated number of new
             cancers diagnosed in India
             every year: 700 - 900,000.
Causes of Cancer


  Tobacco***
  Sunlight***
  Genetic*
  Environment*
  Diet
Tobacco


Lung, mouth, liver,
kidney
Chemicals in smoke
cause cancer
Daily, continuous
exposure
How Do We Decrease
    Tobacco-Related Causes?


•   STOP smoking


•   Decrease amount of cigarette
    smoked
•   Do not inhale
•   Filters
How Does Sunlight Cause Cancer



          U.V. light
          Damages DNA
          Mutation
                 cancer
          Skin cancer
How Do Genes Play a Role in Cancer?



         Prevent cell death
         Increased mutations
         Breast, prostate, intestine
         Cancer families
What Can We Do to Decrease
  Gene-Related Cancers?




   Not much yet
   Future (?)
What Environmental Causes are There?



             Radon
             Some chemicals
             • Mostly are work place

           ¢Asbestos
What Can We Do to Decrease
   Environmental Risks?


       Remove radon and
       asbestos
       Better chemical
       control
What Roles Does Diet Play in Cancer?



       Difficult to determine
       Causation versus correlation
       Salt
       Fats*
       Food preparation and storage
         Microbes and cancer
How Can We Use
Diet to Decrease Cancer Risk?



       Fiber*
       Good nutrition
       Preservatives
       Antioxidants
Why is Cancer So Deadly?


         Detection
         Invasion
         Metastasis
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
What is Invasion?


Benign tumors
Cysts: displace normal tissue
Malignant tumors
  Invade normal tissue
  Disrupt organ function
  Invades blood vessels and lymph
What is Metastasis


 Spread of cancer
 throughout the body
 Blood vessels
 Lymph system
 The real killer
Treatment of Cancer


 Surgery
 Radiation
 Drugs
 Immune system
Prevention of Cancer:
Best But Poorly Understood


   Stop smoking***
   Decrease sun
   exposure***
   Diet
   Antioxidants
   Alcohol
Cancer Incidence

Oesophagus
Lung
Stomach
Colon/rectum
Breast
Prostate
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
Good News!


Protective
factors
Risk factors
Protective Factor: 1


Cabbage family vegetables
Mustard family vegetables

  Cabbages
  Mustards
  Broccoli
  Brussels sprouts
  Cauliflower
Protective Factor: 2

 Fiber
   Whole grain breads
   Whole grain flours
   Wholes grain cereals
   Peas
   Beans
   Fruits
   Vegetables
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
Protective Factor: 3


Vitamin A
Beta Carotene
  Spinach
  Squash           Lettuce
  Broccoli         Carrots
  Sweet potatoes   Peaches
                   Apricots
Protective Factor: 4


Vitamin C
  Tomatoes           Cauliflower
  Peppers            Broccoli
  Celery             Mustard greens
  Brussels sprouts
Protective Factor: 4


   Vitamin C
     Mangoes
     Kiwi fruit
     Currants
      Lemon
      Amla
Phytochemicals


Chemicals in plants that have
nutrient or other functions.
  Dietary Sources
   •   soy, oats, tea, grapes, garlic, tomato
  Supplements Sources
       ginseng, echinacea
Activities of
  Phytochemicals

Antioxidants         Genetic
Enzyme Modulation    Anti-Inflammatory
Cell Proliferation   Endocrine function
Angiogenesis         Platelet aggregation
                     Vascular Reactivity
Protective Factor: 5




 Weight Control
Walk Away the Calories


Brisk Walking For:   Equals:
20 minutes           100 calories
30 minutes           150 calories
45 minutes           225 calories
60 minutes           300 calories
70 minutes           350 calories
Cancer



Cancer risk reduction
Eliminate risk factors
Risk Factor: 1



  Dietary fat
  Fat calories
Risk Factor: 2


 Salt cured
 Nitrite cured
 Smoked foods
Risk Factor: 3


Cigarettes are 87% of lung
cancer
30% of all cancer is
smoking related
Risk Factor: 4


Alcohol
Compound risk:
Alcohol + Cigarettes
Risk Factor: 5


Excessive sun
  Avoid midday sun
  Sunscreen SPF 15
  Protective clothing
  Avoid sunlamps, tanning
  pills and tanning parlors
AIDS/HIV


AIDS/HIV
What is Aids?


Acquired Immune
Deficiency syndrome
How Does Virus Affect Us?


         Targets immune
         cells
          Kills lymphocytes
          Stored in macrophages

         Lose immune
         system
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
What Kills an AIDS Patient?


      Infections:
      "opportunistic
      infections"
      Diet problems
      Organ failure
How Can We Prevent AIDS?



              "Safe sex"
              Clean needles
              Common sense
How Do We Treat AIDS?



     Diet
     Exercise
     Drugs
What Do Drugs Do


Prevent virus from replicating
Prevent virus from reforming
What Are the Problems With Drugs?



          Very expensive
          Complex schedules of
          drug taking
          Resistance
Immune System


Prevents against
invading organisms
Kills tumor cells
What If Immune System Malfunctions



       Autoimmune disease:
       immune system attacks
       itself
       Cancer develops
       Opportunistic infections
Nutrition and HIV/AIDS


    Optimize your health

     Prevention and
     treatment of HIV/AIDS
     associated malnutrition
Weight Loss Means


11Kg   =   17,500 calories
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
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
Link between Malnutrition and HIV/
                              AIDS


                           Malnutrition
                            wasting

Increased requirements                                 Decreased
   Decreased Intake                                     Immunity
   Increased losses
                                   HIV



                          Opportunistic Infections
                         Increased risk of mortality
Causes of Malnutrition

  Calorie intake
  Nutrient absorption
  Altered energy
  expenditure
  Hormone and nutrient
  dysregulation
  Malabsorption
  Change in physical
  activity
Dietary Changes to Treat:


      Increased lipids
      Weight loss
      Diarrhea
      Increased triglycerides
      Increased blood glucose
      Taste changes, nausea,
      swallow difficulties
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
Malabsorption


 Signs and symptoms
   Weight loss
   Nutrient deficiency
   Abdominal distention, gas, discomfort
   Fullness, early satiety
• Consequences
  – Compromised immune function
    and metabolism
  – Reduced medication tolerance
Common Nutrient Deficiencies



   Total Calories   Vitamin E
   Vitamin A       Folic Acid
   Vitamin B6       Magnesium
   Vitamin B12      Selenium
   Zinc
Possible Interventions


    Exercise intervention
    Food supplements
    Vitamin, mineral, protein
    supplement
    Appetite stimulants
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
Multivitamins


Best source food
Ability to absorb

may improve or
     lessen
Research is

inconclusive
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
Food Sources Antioxidants

   Vitamin E
     Foods
       Vegetable oils
       Fortified cereals
       and breads
       Almonds
       Avocado
       whole grains
Food Sources Antioxidants


   Selenium
      Foods
                       Seafood
        Eggs
                       Organ meats
        Chicken
                       Cereals and breads
        Lean meats
                       Beans
        whole grains
Food Sources Antioxidants

    Vitamin A (Beta
    Carotene)
                        Sweet potato
     Foods              Carrots
                        Spinach
       Pumpkin
                        Broccoli
       Mustard greens
       Winter squash
       Apricots
       Mango
Food Sources Antioxidants

    Vitamin C
      Foods
        Citrus fruits       Green peppers
        Strawberries        Mango
        Broccoli            Kiwi
        Fortified cereals
        Brussels sprouts
FOOD SCIENCE AND TECHNOLOGY



   Food Science:

   Knowledge and understanding of the
   nature and composition of food
   material.
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
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
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
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
Pesticides

Insecticides to control
Insects
Rodenticides to
control Rodents
Herbicides to control
weeds
Fungicides to control
mold, mildew, fungi
Video 5: Organic Farming




            Click to Start
Organic Farming


         Minimal use of Chemical
         fertilizers and pesticides
         Standards for allowable,
         restricted prohibited
         material
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
Principles of Nutrition By NHI
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Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI
Principles of Nutrition By NHI

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Principles of Nutrition By NHI

  • 1. Principles of Nutrition Nutrilite Health Institute certification course By Amway India
  • 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
  • 9. Nutrition “What is it” Nutrition “What is it”
  • 11. Food Guide Pyramid FOOD PYRAMID
  • 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
  • 17. Video 1- Micro Nutrients Click to Start
  • 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
  • 20. Energy -yielding Nutrients Carbohydrate Fat Protein
  • 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
  • 22. Energy in Foods Carbohydrates = 4 kcal/gram Protein = 4 kcal/gram Fat = 9 kcal/gram Alcohol* = 7 kcal/gram*
  • 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
  • 29. Water's Role Shock Absorber Body Temperature Regulation Maintains Blood Volume Lubricant and Cushions Joints
  • 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
  • 45. Complete Proteins Essential Amino Acids Nonessential Amino Acids Animal Sources = Essential Amino Acids Meat Cheese Fish Eggs Poultry Milk
  • 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.
  • 51. RDA of Protein ….. contd
  • 52. Experimental assessment of Protein sources.
  • 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.
  • 55. Count What You Eat Protein Value Of Cooked Preperations Preperation Weight(gm) Proteins ( gm) SNACKS Samosa 65 3 Sandwich 65 3 Sevian 80 3 Idli 115 5 Dosa 85 6 Vada 45 6 Dahi vada 165 11 Upma 130 5 Masala omlettee 100 7 CHUTNEY Coconut 55 2 Coriander 20 1 Mint 18 trace Tomato 50 1 NON - VEG Handi Chicken 125 26 Fish cutlet 80 14 Fried fish 85 18 Liver 140 22 Mutton 145 18 Prawn curry 145 18
  • 56. Carbohydrates Compounds composed of carbon, oxygen and hydrogen molecules Carbo = Carbon Hydrate = With Water (H2O)
  • 57. Carbohydrate Family Simple Complex Carbohydrates (Sugars) Carbohydrates Monosaccharides Starch (Polysaccharides)* Glucose (Blood Sugar) Fibers (Nonstarch Fructose (Fruit Sugar) Polysaccharides) Galactose (Milk Sugar) Soluble S Disaccharides Insoluble – Sucrose (Table Sugar) – Lactose – Maltose *Glycogen is a Complex Carbohydrate (a Polysaccharide), but not a Dietary Source of Carbohydrate
  • 58. Starch Glucose Molecules Linked Plants Store Glucose as Starch Humans Eat Plants Body Hydrolysis Starch to Glucose Energy
  • 59. Glycogen Animal Polysaccharide Manufactured and Stored in Liver Not Significant Source of Carbohydrate Not Complex Carbohydrate in Foods Food Sources
  • 60. Fiber Structural Part of Plants – Vegetables, Fruits, Grains, Legumes • Non-Starch Polysaccharides: – Cellulose, Hemicellulose, Pectins, Gums, Mucilages • Non Polysaccharides: Lignins, Cutins, Tannins
  • 61. Fiber: Sources, Actions, Structures Soluble Fibers Insoluble Fibers Food Sources Fruits (Apples, Citrus), Wheat Bran, Whole-Grain Oats, Barley, Legumes Breads and Cereals, Vegetables Delay GI Transit Accelerate GI Transit Action in the Delay Glucose Absorption Increase Fecal Weight Body Lower Blood Cholesterol Slow Starch Hydrolysis Delay Glucose Absorption Gums, Pectins, Some Cellulose, Many Type of Fiber Hemicelluloses, Mucilages Hemicelluloses, Lignins
  • 62. Video 2: Good Fats Click to Start
  • 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
  • 77. Sterols Liquid Compounds Multiple Ring Structure Cholesterol
  • 78. Cholesterol Animal Foods Meats Eggs Fish Shellfish Poultry Dairy Products Organ Meats (Liver, Kidneys)
  • 80. Physiology Organism Cellular Molecular
  • 81. Structural Organization Atoms Molecules • Organ Cells Tissues • Systems Organism
  • 82. Cells Cells: Building Blocks of Our Body Membrane Fat Holds Cell Together Separates Cells
  • 83. Cells Cells: Building Blocks of Our Body Passive Diffusion Active Transport
  • 84. Cytoplasm Liquid Inside "Cell Membrane" Organelles "Tiny Organs" Mitochondria Endoplasm Lysosomes
  • 85. Nucleus Brain of Cell DNA Ribosomes "RNA" Protein Synthesis
  • 86. Energy Food = Energy ATP = EnergyObject 2 Mitochondria
  • 87. Metabolism Anabolic - small large Amino Acids Proteins Uses ATP • Catabolic Fat Acetyl CoA ATP – Proteins Amino Acids – Make ATP
  • 89. Protein Anabolic - Amino Acids Protein Catabolic - Protein Amino Acids Essential Amino Acids Non-Essential Amino Acids
  • 90. Sugar Anabolic - Sugar Glycogen Catabolic - Glycogen Sugar ATP
  • 92. Digestive System Picture 3 Esophagus Stomach Small intestine 21 ft long Large intestine – 5 Ft long Appendix
  • 93. Digestive System Digestion: Breaking Complex Food Into Smaller Particles Mouth Teeth Breakdown Food
  • 94. Digestive System Picture 4 Teeth Tongue Salivary gland Epiglottis Esophagus
  • 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
  • 98. Digestive System Stomach Vomiting • Reflex • Bulimia - Esophagus, Teeth – Ulcers – Gastrectomy
  • 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
  • 106. Respiration Nose Trachea Bronchioles Lungs Trachea Stiff Tubes pharynx Larynx larynx • Bronchioles – Tubes to Lungs trachea – Cilia – Mucus
  • 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
  • 116. Cardiovascular System Blood Red Cells/White Cells/Plasma Plasma - Liquid Proteins
  • 117. Nervous System Nervous System
  • 118. Nervous System Central Nervous System (CNS) Peripheral Nervous System (PNS)
  • 119. Nervous System Brain Spinal Cord Nerves Nerves Spinal Cord Brain Coordinates Body Actions + Functions Processes Information External Internal
  • 120. Nervous System CNS Spinal Cord Gray Matter White Matter Meninges Backbone
  • 121. Nervous System CNS Connects PNS with Brain Coordinates Reflexes Spinal Nerves Senses Movement
  • 122. Nervous System Brain Computer Coordinates + Processes All Information Prepares + Coordinates Responses Gray Matter/White Matter
  • 123. Nervous System Brain Cerebrum (Memory, Reasoning, Intelligence, Personality, Senses, Logic) Cerebellum (Physical Activity) Brain Stem Brain Cord Cord Brain
  • 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"
  • 125. Nervous System PNS Sensory Nerves – (Taste, Smell, Sight, Touch, Hearing) • Somatic Muscle Nerves (Movement)
  • 126. Musculature Skeletal Muscles Movement Connected to Bones Voluntary Red Fibers Slow White Fibers Fast Everywhere Somatic Nerves
  • 127. Musculature Smooth Muscles – Involuntary – Blood Vessels, Visceral organs – Autonomic Nerves Cardiac Muscles Heart Involuntary Autonomic nerves
  • 128. Musculature Consume ATP to do Work Need Calcium, Sodium, Potassium
  • 129. Integumentary System Skin Epidermis (Barrier) Dermis (Blood, Muscles, Connection) • Barrier – Infection – Waterproof – Mechanical
  • 130. Integumentary System Pigment – Protect Against Sunlight Heat Regulation Sweating Blood Flow
  • 131. Integumentary System Vitamin D from Sunlight Touch Pain Pressure Heat Nerve Fibers
  • 133. Vitamins Vita = Life Amine = Containing Nitrogen The First Vitamin Discovered Contained Nitrogen
  • 134. Vitamins Organic Essential Nutrients Requirements Minute (Small) Perform Specific Functions Growth Reproduction Maintenance of Health and Life
  • 135. Vitamins Vitamins Differ from Energy-Yielding Nutrients such as Carbohydrate, Proteins and Fat • Structure • Function • Food Contents
  • 136. Vitamins Vitamins Similar to Energy-Yielding Nutrients: Carbohydrate, Protein and Fat • Vital to Life • Organic
  • 137. Vitamins Available in Foods Organic – Destructible: • Light: Riboflavin (B2) • Oxygen: Vitamin C • Heat : Thiamin (B1) and Vitamin C
  • 138. Vitamins • Solubility: Hydrophilic: (Water-Soluble) Carbohydrate, Protein Vitamins B and C – Hydrophobic: (Fat-Soluble) • Fat • Vitamins A, D, E, K
  • 139. Precursors Provitamins Inactive Vitamin Form Chemically Changed to Active Form of Vitamins
  • 149. Riboflavin-Vitamin B2 Functions Coenzymes FMN and FAD Energy Metabolism Supports Normal Vision Supports Skin Health Food Sources
  • 150. Riboflavin-Vitamin B2 Deficiency Disease – Ariboflavinosis Deficiency Symptoms Skin Rash Cracks and Redness of Mouth Sensitivity to Light
  • 151. Niacin-Vitamin B3 Functions Coenzymes NAD and NADP Energy Metabolism Nervous System Digestive System Food Sources
  • 152. Niacin-Vitamin B3 Deficiency Disease – Pellegra • Deficiency Symptoms
  • 154. Biotin Functions Coenzyme Energy Metabolism Fat Synthesis Amino Acid Metabolism Glycogen Synthesis
  • 155. Biotin Deficiency Symptoms Loss of Appetite and Nausea Abnormal Heart Action Depression Muscle Pain and Weakness
  • 157. Pantothenic Acid-Vitamin B5 Functions Coenzyme A Energy Metabolism
  • 158. Pantothenic Acid-Vitamin B5 Deficiency Symptoms Insomnia Fatigue
  • 159. Pyridoxine-Vitamin B6 Object 6 Functions Coenzymes PLP and PMP Amino Acid Metabolism Fatty Acid Metabolism Converts Tryptophan to Niacin Food Sources
  • 160. Pyridoxine-Vitamin B6 Deficiency Disease Anemia (small-cell type)
  • 161. Folate-Folic Acid-Folacin Functions DNA Synthesis New Cell Formation • Food Sources
  • 162. Folate-Folic Acid-Folacin Deficiency Disease – Anemia (large-cell type) • Deficiency Symptoms Diarrhea Depression/Mental Confusion
  • 163. Cobalamin-Vitamin B12 Functions Coenzymes New Cell Synthesis Fatty Acids Amino Acids Maintain Nerve Cells
  • 164. Cobalamin-Vitamin B12 Food Sources
  • 165. Cobalamin-Vitamin B12 Deficiency Disease – Pernicious Anemia • Deficiency Symptoms Fatigue Degeneration of Peripheral Nerves Hypersensitivity
  • 166. Ascorbic Acid-Vitamin C Functions Collagen Synthesis Antioxidant Amino Acid Metabolism Absorption of Iron Resistance to Infection
  • 167. Ascorbic Acid-Vitamin C Food Sources
  • 168. Ascorbic Acid-Vitamin C Deficiency Disease – Scurvy • Deficiency Symptoms
  • 169. Fat Soluble Vitamins Fat-Soluble Vitamins
  • 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
  • 185. Tocopherol-Vitamin E Functions Antioxidant Stabilization of Cell Membranes Regulation of Oxidation Reactions Protection of PUFA Protection of Vitamin A
  • 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)
  • 189. Vitamin K Significant Sources Food Non-Food Bacteria in GI Bacterial Synthesis
  • 190. Vitamin K Functions Blood-Clotting Synthesis Bone Growth
  • 191. Vitamin K Deficiency Deficiency is Rare Bile Production Diarrhea Malabsorption Diseases (Crohn’s) Sulfa Drugs Antibiotics
  • 192. Vitamin K Deficiency Surgery: Blood Clotting Time Checked Newborn Babies: Sterile Digestive Tract Vitamin K-Producing Bacteria Plasma Prothrombin Concentrations Hemorrhagic Disease
  • 194. Minerals • Major Minerals: Macrominerals – Essential nutrients in larger amounts – Amounts larger than 5 grams • Trace Minerals: Microminerals – Essential nutrients in smaller amounts – Amounts smaller than 5 grams
  • 195. Minerals in 60kg Human Body
  • 196. Inorganic Elements Minerals are inorganic elements Retain chemical identity Cannot be destroyed by: – Heat – Acid – Air – Mixing
  • 197. Inorganic Elements Preservation of minerals Ash from food remains Minerals lost through leaching in water
  • 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
  • 209. Potassium Positively charged ion (+) Body’s principal Cat-Ion inside the cells
  • 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
  • 213. Potassium Deficiency Dietary deficiency rare Excessive losses versus deficient intake: - Diabetic acidosis - Dehydration - Prolonged vomiting - Diarrhea - Diuretics - Steroids - Laxatives
  • 214. Calcium Most abundant mineral in the body Found primarily in: Bones Teeth
  • 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
  • 216. Calcium in Bones Formation/dissolution simultaneously State of constant flux Osteoblast cells build bone Osteoclast cells break down bone
  • 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
  • 223. Calcium-Binding Protein Body regulates calcium absorption Average calcium absorption • Adult = 30% • Pregnant women = 50% • Growing child = 50-60%
  • 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
  • 227. Osteoporosis Osteoporosis: bone loss reaches point when bones fracture under common everyday stress
  • 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
  • 234. Phosphorus Recommendations Age Nutrient 0 – 6 months 400 mg Calcium 300 mg Phosphorus 6 months – 1year 600 mg Calcium 500 mg Phosphorus
  • 235. Magnesium Cat-Ion (Mg++) within body's cells Active in many enzyme systems Over half of body's magnesium is in bones
  • 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
  • 280. Video 4: Childhood Obesity….. Click to Start
  • 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
  • 283. Diet and Heart Disease
  • 284. Why Does the Heart Quit? Not enough oxygen and nutrition Poisons build up in the heart Muscle dies
  • 285. What happens Then? Heart gets bigger Heart works harder Heart tires out Heart fails
  • 286. When Heart Muscles Die What Happens? Muscle replaced with scar tissue Scar tissue does not work More scar tissue less muscle Heart quits
  • 287. What Causes Heart Failure? High blood pressure (Hypertension) Coronary blood vessel disease Atherosclerosis
  • 288. How Does High Blood Pressure Affect the Heart? Heart must work harder Uses more energy Muscle starves
  • 289. What Does Coronary Vessel Do? Blocks blood through heart muscle Less food and oxygen to heart Muscle starves
  • 290. What Does Atherosclerosis Do? Blocks blood flow to brain Brain does not get food and oxygen Brain cells die
  • 291. What Causes High Blood Pressure? Sometimes water balance problems Obesity Other diseases Undetermined causes
  • 292. High Blood Pressure Leads To Stroke Congestive heart failure Heart attack Kidney disease Blood vessel damage
  • 293. How Can We Treat High Blood Pressure? Exercise, diet, stress reduction Increase urine flow Make the heart work less hard Relax blood vessels
  • 294. Cholesterol Is a fat-like waxy substance essential to body chemistry Is manufactured by our bodies Contained in foods we eat
  • 295. Cholesterol • LDL “Bad” cholesterol Lower is better • HDL – “Good” cholesterol – Higher is better
  • 296. Saturated Fats DECREASE YOUR SATURATED FATS!
  • 297. Athersclerosis Leads To Heart attack Stroke Sudden death
  • 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
  • 299. Major Risk Factors for CVD Diabetes Overweight Lack of exercise
  • 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
  • 310. Coronary Heart Disease 1% drop 2% drop cholesterol = coronary heart disease risk
  • 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
  • 314. Sodium Epidemiological evidence Individual response Patients likely to have the greatest response to sodium: Older persons Those with high initial blood pressure Those with a family history of hypertension
  • 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
  • 317. Fiber Eat Fib More er Fiber
  • 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
  • 338. Regulation of Blood Glucose Levels Blood Counterregulatory Insulin Glucose Hormones Fed Fasting
  • 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
  • 341. Nutrition Recommendations For Persons With Diabetes Protein • Fat Carbohydrate • Fiber
  • 342. Diabetes Food Pyramid ~6% of population
  • 343. High-Fiber Foods Legumes Contains guar and pectin Fresh fruit Raw vegetables Whole grains: Contains cellulose Oats, wheat, brown rice
  • 344. Consuming High-Fiber Foods Consuming high-fiber foods may: Lower post-meal blood glucose Lower fasting blood glucose Lower insulin requirements
  • 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
  • 346. Sodium • To choose low sodium in food:
  • 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
  • 354. General Guidelines • Benefits: Easy to understand Good “first step” tool Inexpensive Allows patient to make choices
  • 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
  • 357. Acute Complications of Diabetes Hypoglycemia Hyperglycemia Diabetic ketoacidosis (DKA)
  • 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
  • 359. Hypoglycemia Causes Symptoms Shakiness Sweating Confusion Irritability
  • 360. Hypoglycemia Treat blood glucose < 70 mg/dl 15 g CHO Wait 15 minutes Retest and monitor symptoms Hypoglycemic unawareness
  • 361. Hyperglycemia Symptoms Polyuria Polydipsia Dry mouth Weight loss Fatigue
  • 362. Hyperglycemia Can lead to DKA, coma, and death DKA Blood glucose > 250 mg/dl Urine ketones
  • 363. Treatment Plan for Hyperglycemia Test urine or blood Call physician or health care team Report results and symptoms Follow doctor’s advice
  • 365. Burden of Cancer in India Estimated number of new cancers diagnosed in India every year: 700 - 900,000.
  • 366. Causes of Cancer Tobacco*** Sunlight*** Genetic* Environment* Diet
  • 367. Tobacco Lung, mouth, liver, kidney Chemicals in smoke cause cancer Daily, continuous exposure
  • 368. How Do We Decrease Tobacco-Related Causes? • STOP smoking • Decrease amount of cigarette smoked • Do not inhale • Filters
  • 369. How Does Sunlight Cause Cancer U.V. light Damages DNA Mutation cancer Skin cancer
  • 370. How Do Genes Play a Role in Cancer? Prevent cell death Increased mutations Breast, prostate, intestine Cancer families
  • 371. What Can We Do to Decrease Gene-Related Cancers? Not much yet Future (?)
  • 372. What Environmental Causes are There? Radon Some chemicals • Mostly are work place ¢Asbestos
  • 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
  • 380. Treatment of Cancer Surgery Radiation Drugs Immune system
  • 381. Prevention of Cancer: Best But Poorly Understood Stop smoking*** Decrease sun exposure*** Diet Antioxidants Alcohol
  • 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
  • 385. Protective Factor: 1 Cabbage family vegetables Mustard family vegetables Cabbages Mustards Broccoli Brussels sprouts Cauliflower
  • 386. Protective Factor: 2 Fiber Whole grain breads Whole grain flours Wholes grain cereals Peas Beans Fruits Vegetables
  • 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
  • 388. Protective Factor: 3 Vitamin A Beta Carotene Spinach Squash Lettuce Broccoli Carrots Sweet potatoes Peaches Apricots
  • 389. Protective Factor: 4 Vitamin C Tomatoes Cauliflower Peppers Broccoli Celery Mustard greens Brussels sprouts
  • 390. Protective Factor: 4 Vitamin C Mangoes Kiwi fruit Currants Lemon Amla
  • 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
  • 393. Protective Factor: 5 Weight Control
  • 394. Walk Away the Calories Brisk Walking For: Equals: 20 minutes 100 calories 30 minutes 150 calories 45 minutes 225 calories 60 minutes 300 calories 70 minutes 350 calories
  • 396. Risk Factor: 1 Dietary fat Fat calories
  • 397. Risk Factor: 2 Salt cured Nitrite cured Smoked foods
  • 398. Risk Factor: 3 Cigarettes are 87% of lung cancer 30% of all cancer is smoking related
  • 399. Risk Factor: 4 Alcohol Compound risk: Alcohol + Cigarettes
  • 400. Risk Factor: 5 Excessive sun Avoid midday sun Sunscreen SPF 15 Protective clothing Avoid sunlamps, tanning pills and tanning parlors
  • 402. What is Aids? Acquired Immune Deficiency syndrome
  • 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
  • 407. How Do We Treat AIDS? Diet Exercise Drugs
  • 408. What Do Drugs Do Prevent virus from replicating Prevent virus from reforming
  • 409. What Are the Problems With Drugs? Very expensive Complex schedules of drug taking Resistance
  • 410. Immune System Prevents against invading organisms Kills tumor cells
  • 411. What If Immune System Malfunctions Autoimmune disease: immune system attacks itself Cancer develops Opportunistic infections
  • 412. Nutrition and HIV/AIDS Optimize your health Prevention and treatment of HIV/AIDS associated malnutrition
  • 413. Weight Loss Means 11Kg = 17,500 calories
  • 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
  • 424. Multivitamins Best source food Ability to absorb may improve or lessen Research is inconclusive
  • 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
  • 428. Food Sources Antioxidants Vitamin A (Beta Carotene) Sweet potato Foods Carrots Spinach Pumpkin Broccoli Mustard greens Winter squash Apricots Mango
  • 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
  • 435. Pesticides Insecticides to control Insects Rodenticides to control Rodents Herbicides to control weeds Fungicides to control mold, mildew, fungi
  • 436. Video 5: Organic Farming Click to Start
  • 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

  1. Nutrition begins with food.
  2. 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 &amp; expanding with the findings of research on which it feeds.
  3. Similar foods are grouped in one food-group.
  4. 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.
  5. 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 &amp; sex &amp; physiological conditions like pregnancy, lactation, adolescent. When cultures are old and tradition rules the way of life.
  6. On the bases of similarities of content and function it has been classified as under six classes.
  7. Comparison of different nutrients of foods and of body are given here.
  8. 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
  9. 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.
  10. 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.
  11. Minerals are inorganic substances. Their form remains same. While CHO, proteins, fats &amp; vitamins are organic substances.
  12. 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 &amp; circulation etc. For storage of energy- yielding materials chiefly during childhood &amp; pregnancy.
  13. Carbohydrates, fats &amp; proteins &amp; other nutrients are released from food during digestion, then absorbed into the blood stream and converted into glucose/blood sugar.
  14. 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.
  15. When food is burned in our body cells provides our bodies with energy, which is utilized for internal &amp; external activities of the body.
  16. 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.
  17. Water is clear, colourless, tasteless, odourless, liquid. It gives no calories yet it is fundamental to all life on earth.
  18. The delicate organs like heart, lungs, brain are covered by double layer which has fluid in it &amp; protect them from external shocks. Heat is eliminated by means of evaporation of water from the lungs &amp; 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.
  19. 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.
  20. 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.
  21. 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.
  22. 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).
  23. Plants are the original source of all food proteins. Plants make their own proteins by combining raw materials like nitrogen, carbon, hydrogen, oxygen &amp; energy for the task is obtained from the Sun. Animals eat these plants and build their body proteins.
  24. 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.
  25. 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.
  26. 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.
  27. Histidine is believed to be essential for children which is one of the essential amino acid.
  28. The adult human body can maintain nitrogenous equilibrium on a mixture of 8 pure amino-acids as its sole source of nitrogen.
  29. 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.
  30. 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.
  31. 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.
  32. The carbohydrates are a class of chemical compounds composed of C,H,&amp; O. They contain 2 atoms of hydrogen and 1 atom of oxygen.
  33. 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.
  34. Glucose (grape sugar) Starch consists of glucose in combined form.
  35. 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.
  36. 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.
  37. 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,
  38. Fats contain C, H, &amp; O. They supply more energy than CHO &amp; Proteins because they contain more combustible carbon &amp; hydrogen. Thus they are the concentrated source of energy.
  39. 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.
  40. 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.
  41. EFA are necessary for growth. Like AA they cannot be synthesized by the body and have to be supplied in the diet. Linoleic &amp; Linolenic acid are of vegetable origin. (linoleic-omega 6 FA, linolenic-omega 3 FA).
  42. Arachidonic Acid is a Essential Fatty Acids( EFA) with 4 double bonds. This EFA is synthesized from linolenic acid in fish and animals.
  43. 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.
  44. 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.
  45. Sterols are impt. &amp; widely distributed class of biological substance, all of them have the same basic ring structure. Ex. Cholesterol, Bile salts, Ergosterol.
  46. These are the rich sources of cholesterol.
  47. Physiology tells us how organs and cells function and is further divided into-----------
  48. 1-Organ physiology 2-Cellular physiology 3-Molecular physiology
  49. At simplest level all living beings are made up of atoms such as O,N,C,&amp; 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.
  50. Cell membrane is the outer most component of the cell. This membrane is made up of proteins &amp; fats. It does not allow the unwanted material to get in and the required material to g out. Thus acts like a guard.
  51. Most materials get into the membrane by two methods. 1--- Passive diffusion 2--- Active transport.
  52. 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 &amp; remove it.
  53. Nucleus contains chromosomes, GENES, DNA &amp; RNA. It contains the information of our physical characteristics.
  54. The energy is produced from food that we eat. Mitochondria is responsible for producing energy that cells need.
  55. The food releases energy through a series of chemical reaction through a process called METABOLISM. Metabolism is of two types--- Anabolism &amp; Catabolism.
  56. 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.
  57. Glycogen is a complex molecule consisting of many glucose units. Its main site of storage is liver.
  58. 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.
  59. Chewing breaks down the cellulose envelope and make starch and sugar available for subsequent digestion.
  60. 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.
  61. Epiglottis is a muscular piece of tissue that blocks food from going into our lungs when we swallow food.
  62. 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 &amp; pepsin. Acid– important for the digestion of the food. Mucus– protects the stomach from eating itself up. Pepsin– important in the digestion of proteins.
  63. 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.
  64. 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.
  65. 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 &amp; type II.
  66. 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 &amp; salts are excreted out as urine. We produces about 1500 ml of urine every day.
  67. 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.
  68. 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.
  69. 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.
  70. 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.
  71. 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
  72. 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.
  73. 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 &amp; less pulsing pressure compared to the arterial system. Blood also flows smoothly in veins as the pulsing pressure is less.
  74. 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 &amp; and when the heart relax we get diastolic pressure.
  75. 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 &amp; 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.
  76. White cells are members of our immune system &amp; 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.
  77. 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.
  78. 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.
  79. 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.
  80. 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 &amp; gray matter are the two regions. Spinal cord and the brain are covered by 3 layers called meninges.
  81. 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.
  82. 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.
  83. 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 &amp; medulla oblongata.
  84. 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.
  85. Sensory nerves carries information from our five sense organs and the responses of our CNS back to skeletal muscles &amp; the organs in the body. Somatic muscle nerves (spinal nerves) control much of our skeletal activity.
  86. 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.
  87. 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.
  88. For contraction and relaxation of muscles they need energy, ATP and certain minerals like Ca, K for proper muscle function.
  89. 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.
  90. Melanin is a skin pigment that protects our skin from sunlight. Skin allows us to lose heat from our body by sweating &amp; evaporation &amp; from blood by dilating blood vessels close to skin surface.
  91. 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.
  92. Vitamins are special chemicals found in food.
  93. 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.
  94. 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 &amp; fats.
  95. 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.
  96. Vitamin is a precursor of two enzymes—Flavin-mononucleotide &amp; 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.
  97. NAD &amp; 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.
  98. -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.
  99. Originally called vitamin H. Egg, liver, kidney, yeast, pulses, nuts, chocolates, cauliflower and green vegetables.
  100. --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 &amp; thus helps to produce energy in body cells. --Assists in the synthesis of FA. --Incorporate AA into proteins &amp; help with the formation of DNA &amp; RNA.
  101. Sources– Whole grain cereals, vegetables, peanuts, cheese, eggs-yolk, organ meats.
  102. This vitamin is a constituent of co-enzyme A and is present in all living matter. Important for cellular metabolism of CHO &amp; fats to release energy.
  103. 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 &amp; RNA. - Fish, poultry, egg yolk, soya- bean, bananna, potatoes, cauliflower.
  104. Due to the deficiency of B6 , the RBCs are pale and small and the Anemia is said to be Hypochromic and Microcytic.
  105. Sources– Spinach, liver, peas, sweet potato, bean sprout, wheat germ, soya flour, milk, fruits.
  106. -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.
  107. Bulk of body stores of vitamin B12 is in the form of coenzyme B12.
  108. This vitamin has cyanide group and cobalt group. From animal foods like goat liver, fish, eggs &amp; milk.
  109. 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.
  110. Also helps to maintain healthy blood vessels.
  111. Amala, guava, oranges, all citrious fruits, dark green leafy vegetables, tomatoes, etc.
  112. --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.
  113. Circulates in the plasma with the specific retinol binding protein. This combination is called halo-RBP.
  114. -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.
  115. -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 &amp; green leafy vegetables.
  116. 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.
  117. 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.
  118. In liver it is stored in the form of retinyl esters.
  119. Also called Sun shine vitamin. Skin prepares vitamin D in the presence of sunlight.
  120. -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.
  121. Maintain the blood (plasma) Ca &amp; P levels. Acts like a hormone. Vitamin D main site of action is in the small intestine where promotes Ca &amp; P absorption from the gut &amp; also has direct action on the gut. Raises concentration of plasma Ca &amp; P to promote bone deposition.
  122. Deformity of the weight bearing bones, knock knees, bowing of legs. Loss of bone mineral. Pain in bones. Excessive thirst, diarrhea, nausea, weakness &amp; headach.
  123. Alpha-Tocopherol is the most common and the most active of the seven mentioned forms.
  124. -Natural antioxident. It helps to reduce oxidation of lipid membranes, USFA &amp; breakdown of other nutrients by oxygen. -Protect the cell membrane destruction. -It reacts with free radicals &amp; oxidizing agents. -Found in cell membrane that contain PUFA. It inhibits the reaction involving oxygen. -It protects both vitamin A &amp; carotene from oxidation.
  125. -prevents the oxidation of USFA -protects lungs from oxidative damage from environmental substances. -protects RBC membrane from oxidative damage.
  126. Deficiency– low fat diet, malabsorption syndrome or after gastric surgery. RBC hemolysis occur more easily in vitamin E deficiency.
  127. Originally called Koagulation vitamin.
  128. 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.
  129. 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.
  130. New born babies has sterile GI tract for about a week &amp; 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.
  131. 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.
  132. Phytates the salt of phytic acid bind with Fe, Ca, Zn, Mg. In presence of Ca &amp; Mg it forms insoluble complexes with iron &amp; thus makes unavailable to body. Oxalates the salt of oxalic acid interferes with Ca absorption by forming insoluble salts with Ca.
  133. Sodium forms 90% base (cation) of the extracellular fluid. 95% sodium is excreted through kidneys.
  134. Na is very soluble in water &amp; thus easily absorbed from the stomach and small intestine. Jejunal Na absorption is stimulated by the presence of actively transported glucose or amino acid.
  135. 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.
  136. 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.
  137. 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.
  138. 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 &amp; excretion of K which may produce clinical manifestations.
  139. Besides the above it also maintains Neuro-muscular functions
  140. 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 &amp; reabsorbed. Bones are the Ca bank. When ever required the Ca from the bones are mobilized to maintain the normal serum levels.
  141. 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.
  142. 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.
  143. Ionized Ca is vital to life as it affects the neuromuscular excitability of both voluntary &amp; involuntary muscles.
  144. Ionized Ca is more diffusible. It is controlled by parathyroid hormone. Serum Ca is bound to protein.
  145. 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.
  146. Parathyroid hormone also enhances intestinal Ca absorption. More is the concentration of Ca in intestine more will be the absorption.
  147. 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.
  148. The volume of the bone does not change with age but as it atrophies bone mass is reduced and its density falls.
  149. P is widely distributed in all the cells, tissues and body fluids. P is present both in blood red cells &amp; plasma. P is an important anion with in the cells.
  150. 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 &amp; called phosphoprotein.
  151. 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.
  152. Take care of calcium and phosphorous will take care of itself.
  153. 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.
  154. 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 &amp; needed in DNA production. -Mg helps to transfer phosphate molecule to ATP an energy source generated by the cytochrome system.
  155. -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.
  156. -High alcohol intake produces Mg deficiency. -Metabolic syndrome. -Alimantry loss of Mg may occur in vomiting or diarrhea.
  157. 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.
  158. Trace minerals are concerned in some way with enzymatic action.
  159. 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,
  160. 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.
  161. Fe is important component of hemoglobin which transports oxygen to the various tissues of the body. Life &amp; Fe are inseparable. Vit C reduces Ferric iron to Ferrous iron which remains soluble even at neutral PH and is better absorbed.
  162. There is about 4 gm. Of iron in an healthy adult. Major portion is present in hemoglobin.
  163. Most tissue enzyme contain iron. There are intracellular enzymes which contain iron prophyrins.
  164. Iron absorption decreases on a cereal diet occur with phosphate &amp; 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.
  165. In small intestine iron absorption is by a process of diffusion.
  166. 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.
  167. 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.
  168. The body conserve iron well. The normal body losses in the bile, faces and sweat are small and the urinary excretion.
  169. Znic is used as a cofactor in more than 100 enzymes involved with digestion, metabolism, reproduction &amp; wound healing. Zinc is essential in the synthesis of DNA, RNA. Maintains the body levels of vitamin A.
  170. In alcoholic chirrosis of the liver zinc concentration in the plasma is reduced
  171. Iodine is contained in the hormones stored &amp; secreted by the thyroid gland. Iodine in food &amp; water is quickly absorbed from alimentary canal mostly as inorganic iodide.
  172. Active form of selenium is selenocystein which slows the biological aging process.
  173. For the availability of Iron for the formation of RBC Formation of Myelin by allowing Phospolipid synthesis
  174. 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.
  175. It exist in trivalent &amp; hexavalent forms. Only trivalent chromium is biologically active.
  176. 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.
  177. These were the percentages of leading causes of death in Dec. 2004 by WHO. CVD, stroke, &amp; cancer, are believed to remain the leading cause.
  178. According to WHO Obesity is one of the 10 most preventable health risk.
  179. 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.
  180. 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.
  181. 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.
  182. 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.
  183. Doctors and nutritionists plays important role in preventing &amp; controlling CVD.
  184. When not enough oxygen is supplied by the blood, part of the heart muscle dies. It may heal or may lead to death.
  185. In all the four cases the normal functioning of the heart is impaired.
  186. 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.
  187. 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.
  188. 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.
  189. 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.
  190. 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.
  191. 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.
  192. 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.
  193. Taking a well balanced diet. Drinking plenty of water. Meditation. Avoiding stress and tension.
  194. Cholesterol is a waxy substance produced from the fats you eat. Sources—The exogenous, from food and endogenous synthesis by liver and intestine.
  195. 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.
  196. 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.
  197. -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.
  198. Fixed risk factors we cannot change but can control to some extent by modifying our life style and developing good eating habits.
  199. This is a key factor for good health if we also include exercise.
  200. 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.
  201. The following fats have a higher proportion of fatty acids– butter, ghee, cream, hydrogenated oils, egg yolk.
  202. 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.
  203. There are 3 naturally occurring types of fats– MUFA, PUFA, &amp; SATURATED FA. A fourth type of fat-Trans fats, are man made. It is advisable to cut down trans fats from your diet
  204. Be careful while using oils, type of oil, quantity of oil. Use cooking methods which require little or no fat.
  205. 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.
  206. These are the best way to control blood pressure.
  207. 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.
  208. Fiber plays vital role in controlling bad cholesterol, regular bowel movement and decreasing the risk factor of heart diseases.
  209. Obesity is responsible for no. of these health problems.
  210. Diabetes Mellitus is a clinical syndrome characterized by hyperglycemia, due to deficiency or diminished effectiveness of insulin.
  211. Typical inactivity and in rare cases certain medication, pregnancy, diesease, or accidents that has damaged the Pancreas also cause diabetes.
  212. -- 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.
  213. 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.
  214. In the absence of insulin the blood sugar is raised &amp; 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.
  215. 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.
  216. 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.
  217. Type I - juvenile onset type. Type – maturity onset type. GDM – gestational diabetes. IGT – increase glucose tolerance.
  218. 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.
  219. To manage young insulin dependent diabetics a careful balance has to be maintained between diet for adequate growth, weight regulation, exercise and insulin dosage.
  220. Characterized by the chronic excretion of large amount of pale dilute urine which results in dehydration.
  221. This is usually associated with obesity and is not prone to ketosis.
  222. Controlled clinical trials has shown positive response of weight loss on fasting blood glucose and fasting insulin levels, reduced cholesterol levels.
  223. 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.
  224. When controlled diet, physical activity and drugs are ineffective then it becomes necessary to give insulin.
  225. 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.
  226. 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.
  227. Exercise can help control weight and lower blood cholesterol &amp; sugar levels, raises HDL levels, reduces the severity of the disease &amp; reduce the risk of long term complications.
  228. 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.
  229. 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 &amp; cholesterol.
  230. Same as we have already studied. More portions of food to be consumed from bottom and less from top.
  231. 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.
  232. Soluble fiber slow down the digestion of CHO, which results in better glucose metabolism.
  233. 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
  234. In diabetes insipidus there is increased blood sodium and if the diabetic is suffering from hypertension. Then sodium is restricted.
  235. Sulphonylureas lower blood sugar by stimulating pancreatic insulin secretion and increasing insulin receptors on cells. Dietetic control is still essential even with the tablets.
  236. -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.
  237. 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.
  238. 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.
  239. 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.
  240. 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 &amp; 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 &amp; fats every day to maintain better control of blood glucose level. Find the one that fits your life.
  241. A dietician gives specific instructions, gives wide choices in food and also give some sample menu to understand easily for the patient.
  242. Exchange list is given to the patients so that on there on they can create variety in their meals.
  243. --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.
  244. 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.
  245. 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.
  246. 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.
  247. 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.
  248. 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.
  249. 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).
  250. More than 80% of the cancer cases are attributed to cigarette smoking.
  251. These are the external factors which has proved to cause cancer. Asbestos has been banned in no. of other countries.
  252. Some of the external causes can be controlled to prevent cancer.
  253. 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. .
  254. 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 &amp; 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.
  255. 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.
  256. 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.
  257. There are two types of tumors. Benign tumors are non cancerous &amp; Malignant tumors are cancerous.
  258. 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.
  259. 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.
  260. In spite of knowing people do not want to follow.
  261. Cancer of these organs are common.
  262. 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.
  263. 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.
  264. All these vegetables has anti carcinogenic property and rich source of antioxidants. These vegetables contain flavones which are thought to have anti- cancer activities
  265. 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.
  266. ---have the potential to decrease LDL cholesterol by 20% equivalent to a first line statin drug.
  267. antioxidents
  268. 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.
  269. 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.
  270. 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.
  271. 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.
  272. 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.
  273. 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.
  274. 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.
  275. People with advanced HIV infection are vulnerable to infection &amp; 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 &amp; vomiting and malabsorption severely reduce oral intake.
  276. Although nutritional interventions have not been effective in reversing advanced HIV infection or mortality, early nutritional assessment, intervention, successful symptoms management, &amp; muscle-strengthening exercises improve health and quality of life and may improve response to treatment.
  277. HAART (Highly Active Anti-Retroviral Therapy) can reduce the amount of HIV in someone’s body &amp; 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 &amp; treatment of opportunistic infection remains essential.
  278. This treatment is very expensive with complex schedule, and the poor resistance of the person.
  279. Auto immune disorders occurs when the immune system confuses normal body tissues ”self” with a foreign intruder &amp; attacks. As a way to avoid being attacked by the immune system, some infectious organisms such as bacteria &amp; viruses learn to expose only those parts of themselves that mimic “self” tissues. Thus when immune system becomes weakened the opportunistic infections occurs.
  280. Providing prevention &amp; treatment of opportunistic infections not only help HIV +ve people to live longer, healthier lives but can also help prevent TB &amp; other Transmissible opportunistic infections from spreading to others. The therapeutic approach may be done by prevention of disease progression &amp; treatment of complications that arises.
  281. 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
  282. 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.
  283. 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.
  284. Due to malabsorption, poor appetite, frequent diarrhoea and other complications aggrevates the loss of water and fat soluble vitamins and certain minerals also.
  285. AIDS may make it difficult to eat &amp; 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.
  286. 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
  287. Better to take one multivitamin and mineral tablet daily.
  288. 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.
  289. Selenium is directly related to improved mortality in HIV INFECTION.
  290. 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.
  291. 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.
  292. Almost everything we eat starts with the planting of a seed that grows into a plant &amp; 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.
  293. 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.
  294. 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.
  295. 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.
  296. 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.
  297. 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.
  298. 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.
  299. 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.
  300. 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.
  301. 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.
  302. Parsley and tomatoes are now a days much used to give color to a dish.
  303. Water is added to milk In tea caffeine and theobromine. Pesticides residues in fruits &amp; vegetables Some antibiotics/drugs given to cattles Heavy metals in soil, utensils
  304. 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.
  305. 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.
  306. Khesari dal alone mixed causing Lathyrus Sativus.
  307. Added to oils
  308. 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.
  309. Animal fat and other high melting fats, edible oils- palm oil, argemone oil, non edible olis.
  310. Protection of food from flies. these important features are especially for mothers.
  311. All foods that are eaten raw should be carefully washed immediately before consumad.
  312. Raw and ready to eat foods should be kept separate.ssss
  313. 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.
  314. As it kills the germs.
  315. 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 &amp; temperature varies very much from one food to another.
  316. Do not keep raw foods along with cooked foods.
  317. Foods kept in danger zone allows bacteria to grow fast.
  318. Chopping board should be smooth and without pores so that bacteria don’t grow in those cracks.
  319. 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
  320. 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
  321. 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.