NCM 105
NUTRITION
AND DIET THERAPY
Course description
This course deals with the study of food in relation to health and illness. It covers nutrients and other
substances and their action, interaction, and balance in relation to health and diseases and the
process by which the human body ingests, digests, absorbs, transports, utilizes, and excrete food
substances. It also focuses on the therapeutic and food service aspects of delivery of nutritional
services in hospitals and other healthcare institutions. The learners are expected to develop the
competencies in appropriate meal planning and education of a given client.
Course outline
 History of Nutrition from International and National Point of View
 The Philippine Nutrition Situation
 The Philippine Plan of Action for Nutrition (PPAN)
 Basic Concepts in Nutrition
 Various Disciplines Related to Nutrition
 The Role of Nutrition in the Development of Healthy Mind and Body
 Basic Tools of Nutrition
Chapter 1
History, Overview,
and Definition of Terms in Nutrition
Nutrition- is the study of food in relation to health of an individual, community, or society and the
process through which food is used to sustain life and growth.
Organ systems and their role in nutrition
Cardiovascular (heart, blood vessels, blood) – transports nutrients, gases, waste products, regulates
body temperature, involved with the immune response.
Digestive (mouth, esophagus, stomach intestines, liver, pancreas) – digests and absorbs nutrients;
eliminates waste products.
Endocrine (endocrine glands, e.g., thyroid, pituitary, adrenal glands) – helps regulate metabolism,
reproduction, water balance, etc. (by hormones secreted).
Immune (white blood cells, lymph, spleen, thymus gland)-provides defense against foreign
substances.
Integumentary (skin, hair, nails, sweat glands) – protects the body; regulates temperature; aids in
acid-base and water balance; production of vitamin D.
Lymphatic (Lymph vessels, nodes)-helps in fluid balance and fat absorption;removes foreign
substances from the blood.
Muscular (skeletal, cardiac, and smooth muscles)-maintains posture;directs body movements;and
produces body heat.
Nervous(brain,spinal
cord,nerves,sensory
organs
and
receptors)-controls
intellectual
function;detects sensations and controls movements.
Respiratory (lungs and respiratory tract)-regulates gas exchanges and acid-base balance.
Reproductive-regulates sexual functions and reproduction.
Skeletal(bones,joints, and cartilages)-main frame body support; aids with body movements; stores
minerals, produces blood cells.
Urinary (kidneys, urinary tract)- removes waste products;regulates fluid, acid-base balance; aids with
homeostasis.
Food- is any substance, organic or inorganic, when ingested or eaten, nourishes the body by building
and repairing tissues, supplying heat and energy, and regulating bodily processes.
Ideally, food must have the following qualities;
 It is safe to eat. It is prepared under sanitary conditions, aesthetically and
scientifically.
 It is nourishing or nutritious.
 Its palatability factors (colors, aroma, flavor, texture, etc.) satisfy the consumer.
 It has satiety value.


It offers variety and planned within the socio-economic contect, (e.g.,within the
budget and lifestyle of the person, including cultural, religious practices and other
aspects.)
It is free from toxic agents or does not contain substances deemed deleterious to
health.
Nutrient- is a chemical component needed by the body for one or more of these three general
functions: to provide energy, to build and repair tissues, and to regulate life processes.
 It is found chiefly in foods and normal nutrition necessitates the ingestion of
nutrients from natural food sources.

Some are manufactured in the body ( a process called ‘biosynthesis’) while some
other are made in the laboratory.
Six General Groupings or Categories of Nutrients- groups of individual nutrients each of which has
important physiological role in the body.
 Water
 Protein
 Carbohydrates
 Fats
 Vitamins
 Minerals
DIETARY ESSENTIALS
Dietary Essential- these should be supplied from food because the body does not synthesize them.
 According to concentration, nutrients may be termed macronutrient or
micronutrients.
Macronutrients- present in large amounts in the body.(Water, Protein, Fat, Carbohydrates)
Micronutrients- measured in milligrams or fractions. (Vitamins, Minerals)
 All persons need the same kinds of nutrients, but the amounts vary according to
factors like age, sex, body size, physical activity, state of health, and specific
physiological conditions.
 No natural food by itself has all the nutrients one need, but with careful planning,
including a variety of foods plus caloric control, an adequate and well balance diet is
obtainable.
 Individualization- planning a person’s daily diet observing: adequacy, balance, and
variety of food choices.
Enzymes- are organic catalysts that are protein in nature and are produced by living cells. A catalyst
hastens chemical reactions without itself undergoing change.
Nutritional Status (Nutriture)- is the condition of the body resulting from the utilization of essential
nutrients.
Categories:
1. Optimum/Good Nutrition
2. Malnutrition
Optimum or Good Nutrition-means that the body has adequate supply of essential nutrients that are
efficiently utilized such that growth and good health are maintained at the highest possible.
Malnutrition-is opposite of good nutrition (mal-meaning “bad”). It is condition of the body resulting
from a lack of one or more essential nutrients (nutritional deficiency) or it may be due to an excessive
nutrient supply to the point of creating toxic or harmful effects (e.g., overnutrition and
hypervitaminosis). Other term: Imbalanced Nutrition.
Nutritional deficiencies may be caused by:
Primary Factors- refers to faulty diet.
Secondary Factors- are multiple and include all conditions within the body that reduce the ultimate
supply of nutrients to the cells after the food goes beyond the mouth. Ex: gastrointestinal disorder,
lack of appetite, etc.
Anthropometry –weight, height,MUAC
Biochemical –urine, blood, hair, nails
Clinical – Physical signs/ECG/MRI
Dietary- diet history, diet recall, food records
HISTORY OF NUTRITION FROM INTERNATIONAL AND NATIONAL POINT OF VIEW
Guthrie, a well known nutrition authority, identified four eras in the history of nutrition as a science:
-Naturalistic Era (400 B.C. to 1750 A.D.)
-Chemical Analytical Era (1750-1900)
-Biological Era (1900-1955)
-Cellular or Molecular Era (1955-1980)
-1885- nearly all of the nutritional studies were carried out in Western Europe and most
were concerned with the need for either energy and protein.
NATURALISTIC ERA
Hippocrates- also known as the “Father of Medicine” was the first physician to show an interest in
nutrition
CHEMICAL-ANALYTICAL ERA
Lavoisier gained the name “Father of Nutrition” because of his respiration and oxidation studies.
-It was during this period that chemical studies were conducted which led to the discoveries of
oxygen, carbon dioxide, hydrogen, and nitrogen.
-Later reports disclosed studies on the different substances needed by the body as carbohydrates,
fats, and protein, and mineral ash.
BIOLOGICAL ERA
The role of nutrition education, especially the application of scientific principles in the improvement
of nutritional status, was focused in this period.
CELLULAR ERA
-More information was obtained regarding the role of different nutrients play in growth, development
and maintenance of the cells and ultimately to the whole body.
MOLECULAR BIOLOGY ERA
-A whole new world of genetic engineering or biotechnology was founded.
PHILIPPINEHISTORY
-Chamberlain, Vedder, and R.R.Williams made a significant contributions because of their
studies on the cause of Beri-beri (vitamin b1/thiamine deficiency), thus making possible the largescale manufacturing of tiki-tiki extracts.
-Francisco O. Santos – the Father of Nutrition in the Philippines.
-1932- the National Research Council (NRC) was established.
-1947- Philippine Institute of Nutrition was created.
-1955- Dietetic Association of the Philippines was organized.
-June 25, 1974- National Nutrition Council (NNC) was created.
-Nutrition Dietetics Decree of 1977, P.D. 1286 – allowed all nutrition graduates to take the
licensure examination.
1978 –DAP was changed to Nutritionist-Dietitian’s Association of the Philippines (NDAP).
1993- Philippine Plan Action for Nutrition (PPAN) for 1993-1998 was drafted and launched.
2005 – Department of Health became the chair of NNC, with the DA and DILG as vice-chairs.
SCOPE OF NUTRITION AS A SCIENCE
Basic or Fundamental Nutrition – is a study of physiologic needs in terms of specific nutrients.
Nutrition of Growth and Development or Child and Maternal nutrition – is a study of nutritional
principles and application throughout the life cycle or it could be concentrated on infancy, childhood,
pregnancy, and lactation, which are the most vulnerable groups.
Medical Nutrition Therapy (MNT) – which deals with the adequacy of nutrient intake and diet to
meet the individual’s needs under pathological conditions. Also called Clinical or Medical Nutrition.
Community Nutrition- refers to ways and means of supplying adequate diets in a group of people
starting with the family or a community and it could be nationwide or international.
Community Nutrition- refers to ways and means of supplying adequate diets in a group of people
starting with the family or a community and it could be nationwide or international.
Other areas of specialization:
 Nutrition in Dentistry
 Geriatric Nutrition
 Pediatric Nutrition
 Nutrition for Chiropractics
Nutrigenomics – is the latest area of nutrition research. It is the science of how human genes interact
with nutrients and their metabolism.
SUMMARY OF BASIC CONCEPTS OF NUTRITION
-Adequate Nutrition is essential to good health.
-The nutrients in our body are in dynamic equilibrium.
-Dietary intake and nutrient needs should be individualized.
-Human requirements for nutrients are known for some and have to be determined as yet for others.
-An adequate diet is the foundation of good nutrition and it should consist of a wide variety of foods.
-The physiological functions of food are attributed to the roles of the nutrients.
-Malnutrition is brought about by a faulty diet and/or by conditioning factors like hereditary,
infections, ingestion of certain drugs, and parasitism.
-Nutrition education, abundant food supply, and use of various resources are needed to improve
nutritional status of a population.
-The study of nutrition is interrelated with allied arts and sciences.
-Nutrition education is a multidisciplinary process and forms a bridge between the educator and the consumer in the transport of nutritional principles and application.
BASIC TOOLS IN NUTRITION
Introduction
-Reliability and validity are measures of evidence-based research and the use of basic tools is
of prime importance. The term “tool” refers to a handy object or method needed to perform specific
tasks.
-in the study of nutrition,the commonly used tools are:
 Food guides: food pyramid or other visual aids\
 Dietary Standard
 Dietary Guidelines
 Food Composition Tables
 Food Exchange Lists
 Use of Computers


Nutrient Density
Nutrition Labeling
Food Guides: The Food Pyramid
-Foods containing high levels of certain nutrients are grouped together and the serving portions are
stated in household measures of the layman to understand.
-The Food and Nutrition Research Institute (FNRI) has developed a food guide pyramid, a simple and
easy-to-follow daily eating guide for Filipinos.
-The Food Guide Pyramid teaches the principles of eating a variety of food every day in proper
amounts of servings.
Dietary standards
-It is the compilations of nutrient requirements or allowances in specific quantities.
-They are tentative and may be changed, as newer findings from research unveil.
-As quantitative tools in assessing the nutritional adequacy of diets, the principle of individualization
is observed.
Dietary requirements
-These are minimum amounts needed for essential nutrients to attain good health under specific for
age, sex, weight, physical activity,physiological conditions, state of health, etc. Example: RENI
Recommended Dietary Allowances (RDA)/RENI
-These data consist of minimum requirements plus a safety factor called “margin of safety” to allow
for individual variations of body storage, state of health, nutrient utilization, and other day-to-day
variations within a person.
-1989 RDA was revised in 2002 and became the Recommended Energy and Nutrient Intakes (RENI).
-The RENI is a nutrient-based dietary standard recognized in the nutrition and health community as
the source of information.
Uses:
Food planning and procurement – use to develop plans for feeding groups of healthy people.
Food Programs-serves as a basis for the nutritional goal for feeding programs.
Evaluating Dietary Survey Data
Guides for Food Selection
Food and Nutrition information and education
Food labeling
Food Fortification
Developing new or modified food products
Clinical dietetics
Nutrient supplements and special dietary foods
The nutritional guidelines for Filipinos
-Eat a variety of foods everyday to get the nutrients needed by the body.
-Breastfeed infants exclusively from birth up to six months and then give appropriate complementary
foods while continuing breastfeeding for two years and beyond for optimum growth and
development.
-Eat more vegetables and fruits to get the essential vitamins, minerals, and fiber for regulation of
body processes.
-Consume fish, lean meat, poultry, egg, dried beans or nuts daily for growth and repair of body tissues.
- Consume milk, milk products, and other calcium-rich food such as small fish and shellfish, everyday
for healthy bones and teeth.
-Consume safe foods and water to prevent diarrhea and other food-and water-borne diseases.
-Use iodized salt to prevent Iodine Deficiency Disorders.
-Limit intake of salty, fried, fatty, and sugar-rich foods to prevent cardiovascular diseases.
-Attain normal body weight through proper diet and moderate physical activity to maintain good
health and help prevent obesity.
-Be physically active, make healthy food choices, manage stress, avoid alcoholic beverage, and do not
smoke to help prevent lifestyle-related non-communicable disease.
USED COMPOSITION TANLES (FCTS)
-Used worldwide.
- Examples are: The Philippine Food Composition Tables, 1997; USDA (series of books), Pennington’s
Latest Edition of Bowes and Church’s FCT, and FAO Food Values.
-The chemical composition of a food, whether of animal or plant origin, varies according to kind or
breed, maturity or age, part of plant of carcass, soil fertility, climate handling and storage conditions,
marketing and agricultural practices and a host of other uncontrollable factors.
-The volume of the current edition totals 160 page with 17 categories of foods.
Food Exchanged List
-It is a grouping of common foods that have practically the same amount of protein, carbohydrates,
and fat.
-Within a group, one food item can be exchanged with another provided the specified serving portion
is followed.
-It is commonly used by clinicians as a quick method to calculate protein, carbohydrates, fats, and
calories for any given meal or diet.
NUTRITION DENSITY
Is a relative measure of nutrients in a food in proportion to its caloric content. Some nutritionists
advocate the use of INQ or index of nutrient quality which is defined as:
Percent RDA of Nutrient
Percent Energy Requirement
If a food has an INQ of 1 or more for at least four nutrients, or an INQ of 2 for at least two nutrients,
then the food is considered nutritious.
FOOD AND NUTRITION LABELING
-Are the primary means of communication between the producer or the manufacturer and the
purchaser or consumer.
-It is a description intended to inform the consumer of nutritional properties.
-It consists of:
:Nutrient Declaration- a standardized statement or listing of the nutrient content of food.
:Nutrition Claim- representation that states, suggests, or implies that a food has particular
nutritional properties. Ex; High in Vitamin C; free of cholesterol
:Health Claim- representation that states, suggests, or implies that a relationship exists
between a food or a constituent of that food and health. Ex; reduction of disease risk claim.
:Nutrition Facts - a statement or information on food labels indicating the nutrients and the
quantity of said nutrient found or added in the processed foods or food products.
:Nutrition labeling- a system describing processed foods or food products on the basis of
their selected nutrient content. Printed as “Nutrition Facts”.
THE USE OF COMPUTERS
Health Informatics- is the use of the principles and practices of computer science in addressing the
problems of health and health care.
E-Health (Electronic Health) is the use of information technology to improve the delivery of health
care.
USES OF COMPUTERS IN THE HEALTH FIELDS:
A. EDUCATION
a) -Instructions and lesson plans
b) -LECTURES/HAND OUTS
c) -Examinations
d) -Grades/evaluation
e) -Information retrieval
f)
-Website research
g) -eBooks
B. AMINISTRATION
- Application forms
-Job Descriptions
-Staff/ personal records
-assessment and evaluation
-Payrolls
-financial reports
-Organization charts
C. CLINICAL RECORDS
-Medical records
-Drug lists and information
-Computer-assisted diagnosis
-Patients files/Schedules
-Nutritional assessments
-Diet instruction handouts
D. INFORMATION STORAGE
-Message via internet
-Access to technical literature
-Videoconferencing
-Graphics
-robotics
-Epidemiology Data and Demographics
SUMMARY
Nutrition- is the study of food in relation to health of an individual, community, or society and the
process through which food is used to sustain life and growth.
According to Guthrie, there are four eras in the history of nutrition as a science: Naturalistic Era,
Chemical Analytical Era, Biological Era and Cellular or Molecular Era.
Francisco O. Santos is the Father of Nutrition in the Philippines.
The scope of Nutrition are: Basic Nutrition, MNT, Community Nutrition, Nutrition in Dentistry,
Geriatric Nutrition, Pediatric Nutrition and Nutrition for Chiropractics.
CHAPTER 2
THE MACRONUTRIENTS: CARBOHYDRATES
Carbohydrates
Were originally called “saccharides”, a Greek word means sugars.
Form the basis of the energy cycle on Earth.
About 50-60 % of energy needs come from Carbohydrates.
According to the number of sugar units:
-Monosaccharides
-Disaccharides
-Oligosaccharides
-Polysaccharides
Dietary Purposes:
-Simple Carbohydrates
-Complex Carbohydrates
According to the Digestibility
-Completely Digestible
-Partially Digestible
-Indigestible
ACCORDING TO THE NUMBER OF SUGAR UNITS
Monosaccharides (1 sugar Unit)
1. Glucose
Also known as dextrose or grape sugar. Is the most important physiologic sugar, hence, the other
name for it is “physiologic sugar”. Digestive end product of all sugars and starches.
2. Fructose
The sweetest of all the sugars. Found preformed in honey, ripe fruits, and vegetables.Also called
“levulose”. It is changed to glucose in the liver and intestine.
3. Galactose
Not found in nature but is hydolized from lactose or “milk sugar”. It is changed to glucose in human
metabolism. Component of some compound lipids called the cerebrosides, which are found in the
brain and nerve tissues.
4. Pentoses (Ribose and Ribulose)
Found in nucleic acids of meat and seafoods in bound form. Ribose is an important component of
coenzymes and the backbone of the genetic molecule known as RNA.
Disaccharides (2 sugar Unit)
1.Sucrose
Sometimes called “cane sugar” or “beet sugar” since it is commercially prepared from sugarcane
and sugar beets. It is also called “table sugar”. It is hydrolyzed into one molecule of glucose and one
molecule of fructose.
2. Maltose
Also called “malt sugar” because it is derived from the digestion of starch with the aid of the
enzyme “diastase”, found in sprouting grains. Not free in nature. Yields 2 molecules of glucose.
3. Lactose
All called “milk sugar” is found in milk and milk products. It is hydrolized to glucose and galactose.
It is slowly digested compared to other disaccharides. The least sweet.
POLYOLS
Commonly referred to as sugar alcohols.
The three important sugars are: sorbitol, xylitol, and mannitol.
Sorbitol – is absorbed more slowly than other monosaccharides.
Xylitol – found in the fibers of fruits and vegetables.
Mannitol – is poorly absorbed in the intestines and is used more as a food ingredient as
drying agent.
Oligosaccharides (3-4 Sugar units)
1. Trisaccharides (3 Sugar Units)
Raffinose – from sugar beets, legumes
Melizitose – from honey, poplars, conifers
Maltotriose- made up of 3 maltose residues.
2. Tetrasaccharides
a. Stachyose – from peas, beets, lima beans
POLYSACCHARIDES
1. Starch
Is the world’s most abundant and cheap form of carbohydrate.
It is the storage form of carbohydrates in plants: in grains, seeds, tubers, roots, and unripe fruits.
Complete hydrolysis yields glucose.
Partial hydrolysis yields dextrin and maltose.
2. Dextrin
Is an intermediate products of starch digestion or it is formed from partial hydrolysis of starch.
The action of dry-heat on starch (as in toasting bread or browning of cake crust in the oven) produces
dextrin.
3. Glycogen
is sometimes called “Animal Starch” because it is the storage form of carbohydrates in the body,
chiefly in the liver and muscles.
Muscle glycogen is used directly to supply energy as during exercise or work.
Liver glycogen may be changed to glucose and circulated as such by the blood.
Food sources are liver, oysters, minutes after the slaughter of animal.
Excess amount of glucose beyond the limits of glycogen storage will be converted into body fat and
stored in adipose tissues.
DIETARY PURPOSES
Simple Carbohydrates
These are the Monosaccharides and Disaccharides.
Also known as sugars, and exist either in natural or refined form.
Found in: biscuits, cakes, and pastries, chocolate, honey, jams, jellies, brown and white cane sugar,
pizzas, prepared foods and sauces, soft drinks, sweets and snack bars
Complex Carbohydrates
These are the oligosaccharides and polysaccharides.
Often referred to as starch or starchy foods.
Found in: bananas, barley, beans, brown rice, chickpeas, lentils, nuts, oats, potatoes, root vegetables,
sweet corn, wholegrain products, yam, etc.
DIETARY FIBER
Also called as “roughage”, is the indigestible part of food.
It is derived from plant sources and contains polysaccharides such as cellulose, hemicellulose, pectin,
gums, musilages, and lignins.
1. Insoluble fibers-do not dissolve in water.
Cellulose – whole wheat flour, bran, and vegetables.
Hemi-cellulose- bran and whole grains
Lignin-is a woody fiber found in wheat bran and seeds of fruits and vegetables.
2. Soluble Fibers – dissolves in water
Pectins – absorbs water and forms a gel. Often used in jams and jellies.
Mucilages- contains galactose, mannose, and other monosaccharides
Gums – found in oats, legumes, guar, and barley
Psyllium – obtained in seed of a plant known as genus plantago ovata.
The FNRI-DOST recommends daily intake of 20-35 grams of dietary fiber comprosing of 5-7 grams of
soluble fibers and 15-23 grams of insoluble fibers.
20-30 grams of dietary fiber daily is recommended by the U.S. National Cancer Institute and Dietetic
Associations.
According to the Digestibility
Digestible – starch, dextrins, glycogen
Partially Digestible – Galactogens, Inulin, Mannosans, Pentosans
Indigestible- cellulose, hemicellulose
Functions of the Carbohydrates
1. Chief Source of Energy
Body cells require a steady and constant suppy of energy mainly as glucose and its intermediate
products.
Yields 4 calories/gram of CHO.
10 grams of glucose circulating in the blood or a constant 70-100 mg of glucose per 100 ml of blood.
This must be kept constant and ready for utilization.
2. Cheap and Main Energy Food
CHO foods mainly as cereal grains, sugars, most fruits and starchy vegetables contribute at least half
or 50% total energy needs of people.
Low-cost and widely distributed.
Easily stored without refrigeration.
3. Protein Sparer
The energy need of the body is given first priority over body-building needs.
If CHO foods are not adequately supplied, protein will be catabolized to provide energy instead of
being used for building and repairing tissues.
4. Regulator of Fat Metabolism
CHO prevent complete oxidation of fats.
If energy is not sufficiently supplied by CHO sources, fat catabolism is excessive at a rate the body
cannot handle such that ketone bodies are accumulated and acidosis occurs.
5. Sole Energy Sources for the Brain and Nerve Tissues
The brain and nerve tissues utilize only glucose for energy.
Lack of glucose or oxygen needed for the oxidation of glucose to release energy will result in
irreversible damage to the brain.
6. Storage Form of Energy as Glycogen
Gylcogen provides immediate source of energy.
Muscle glycogen is used for exercise or muscle activity without changing to blood glucose.
Glycogen is the immediate source of contractile energy for the heart.
7. Regulator of Intestinal Peristalsis and Provider of Bulk
Cellulose and indigestible polysacharrides acts as a broom and regulates intestinal peristalsis.
Hemicellulose, agar, and pectins provide bulk by swelling after absorbing large amounts of water in
the colon.
FOOD SOURCES OF CARBOHYDRATES
-Sugars
-Cereal grains and their products (rice, corn, oats, breads, and other baked goods, noodles, or pasta,
etc.) rootcrops, starchy vegetables, and dried legumes.
-Fruits
-Milk
DIGESTION, ABSORPTION, AND UTILIZATION
Digestion in the Mouth
With the entrance with the mouth, digestion started by means of mastication.
Mastication- for the stimulation of saliva.
The Saliva contains a starch-splitting enzyme amylase (ptyalin) and mucin responsible for
moistening food.
Only a small portion of complex CHO is converted into dextrins and maltose and sugar in a
alkaline medium.
When the masticated food mass called bolus is swallowed, it passes downward to the
esophagus.
Peristalsis then moves the food rapidly into the stomach.
Digestion in the Stomach
The stomach receives the food and acts as a reservoir for a short time. the peristaltic activity
in the stomach walls reduces the mass to a semi-fluid chyme.
The acidity of the stomach caused by the secretion of the hydrochloric acid (HCl) in the
gastric juice stops the digestive action of ptyalin in the food mass.
A thick slimy mucus called mucin is secreted from the stomach wall to protect the cells from
being digestive by the enzymes.
All foods are liquified and mixed with HCl.
The food leaves the stomach in the form of chyme.
The stomach is normally emptied in 1-4 hours with CHO leaving the stomach rapidly,
followed by protein and fat.
Digestion in the Small Intestine
The small intestine is divided into doudenum, jejunum, and ileum.
Majority of the digestive processes is completed in the doudenum.
The pancreas secretes enzymes capable of digesting CHO, protein, and fats.
Digestion in the Large Intestines
Large Intestine does not take part in the digestion of foods.
Any bulky and unused parts of the diet are passed on to it.
In the colon, water is reabsorbed causing the formation of fairly solid mass. When the
rectum is reached, the mass evacuated in the form of feces.
Utilization of the Carbohydrates
-Fructose and galactose are first converted to glucose in the liver.
-Glucose enters a series of chemical reactions and the ultimate pathway is known as Krebs Cycle or
Citric Acid Cycle.
-Complete oxidation of Glucose results in the release of energy, production of metabolic water, and
excretion of carbon dioxide.
-Any excess glucose after fulfilling energy needs will be converted to body fat, a chemical process
called lipogenesis.
Recommended Daily Intake of Carbohydrates
130 g/dl – Institute of Medicine RDA
55%-75% - WHO
More than 25 grams/day of dietary fiber.
In the Philippines, the RDA is:
50-60% of total caloric needs should be provided by CHO.
COMPUTATION OF CARBOHYDRATES REQUIREMENTS
Given:
Height= 5’3
Work=College Student
Gender=Female
Physical Activity (FEL)= 35
BMI for Women= 21
BMI for Men=22
1. Compute for the Desirable Body Weight:
a. Convert height into inches
5 (the student height)×12 incℎ (1 foot=12 inches)=60 inches
60 inches + 3 inches= 63 inches
b. Compute height (inches) into centimeters:
63 inches ×2.54 (1 inch=2.54 cm) = 160.02 cm
c. Convert cm into m^2(meter-squared)
160.02÷100=1.6002m^2
1.6002m^2 = 2.56064
d. Computed for DBW
2.56064 x 21 = 54 kg Desirable Body Weight
Given:
Height= 5’3
Work=College Student
Gender=Female Physical Activity (FEL)= 35
BMI for Women= 21
BMI for Men=22
2. Compute for the Total Caloric Requirement
54 kg ×35=1,890 calories/Day
3. Compute for the CHO Requirement:
(Note: 50-60% of total caloric needs should be provided by CHO.)
1,890 calories × .60 (60% CHO)=1,134 calories
1,134 calories÷4 calories (1 gram of CHO=4 calories)
CHO Requirement: 283.5 grams/day
EFFECTS OF DEFECIET INTAKES
PROTEIN ENERGY MALNUTRITION
Marginal energy, but insufficient protein intake (KWASHIORKOR) “the disease that the first child gets
when the new child comes
Insufficient protein and energy intake (MARSMUS) “to waste away or dying away”
KWASHIORKOR: Scally skin, Distended abdomen (ascites) and Swollen ankles (oedema)
MARASMUS: Hair Loss, Old Person’s face, Wrinkled skin And severe mudcle wasting
Effects of Excessive Intakes
Obesity/Adiposity
If the intake of fat or protein is normal but the CHO intake is lower than the recommended level to
supply the caloric requirements, ketosis or acidosis occurs.
SUMMARY
Carbohydrates are classified to: According to the number of sugar units, Dietary Purposes, and
According to the Digestibility.
In the Philippines, the RDA is 50-60% of total caloric needs should be provided by CHO.
The functions of Carbohydrates are: Chief source of energy, chief and main energy food, protein
sparer, etc.
Excessive intake will cause Obesity/Adiposity while deficiency will cause PEM.
Chapter 3
THE MACRONUTRIENTS:
PROTEIN - Originated from Greek word “proteios” meaning “to hold first place” or “is of prime
importance. Amino acids- the building blocks of protein. Protein has 22 Amino acids.
Classifications
1. According to Essentiality
Essential
Semi-essential
Non-essential
2.According to the Chemical Composition of Their Side Chains
Basic Amino Acids
Acidic Amino Acids
Neutral Amino Acids
Branched Chained Amino Acids
3.According to Hydrolytic Products and Sources
4.According to Structure and Spatial Arrangement of Amino Acids
Essential Amino Acids
Is the one that cannot be synthesize by the body. They must be supplied ready-made or preformed in
the diet. Essential Amino acids are: histidine, isoleucine, leucine, lysine, methionine, phenylalanine,
threonine, trypthopan, valine
Semi-Essential Amino Acids
Reduces the need for a particular Essential Amino Acids (EAA) or partially spares it. However, it
cannot completely replace it. Semi-essential Amino Acids are: Arginine, Tyrosine, Cysteine, Glycine,
Serine
Non-Essential Amino Acids
Is not a dietary essential. It can be synthesized by the body as long as the materials for synthesis are
adequate. Non-essential Amino Acids are: Glutamine, Glutamic Acid, Alanine, Aspartic Acid,
Asparagine, Cystine, Proline, Citrulline, Homocysteine, Norleucine, Ornithine, Taurine, Hydroxyglycine,
Hydroxyproline
ACCORDING TO THE CHEMICAL COMPOSITION OF THEIR SIDE CHAINS
1.Basic Amino Acids
Those with additional amino acid group.
Examples are lysine, arginine, histidine
2. Acidic Amino Acids
Those that contain additional carboxyl group.
Examples are: aspartic acid, glutamic acid
3. Neutral Amino Acids
Those that contain additional acidic or basic group.
Examples are: threonine, glycine, serine, alanine, tryptophan, phenylalanine, tyrosine
4. Branched-chain Amino Acids
Are having aliphatic side-chains with a branch.
Examples are: leucine, isoleucine, valine
ACCORDING TO HYDROLYTIC PRODUCTS AND SOURCES
Glucogenic – they follow CHO pathways in metabolism.
Ketogenic- they are converted to ketone bodies like acetate
ACCORDING TO STRUCTURE AND SPATIAL ARRANGEMENT OF AMINO ACIDS
FIBROUS PROTEINS
Consists of long coiled/ folded chains of amino acids bound together in parallel line.
Are insoluble in water and are able to provide support for cells and tissues. Examples:
A. Keratin-chief protein of hair
B. Collagen-connective tissue in tendons and bone matrices
C. Fibrin-of a blood clot
D. Myosin-of muscle
E. Elastin-in blood vessel walls
GLOBULAR PROTEIN
Coiled and tightly wounded and is relatively soluble in water.
Examples: casein in milk, cheese, albumin in eggs whites
Classification of Protein and Sources
1. Simple Proteins-yield only amino acids on hydrolysis.
-Albumins
-Globulins
-Glutelins
-Prolamins
-Scleroproteins/Albuminolds
2. Conjugated Proteins-has “prosthetic” group.
-Nucleoproteins
-Mucoproteins
-Lipoproteins
-Chromoproteins
-Phosphoproteins
-Metalloproteins
-Flavoprotein
3.Derived Protein-substances produced by partial hydrolysis
A.Primary protein derivatives
-Proteins
-Metaproteins
-Coagulated proteins
B.Secondary protein derivatives
-Proteoses
-Peptones
-Peptides
FUNCTIONS
GENERAL FUNCTIONS
1. Build and repair cells and tissues.
2. Supply energy.
3. Regulate body processes.
1.Body-building or Structural Role
-20% of an adult body weight is protein.
-Protein is an integral part of cell nuclei and protoplasm.
-Solid mass of soft tissues like the vital organs, blood cells, and muscles are protein in nature.
-All enzymes are protein and only some hormones are protein.
-All body fluids and secretions have protein, except bile.
-Antibodies contain protein.
2. Source of Energy
-One gram of protein supplies 4 calories.
-Adequate CHO and fat must be the primary sources of energy to save protein for its unique function
of building and repairing tissues.
-Of the total caloric needs, 10-15% should be coming from protein.
3. Regulator of Body Processes
-Protein regulates osmotic pressure; hence helps maintain water balance and acid-base balance.
-If person has low plasma proteins, fluids accumulate between tissues resulting in edema.
-Protein transports substances (lipids, vitamins, minerals, and oxygen) around the body.
FOOD SOURCES of Proteins
Lean meat, poultry
Eggs
Cheese
Dried Fishes
Fresh Fishes
Shellfish
Milk, dairy products
Legumes and seeds
Nuts
Cereals and cereal products (rice, corn, etc.)
Vegetables
Digestion, Absorption, Utilization
-After protein is ingested, it passes through the gastrointestinal tract until the end-products (amino
acids) are absorbed and circulated by the blood.
-The amino acids enters the metabolic pool and cells to perform various physiologic and structural
roles.
General Principles of Protein Metabolism
The amino acids are in a dynamic state.
The All or None law applies in formation of cells and tissues.
There is a limited number of amino acids that are labile.
Synthesis of a particular protein is controlled by a genetic material (DNA and RNA).
Protein metabolism is closely related with fat and CHO metabolism.
Protein Requirement and Allowance
In the Philippines, 1.14 g/kg body weight for adults.
In the USA, 0.9 g/kg is recommended.
10-15% of total caloric needs.
Example:
Total Caloric need= 1,890 Kcal
1,890 × .15 (15%) = 283.5 kcal
283.5 kcal ÷ 4 kcal/gram (1 g of CHON=4 kcal)
Protein Requirement=70.9/71 g/day
Effects of Excessive and Deficient Intakes
PROTEIN ENERGY MALNUTRITION
Marginal energy, but insufficient protein intake (KWASHIORKOR) “the disease that the first child gets
when the new child comes
Insufficient protein and energy intake (MARSMUS) “to waste away or dying away”
KWASHIORKOR: Scally skin, Distended abdomen (ascites) and Swollen ankles (oedema)
MARASMUS: Hair Loss, Old Person’s face, Wrinkled skin And severe mudcle wasting
Effects of Excessive Intakes
The body is unable to store excess protein.
Excess amino acids are converted to other usable molecules by the liver in the process of deamination.
Deamination converts nitrogen from the amino acids into ammonia which is converted by the liver
into urea in the urea cycle.
Excretion of the urea is done by the kidneys.
SUMMARY
Proteins are classified according to: Essentiality, the Chemical Composition of Their Side Chains,
Hydrolytic Products and Sources, and Structure and Spatial Arrangement of Amino Acids.
Deficiency will cause PEM.
The functions are: build and repair cells and tissues, supply energy, and regulate body processes.
THE MACRONUTRIENTS:
FATS AND LIPIDS
Fats and lipids in the right kind and amount, are necessary as component of tissues and to regulate
certain body processes.
True fats belong to a larger group of organic compounds chemically called Lipids.
Fats stay solid at room temperature and oils stay liquid.
CLASSIFICATION OF LIPIDS
According to Complexity of Molecule and Chemical Composition
1. Simple
a. Triglycerides or neutral fats
Mixed fats
Simple fats
Sources: adipose, tissue, butterfat, cream, olive oil
b. Esters of fatty acids and higher molecular alcohols
Waxes –beeswax
Cholesterol esters- blood,liver
Vitamin D and A esters- blood, liver
2. Compound Lipids
A. Phospholipids containing phosphoric acid and a nitogenous base
-Phosphoglycerides
-Phosphosphingosides
B. Glycolipids
-Cerebrosides
-Gangliosides
-Sulfolipids
C. Aminolipids – lipoproteins
3. Derived Lipids
A. Fatty Acids
B. Mono and Diglycerides
C. Sterols (precursors of Vitamin D)
-Cholesterol
-Ergosterol
-Calciferol
Fatty Acids
Saturated Fatty Acids (SAFA)
Monounsaturated Fatty Acids (MUFA)
Polyunsaturated Fatty Acids (PUFA)
Trans Fatty Acids (TFA)
-PUFA and MUFA have a beneficial impact on health.
-SAFA and TFA can have a negative impact on health.
-PUFA consists of two families: Omega-3 (n-3) and Omega-6 (n-6).
-If the double bond is three carbons away, it is called Omega 3 while Omega 6 if it is six carbons away.
Omega-3 Fatty Acids
-Are found in seafoods, some plants, and some livestock rations.
-However fish and fish oils are the only concentrated source of eicosapentaenoic acid (EPA) and
decosahexaenoic acid (DHA) and docosapentaenoic acid which are types of Omega-3 FA.
-90-120 g of fish oil lower plasma triglyceride levels.
-Consume 2-4 fish meals a week.
Trans Fatty Acids
-Also called trans fat.
-It has potential role as one of the risk factors for cardiovascular diseases.
-They are made from the hydrogenation of polyunsaturated fatty acids which changes liquid oils to
solid fats.
CHOLESTEROL
-Is essential component of cell membranes.
-It is the precursor of 7-dehydrocholesterol, which has vitamin D activity.
-It is part of the bile acids for dietary fat emulsification.
-It is also utilized in biosynthesis of adrenocortical hormones, which are important in the
development of secondary male and female characteristics.
-Total concentration of blood plasma cholesterol is from 180-250 mg/100 ml.
-Normal intake should not exceed 300 mg/dl.
Ergosterol and Calciferol
-Are both vitamin D precursors.
-Phytosterols – sterols of vegetable origin
-Stigmasterol – from soybean oil
FUNCTIONS of fats
1. Concentrated Source of Energy and Storage Form of Energy
-Fats provides 9 calories/gram.
-As adipose tissue, fat is the largest reservoir of potential energy.
-The principal sites of adipose tissue in the body are: the subcutaneous tissues (50%),
abdominal cavity (45%), and intramuscular tissues (5%).
2. Structural Component
-Moderate deposits of fat beneath the skin and around the internal organs, act as protective
pad and give support to the organs.
-Subcutaneous fat also prevents rapid heat loss from the skin, thereby conserving heat in the
body.
3. Supplier of Essential Fatty Acids
-EFA are needed for growth and development, because they are the building blocks of new
tissues, they are integral components of cell membrane phospholipids, and play important in
structural and functional roles in the cell.
Essential Fatty Acids:
-Omega-3 Fatty Acid (Linoleic Acid)
-Omega-6 Fatty Acid (Alpha Linoleic Acid)
4. Carrier of Fat-Soluble Vitamins
-Vitamins A, D, E, and K need fat soluble medium to keep them in solution and to facilitate
reactions, whether in foods or in the body.
5. Sparer of Protein, Thiamin, and Niacin
-Thiamin and niacin are not appreciably needed in fat metabolism as compared to CHO
metabolism.
6. Other Special Functions
-Fat has a high satiety value.
-It is also contributes to flavor and palatability.
-It helps retain moistness in food products.
-Certain lipids are emulsifying agents which help in the transport of fatty substances that
cannot easily pass through the cell membrane.
-Fatty acids are precursors of a group substance called prostaglandins, which participates in
the regulation of blood pressure, heart rate, and lipolysis.
Food sources
Trans fats: Hydrogenated vegetable oils, Fast foods, cakes/pastries, chocolate, and Deep fried foods.
Saturated Fats: Vegetable fats: Coconut, Palm oil, 3-in-1 and 2-in1 beverages, creamer and
condensed milk. Animal Fats: Poultry Skin, Fatty meet, butter, ghee, Tallow/lard, Full cream dairy
products.
Unsaturated Fats: Polyunsaturated fats: com oil, Soybean oil, sunflower oil, seeds and cold-water fish.
Mono saturated: Olive oil, canola oil, Peanut oil, Sesame oil, Avocado oil, and most nuts.
9 of the healthiest fat sources
Avocado, Salmon, egg yolks, sardines, olives, chia seeds, nuts, sunflower seeds, and peanut butter.
DIGESTION, ABSORPTION, AND UTILIZATION
-In the stomach, emulsified fat is digested to free fatty acids and glycerol by the action of
gastric lipase.
-Non-emulsified fat is acted upon by the bile salts in the small intestines and the resulting
emulsified fat is hydrolyzed by the pancreatic lipase to fatty acids and glycerol.
-Almost all fats are absorbed into the lymphatic system from the intestinal mucus as
chylomicrons.
-The glycerol portion and short-chained free fatty acids are absorbed directly into the portal
circulation via the liver.
-The major site of lipid metabolism is in the liver.
-Oxidation of fatty acids to release energy is accomplished by the beta-oxidation process.
-The active acetate enters the Krebs Cycle, which is the common pathway for energy release.
RECOMMENDED DIETARY ALLOWANCES
RDA
-At least 20% of total caloric allowance be supplied by the dietary fat.
-The RDA for Essential Fatty Acids is 2%.
-An adequate Omega-3 FA intake for adults is 3-6 grams/day.
-The consensus of opinion by professional organizations such as dietetic associations, heart
associations, and cancer institutes, as implemented by nutritionists and dietitians, is to provide 30%
of total calories from fat sources. The recommended distribution are:
-6-10% from PUFA
-10-15% from MUFA
-10% or less from SUFA
-1% or less from TFA
Example:
Total Caloric need= 1,890 Kcal
1,890 × .25 (25%) = 472.5 kcal
472.5 kcal ÷ 9 kcal/gram (1 g of fat=9 kcal)
Fat Requirement=52.5 g/day
CHO Requirement (60%) = 283.5 g/day
CHON Requirement (15%) = 71 g/day
Fat Requirement (25%) = 52.5 g/day
EFFECTS OF EXCESSIVE AND DEFICIENT INTAKES
-Deficiency will reduce the caloric supply in the body and cause protein catabolism. Depot fats will be
withdrawn and body weight reduced.
-Deficiency of EFA causes retarded growth and eczematous skin in infants.
-Excessive intake above the normal level leads to obesity.
SUMMARY
-Fats is classified according to Complexity of Molecule and Chemical Composition.
-The main function of fats is concentrated source of energy and storage form of energy.
-Deficiency will reduce the caloric supply in the body and cause protein catabolism. Excessive intake
above the normal level leads to obesity.