Nutrition & Health
Nutrition is the provision, to cells and organisms, of the
materials necessary (in the form of food) to support life.
Nutrition is the science of food & its relation to health.
Many common health problems can be prevented or
NUTRITIONAL DISORDER alleviated with good nutrition.
Poor diet can have an injurious impact on health, causing
deficiency diseases such as scurvy, beriberi, and
kwashiorkor; health-threatening conditions like obesity and
metabolic syndrome, and such common chronic systemic
diseases as cardiovascular disease, diabetes and
osteoporosis.
Nutrition Dietary Nutrients
Nutrition is the provision, to cells and organisms, of the Nutrients are the chemicals taken into the body
materials necessary (in the form of food) to support life.
that are used to produce energy, provide
Nutrition is the science of food & its relation to health.
building blocks for new molecules, or function
in other chemical reactions.
Nutrition & Health
Essential nutrients are nutrients that must be
Many common health problems can be prevented or
alleviated with good nutrition ingested because the body cannot
Poor diet can have an injurious impact on health, causing
manufacture them or is unable to manufacture
deficiency diseases such as scurvy, beriberi, and adequate amounts of them. e.g. essential
kwashiorkor; health-threatening conditions like obesity , amino acids, most vitamins.
common chronic systemic diseases e.g. cardiovascular Macronutrients (carbohydrates, proteins, fat,
disease, diabetes and osteoporosis
macro minerals, and water) & micronutrients
(vitamins & trace minerals)
1
Carbohydrates requirement
Cm(H2O)n
Dietary Balance & Energy requirement
Preferred source of energy in the body
Mono-, di-, oligo- & polysaccharides (simple & complex
Appropriate balance of different proportions of carbohydrates)
proteins, carbohydrates, fats, minerals and Based on risk of heart disease & obesity, WHO
vitamins to maintain health recommends national dietary guideline set a goal of 55-75%
Most of the bodys energy is derived from fats & of total energy from carbohydrates, with only 10% directly
from sugar or simple carbohydrates, <5% would have
carbohydrates in the diet additional benefits
The average physiological available energy in each Whole vs refined grains
gram of carbohydrate, protein and fat in the diet is Simple vs complex carbohydrates in food
4, 4 and 9 calories, respectively.
Protein requirement Protein requirement
Proteins provide 22 amino acids, of which 9 essential Protein is mainly for growth & body repair
amino acids are needed for protein synthesis and for When there is insufficient intake of energy, protein would be
maintaining nitrogen balance in adults.
broken down as body fuel, which may lead to protein-
Complete protein food contains adequate amounts of all energy malnutrition
essential amino acids whereas incomplete protein food
does not. The usual recommended allowance for an adequate protein
The biological value of different proteins depends on the intake is about 10-15% of the total calories or 65 g in an
relative proportions of essential amino acids they contain. adult; the minimum daily requirement is 40 g of good
Proteins of animal origin are generally of higher biological biological value protein.
value than proteins of vegetable origin which may be Nitrogen balance: nitrogen content of ingested protein is
deficient in one or more of the essential amino acids. equal to the nitrogen excreted in urine & faeces.
2
Lipids requirement Lipids
Saturated fats increase total and LDL cholesterol; Diets rich
Lipids serve as structural components of cell membranes, in saturated fats increase risk of coronary artery disease
energy source & storage, signaling pathway. and atherosclerosis
Rich energy source 1g fat yields 9kcal Unsaturated fats will lower your LDL (bad cholesterol)
Cushion and protect the major organs, insulator, preserving without affecting your HDL (good cholesterol) making them
body heat, and protecting against excessive cold the healthiest of possible fat sources in the diet
Fat carries fat soluble vitamins Polyunsaturated fats will lower both your LDL & HDL
Certain essential fatty acids must be obtained from the diet Trans fat (unsaturated fat with trans isomer fatty acids)
Cholesterol cannot dissolve in the blood, has to be increase level of bad LDL cholesterol and decrease level of
transported by lipoprotein good HDL cholesterol; diets rich in trans fat increase risk of
coronary heart disease; WHO 2003: trans fat <1% of overall
Good cholesterol (HDL) and bad cholesterol (LDL)
energy intake
LDL leads to atherosclerosis, heart disease and stroke
American Heart Association: take less fat, limit saturated &
HDL carries cholesterol away from arteries & back to liver, trans fats & cholesterol
slowing atherosclerosis
Blood Cholesterol & Risk of heart Disease
Ratio of LDL to HDL
Risk Men Women
Very low (1/2 average) 1 1.5
Average risk 3.6 3.2
Moderate risk (2x average) 6.3 5.0
High risk (3x risk) 8 6.1
The National Cholesterol Education Program, 2001 , Journal of the American Medical Association
3
Food Guide Pyramid
Free Radicals & Antioxidants
Damage from free radicals may
contribute to aging & certain diseases
e.g. atherosclerosis & cancer
Free radicals replace their missing
electrons from cell molecules resulting
in cell damage
Antioxidants prevent oxidation by
donating electrons to free radicals
E.g. Vitamin C, Vitamin E, melatonin,
beta carotene (provitamin A)
4
Dietary Fibre Daily Requirement of Vitamins & Minerals
No nutritive value
Good for health
Guyton & Hall, Textbook of Physiology Ch 71
Minerals and Trace Elements Nutritional Disorders
Quantitative & qualitative
Over-nutrition & under-nutrition
Nutritional disorder particularly serious in children,
since they interfere with growth & development
Deficiency of trace elements extremely rare as requirements are so low. and may predispose to infection and chronic
disease.
5
Nutritional Disorders
1. Quantitative dietary deficiency: not enough
Causes of Nutritional Disorders
food leading to under-nutrition or starvation Social & economic causes
2. Qualitative dietary deficiency: wrong food Pathological causes:
leading to malnutrition e.g. rickets, scurvy, night-
blindness, iron deficiency anaemia 1. Defective intake of food
3. Quantitative over-nutrition: leading to 2. Defective digestion & absorption
overweight & obesity 3. Defective utilization
4. Qualitative over-nutrition: e.g. too much 4. Loss of nutrients from the body
saturated fat leads to hypercholesterolemia, high
5. Increased nutritional needs
salt intake leads to hypertension
Effects of toxins in food
Body Mass Index (BMI)
Quantitative over/under-nutrition
Weight (kg)
___________________
Obesity & overweight Height x Height (m x m)
Starvation & underweight Index used to classify sedentary individuals with an
average body composition
Measured by BMI (body mass index)
Index used to assess how much an individuals body
weight departs from what is normal or desirable for a
person of his or her height
6
NIH Definition of BMI categories Asian BMI Categories
BMI Category
____________________________ BMI Category
____________________________
<15 Starvation <18.5 Underweight
<18.5 Underweight 18.5 22.9 Normal
18.5 24.9 Normal 23 27.5 Overweight
25 29.9 Overweight >27.5 Obesity
>30 Obesity ___________________________
>40 Morbid Obesity
Central Obesity Obesity
The absolute waist circumference
Obesity is a medical condition in which excess body
(>102 centimetres (40 in) in men and
fat has accumulated to the extent that it may have an
>88 centimetres (35 in) in women) adverse effect on health, leading to reduced life
waist-hip ratio (>0.9 for men and >0.85 for expectancy and/or increased health problems.
Assessed by body mass index (BMI)
women) Causes:
associated with a statistically higher risk Excess food energy intake, including childhood obesity
of heart disease, hypertension, insulin
Underactivity
Maybe related to genetics, medical conditions, psychiatric
resistance, and diabetes mellitus type 2 Increasing rates of obesity at a societal level are felt to be due to
an easily accessible and palatable diet, increased reliance on
cars, and mechanized manufacturing.
7
Obesity Obesity
Treatment:
Health problems: Decrease Energy input below energy expenditure
Hypertension Increase energy expenditure: exercises
High cholesterol Diet: increase bulk (non-nutritive cellulose
(gallstones & gall bladder problems) substances), decrease fat, decrease salt
Stroke or cerebral vascular accident Drugs:
Fibre-rich products
Coronary artery diseases, heart diseases Only one anti-obesity medications orlistat is
(angina, myocardial infarction) currently approved by the FDA for long term use. It
reduces intestinal fat absorption by inhibiting
Diabetes mellitus pancreatic lipase.
Decrease life expectancy Surgical:
Psychological disturbances Intragastric balloon, small intestine bypass
For morbid obesity cases
Mechanical disabilities e.g. osteoarthritis
Obstructive sleep apnoea
Malnutrition Nutritional Marasmus
Particularly important in childhood since it increases
Definition
risk of infection, stunted growth, regressive
Deficiency of energy intake including
development, cognitive developmental disorder &
protein
increased susceptibility to chronic diseases
Starvation
Aetiology
Affects principally infants under 1 year
Protein-calorie malnutrition (marasmus) of age
Protein malnutrition (kwashiorkor) In poor people in underdeveloped
Vitamin & mineral deficiency countries who live in cities
e.g. iodine deficiency & goitre, iron deficiency & Predisposing factors: multiple
anaemia pregnancies, early abrupt weaning,
followed by dirty artificial feeding with
Eating disorder very dilute milk or milk products given in
Anorexia nervosa inadequate amount to avoid expenses
Bulimia nervosa
8
Nutritional Maramus Kwashiorkor
Clinical features Definition
Retardation of growth Deficiency of protein with
relatively adequate energy
Reduction of weight (much more marked than length)
(calorie) intake
Wasting of subcutaneous fat and muscles
Aetiology
Oedma is variable
Typically arises after
Watery diarrhoea prolonged breast feeding,
Liver is not fatty the child is weaned on to a
traditional family diet which is
Chronic infection common
low in protein
Kwashiorkor Anorexia Nervosa
Pathology Psychological disorder, mainly affecting
Low protein content in body
teenagers & young women
Failure to synthesize plasma ablumin
Subnormal immunity, prone to infection
Characterised by extreme concerns about
Clinical Features weight, intense fear of gaining weight or
Failure of growth
becoming fat, deliberate maintenance of a
Muscles are wasted, lack of subcutaneous fat
very low boy weight
Mental changes: child is apathetic & miserable Tends to exercise vigorously
Hair: fine, straight & sparse Treatment options include counsellors,
Skin: pigmentation, desquamation & ulceration nutritionists, psychologists, psychiatrists
Mucous membrane: stomatitis, cheliosis, smooth Effects:
tongue
osteoporosis, bradycardia,
Liver: enlarged, fatty
Odema
hypotension, arrhythmias, anaemia,
GI system: anorexia, vomiting, diarrhoea
sex hormone dysfunction
Anaemia
(amenorrhoea, infertility)
Associated vitamin deficiencies
9
Vitamins - Requirements & Deficiencies
Bulimia Nervosa
consume large amounts of food 1. Water soluble soluble vitamins
and then rid their bodies of the
excess calories by vomiting,
utilising laxatives or diuretics,
taking enemas, or excessive
exercising.
"binge and purge" in secret to
maintain normal or above normal
body weight
Typically begins in adolescents, more Not stored in body deficiency leads to rapid clinical symptoms
common in women
Vitamins - Requirements & Deficiencies
References
2. Fat soluble vitamins
1. Vander, Sherman, Luciano, Human Physiology:
The mechanisms of Body Function Ch 16
Section B
2. Guyton & Hall, Textbook of Physiology Ch 71
10
