NUTRITIONAL DISORDERS
Dr. Saleem Shaikh
Introduction
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Nutritional imbalance or disorders in a society generally
depends on the socioeconomic conditions.
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In developed countries problems are related to over eating
and obesity and in underdeveloped or developing countries
chronic malnutrition is a serious health risk, particularly in
children.
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For good health, humans require energy providing nutrients
(proteins,fats and carbohydrates), vitamins, minerals, water
and non-essential nutrients
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Energy: the requirement of energy by the body is calculated
in Kcal per day. Inorder to maintain stable weight the energy
intake should match the energy output.
The average requirement for an individual is calculated by the
formula: 900+10w for male and 700+7w for females;
(w= weight in kgs)
The obtained number is then multiplied by 1.2,1.4 or 1.8
depending on the physical activity of the person.
Proteins: dietary proteins provide the body with amino acids
for endogenous protein synthesis and are also a metabolic
fuel for energy. Some amino acids are not synthesized in the
body, these are known as essential amino acids.
(1g of protein provides 4Kcal of energy)
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Fats: fats and fatty acids should constitute not more than
35% of diet. 1g fat provides 9Kcal of energy.
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Carbohydrates: Dietary carbohydrates are the major source of
calories, especially for the brain. 1g provides for 4 Kcal of
energy. Atleast 55% of the caloric intake should be derived
fro carbohydrates.
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Vitamins: these are mainly derived from exogenous sources
and are essential for normal structure and functions of cells.
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Minerals: iron, calcium, phophorus, zinc, coper, iodine etc are
very essential for health and deficiencies may result in a
variety of syndromes.
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Water: very important – 1-1.5ml per K al of energy spent.
Pathogenesis of deficiency diseases.
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Nutritional deficiency develops when the essential nutrients
are not provided adequately to the cells. Nutritional
deficiency may be of two types:
1. primary – due to decreased amount in diet.
2. secondary – due to various factors like
* interference with ingestion
* interference with absorption
* interference with utilisation
* increased excretion
* increased demand
Obesity
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Dietary imbalance and over nutrition may lead to obesity.
Obesity is an excess of adipose tissue that imparts a health
risk, a body weight of 20% weight over ideal weight for age,
sex and height is considered a health risk.
Body mass index (BMI) – most widely used method;
weight in kgs / height in m2.
a BMI value of over 30 is considered obese.
Obesity results when caloric intake is more than energy
output
This may be due to – over eating, sedentary life style,
carbohydrate and fat rich diet, genetic predisposition and
underlying diseases (cushings disease, hypothyroidism etc)
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Starvation is a state of overall deprivation of nutrients.
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Protien-Energy Malnutrition [PEM]: inadequate
consumption of protein as a result of primary deficiency or
due to secondary deficiency may cause loss of body mass and
adipose tissue.
Two variants of PEM
1. Kwashiorkor – deficiency of only protein, although the
caloric intake may be sufficient
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2. Marasmus: starvation in infants occouring due to
overall lack of calories.
Vitamins

Vitamins are organic substances which cannot be synthesized
within the body and are essential for maintenance of normal
structure and functions of cells.
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Classification of vitamins: vitamins can be divided into 2
groups - Fat soluble and Water soluble
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Fat soluble: there are four fat soluble vitamins – A,D,E & K.
these are absorbed from the small intestine in presence of bile
salts.
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Water soluble: vitamin C and B complex. Easily absorbed
from small intestine. Being water soluble these are more
easily lost by cooking or processing of food.
Vit A
Vit D
Vit E
Vit K
Water soluble vitamins