Nutrition

1. Nutrition

2. Nutrition – You Are What You Eat • Nutrition – Has been defined as the food you eat and how your body uses it. • Nutrients – are chemical substances supplied by food that the body needs for growth , maintenance and repair • Macronutrients – are carbohydrates, fats, and proteins • CHO, fats are well known as fuel foods – but protein is sometimes forgotten • CHO – 4Kcal/gm • FAT – 0 Kcal/gm • Protein – 4 Kcal/gm

3. Diet & Illness • Some of out nation’s top leading causes of death have been associated with diet: • 1. Coronary heart disease • 2. Certain types of cancer • 3. Stroke • 4. Diabetes • 5. Atherosclerosis

4. Nutrition - Purpose • 1. Provide energy for body processes & movement • 2. Provide structural material for body tissue • 3. Regulating body processes

5. Photosynthesis • Plants with green leaves trap the radiant energy of sun & through this process, store it as chemical energy in CHO • CO2 = H2O + Chlorophyll = CHO ---- either as a starch or sugar • Plants – Such as: • potatoes, wheat, rice = starch • peas, bananas, cherries, or beets = sugar • CHO (Carbohydrates) are most economical form of energy, readily accessible foods, the energy used by the brain

6. Simple vs Complex Carbohydrates • Simple: • Monosacchrides: • Glucose, Fructose, Galoctose • Foods: grapes, oranges, dates, honey, corn syrup • Type CHO that is absorbed from intestinal tract

7. Simple CHO • Disacchrides : Double sugar • Succose, maltose, lactose • W & B Sugar, molasses, honey, sweet potatoes, pineapples, carrots

8. Complex CHO • Polysaccharides - • Starches • Fiber

9. Complex - Polysaccharides • Starches – Large molecule of glucose • Requires longer to digest • Glucose available slower • Ex: Cereal grains, corn, peas, potatoes, squash, legumes • Starch increases with maturity

10. Fiber • Cellulose • Absorbs water to provide bulk or roughage in diet • Bulk stimulates peristalsis • Cellulose is undigested

11. Dietary Fiber 20-35 g/day • Soluble: • Able to dissolve in H2O • Beans, oatmeal, barley, broccoli, citrus fruits • Regulate blood glucose level • Weight loss • Lowers cholesterol

12. Dietary Fiber • Insoluble: • Incapable of being dissolved • Fruits and veg. skins, nuts, popcorn • Promote bowel regularity • Decreases risk diverticular diseases, cancer

13. Circulating Blood Glucose • 40mg/dl - 80 -- 120 - 160 - 180 --- 500 • Hypoglycemia Glucose Exceeds • Body secretes Renal threshold • Hormones i.e. Glucosuria • Epinephrine, Insulin is secreted Growth from Beta cells of *Glucagon Pancreas to< BGL

14. Circulating Blood Glucose (con’t) • *Glucagon (Job is to increase BGL) • Is secreted by alpha cells of pancreas • Stimulates the breakdown of glycogen & release of glucose by the liver > increases blood sugar levels • That’s why if you are hungry @ 10-11am you will be able to wait until 1 pm or so to eat

15. Circulating Blood Glucose (con’t) • Glycogen: • Is a polysaccharide • Is stored in liver & muscle tissue (called animal starch) • Is a string of glucose. • 50-75 gm of glucose is stored in the liver as “hepatic glycogen” • An adult male has 300 gm stored in the liver & muscles • An important link in energy metabolism: • Helps sustain normal blood sugar levels during fasting periods such as sleep hours • Provides immediate fuel for muscle action especially athletic activity.

16. Digestion of CHO • Mouth -> chewing food particles ->mixes with Saliva (Salivary Amylase) > changing dextrins & maltose • Stomach – Mixing continues > Thicker > Chyme • Small Intestines – With aide of: • Pancreatic Amylase & Intestinal Secretions > conversion from complex to simple sugars • From small intestines -> • 1. portal circulation to liver to be converted to glucose & then glycogen & Stored • 2. To blood stream to all cells for Energy • 3. Or stored as Fat

17. CHO: Signs & Symptoms of Inadequate CHO Intake • 1. Fatigue • 2. Dehydration • 3. Energy Loss • CHO are stored for around 24 hours • *If CHO are lacking then: • 1. Protein catabolism begins only after a few hours rather than using protein for healing • 2. Fat tissue is broken down with release of fatty acids, glycerol & ketone bodies which means fats burn incompletely & acidosis occurs. *Glucose is required for complete oxidation of fats.

18. CHO: Signs & Symptoms of Inadequate CHO Intake (con’t) • As long as glucose is present, ketones are quickly metabolized by muscle tissue so that ketone levels of the blood remain unchanged. • Pts. with Ketoacidosis have excessive ketone bodies in the blood. They exhibit hyperventilation, loss of Na, K+, Cl- and H2O form the body. • Excessive glucose is converted to glycogen until this limited glycogen storage capacity is filled (50-75gm) simultaneously glucose is also converted into fats & stored as adipose tissue.

19. Normal Blood Glucose Level:80 – 120 mg/dlFactors that affect how much CHO are available for the body to use: • 1. State of mucous membrane of GI tract: • i.e.: intestinal disease or hypermotility (Diarrhea) • This limits or alters contact with CHO to intestinal wall for absorption • 2. Hormones: • i.e.: Insulin, Glucagon (from pancreas) & epinephrine (from adrenal glands) • 3. Vitamins: especially “B” complex are involved in the metabolism of CHO • B1 – Thiamin, B2 – Riboflavin, B3 – Niacin • *** Remember TRN 123 Temporary Registered Nurse

20. CHO are Protein sparing: • If CHO are present in adequate amounts you don’t use protein for energy. • Need 100g/day to prevent this • CHO’s prevent formation of ketones (Ketoacidosis): • if CHO decreased (starvation, diabetes) • excess fat is oxidized and therefore increases ketones

21. Energy from CHO is in the form of: • Heat • Muscle contraction • Synthesis of essential compounds • Conduction of nerve impulses

22. Health Problems & CHO’s • Dental caries • Obesity • Hypoglycemia/ Hyperglycemia • Alcohol blocks glucose production by the liver

23. Lipids -- Fat • Classified According to three Criteria: • 1. Whether the fat is emulsified or nonemulsified • 2. Visible or invisible • 3. Simple or Compound

24. Lipids – Fat (con’t) • The term Emulsion is applied to a liquid dispersed in another liquid with which it does not usually mix. • i.e.: Oil and Vinegar do not mix • Fat is insoluble in H2O • A means of transporting fat thru the water based blood is a problem. • So the body must emulsify dietary fat. • This occurs in the small intestine thru the action of bile salts (from liver to GB)

25. Visible vs. Invisible • Visible Fat: 40% Invisible Fat: • Easily seen Hidden in foods on meat Egg yolk • Oil Baked goods • Butter Snacks • Emulsified milk • Cheese • Olives • Nuts • Avocados

26. Simple vs Complex • Lipids in foods and in the human body fall into 3 classes: • 1. Triglycerides (simple) – 95% • 2. Phospholipids – ex. Lecithin • 3. Steriods – ex. Cholesterol • Blood lipids, cholesterol, fats & oils all contribute to health and detract from it.

27. Fats Provide: • 1. Energy – for now & stored fat for later energy • 2. Insulation – Maintaining body temp & padding (protecting organs) • 3. Cell membrane integrity • 4. Nerve impulse transmission • 5. Carries fat soluble vitamins (ADEK) • Taste (satiety) – Adds texture & flavor to foods

28. Usefulness of Fats • In Foods: • Makes foods taste better • Taste, smell, feel full • Provide essential fatty acids • Provide energy • Carry fat soluble vitamins • In Body: • Insulation • Padding • Energy • Cell membrane material

29. Fatty Acids • Saturated: Unsaturated: • One whose Has at least one structure is unfilled H+ spot completely Monounsaturated filled with all vs H+ it can hold Polyunsaturated • Heavier, more The more unsat. dense,more solid the more liquid • Requires higher at room temp. Temp. to melt

30. Monounsaturated Fatty Acid • Usually Plant Origin • Liquid at Room Temp • Can Become saturated if a chemical change occurs • Foods: Peanuts, Peanut oil, Olives & Olive oil, Almonds, Pecans, Canola oil

31. Polyunsaturated Fatty Acids • Plant Origin • Liquid at Room Temp. • Foods: Veg. Oils • Sunflower oils • Some margarines • French Dsg. • Walnuts

32. Trans-Fatty Acids • Have implications for the body’s health • Not currently mentioned on food labels • Carry a risk similar to saturated fats • Elevated blood cholesterol & thus raise the risk of heart disease & heart attack • Are found in fast foods, chips, baked goods, & other commercially prepared foods • High in fats can contain up to 50% trans-fatty acids

33. Chemical Digestion Fat Begins • Mouth -> via chewing -> smaller parts & warms food • Stomach -> Fats emulsified due to Gastric lipase & peristalsis • Small Intestine -> • Bile Salts: Fat in duodenum -> releases of cholecystokinin > causes GB to contract > releases bile • Bile: 20-60 ml held in Gallbladder, produced in liver • Enzymes: pancreatic lipase & enteric lipase • End Products: Monoglycerides, Fatty acids, Glycerol

34. Blood Lipid Profile • Triglycerides: <100 mg/dl desired • Cholesterol: <200mg/dl • 200-239 Borderline • CVD. > 240 ^ risk • Lipoproteins: • HDL – High density – good • 29-77 mg/dl • Carry cholesterol away from cell • LDL Low density – bad • 62-185 mg/dl • Carry cholesterol to cell

35. The Good , Bad & The Ugly - Cholesterol • Important in structure of brain & nerve cells • Nonessential nutrient • Endogenous supply • 1000mg/day • Take in more > Body makes less • Major contributor of plaque • <200 mg/dl • Keep intake <300mg/day

36. Cholesterol – Food Sources • Egg Yolk • Organ meats (especially liver & kidney) • Cream • Butter • Ice Cream • Cheese* ( The lighter in color the lower the amount of cholesterol) • Remember – if it had or has a heart beat, it has cholesterol

37. What about Fat Substitutes? • “O’lean”, Olestra • O’lestra: is indigestible therefore the body has no way to take it apart • Problems: causes digestive distress & nutrient losses • i.e.: gas, diarrhea, cramping, strong “urge to go” • Oil can leak thru feces & leak from the anus • May interfere with absorption of fat soluble vitamins

38. Proteins – The Most Expensive Nutrient • Proteins are the building blocks of blood and bone & all other tissues. They are the structural part of every cell. • They are made up of smaller building blocks called amino acids. • Found in scar tissue, hair growth, blood albumin, Hemoglobin

39. More on Proteins • Chemical elements – C, H, O2 & Nitrogen • Linked together by peptide bonds • 50,000 different proteins • 24 Amino Acids • Change the number or arrangement you change the Amino Acid • Essential vs Nonessential

40. 4 Major Functions in Body • 1. Maintenance of Growth • 2. Regulation of Body Process • 3. Development of Immunity • 4. Energy

41. Amino Acids • Essential: • Means they cannot be manufactured by body & must be obtained from food • 9 • All 9 must be available simultaneously & in sufficient quantities for synthesis of body proteins • Nonessential: • Can be synthesized by body • Often derived from other amino acids

42. Complete vs Incomplete Protein Foods • Complete: • Have all 9 Essential Amino Acids • Examples: Meat, Eggs, & Milk • Incomplete: • Lack some Amino Acids • Some foods mixed together = a complete protein food • Examples: • Corn & peas • Spaghetti Noodles & cheese • Milk & cereal • Rice with pork • Noodles with tuna

43. Keeping a Positive Nitrogen Balance • Protein Balance: The body’s tissue proteins are constantly being broken down into amino acids, a process called catabolism & the resynthesized into tissue proteins as needed , a process called anabolism. • To maintain Nitrogen balance, the Nitrogen containing element of the amino acids can be removed by a process called deamination – converting to ammonia (NH3) & the Nitrogen is excreted as urea in the urine.

44. Keeping a Positive Nitrogen Balance (con’t) • A positive nitrogen balance exists when nitrogen intake exceeds output, that is when protein anabolism exceeds protein catabolism. • A negative nitrogen balance exists when nitrogen output exceeds intake. This state usually occurs when a person does not consume adequate essential amino acids & or calories, is immobilized, or is exposed to unusual stress as a result of trauma. To prevent this a person must ingest at least 20-30 gms of protein each day.

45. Protein Metabolism • Mouth -> chopping into smaller parts • Stomach -> Chemical digestion begins with help of: Pepsin, HCL, & Rennin • Small Intestines -> Digestion is completed here • Pancreatic Secretions: Intestinal Secretions: • Ex: Tryosin Ex: Ainopeptidase • Chymotrypsin Dipeptidase • Carboxypeptidese • Absorption occurs thru lining of small intestines with help of Na • End Products: H2O – Urea – CO2 > Liver

46. Lab Values - Protein • Albumin accounts for >50% of total protein & therefore reflects the protein status of blood & organs. • Albumin levels: 3.5-5 g/dl or 35-45 gms • Albumin levels increase & decrease slowly therefore when decrease serum albumin is seen associated with malnutrition, it reflects prolonged protein depletion. • Other conditions that show decreased albumin levels are, liver & kidney disease, AIDS, Ca, & burns.

47. Daily Allowances of Protein • Based on age & desired weight • Newborn: 2.2 gm/kg • 7-10: 1.2 gm/kg • Adolescent: 1 gm/kg • Adult: 0.8 gm/kg • A man weighing 154 lbs. = 56 gm of daily protein • Food examples: • 7 inch carrot = 1 gm protein • 1 small raw tomato = 1 gm of protein • Egg = 6 gm of protein • Meat = 7 gm/ounce • Milk = 9 gm/cup

48. Water – H20 • Must be consumed often & in greater quantities • Solvent in which chemical reactions occur • Medium for transporting substances. Ex: Blood, Lymph, Waste • Provides lubrication. Ex: Synovial fluid & mucous • Contributes turgor to cells • Regulates body temperature via Evaporation • Which food are high?

49. Micronutrients - Vitamins • Fat Soluble: A, D, E, K • Stored in the body • Stable in heat • No nitrogen • Require bile for absorption • Soluble in fats • Water Soluble: C, B Complex • Soluble in water • May be affected by cooking methods • B Complex contain Nitrogen • Very little stored therefore few toxic levels occur

50. Minerals • Minerals, or elements: are inorganic substances • Required in small amounts • Cannot be synthesized in the body, must be obtained from food • Some are important constituents of bones (Ca), others are required to activate specific enzymes involved in chemical reactions, to maintain acid-base balance (Mg, P, Na, Cl) & water balance (K, Cl) & muscle functions (Mg, K, Na, Ca). • Approx. 3-6% of the body weight is made up of minerals (ash). Minerals should be supplied daily because they are excreted every day by the kidneys, bowel, & skin. • Minerals are stored!