MODULE 3
energy expenditure.
NUTRITION FOR HEALTH AND
FITNESS
A. Nutrition in Weight Management
      Weight Management
 It is used to describe both the
techniques and the underlying
physiological processes that
contribute to a person’s ability to
attain and maintain a certain weight.
 Most weight management techniques
encompass long term lifestyle
strategies that promote healthy eating
and daily physical activity.
Overweight and underweight
 Both result in energy imbalance.
 Overweight = people have consumed
more food energy than they have
expended and have banked the
surplus in their body fat.
 To reduce body fat, overweight
people need to expend more energy
than they take in from food.
 Underweight = have consumed too
little food energy to support their
activities and so have depleted their
bodies’ fat stores and possibly some
of their lean tissues as well.
 To gain weight, they need to take in
more food energy than they expend.
  Causes of Obesity:
1. Genetics
 A person’s genetic makeup
influences the body’s tendency to
consume or store too much energy or
to expend too little.
 Evidences that genes influence
eating behavior and body
composition comes from family,
twin or adoption studies (adopted
children).                                1. WEIGHT-LOSS PREDICTIONS
          Leptin
 A hormone primarily produced and
secreted by the fat cells in proportion
to the amount of fat stored.
 It decreases appetite and increases
            Leptos = thin
 A gain in body fatness stimulates the
production of leptin, which by way
of the hypothalamus, suppresses the
appetite, increases energy
expenditure and produces fat loss. 
            Hypothalamus
 A brain center that controls activities
such as maintenance of water
balance, regulation of body
temperature and control of appetite.
 Fat loss produces the opposite effect
—suppression of Leptin production,
increased appetite and decreased
energy expenditure.
2. Environment
 Obesity reflects the interaction
between genes and environment.
 An obesogenic
environment includes all the
circumstances that people encounter
daily that push them toward fatness.
 Over the past decades, the demand
for physical activity has decreased as
the abundance of food has increased. 
                    Satiety = the feeling of fullness
and satisfaction that occurs after a meal and
inhibits eating until the next meal. It
determines how much time passes between
meals.
                    Satiation = the feeling of
satisfaction and fullness that occurs during a
meal and halts eating. It determines how
much food is consumed during a meal.
BEST PRACTICES IN NUTRITION
AND WEIGHT MANAGEMENT 
                 The goal of a dietary intervention
to decrease weight is to create a caloric
deficit so that fewer calories are consumed
than are expended.
                 With about 3,500 calories in a
pound of fat, a 500- to 1,000-calorie deficit
each day through decreased food intake and
increased physical activity leads to about a
1- to 2-pound weight loss per week.
2. AVOIDING WEIGHT GAIN OVER
TIME
                 While a small decrease in daily
energy expenditure with aging is inevitable,  among young middle-class girls.
adults can avoid the average weight gain
resulting from decreased metabolism by
eating low- calorie, nutrient-dense foods like
vegetables and lean proteins, moderating
caloric intake, engaging in regular
cardiovascular physical activity to maintain
a high level of  energy expenditure, and
strength training to maintain metabolically
active muscle mass. 
 SUMMARY  requirements,  leading to a significantly low
Any weight-loss journey requires
careful attention to nutritional choices.
Lasting weight loss is determined by how
early choices are integrated and sustained
through lasting lifestyle changes.
B. Nutrition Eating Disorders
Healthy eating behaviour
- is based on two sensations: hunger
and satiety.
          Eating disorders disrupt this
mechanism.
          This disturbance is a physiological
consequence of malnutrition and can be
reversed if diet is improved.
          Anorexia and bulimia, recognized as
conditions in their own right, are two
examples of eating disorders.
         It is estimated that 9% to 10% of adult
women suffer from compulsive-type eating
problems.
         Men represent 10% to 15% of people
affected by an eating disorder.
        These disorders are very often
triggered during adolescence.   
Eating Disorder
 A disturbance in eating behavior that
jeopardizes a person’s physical and
psychological health.
 An estimated 6% of females and 3%
of males have anorexia nervosa,
bulimia nervosa, or  binge eating
disorder.
 These are common, especially
Disordered Eating
          Eating behaviors that are neither
normal nor healthy, including restrained
eating, fasting,  binge eating and purging.
1. Anorexia Nervosa
                    An eating disorder characterized
by restriction of energy intake relative
body weight and a disturbed perception of
body weight  and shape; seen (usually) in
adolescent girls and young women.
  Anorexia = without appetite
  Nervosa = of nervous 
2. Binge Eating Disorder
                    An eating disorder characterized
by recurrent episodes of eating a significant
amount of food in a short period of time
with marked feelings of lack of control.
3. Bulimia Nervosa
                   An eating disorder characterized
by repeated episodes of binge eating
combined with a fear of becoming fat ,
usually followed by self-induced vomiting,
misuse of laxatives or diuretics, fasting or
excessive exercise.
 Cathartic = a strong laxative
  Emetic = an agent that causes vomiting
Causes and prevention of eating
disorders
          ü There is no single main cause of
eating disorders.
          ü Several factors are generally at the
root of eating disorders, comprising
a combination of genetic and psychological
factors, problems within the family circle
and/or the cultural and social environment.
       ü This disorder is therefore often the
expression of a deeper malaise which
the afflicted person feels unable to control
and strives to control his/her body weight by
way of compensation.
      ü The support of family and friends and
adapted treatment can help the patient
recover.
      ü It is important to detect these disorders
as early as possible to prevent physical
and psychological consequences.
      ü The priority for those suffering from
anorexia is to reach a weight where their life
is no                       longer in danger, while
people with bulimia aim to reduce their
episodes of overeating.
     ü The issues of self-esteem, body image
and the potential problems causing the
disease can then be addressed.
Strategies to combat Bulimia Nervosa
          Planning Principles
         1. Plan meals and snacks; record plans
in a food diary prior to eating.
         2. Plan meals and snacks that require
eating at the table and using utensils.
         3. Refrain from finger foods.
4. Refrain from fasting or skipping
meals.
       Nutrition Principles
         1. Eat a well-balanced diet and
regularly timed meals consisting of a variety
of foods.
         2. Include raw vegetables, salad, or
raw fruit at meals to prolong eating times.
         3. Choose whole grains, high-fiber
breads, pasta, rice and cereals to increase
bulk.
         4. Consume adequate fluid,
particularly water.
       Other Tips
          1. Choose foods that provide protein
and fat for satiety and bulky, fiber-
rich carbohydrates                  for immediate
feelings of fullness.
          2. Try including soups and other
water-rich foods for satiety.
         3. Choose portions that are appropriate
for your energy needs according to the
USDA Food                 Patterns.
         4. For convenience (to reduce
temptations) select foods that naturally
divide into portions. Select one potato other
than rice or pasta that can be overloaded
onto the plate;  purchase yogurt and cottage
cheese in individual containers; look for
small packages of  precut steak or chicken;
choose frozen dinners with measured
portions.
         5. Include 30 minutes of physical
activity everyday-exercise may be an
important tool in defeating bulimia. 
C. Nutrition Exercise and Sports
            Nutrition for sport and exercise
            ü All aims to eat a healthy, varied
diet based on the principles of the Eat
Well Guide, and  this is also the case when
you are active.
           ü When physically active, your body
will use up more energy (calories).
           ü This can help with weight control
or if you are not looking to lose weight, you
may find you need more food to replace the
extra energy used.
           ü It is also important to keep well
hydrated.

Eating well for physical activity and sport
can have many benefits including:
      ü allowing you to perform well in your
chosen sport or activity;
      ü reducing the risk of injury and illness;
      ü ensuring the best recovery after
exercise or a training programme.
      ü However, the dietary patterns that will
best suit an individual will depend on the
amount  and intensity of activity.
      ü This can range from those who are just
starting to get more active, those meeting the
activity guidelines (of 150 minutes moderate
activity per week), those who are active at 
higher levels (such as those training for an
endurance event such as a marathon or doing
organized team sports) or professional
athletes.
      ü For professional athletes, getting
personalized nutrition advice from a
qualified sports nutritionist or dietitian is
likely to be an important part of their
training support.
  
 Physical activity when losing weight
       ü Doing physical activity will increase
your energy expenditure (the calories you
use), as energy is required during exercise to
fuel the contracting muscles, increased
breathing and heart rate and metabolism.
      ü It is difficult to lose weight just by
getting more active and it is still important
to control  your calorie intake for weight
control.
      ü The most effective weight loss
programmes include both a controlled diet
and increased  physical activity.
       ü It is also important to be active to
keep weight off after weight loss.
       ü A study of people in the US who have
successfully maintained their weight loss
shows that they tend to be active for about
an hour a day (usually walking) and spend
less time in sedentary activities like
watching TV in their free time.
      ü The benefits of physical activity go
beyond just burning off calories, and can
help preserve muscle as you lose weight and
increase the proportion of muscle in the
body.
      ü  We also know that physical activity,
and spending less time sitting, can reduce
your risk of developing a number of chronic
diseases, such as heart disease.
Foods for fuel and exercise
1. Carbohydrates
                ü The main role of carbohydrates
in physical activity is to provide energy.
                ü For athletes, if their diet does not
contain enough carbohydrate, it is likely that
their performance and recovery will be
impaired, as carbohydrate is the key fuel for
the brain and for muscles during exercise.
               ü The body can store carbohydrates
in the muscles and liver as glycogen, and use
these stores as a source of fuel for physical
activity.
              ü These glycogen stores are limited,
so for those training at a high level, it is
important to be fully fuelled at the start of
any exercise. 
             ü Glycogen is the main source of
energy at the start of exercise and during
short bursts of exercise. 
            ü  If you are doing high intensity
training for long periods and your glycogen
stores are not sufficient you may feel tired,
lack energy and not be able to perform at
your best.
            ü So, regular intake of carbohydrate-
rich foods can be important in this case to
keep stores topped up.
           ü The correct food choices can help
ensure the body has enough energy for
activity, as well as help aid recovery.
 2.  Protein
          ü  Protein is important in sports
performance as it can boost glycogen
storage, reduce  muscle soreness and
promote muscle repair.
          ü  For those who are active regularly,
there may be benefit from consuming a
portion of protein at each mealtime and
spreading protein intake out throughout the
day.
          ü As some high protein foods can also
be high in saturated fat, e.g. fatty meats or
higher fat  dairy products, it is important to
choose lower fat options, such as  lean
meats.
         ü It is important to consume a variety
of plant proteins to ensure enough essential
amino acids are included. This is known as
the complementary action of proteins.
3. Fat
          ü Is essential for the body in small
amounts, but it is also high in calories.
          ü Consuming too much fat can lead to
excess calorie intake which can lead to
weight gain over time, so this is a particular
concern if you’re trying to control your
weight.
          ü The type of fat consumed is also
important.
          ü Studies have shown that replacing
saturated fat with unsaturated fat in the diet
can  reduce blood cholesterol, which can
lower the risk of heart disease and stroke.
          ü Fat-rich foods usually contain a
mixture of saturated and unsaturated fatty
acids, but choosing foods that contain higher
amounts of unsaturated fat and less saturated
fat, is preferable as most of us eat too much
saturated fat.
How to stay well hydrated
         ü Water is essential for life and
hydration is important for health, especially
in athletes and those who are physically
active, who will likely have higher
requirements.
        ü Drinking enough fluid is essential for
maximizing exercise performance and
ensuring optimum recovery.
      ü Exercising raises body temperature and
so the body tries to cool down by sweating.
This causes the loss of water and salts
through the skin.
    The amount an individual sweats varies
from person to person and depends on:
1. Intensity and duration of exercise –
longer and higher intensity exercise
can cause greater sweat loss.
2. Environmental temperature – in hot,
humid conditions sweat loss can
increase.
3. Clothing – the more clothing that is
worn, the quicker you are likely to
heat up which may cause greater
sweat loss.
4. Genetics – some people sweat more
than others.
         ü Average sweat rates are estimated to
be between 0.5–2.0 L/hour during exercise.
        ü Dehydration can cause tiredness and
affect performance by reducing strength and
aerobic capacity (especially when exercising
for longer periods). 
        ü So, especially when exercising at
higher levels or in warmer conditions, it is
important to try and stay hydrated before,
during and after exercise to prevent
dehydration. In most  cases, unless training
at a high intensity for over an hour,  water is
the best choice as it hydrates without
providing excess calories or the sugars and
acids found in some soft drinks that can
damage teeth.
Below are some examples of other drinks,
other than water that may be used by
athletes,both recreational and elite.
1. Sports drinks: sports drinks contain
carbohydrates in the form of glucose,
as well as electrolytes such as
sodium.
       ü Sodium will replace any lost from
sweating and enhance rehydration, and
glucose will replenish carbohydrate stores.
      ü Sports drinks have been shown to help
endurance performance and recovery for
active individuals performing endurance
exercise over a longer duration (60 minutes
or more) (e.g. participating in a marathon).
     ü However, it is important to remember
that sports drinks are similar to other soft
drinks that contain sugars.
    ü This means that they can be high in
calories and contribute to tooth decay, so
they are only suitable if taking part in high-
level endurance sports or if sweat loss is
high.
Sports drinks can be expensive compared
to other drinks; however it is easy to make
them yourself! To make your own isotonic
sports drink, mix: 200ml fruit squash
(containing sugar rather than sweeteners),
800ml water and a pinch of salt.
 Milk: Skimmed or semi-skimmed
milk has been used in some studies
as a post-exercise recovery drink. It
contains minerals that can replace
those lost via sweating, as well as
providing nutrients involved in
muscle function and bone health
(potassium and calcium). It also
naturally contains high quality
protein and some carbohydrate in the
form of lactose, and is relatively
cheap to buy.
 Energy drinks: are not designed to
replace the electrolytes lost in sweat
and may contain other ingredients
with stimulant properties, such as
caffeine. As some are high in sugars,
they can increase the risk of tooth
decay and contain energy, which
may cause weight gain if consumed
in excess.
Supplements
 Supplements are one of the most
discussed aspects of nutrition for
those who are physically active.
        ü Athletes are advised to follow a ‘food
first’ approach to avoid using supplements
that  aren’t needed or could result in nutrient
intakes that are too high.
        ü For most people who are active, a
balanced diet can provide all the energy and
nutrients   the body needs without the need
for supplements.
 Sports supplements can include
micronutrients, macronutrients or
other substances that may have been
associated with a performance
benefit, such as creatinine, sodium
bicarbonate or nitrate.
        ü The main reasons people take
supplements are to correct or prevent
nutrient deficiencies that may impair health
or performance; for convenient energy and
nutrient intake around  an exercise session;
or to achieve a direct performance benefit.
 For athletes, supplementing the diet
may be beneficial, possibly on
performance, on general health or for
reducing injury and illness risk.
        ü Any athletes considering
supplementation will need to weigh the
potential benefits with  the possible negative
impacts, such as negative effects on general
health or performance,  risk of accidental
doping or risks of consuming toxic levels of
substances (such as caffeine).
 
D. Nutrition and Bone Health
   The function of bone:
1. Bone supports and protects the
tissues of the body and it provides a
framework to enable body
movements.
 2. It also has metabolic functions which
are crucial for the maintenance of
life including the homeostasis of
ionized calcium in the blood.
3. Within cells calcium ions are
essential for the maintenance of the
internal cellular structure and the
passage of impulses and signals
within and between cells.
4. Calcium ions also contribute to a
wide range of metabolic functions as
well as other complex interactions
such as blood clotting.
5. The extracellular fluid concentrations
of ionised calcium are strictly
maintained and this metabolic call on
the calcium in bone has priority          General Report, 2004).
          ü  Low bone mass leads to fracture
risk.
          ü Osteoporosis affects over 10% of
the population and one of every two women
over the age of 50 years.
          ü Genetics predicts more than half of
bone mass.
          ü Diet and weight bearing exercise are
two lifestyle choices that can influence the
risk of fracture.
        ü Nutrients are the structural
constituents of bone.
        ü As bone is a living tissue and turns
over, there is an obligatory loss of minerals
daily that must be replaced through diet.
       ü Three servings of dairy products daily
are recommended to replace those losses.
      ü We build bone to our adult maximum
called peak bone mass and begin losing
bone thereafter.
     ü Two strategies to reduce the risk of
fracture are to maximize peak bone mass
within our genetic potential and to slow the
rate of bone loss with age.
     ü Fractures do not only occur in adults,
but also in children.
     ü Fractures in children are most prevalent
during the pubertal growth spurt before
bone consolidation occurs which results in a
period of relatively low bone mass (Faulkner
et al, 2006).
     ü Diet, exercise, and other exposures
including smoking, alcohol, drugs, and
hormones influence risk of fracture.
    ü This review focuses on diet which
provides the building blocks for bone mass.
In contrast, exercise, especially prior to
puberty, can influence bone size, a powerful
modulator of bone  strength.
     ü Both diet and exercise are modifiers
that form the basis of public health
recommendations for bone health (Surgeon
 
     ü The menopause is defined as the
cessation of menses which marks failure of
the ovarian function to secrete the sex
hormones, oestrogen and progesterone.
     ü In the pre and early postmenopausal
period there is sparse evidence to link bone
loss with customary calcium intake, or little
to support widespread pharmacological
calcium supplementation.
E. Nutrition for Oral and Dental
Health 
          Key Points
1. Diet and nutrition affect the health of
the tissues in the mouth; and the
health of the mouth affects nutrients
consumed.
2. The consumption of sugars has been
associated with an increased risk of
developing dental caries.
3. The complex nature of periodontal
disease makes it difficult to
determine its relationship with diet
and nutrition.
4. Frequent consumption of acidic food
and beverages is associated with an
increased risk of erosive tooth wear. 
     Diet and nutrition
            ü Are significant influencers of oral
health, and can affect the development
and progression of oral diseases and
conditions such as caries, periodontal
disease, erosion, and others.
          ü While nutrition can be defined as
the micro- (vitamins and minerals) and
macro-  (carbohydrates, protein, and fat)
nutrients as they relate to the body’s dietary
needs,  diet refers to the specific foods
consumed.
         ü The relationship that diet and
nutrition have with oral health is
bidirectional, as  compromised integrity of
the oral cavity can also influence an
individual’s functional ability to eat.
        ü Older patients, for example, may
experience tooth loss, reduced masticatory
ability, and  decreased appetite, which may,
in turn, influence their nutritional status.
       ü A systematic review examined the
association between food intake and oral
health in  elderly found that tooth loss in the
older population was associated with
changes in food  intake and nutritional
deficiency.
Dental Caries
          ü Can be used to describe both the
disease process and the cavitated or
noncavitated lesions that form as a result of
the disease process.  less cariogenic than sucrose, fructose, and
         ü The caries disease process is biofilm-
mediated, sugar-driven, multifactorial, and
dynamic  in the phasic demineralization and
remineralization of dental hard tissues.  apples, cranberries, tea, and high-fiber foods
 
   Types of Carbohydrates
            ü The relationship between
carbohydrates and dental caries depends on
the type of carbohydrate (sugars or starches)
consumed because the cariogenic potential
(i.e.,  promoting the development of tooth
decay) of a given carbohydrate is dependent
on how efficiently it can be metabolized by
the bacteria that ferment it.
           ü Sugars, specifically, are considered
to be the most important drivers of caries
development.
          ü The term free sugar includes all
sugars added to food/beverages, as well as
the naturally occurring sugars found in fruit
juices and concentrates, honey,  and natural
syrups.
         ü Collectively, natural and free sugars
(e.g., sucrose, glucose, and fructose)
are considered the primary necessary factors
in the development of caries.  
        ü Sucrose, a disaccharide of glucose
and fructose, is the most cariogenic sugar. 
        ü Sucrose acts as a substrate for the
synthesis of intra- and extracellular
polysaccharides in dental plaque.  
       ü Additionally, dental plaque formed in
the presence of sucrose has been shown to
have lower concentrations of calcium,
inorganic phosphate, and fluoride, which are
the ions required to remineralize enamel and
dentin.
       ü Sucrose and its constituent
monosaccharides, glucose and fructose, are
also more cariogenic than starches because
they enter the glycolytic pathway more
rapidly and result  in a more pronounced
drop in pH.
     ü Although lactose is also a sugar, it is
glucose  because its fermentation produces a
smaller drop in pH. 
    ü Foods such as milk and dairy products,
have been suggested to have cariostatic
properties (i.e., inhibiting the development
of caries), although more careful
examination is needed. 
    ü It has been postulated that the calcium
in dairy products offsets some of the
cariogenic properties of lactose by limiting
enamel undersaturation during
acidogenesis. 
        Vitamin D
            ü Vitamin D influences the
regulation of calcium and phosphate
metabolism. 
            ü According to some observational
studies, higher prenatal intakes of vitamin D
and prenatal serum vitamin D levels may be
associated with reduced caries risk in
children and infants.  pasteurized milk should be used.
           ü Historical reports as well as a 2016
cross-sectional study suggest an
association between dental caries and lower
serum levels of vitamin D in children. 
 Dietary Modification and Dietary
Therapy
A. General Diets
          ü In keeping the overall aim of eating
foods as nearly as their natural states as
possible, cooking should be minimized in
both time and temperature.
          ü Most fruits and vegetables should be
eaten raw, lightly steamed or sautéed.
          ü Include at least one green, leafy
salad a day.
          ü When they are cooked, the root
vegetables (potato, carrots, turnips, etc.)
should be baked  or steamed in their skins to
preserve the minerals.
         ü Green vegetables should be steamed
in a small amount of water only until tender,
or  sautéed quickly in butter or vegetable oil.
         ü The left over juice, which contains
many minerals, can be poured back over
them or used  in soup.
         ü The reason for cooking in this
manner is enzymes are destroyed at 100 –
120OF (37.7O –  48.8 OC)
        ü Where certified raw milk is available,
it should be chosen above pasteurized, since
pasteurization at 145 degrees destroys
enzymes and vitamins may alter milk’s
protein molecule.
       ü It should be stress that raw milk must
come from a certified dairy where the
highest standards of sanitation are
maintained and the milk is checked daily for
bacteria content.
       ü Unless such a dairy is near at hand,
           
       ü While it does not have quite the
nutritional value of raw milk, it is certainly
adequate.
       ü Whenever possible use foods that are
free of chemical sprays, preservatives and
dyes.
       ü If it is not organic, it should be peeled
before eating to remove chemical
insecticide residues.
      ü It is true that the peeling that the
peeling of many fruits removes essential
trace  minerals , but under the circumstances
it is better to sacrifice these than to eat
the chemicals. (Washing only reduces them).
     ü Break the sweet habit. Learn to drink
coffee without sweetening. You will
probably learn to like it better that way in
time.
     ü If you need sweetening on cereals, use
honey, which contains its own vitamins and
minerals and is more readily utilized by the
body.
     ü Unless you have a medical reason for
not doing so, use butter in preference to
margarine.
     ü Margarines contains high qualities of
saturated fats and hydrogenated oils in light
of  research findings.
      ü Use whole grain breads: wheat, rye,
corn, etc. and only brown or wild rice.
      ü Make liberal use of fish, which is high
in minerals and iodine, and all meats,
including poultry and the organ meats:
liver, heart, kidney, etc. Recommended
eating of liver at least once a week.
      ü Dairy products: Cheese, eggs yogurt,
buttermilk and dry skimmed milk, as well as
raw  pasteurized milk and butter, are vital to
good nutrition.
     ü For dessert eat fresh fruits and cheeses
instead of cakes, pies and other pastries.
Nuts and  nuts butter are highly nourishing.
      ü Minimize the use of salts, although the
sparing use of it and other seasonings to
improve the flavour of food is certainly
permissible. Just use common sense about it.
       ü Drink plenty of water, preferably
bottled water.
     ü Fried foods are more difficult than
others to digest and heated fats and oils are
not well  tolerated by the body. They have
the tendency to accumulate in the liver and
arteries,  leading to atherosclerosis.
     ü Tobacco has been beyond reasonable
doubt to increase the incidence of lung and
other cancers and heart disease, not only in
smokers but also in those subjected to
sidestream smoke.

       ü Tea, coffee and alcohol in moderation,      ü Obviously there is nothing complicated

may have beneficial psychological effects on
some persons, if not prohibited by health
reasons.
       ü Some alcohol, particularly red wine,
have been found to have benefit in
prevention of  cardiovascular disease.
       ü When using oils or butter in frying be
careful not to heat them to smoking. High
eat changes the chemical structure of fats
and oils and forms certain toxic chemicals.
Also, foods cooked in deep fat and fried may
take longer to digest.
       ü Use whole grain cereals and give them
added value with a teaspoonful or more of
wheat germ per bowl.
about a good basic diet.
     ü The “musts” are fresh and cooked
vegetables, fresh and dried fruits, the
proteins and dairy products, meat, fish and
fowl and whole grain breads and cereals.
These are the “protective foods” in terms of
nutrition.
     ü For those who lives sedentary lives and
that includes most of us, the energy foods
- starches, simple carbohydrates and fats  -
should be eaten in extreme moderation.

      ü Use dietary supplements, especially

recommended vegetables juices, yeast
powder, wheat germ and desiccated liver
powder or capsules.  These are actually
concentrated foods.

     ü Avoid such refined or altered foods as

“enriched” breads, refined sugar, cakes,
candy, pastries, macaroni, polished rice and
ice cream, which contain many chemical
additives and large amounts of refined sugar.

     ü In the refining, these foods lose

vitamins and trace minerals, which are
necessary for the   metabolism of the body.
Without them carbohydrates are not properly
metabolized, with the result that toxic by-
products are formed which accumulate in
the nervous system and   red blood cells.

     ü Soft drinks are nutritionally valueless

and contained refined sugars and other
substances  which are harmful to the teeth.