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PROTEIN
Objectives
• State the functions of proteins in the body.
• Identify the elements that make up
proteins.
• Describe the effects of protein deficiency.
• State the energy yield of proteins.
• Identify at least six food sources of
complete proteins and six food sources of
incomplete proteins.
Facts
• Of the six nutrient groups, only proteins
can make new cells and rebuild tissue.
• Proteins are essential throughout the
entire lifespan.
• Proteins are the basic material of every
body cell.
• Proteins are the only nutrient group that
contains nitrogen.
Amino Acid
• Proteins are composed of amino acids.
• Amino acids are nitrogen-containing
compounds.
• Essential amino acids must be provided by
the diet.
• There are 8 essential amino acids and 2
that are essential during childhood only.
• Nonessential amino acids can be
produced by the body.
• Your client is concerned because her
daughter is a vegetarian and does not eat
meat. Your client states, “My daughter does
not eat meat, so I know she doesn’t get any
protein. She is ruining her body.”
• How do you respond?
6-9
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• Although animal foods are the best sources of
complete proteins, foods that provide
incomplete proteins can be combined to make
complete proteins.
• The best sources of incomplete proteins are
legumes, corn, grains, and nuts.
• Soy protein and tofu are nutritious meat
replacements.
6-10
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Functions
1. Building and repairing body tissue
– as cells are broken down during
metabolism (CATABOLISM)
– some amino acids released into the
blood are recycled to build new and
repair other tissue (ANABOLISM).
Functions
2. Regulating body functions
– Metabolism and digestion
– Fluid and electrolyte balance
– Development of antibodies
Functions
3. Providing energy
– Each gram of protein provides 4 calories.
– They are more expensive than
carbohydrates, and most of the complete
proteins also contain saturated fats and
cholesterol.
Food Sources
• Animal food sources
– Complete proteins.
– Meats, fish, poultry, eggs, milk, and cheese
• Plant food sources
– Incomplete proteins
– Corn, grain, nuts, sunflower seeds, sesame
seeds, and legumes
(continues)
(continued)
Food Sources
• Analogues
– Meat alternatives made from soy protein and
other ingredients to simulate various kinds of
meat
– Tofu is a soft, cheeselike food made from
soy milk
– Helpful to strict vegetarians to meet their
protein needs
Classification
(continues)
Classification
• Complete
– Essential amino acids are necessary for normal
growth and development and must be provided in the
diet.
– High quality
– Contains all 10 essential amino acids
• Incomplete
– Lacks one or more amino acids
– Cannot build tissue without help
• Bioavailable
– ability of a nutrient to be readily absorbed and used by the body
(continues)
(continued)
Classification
• Complementary proteins
– Occur when a combination of incomplete
proteins are eaten in the same day to make a
complete protein
– Examples: corn and beans, rice and beans,
bread and peanut butter, bread and split pea
soup, bread and cheese, bread and baked
beans, macaroni and cheese, cereal and
milk
(continued)
Composition
• Like carbohydrates and fats, proteins contain
carbon, hydrogen, and oxygen, but in different
proportions.
• Proteins are composed of chemical compounds
called amino acids.
Amino acids
• nitrogen-containing chemical compounds of which
protein is composed
Nitrogen
• chemical element found in protein; essential to life
Digestion and Absorption
• Mechanical digestion
– Begins in mouth
– Teeth grind food into small pieces.
• Chemical digestion
– Begins in stomach
– Hydrochloric acid prepares stomach
– The enzyme pepsin reduces proteins to
polypeptides.
• Polypeptides
– ten or more amino acids bonded together (continues)
(continued)
(continues)
(continued)
(continues)
Dietary Requirements
• The National Research Council of the
National Academy of Sciences considers
the average daily requirement to be 0.8 g
of protein for each kilogram of body
weight.
(continues)
(continued)
Dietary Requirements
• To determine your requirement:
1. Divide body weight by 2.2 (the number of
pounds per kilogram).
2. Multiply the answer obtained in the first step
by 0.8 (grams of protein per kilogram of body
weight).
• Your client weighs 170 pounds.
• What is the client’s daily
requirement for protein?
6-18
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• Your client weighs 170
pounds.
• What is the client’s daily
requirement for protein?
6-18
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• 170 pounds ÷ 2.2 pounds/kg =
77.27 kg
• 77.27 kg x 0.8 grams of protein =
61.81 g
• Answer: 62 grams of protein
6-19
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Protein Excess
• Saturated fats and cholesterol found in
complete proteins may contribute to heart
disease
• Connection to colon cancer
• Substitute for essential fruits and
vegetables
(continues)
(continued)
Protein Excess
• Increased demand on kidneys
• National Research Council recommends
that protein intake represent no more than
15%–20% of one’s daily caloric intake
and not exceed double the amount given
in the table of Recommended Dietary
Allowances.
• You are the nurse and your client asks you whether
or not taking daily protein supplements will help build
muscles, strengthen nails, and control weight.
• How do you respond?
6-22
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• You are the nurse and your client asks you
whether or not taking daily protein
supplements will help build muscles,
strengthen nails, and control weight.
• How do you respond?
6-22
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• “Bulking up” athletes
§ Lifting weights, not supplements, builds
muscle
• Growing fingernails
§ Fingernails have never been affected
by extra protein
• Spare body protein in weight loss
§ Dieters need a balanced diet using the
guidelines of MyPyramid.
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Nitrogen Balance
• Nitrogen intake equals nitrogen excreted.
• Positive nitrogen balance exists when
nitrogen intake exceeds amount excreted.
• Negative nitrogen balance exists when
more nitrogen is lost than taken in.
• Positive nitrogen balance
§ Pregnancy
§ Growth periods
§ Building muscle
§ Rebuilding tissue after trauma or illness
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• What conditions cause a positive nitrogen
balance?
• What conditions cause a negative nitrogen
balance?
6-25
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• Positive nitrogen balance
§ Pregnancy
§ Growth periods
§ Building muscle
§ Rebuilding tissue after trauma or illness
6-26
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• Negative nitrogen balance
§ Fever
§ Injury
§ Surgery
§ Burns
§ Starvation
§ Immobilization
6-27
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Protein Deficiency
• Muscle wasting occurs.
• Albumin (protein in blood plasma)
deficiency causes edema.
• Loss of appetite, strength, and weight
• Lethargy, depression, and slow wound
healing
Protein Energy Malnutrition
(PEM)
• Lack protein and energy-rich foods
• Found in developing countries with
shortages of protein and energy-rich foods
• Causes stunted growth in children
• Mental retardation may occur in infants
born from mothers with protein deficiency.
Marasmus
• Affects very young children
• Results from severe malnutrition (lack of
energy, protein, vitamins, and minerals)
• Emaciated, no edema
• Hair is dull and dry; skin is thin and
wrinkled
Kwashiorkor
• Sudden or recent lack of protein-
containing food; affects children and adults
• Fat accumulates in the liver, and lack of
protein and hormones results in edema,
painful skin lesions, and changes in
pigmentation of skin and hair
• High mortality rate
• Differentiate between marasmus
and kwashiorkor by identifying
three differences between the two
conditions.
6-32
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• Differentiate between marasmus and
kwashiorkor by identifying three
differences between the two
conditions.
6-32
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• Marasmus • Kwashiorkor
§ Weight decreased § Weight within normal
limits
§ Visceral proteins
§ Visceral proteins
within normal limits
decreased
§ Immune function § Immune function
within normal limits decreased
§ Dull, dry hair § Reddish color hair
§ Emaciated, wrinkled § Edema, puffy
appearance appearance
6-33
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Conclusion
• Proteins contain nitrogen.
• They build and repair body tissues,
regulate body processes, and supply
energy.
• Each gram of protein provides 4 calories.
• Proteins are composed of amino acids.
• Ten of the amino acids are essential for
growth and development.
Vitamins
7
Objectives
7-48
Facts
• Fat-soluble (4): A, D, E, K
• Water-soluble (9):
– Vitamin C
– Vitamin B complex which includes:
thiamin (B1), riboflavin (B2), niacin,
v i t a m i n B6, f o l a t e , v i t a m i n B12
(cobalamin), pantothenic acid, biotin
7-50
Requirements
7-52
• Also, deficiencies of fat-soluble vitamins
occur in patients with chronic
malabsorption diseases such as :
– cystic fibrosis
– celiac disease
– Crohn’s disease.
53
Deficiency of Fat-Soluble Vitamins
59
• Synthetic vitamins are frequently added
to foods during processing. When this is
done, the foods are described as
enriched or fortified.
• Examples of these foods are enriched
breads and cereals to which thiamine,
niacin, riboflavin, folate, and the mineral
iron have been added.
• Vitamins A and D are added to milk and
fortified margarine.
60
Avoiding Vitamin Loss
7-62
Classification
CATALYSTS
• substances that cause another substance to
react
COENZYMES
• active parts of an enzyme
PRECURSOR
• something that comes before something else;
• in vitamins it is also called a
PROVITAMIN, something from which the body
can synthesize the specific vitamin
63
Fat-Soluble Vitamins
• Vitamins A, D, E, K
• Not lost easily in cooking
• Lost when mineral oil is ingested
• Excess amounts are stored in the liver.
• Deficiencies are slow to appear.
7-64
Vitamin A
• Preformed
– Retinol: the active form of vitamin A
• Provitamin A carotenoids
– Beta carotene, lutein, lycopene, and
zeaxanthin
– Inactive form of vitamin A found in
plants; converted to retinol
7-65
Functions of
Vitamin A
7-66
Sources of Vitamin A
7-68
• What are the signs and symptoms you
would expect to see with too much
vitamin A?
• What are the signs and symptoms you
would expect to see with too little
vitamin A?
7-17 7-69
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• Excess • Deficit
§ Birth defects, § Night
hair loss, dry blindness, dry,
skin, headaches, rough skin,
nausea, dry increased
mucous mem- susceptibility
branes, liver to infections,
damage, and and blindness
bone and joint or
pain xerophthalmia
7-18 7-70
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Vitamin D
7-71
Functions of Vitamin D
7-72
Sources of Vitamin D
7-73
• What are the signs and symptoms you
would expect to see with too much vitamin
D?
• What are the signs and symptoms you
would expect to see with too little vitamin
D?
7-22 7-74
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• Excess • Deficit
§ D e p o s i t s o f § Poor bone and tooth
calcium and formation, rickets
phosphorus in which causes
soft tissues, malformed bones
and pain in infants
kidney, and
heart damage, § Osteomalacia
a n d b o n e (softening of bones)
fragility § Osteoporosis (brittle,
porous bones)
7-23 7-75
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76
Vitamin E
• Tocopherols
– Alpha (most biologically active)
– Beta, delta, and gamma
• Tocotrienols
• G i v e n a s α - T E ( a l p h a - t o c o p h e r o l
equivalents)
• 1 mg of α-TE = 1 international unit
7-77
Functions of Vitamin
E
• Antioxidant
• Prevention of hemolytic anemia among
premature infants
• Enhances immune system
• Retards spoilage of commercial foods
7-78
Sources of Vitamin E
7-79
80
• Your client asks you if it is possible to
take too much vitamin E. How would
you advise the client?
• What signs and/or symptoms can
result from too little vitamin E?
7-27 7-81
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• Your client asks you if it is possible to
take too much vitamin E. How would you
advise the client?
• What signs and/or symptoms can result
from too little vitamin E?
7-27 7-82
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• Excess • Deficit
§ R e l a t i v e l y § Serious
nontoxic, fat- neurological
soluble vitamin
defects can
§ Excess stored occur from
in adipose
tissue malabsorption.
§ A v o i d l o n g -
t e r m
megadoses.
7-28 7-83
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Vitamin K
7-84
Functions of Vitamin K
7-85
Sources of Vitamin K
7-32 7-87
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• What signs and/or symptoms can
result from too much vitamin K?
• What signs and/or symptoms can
result from too little vitamin K?
7-32 7-88
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• Excess • Deficit
§ Anemia can § Defective blood
coagulation,
result from which increases
excessive clotting time and
amounts of makes client
synthetic prone to
hemorrhage.
vitamin K.
7-33 7-89
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Water-Soluble
Vitamins
7-90
Vitamin B Complex:
Thiamin/B1
7-91 (continues)
(continued)
Vitamin B Complex:
Thiamin/B1
7-92
(continued)
7-93
Vitamin B Complex:
Riboflavin/B2
• N e c e s s a r y f o r t h e m e t a b o l i s m o f
carbohydrates, protein, and fats; tissue
maintenance (especially the skin around
the mouth); and healthy eyes
• Sources: milk, meats, poultry, fish,
enriched breads, cereals, broccoli,
spinach, and asparagus
7-94 (continues)
(continued)
Vitamin B Complex:
Riboflavin/B2
7-95
Vitamin B Complex:
Niacin
7-98
99
Vitamin B Complex: B6
7-100 (continues)
(continued)
Vitamin B Complex: B6
• Measured in milligrams
• Sources include poultry, fish, liver, kidney,
potatoes, bananas, spinach, and unrefined
whole grains (oats and wheat)
• Deficiency symptoms include irritability,
depression, and dermatitis
7-101 (continues)
(continued)
Vitamin B Complex: B6
7-102
Vitamin B Complex: Folate
• Measured in micrograms
• Average adult requires 400 µg/day
• 600 µg/day required 1 month before
conception through first 6 weeks of
pregnancy
• Excess can mask vitamin B12 deficiency
and inactivates phenytoin, an
anticonvulsant drug used by epileptics
7-104 (continues)
(continued)
Vitamin B Complex:
Folate
7-105
106
107
Vitamin B Complex:
B12
7-110 (continues)
(continued)
Vitamin B Complex:
Pantothenic Acid
7-111
Vitamin B Complex: Biotin
7-112 (continues)
(continued)
Vitamin B Complex: Biotin
7-113
Vitamin C: Ascorbic Acid
7-115
• What disease results from a deficiency in
vitamin C?
• What are the associated signs and/or
symptoms?
• What results from an excess of vitamin C?
7-56 7-116
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• Scurvy: disease characterized by gingivitis,
easy bruising, pinpoint hemorrhages of the
skin, poor wound healing, sore joints and
muscles, and weight loss. Extreme cases
result in death.
• Found in sailors who lived without fresh
fruits and vegetables
7-57 7-117
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• Deficiency of vitamin C: bleeding gums,
loose teeth, tendency to bruise easily, poor
wound healing, scurvy
• Excess: diarrhea, nausea, cramps,
excessive absorption of food iron, rebound
scurvy (when megadoses are stopped
abruptly) and possibly oxalate kidney
stones; generally considered nontoxic
7-58 7-118
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Vitamin Supplementation
7-120