NUTRITION AND DIET THERAPY

Lecture Notes

BASIC CONCEPTS IN NUTRITION AND DIET THERAPY

I. DEFINITION OF TERMS

Nutrition - according to WHO, it is the science of food and its relationship and its
relationship to health. It is
concerned primarily with the part played by the
nutrient in body growth, development and
maintenance.
Food - Anything that is taken into the body which gives nourishment, build and repair
worn out tissues.
Malnutrition - Refers to deficiencies, excesses or imbalances in a person’s intake of
energy and/or nutrients
Undernutrition - It is caused by lack of proper nutrition which results to stunting,
wasting, overweight or obesity.
Overnutrition - Arising from the excessive intake of nutrients leading to accumulation
of body fats that impairs
health
(i.e. overweight or obesity)
Overweight - Above a weight considered normal or desirable Obesity - The condition
of being grossly fat or overweight Body Mass Index (BMI) - It is an indicator that your
weight is proportional to your height.
Desirable Body Weight (DBW) - Also known as “ideal body weight” (IBW); a healthy
body weight that is ideal for each person.
Total Energy Requirement - The required calories to be consumed by an individual on
a daily basis

II. MACRONUTRIENTS
A. Carbohydrates
Defined “as any one of the large group of compounds, including the “sugars” and
“starch”, that contain and have a general formula C 2(H20)” (Concise Medical Dictionary).
It considered as an important source of energy. Such nutrient is manufactured from
plants. Alongside protein and fat, it constitutes the three main constituent of food.

ALL carbohydrates are eventually broken down in the body into simple sugars called
“glucose”. Glucose take part in the energy-producing metabolic processes. On one
hand, excess carbohydrate, not yet used by the body are stored in the liver and muscles
in the form of “glycogen”

Types, Sources and End-Products of Carbohydrates

Carbohydrates Food Sources End-Product of Remarks
Digestion

Polysaccharides Indigestible

Celluloses Stalks and - These

leaves of polysaccharides
Hemicelluloses vegetables, may be partially
outer covering split to glucose by
of seeds bacterial action in
large bowel: they
Pectins Fruits - have an affinity
water, form bulk,
Gums and mucilages Plant - slow gastric -
secretions and
seeds

Algal substances Seaweeds and -

 algae

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emptying time
and may bind
bile acids.

Polysaccharides Partially Digestible

Inulin Jerusalem Fructose Digestion is

artichokes, incomplete, and
onions, garlic, further splitting by
mushrooms bacteria may
occur in the large
Galactogens Snails Galactose bowel. Flatus
may result from
Mannosans Legumes Mannose raffinose and
stachyose.
Raffinose Sugar beets, Glucose, fructose,
kidney beans, galactose
lentils, and
navy beans

Stachyose Beans Pentoses

Pentosans Fruits and gums -

Polysaccharides Partially Digestible

Starch and dextrins Grains, Glucose These

vegetables substances
(especially comprise the
tubers and most important
legumes) group
quantitatively and
Glycogen Meat products Glucose are usually
and seafood accompanied by
some maltose.

Disaccharides and Oligosaccharides

Sucrose Cane and beet Glucose and -

sugars, fructose
molasses, and
maple syrup

Lactose Milk and milk Glucose and -

products galactose

Maltose and Malt product Glucose -

maltotriose and some
breakfast
cereals

Lactulose Synthetic Not metabolized Lactulose does

products not appear in
food and is
synthetic. It is not
digested and is
used as laxative.

Trehalose Mushrooms, Glucose -

insects, yeast
 Sucralose Splenda - Sweetener

Monosaccharides Hexoses

Glucose Fruits, honey, Glucose In fruits and

corn syrup vegetables, the
amount of
Sorbitol* Fruits, Glucose glucose and
vegetables, fructose depends
dietetic products on species
ripeness and
state of
preservation

Fructose Fruits, honey Fructose These

monosaccharides
Galactose - Galactose do not exist in
free form in
foods.

Mannose - Mannose

Mannitol* Pineapples,
olives,
asparagus,

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sweet potato,
carrots, dietetic
products

Monosaccharides Pentoses

Ribose - Ribose Ribose, xylose

and arabinose do
Xylose Fruits, Xylose not exist in free
vegetables, form in foods.
Xylitol* cereals, They are derived
mushrooms, from pentosans
seaweed, in fruits and from
dietetic the nucleic acid
chewing gum, of meat products
other dietetic and seafoods.
products

Arabinose - Arabinose

Carbohydrate Derivatives

Ethyl alcohol Fermented Absorbed as These

liquors same substances are
the products of
Lactic acid Milk and milk natural or induced
products carbohydrate
breakdown.
Malic acid Fruits

*sugar alcohol forms of the designated sugars.

Source: Mahan, et.al., Krause’s Food, Nutrition, & Diet Therapy 11th Edition

B. Protein
 One of the groups of organic compounds of carbon, hydrogen, oxygen, and nitrogen
(Sulphur and phosphorous may also be present) (Concise Medical Dictionary). It is a
complex structure made up of one or more chains of “amino acids” which are linked by
peptide bonds. Protein are essential as they form the structural material of muscles,
tissues, organs, etc. They are of equal importance as enzymes and hormones. Excess
protein is not required by the body, and can be converted into glucose and used as an
energy source.

Food Combinations Providing All Essential Amino Acids

Excellent Combinations* Examples

Grains and legumes Rice and beans,

pea soup and toast,
Lentil curry and rice,

Grains and dairy Pasta and cheese,

Rice pudding
Cheese sandwich

Legumes and seeds Garbanzo beans and sesame seeds;

Hummus as dip, falafel, or soup

*other combinations, such as dairy and seeds, dairy and legumes, grains and seeds are less effective
because the chemical scores are similar and not effectively complementary.
Source: Mahan, et.al., Krause’s Food, Nutrition, & Diet Therapy 11th Edition

C. Fats
A substance that contains one or more fatty acids (in the form of triglycerides) and is the
principal form in which energy is stored by the body (in adipose tissues) (Concise
Medical Dictionary). It serves as an insulating material beneath the skin and around
certain organs.

It is necessary in the diet to provide an adequate supply of essential fatty acids and for
the efficient absorption of fat-soluble vitamins from the intestine. Excessive deposition of
fat in the body leads to obesity.

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Saturated Fatty Acids (SFA) – derived from both animal fats and plant oils. Rich
dietary sources include butter fat, meat fat, and tropical oils (palm oil, coconut oil and
palm kernel oil) (www.sciencedirect.com)

Monounsaturated Fatty Acids (MUFA) – These are types of unsaturated fats which
may be sourced from nuts, avocado, canola oil, olive oil, sunflower oil, peanut oil and
peanut butter, and sesame oil. Monounsaturated fats can have a beneficial effect on
your heart when eaten in moderation and when used to replace saturated fat and trans-
fat in your diet.

Polyunsaturated Fatty Acids (PUFA) - This type of fats is mainly found in vegetable
oils such safflower, sunflower, sesame, soybean and corn oils. It is also the main fat
found in seafood. Eating PUFA in place of saturated fat may lower low density
lipoprotein (LDL) cholesterol (or the bad cholesterol).

For good health, the majority of the fats that you eat should be monounsaturated or
polyunsaturated. Eat foods containing monounsaturated fats and/or polyunsaturated fats
instead of foods that contain saturated fats and/or trans fats.
 Trans Fatty Acids (TFA) – an unsaturated fatty acid of a type occurring in margarines
and manufactured cooking oils such as a result of the hydrogenation process, having
trans arrangement of the carbons atoms adjacent it double bonds. Consumption of such
acids is thought to increases the risk of atherosclerosis (Oxford Languages).

Atherosclerosis is a disease of the arteries in which fatty plaques develop on their inner
walls, with eventual obstruction of blood flow.
Fatty Acid Group Meats, Fats Dairy Legume Eggs Other
Poultry, and Product s, Nuts (%) (%)
Fish (%) Oils (%) (%) (%)

Saturated Fatty 39 34 20 2 2 3
Acids

Monounsaturat 35 48 8 4 2 3
ed Fatty Acids

Polyunsaturat 18 68 2 6 2 6
ed Fatty
Acids

Source: Mahan, et.al., Krause’s Food, Nutrition, & Diet Therapy 11th Edition

D. Dietary Fiber
This is a type of carbohydrate that cannot be digested by our body’s enzymes. It is found
in plant foods such cereals, fruits, vegetables, dried peas, nuts, lentils, and grains. It is
grouped by its physical properties and may be soluble, insoluble, or resistant
(www.nestle.co.nz). In other words, it is beneficial for a healthy bowel movement.

Sources of Fiber Components

INSOLUBLE

Cellulose Hemicellulose Lignin

Whole-wheat flour Bran Mature vegetables

Bran Whole grains Wheat

Vegetables Fruits and edible seeds

such flax seeds and
strawberries

SOLUBLE

Gums Pectin

Oats Apples

Legumes Citrus fruits

Guar Strawberries

4
Barley Carrots

Source: Mahan, et.al., Krause’s Food, Nutrition, & Diet Therapy 11th Edition

E. Water
 It serves as a carrier, distributing nutrients to cells in removing wastes through urine. It is
a very needed agent in the regulation of body temperature and ionic balance of the
blood, is essential for metabolism, and is required as lubricant and as a shock absorber.

Benefits of Drinking Water (agelessinvesting.com):

1. Supports heart health III. MICRONUTRIENTS
2. Improves blood circulation A. Vitamins
3. Increases waste removal 9. Supports muscle-building 10.Enhances brain
4. Flushes out toxins from the body functions 11.Boosts immune system 12.Prevents
5. Enhances nutrient absorption headaches 13.Prevents kidney stones 14.Prevents
6. Increases energy and alertness muscle cramps 15.Supports joints
7. Supports healthy weight loss 16.Prevents backaches 17.Prevents bad breath
8. Improves complexion

Summary of Vitamins, Functions and Food Sources

Group Functions Food Sources Remarks

Fat Soluble Vitamins

Vitamin A Eyesight, cell Liver, kidney, milk

differentiation, gene fat, egg yolk,
regulation yellow and dark
green leafy
vegetable,
cantaloupe, peaches

Vitamin D Calcium Vitamin D- Exposure to

homeostasis; bone fortified milk, sunlight helps in
metabolism milk fat, liver, the absorption
egg yolk, of this vitamin
salmon, tuna
fish, sardines

Vitamin E Membrane antioxidant Wheat germ,

vegetable oils,
green leafy
vegetables, milk
fat, egg yolk, nuts

Vitamin K Blood clotting; Liver, soybean oil, Synthesized by

calcium metabolism other vegetable intestinal track
oils, green leafy bacteria
vegetables,
wheat bran

Water Soluble Vitamins

Vitamin C Synthesis of collagen Citrus fruit,

and carnitine; wound tomato, melon,
healing peppers,
greens, raw
cabbage, guava,
strawberries,
pineapple, potato,
kiwi

Vitamin B1 Essential for growth, Pork liver, organ

(Thiamin) normal appetite, meats, legumes,
digestion and healthy whole grain,
 nerves enriched cereals
and bread, wheat
germ, potato

Vitamin B2 Essential for growth, Milk and diary

(Riboflavin) plays enzymatic role foods, organ
in tissue respiration meats, green leafy
and vegetables,

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acts as transporter of enriched,
hydrogen ion. enriched cereals
and breads, eggs

Niacin Involved in Fish, liver, meat,

glycolysis; fat- poultry, many
synthesis and tissue grains, eggs,
respiration peanuts, milk,
legumes, enriched
grains

Vitamin B6 Essential for normal Pork, glandular Aids in the

(Pyridoxine) growth meats, cereal synthesis and
bran and germ, breakdown of
milk, egg yolk, amino acids
oatmeal,
legumes

Folic Acid Important in early Green leafy

fetal development; vegetable, liver,
essential for normal lean beef, wheat,
maturation of red eggs, fish, dry
blood cells beans,
lentils, cowpeas,
asparagus,
broccoli, yeast

Biotin Essential component Liver, mushrooms, Synthesized by

of enzymes; involved peanuts, yeast, intestinal
in synthesis and milk, meat, egg bacteria
breakdown of fatty yolk, most
acids and amino vegetables,
acids banana,
grapefruit,
tomato,
watermelon,
strawberries

Pantothenic Acid Synthesis and All plant and Possibly

breakdown of many animal foods. synthesized by
vital body Eggs, kidney, intestinal
compounds; liver, salmon, bacteria
essential in the yeast
intermediary
metabolism of
carbohydrates,
fats and protein

Vitamin B12 Plays a role in Liver, kidney, Vegans require

(Cobalamin) metabolism of milk and dairy supplement
nervous tissue; foods,
involved with folate meat, eggs
 metabolism. Related
to growth

Adapted from Mahan, et.al., Krause’s Food, Nutrition, & Diet Therapy 11 th Edition

B. Minerals
Summary of Minerals, Functions and Food Sources
Group Functions Food Sources Remarks

Macronutrients Essential at Daily Levels of 100-mg or More

Calcium Bone and teeth Milk and milk 99% is found

formation products, in bones and
sardines, clams, teeth
oyster, kale,
turnip greens,
mustard greens, tofu

Phosphorus Component in Cheese, egg About 80% is

every cell; yolk, milk, found in
important meat, fish, inorganic
metabolites poultry, whole grain portion of
including DNA, cereals and almost bones and
RNA, ATP, all other foods teeth
phospholipids.
Important for pH
regulation; help
build and repair
bones

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Magnesium protein synthesis, Whole grain About 50% is
muscle and nerve cereals, tofu, nuts, found in
function, blood meat, milk, green bones, the
glucose control, and vegetables, remaining
blood legumes, chocolate 50% is almost
pressure regulation entirely inside
body cells
with only
about 1%
located in
the
extracellular fluid

Sulfur Functions in Protein foods Bulk of dietary

oxidation reduction such meat, fish, Sulfur is
reactions, as part of poultry, eggs, present in
thiamin and biotin milk, cheese, Sulfur
legumes and nuts containing
amino acids
needed for
synthesis of
essential
metabolites
Micronutrients Essential at Daily Levels of a Few Milligrams or Less

Iron Is a component of Liver, meat, egg About 70% is

hemoglobin and yolk, legumes, found in
 myoglobin, and is whole or enriched hemoglobin;
important in grains, dark green about 25% is
oxygen transfer. vegetables, dark stored in liver,
It is also molasses, spleen and
present in certain shrimp, oysters bones
enzymes

Zinc Constituent of many Oyster, shellfish, Present in

enzyme and of herring, liver, most tissues
insulin; important for legumes, milk, with
nucleic acid wheat bran greatest
metabolism; helps amounts in the
improve immune liver,
system; wound- voluntary
healing and for muscles and
sense of taste and bones
smell

Copper Integral part of DNA Liver, shellfish,

or RNA whole grains,
cherries,
legumes, kidney,
poultry, oyster,
chocolate, nuts

Iodine Constituent of T4 Iodized table salt, Iodization of

and related seafood, water and table salt is
compounds vegetables in recommend
synthesized by the regions without ed
thyroid gland. T4 goiter especially in
functions in the areas where
control of reactions food in low in
involving cellular iodine
energy.

Manganese Constituent of Beet greens, The highest

essential enzyme blueberries, whole concentration
systems and is rich grains, nuts, of manganese
in mitochondria of legumes fruit, tea is in bones
liver cells

Fluoride Reduces dental Drinking water, Exists in

carries and may tea, coffee, rice, bones and
minimize soybeans, teeth
bone loss spinach, gelatin,
onions,
lettuce

Molybdenum Constituent of an Legumes,

essential enzyme cereals, grains,
(xanthine oxidase dark green leafy
and flavoproteins) vegetables,
organ meats

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Cobalt Essential for the Liver, kidney,
normal function of all oysters, clams,
cells particularly in poultry, milk
the bone marrow,
nervous
and
 gastrointestinal
systems

Selenium Involved in fat Grains, onions, Varied

metabolism; meats, milk amounts in
cooperates with vegetables
Vitamin E and acts depending on
as an antioxidant the selenium
content of soil

Chromium Associated with Corn oil, clams,

glucose metabolism whole grain
cereals, brewer’s
yeast,
meats, drinking
water (amount
varies)

Adapted from Mahan, et.al., Krause’s Food, Nutrition, & Diet Therapy 11 th Edition

Prepared by:

ANI ROTZEH A. MAPESO, RND, LPT

Instructor
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