مادة التغذيه

First Unit
Nutrition
First . The overall view
A - Target group: - Students of the second stage / College of Health and Medical Technology
B – Justifications :- This unit is designed to identify the composition of nutrients from
nutrients, what is meant by healthy food and balanced food, caloric
nutrient content
C- Central idea :- Definition of the feeding process
Definition of nutrition science
Food function for the body
Classification of nutrients
Major nutrients and micronutrients
The importance of water to the body
D- Instruction:- 1- Look at the overall overview well
2- Learn about the unit's objectives
3- Do the pre-test, if you get the
A - 8 degrees or more, you do not need to study the module and you have
to review the supervisor
B- If you get less than 8 degree, you need to study the module
4- After studying the contents of the module, perform the post-test, if your
Collection.
A - 8 degrees or more , turn to study the following module
B - If you get less than 8 degrees you should re-study the unit or any
part of them and then returned to perform the post-test
Second: Performance Objectives:
After your study module will be able to
Know what is the food and what are the characteristics of healthy food
Food components are known as nutrients
Know the types of food
Defines the functions of food.
Third :- Pre test :-
Explain the food components of nutrients in the form of a scheme
1
Nutrition
Nutrition: is the sum of the biological processes which the organism that gets on all the
necessary materials to be used in the construction of the body and regeneration the loss
of tissue and survival in a healthy condition.
The Food:- Is any liquid or solid food intake rights and performs the function of one or
more such as:
Supply the body with energy and activity.
Growth and construction.
Tissue regeneration.
The organization of biological processes within the body.
Calories: units of heat that measure the energy used by the body and energy supplied to
the body by foods.
The Importance of Good Nutrition-:

Good nutrition enhances your quality of life and helps you prevent disease. It provides you
by the calories and nutrients your body needs for maximum energy and wellness.
what are the factors which Influences the Your Food Choice
1. Hunger and Appetite:
Hunger: Natural need to eat and not starve.
Appetite: A desire to eat.
2. Emotions:
• Stress, Anger, Happy, Sad, Boredom, etc,
3. Environment:
• Family and Friends
4. Cultural and Ethnic Background:
• Race, Religion, Heritage
5. Convenience and Cost:
• Where you live, lifestyle, Family income
6. Advertising:
• Health messages, Influence your looks
2
The Food Composition or (food groups)
DM Water
Organic Materials In organic Materials
Carbohydrates Proteins Fats Vitamins Macro element Micro el-
NFE Fibers True NPN Neutral fats W .S. V F .S .V Ca Cu

Sugars Cellulose Protein Amids Sterols , B1 P
Starches H.Cellul EAA Nitrat Fatty acid B2 A Na Z
Pentoses Non EAA Free acid B6 D K Mn
Urea B 12 E S I
Niacin K Cl Se
Biotin Mo
Folic acid
Pantothenic acid
GROUPS OF NUTRIENTS:
• Carbohydrates * proteins * Fats * Minerals * Vitamins
* Water
Carbohydrates -:
Carbohydrates: are the starches and sugars present in food.
They are classified as either simple or complex.
 Complex carbohydrates are starches. Examples include:
• whole grains
• seeds
• Legumes
Simple carbohydrates: are sugars. Examples include:
• glucose
• fructose
• lactose.
• Bodys preferred source of energy.
• Body converts all carbohydrates to glucose, a simple sugar.
• Glucose is not used right away and it is stored as glycogen.
• Too the excess of carbohydrates will store in the body as fat.
Fiber is an indigestible complex carbohydrate that helps move waste through the
digestive system.
3
Proteins: -
Proteins are nutrients that help build and maintain body cells and tissues.
Proteins are classified into two groups: complete and incomplete.
• Complete proteins contain amounts of all nine essential amino acids.
SOURCES INCLUDE:
*Fish, meat, poultry, eggs, milk, cheese, yogurt, and many soybean products.
• Incomplete proteins lack one or more essential amino acids.
SOURCES INCLUDE:
*Beans, peas, nuts, and whole grains.
• Proteins have many functions:
- Help make new cells
-Help make and repair tissues
- Help make enzymes, hormones, and antibodies
- Provide energy.
• Fats :- are a type of lipid, a fatty substance that do not dissolve in water.
• The building blocks of fats are called fatty acids
• Fatty Acids are classified as two types
• Saturated:
– Animal fats and tropical oils
– High intake is associated with an increased risk of heart disease
• Unsaturated:
– Vegetable fats
– Associated with a reduced risk of heart disease
• Fatty acids that the body needs, but is unable to make are called essential fatty acids
• Transport vitamins A, D, E, and K
• Sources of linoleic acid- essential fatty acid that is needed for growth and healthy skin
• High intake of saturated fats is linked to increased cholesterol production
• Excess cholesterol can lead to an increased risk of heart disease
vitamins and minerals :-
Vitamins are compounds that help regulate many vital body processes that include:
1. Digestion 2. Absorption 3. Metabolism 4. Circulation
Vitamins are classified into two groups:
– Water-soluble vitamins dissolve inater and pass easily into the blood during
digestion. The body does not store these so they need to be regularly.
Replenished. Includes vitamins C, B1 ,B2, Niacin, B6, Folic acid, and B12.
– Fat-soluble vitamins are absorbed, stored, and transported in fat. Your body
stores these vitamins in your fatty tissue, liver, and kidneys. Excess buildup can
be toxic .These include vitamins A, D, E, and K.
Minerals are substances that the body cannot manufacture but are needed for forming
healthy bones and teeth and regulating many vital body processes.
– Important minerals include:
– -Calcium -Phosphorus Magnesium -Iron
4
Water :- helps to maintain many bodily functions.
• Lubricates your joints and mucous membranes.
- Enables you to swallow and digest foods.
- Absorb other nutrients, and(rid from wastes ) eliminate wastes.
- Perspiration (sweat). helps maintain normal body temperature.
• Water makes up around 65% of the body.
• Its important to drink at least 8 cups of water a day to maintain health.
The Food Guide Pyramid :-
Food Sensitivity and the diseases Food borne:-

1- Food Allergy - a condition reacts in it the bodys immune system with substances in
some foods.
Allergies to peanuts, tree nuts, eggs, wheat, soy, fish, and shellfish.
through a simple blood test ,can indicate whether a person is allergic to a specific food.
These reactions may include rash, hives, or itchiness of the skin; vomiting, diarrhea or
abdominal pain; or itchy eyes and sneezing.
2. Food Intolerance - a negative reaction to a food or part of a food caused by a metabolic
problem.
The inability to digest parts of certain foods or food components.
May be associated with certain foods such as milk or wheat, or even with some food
additives.
Common symptoms include nausea, vomiting, diarrhea, and fever.
3. Foodborne Illness A term that means a person has food poisoning.
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• To prevent foodborne illness you should clean, separate, cook and chill food
when handling it.
• A foodborne illness can result from eating foods contaminated with pathogens
or poisonous chemicals.
• The symptoms from the most common types of food poisoning generally start
within 2 to 6 hours of eating the food. That time may be longer (even a
number of days) or shorter, depending on the toxin , the organism responsible
for the food poisoning. The possible symptoms include: nausea/vomiting,
abdominal cramps, diarrhea, weakness, fever and headache.
• Even though food poisoning is relatively rare, it affects between 60 and 80
million people worldwide each year and results in approximately 6 to 8 million
deaths.
Post-test: A- Recall the basic functions of food

B- Explain the role of water in the body
second Unit
6
Energy intake Versus Energy Output
B – Justifications :-
This unit is designed to identify the importance of energy to the body and the
performance of vital activities in the body, as well as to identify the content of
different foods from calories, how to calculate the calories of individuals, both by
activity
C- Central idea :- What energy is, how it is measured
The importance of energy to man
How to calculate an individual's energy needs
B- If you get less than a degree, you need to study the module
Collection.
A – 8 degrees or more I turn to study the following module
art of them and then returned to perform the post-test
1- knowledge how to measure energy in food
2- Calculate the body's energy needs and how to maintain energy balance
3- knowledge the food content of energy

Determine the content of one gram of carbohydrate, protein and fat
calories, then explain the vital importance of energy in the human body
Energy intake Versus Energy Output
7
The genetics is a factor in being overweight, a person cannot become fat without
taking more energy food (calories) than are expended.
Energy intake:-
Scientists use a bomb calorimeter to measure a food's caloric value. A portion of
food is placed inside the chamber and then burns the food , it raises the temperature
of the water that surrounds the chamber ,.Scientists ,measure the change in water
temperature and calculate the number of calories in the food . The energy value of
food is often, reported in kilocalories (kcal). A kilocalorie: is the amount of heat that
raise the temperature of a liter of water one C°.
For practical purposes, you can estimate a food's calorie value if you know how
many grams of carbohydrate , fat , protein and alcohol contains. Each gram of
carbohydrate or protein supplies 4 kcal, and each gram of fat supplies 9 kcal .
Although alcohol is not a nutrient, it is considered a food , and each gram supplies 7
kcal. Therefore, if a serving of food contains 30 grams of carbohydrate , 9 grams of
fats and 5 grams of protein, it can be supplies 221 kcal.
Carbohydrate 30 g × 4 kcal = 120 kcal
Fat 9 g × 9 kcal = 81 kcal
Protein 5 g × 4 kcal = 20 kcal
Total energy 221 kcal
Energy output:-
The body expends energy primarily for
1- Metabolic
2- Physical activity
3- Digesting , absorbing and processing the nutrients from food .
Scientists can access a person's energy a particular expending to physical
activity by measuring oxygen intake and dioxide output during performance
of the activity .
How to estimate your daily energy intake
1- Number of kcal needed daily for metabolic function. Multiply your weight in
kilograms (weight in pounds divided by 2.2) with factor 1.0 if you are a man ,
and with factor 0.9 if you are a woman. And then multiply that number by 24.
Weight of Mona 130 pounds (59 kg). would use following steps to calculate
her daily caloric use:
0.9 × 59 kg × 24 hours = approximately 1.274 kcal/day.
2- number of kcal needed daily for physical activity . Chose a multiplication factor
from one of the follow categories .
Sedentary activity (little or no physical activity) = 0.20 to 0.40
Light activity(walk daily) = 0.55 to 0.65
Moderate activity ( daily vigorous exercise) = 0.70 to 0.75
Heavy activity (perform physical labor / endurance training) = .80 t01.20
Multiplication these factors with the kcal value which obtained in step 1 .
Mona performs light physical activity daily. She multiplies
0.55× 1.274 kcal to determine her physical activity use, which is 0.701 kcal.
3-number of kcal needed to digestion , absorption, and processing of nutrients.
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Mona adds 1.274 kcal and 0. 701 kcal to calculate her total energy needs
so far . The answer is 1.975 kcal .
Multiplication this value with factor (0.1) , and add it to the total kcal from step 1
and 2 to Get on her total daily energy needs.
Ex : multiplies 1.975 kcal with ( 0.1) and adds that value (0.1975) to
1.975 to obtain her total daily energy needs of 2.172 kcal .
Therefore . Mona will maintain her weight of 130 pounds if she continues to
consume about 2.170 kcal day and to perform light physical activities.
There are many methods to calculate the energy needed :-
The first method:-
The man needs one calories per kilo of weight in each hour:-
A man weighing 70 kg , needs in every hour to 70 * 1 = 70 kcal
And it needs per day to 70 *1* 24 = 1680 calories
Women need to (0.85) kilocalories per kilo of weight per hour
Woman weighing 70 kg need every hour to 70 * 0.85 = 59.5 calories
And you need per day to 59.5 * 24 = 1428 calories
These calories are what represent the basic energy for the body
And called the basic calorie for the body ,and the body burn it , even if we stayed in bed
all day without doing anything . They are essential for vital processes of the body as
Blood transfusions, heart rate, respiration, digestion of food, absorption of food, the
movement of cells, cells work .
In other meaning , it's the calories which needed to stay a live without doing any effort
To calculate the calories we apply one of following systems , only to stay a life :
Active person needs to (50-70%) of the basic energy to help stay a life
the medial active person , needs to (40 -50%) of the basic energy
Non-active person needs to (30 - 40%) of the basic energy
And as an application on the above example:-
The man who weighed 70 kg if very active, he needs to
0.50 * 1680 = 840 Additional calories to do by his works
0.70 * 1680 = 1176 calories
It is what we call the activity energy.
The figure would range between 840 - 1176 calories a day
Now to see total calorie
collect basic energy + energy activity
1680 + 840 = 2520 calorie 1680 + 1176 = 2856 calorie
If the man who weighed 70 kg and live a very active life of the system needs to
2520 - 2856 calories a day
To obtain more accurate results we multiply the previous figures by the number 1.1
The result becomes
1.1 * 2520 = 2772 1.1 * 2856 = 3141.6
And that the final outcome of this man should be consumes worth
2772 to 3142 calories a day to maintain current weight
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But if he wanted to decreases in kilo every week, then he has to dispense with the value
of 1000 kcal per day
Becomes the new consumption
1772 to 2142 kcal and will decline in the kilo each week while maintaining the same
current activity without an increase or decrease
second method:-
25 Calorie per kilo of body weight for people with weak activity such as staff offices and
light housework
30 Calorie per kilo of body weight for people with medium activity such as teachers or
doctors
35 - 40 Calorie per kilo of body weight for people with hyperactivity, such as farmers and
construction workers, athletes
Example:
Woman weighing 60 kg . If the housewife they need to
25 * 60 = 1500 calories daily
If a teacher or a doctor they need to
30 * 60 = 1800 calories daily
If the sports they need to
35 * 60 = 2,100 calories
third method:
If the person is active 1.5 * weight * 1 * 24
If the person modern activity 1.4 * weight * 1 * 24
If a person weak activity 1.3 * weight *1 *24
fourth method
This method is the most accurate way to take into account all the differences they
Weight , Length , Age , Gender
The actual number of burned calories from Sports
If applied to the following data
We begin the way
Weight: 94 , Height: 159
1) We calculate BODY MASS INDEX
A body mass index = weight / square of the height in meters
= 94 / (1.59 * 1.59) = 37.2
The ratio is high Therefore, it is necessary to reduce weight ,the normal rate range 20-
25
2) Identify the basic calories for the body The equation for men
basic calorie = 655+(9.6 * weight in kilograms) + (1.8 * height in centimeters) - (4.7 * Age in years)
by applying the above data (weight 94 kg . Height: 159 )
655 + 902.4 + 286.2-131.6 = 1712 calories essential for my body
The figure came with us to step 2 Multiply by 1.2
The number of calories core * 1.2
10
1712 * 1.2 = 2054.4 calories daily
This number of calories for my present without Sport

3) determine the daily requirement of calories with playing sports
If applied exercises burn 2910 calories per week
Divides the figure on 7 to find how to burn a day
2910/7 = 415.7 kcal burn day because of sports
To find my need daily caloric with playing sports
Collect the second step with the sport(step 3) because of the burn
415.7 + 2054.4 = 2470.1 kcal
I need of daily calories to maintain my current weight without increase or decrease
-:Specified Dynamic Action in the food
Do any body of you noticed what happens to his body after eating a large meal rich
in compounds food? Did any of you felt of light cold in the body for a short period
after that meal? This phenomenon can be observed especially when the
temperature of surrounding air is low relatively. This means that relative increase of
the temperature inside the body of the temperature in the ambient air. This is which
leads the body to the feeling of cold. The explanation for this is due to the food that
you eat human contains a range of nutrients (carbohydrates; fat; protein), these
compounds are exposed to digest and turn into simple compounds absorb into
different cells for use as sources of energy and protein ... etc.. When oxidation the
final products to digestion the nutrients (glucose; amino acids ... etc.) for energy or
protein. composition of protein in the body, there is the amount of energy lost from
those vehicles. When the oxidation of glucose, for example, to supply the body's
energy during the transformation of a compound ATP to a compound ADP it does
not turn completely into energy, but only part of it, which is to take advantage of it
which is about 68% of the energy of glucose converted to single heat , while the
other 32% does not benefit the body and works get rid of them by different natural
means (breathing; contact; evaporation of the body ...) and when you configure the
protein in different tissues of the body or in the form of other protein compounds. the
Federation of amino acids resulting from the decomposition and digestion of protein
(which is of plant origin in human feed) to configure the types of animal protein is not
efficiently complete 100% and be the result of this loss occurrence also in energy in
the form of heat. It has been estimated that this loss equals 600 kcal when
producing one kilogram of protein within the body. This loss of thermal energy
occurring in viable metabolizable of food (in addition to other sources) called the
Heat Increment (HI). this source of loss does not benefit the body and graduated
out of the body. In certain cases, can only be to the benefit of those heat of the body
during cold weather conditions where the human can use this heat released to
.warm the body from the inside
other sources to loss of part from the food energy metabolic it's those the required
heat in Specific dynamic action SDA; in addition to the heat lost to the
food, include operations of grinding and chewing and digestion of food in addition to
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those of heat lost as a result of the effort required for the movement of food within
, ,the digestive system and move from one part to another
Of the total of the above is clear there has been a significant source to lost part of
metabolic energy who dealt with the human can not be avoided
This source of loss called Heat Increment (HI), therefore termed nutrition scientists
label this as a loss of Tax, which must be incurred in order to reach energy food for
.the body in the form of useless
This loss of metabolizable energy of food is considered last form of loss of the total
energy of the food, which dealt with the human as a result of loss remaining part of
the energy for the benefit of the body energy, both to Maintenance or production this
.part of the energy food known Net Energy (NE)
.Net Energy (NE)

Gross energy
Digestible Energy Missing Energy in the waste
Metabolizable Energy Missing Energy in the urine
Net Energy Heat Increment
Growth maintain
Post-test:
Calculate the daily caloric needs of a woman who weighs 59 kg
and practices light activity
Tired Unit
12
Dietary Standards
B – Justifications :- This unit is designed to
Identify the proposed food courses.
Evaluation of diets taken using dietary supplements.
C- Central idea :-
Defining the student with different nutritional measures to calculate nutritional
requirements
Collection.
used the tables of dietary recommendations to evaluate daily meals
Comparison of nutrients taken with daily nutrient requirements. -

define the EAR ,RDA , AI ?
Dietary Standards
13
-:Proposed dietary standards (requirements)
-Is the amount of essential nutrients that are recommended to be consumed per day
-To avoid the appearance of symptoms of malnutrition, it is enough to secure all
Food needs
It is applied to the proper person and has not been taken into account for application -
to the Patient or chronic diseases
The proposed dietary standards are designed to provide the person with more than -
his / her of daily needs of nutrients, any, the lack of any nutrient component
does not mean that the food is inadequate . This is because the values of
.differing needs among individuals
If the individual takes (67% 100%) of the recommendations He took a full day of
food needs
If the individual takes less than 67 % He has a shortage of

food needs
If the individual takes higher than 100% He has an increase

over its nutritional
needs
Split different categories into tables

dietary standards (requirements) according to age and sex:
Infants: Two groups of infants
1- ( 0 0.5) newborns up to six months

2- (0.5-1) from six months to one year
Children Groups
1- Between (1) to (3) years.
2- Between the ages of (4) to (8) years.

Males:- Six groups for males
1- two groups of adolescents from (9 - 13 years) And (14-18 years)

2- two groups of adult from (19 30 years) and (31 50 years)
3- two groups for the elderly from(51 70 years) and more than (70) years
Females:- Six groups for females
1- two groups of adolescents from (9 - 13 years) And (14-18 years)

2- two groups of adult from (19 30 years) and (31 50 years)
3- two groups for the elderly from(51 70 years) and more than (70) years
Split different categories into tables

14
Dietary standards (requirements) according o f age and sex:-
Pregnancy:- Three groups
1- from age of (18) years or less

2- from (19 - 30) years
3- from (31 50 ) years
Lactation:- three groups
1- from age of (18) years or less

2- from (19 - 30) years
3- from (31 50 ) years
Evolution of dietary standards (requirements)

Old dietary standards :
Established In 1943 by the Food & Nutrition Board in Nutrition Research Council (NRC) ,
These recommendations included only the energy and seven nutrients .
These recommendations have been revised and revised several times depending on
available scientific information. And last version is the tenth version in (1989), and
included energy and (19) other nutrients.
When designing American food scales, assume that people (23 years) and above
they do light activities and live at an average temperature of 20 C°.
dietary standards modifiers:
The new amendment to dietary allowances was introduced in 1997 and 1998, and was
called Dietary Reference Intakes(DRI),It was adopted in the United States and Canada and is
divided into two groups:
1- Recommended Dietary Allowance (RDA) which recommended based on scientific
evidence which is a target for individuals to prevent the occurrence of disabilities
(malnutrition).
2- Adequate Intake:This term is used in the absence of adequate scientific evidence,
to determine the recommended dietary parameters (because the information
available on human needs is a range and this is not enough to develop their
dietary requirements), and in the case of sufficient evidence, the term Rang
becomes (dietary requirements)
Dietary Reference Intakes (DRIs)
Estimated Average Requirement (EAR)
Is the amount that covers the needs of (50%) of individuals at different age and sex and
depends on Functional indicators and optimal health.
15
Recommended Dietary Allowance (RDA) 
The amount that covers the needs of most individuals according to their sex and age
Adequate Intake (AI)

Quantities that are believed to be sufficient for most individuals are used when they can
not be estimated EAR- RDA
Tolerable Upper Intake Level (UL):-

Food intake, if exceeded, is harmful
16
-:Uses of dietary requirements tables
- Planning integrated diets for individuals and groups .1
Daily evaluation of the quantities of food eaten (Dietary Intake) and comparing the -
. .content of the meal from nutrients with dietary requirements
Helps in the development and planning of future agricultural production Scheduals -
- Helps to develop the nutrition education programs.
- dietary requirements tables are used to explain the national food labeling models
listed in the records which forms for large groups of individuals.
-Use as Food guide in nutrition programs such as the school lunch program and
group Feeding It is also the foundation To control the regulation of food
.components and food labels
Other dietary requirements
There are dietary requirements issued by different countries to its peoples, which are
similar to the United States, including
- :Canadian requirements
British requirements: -
Requirements of WHO / FAO are the amounts of nutrients that recommended by
WHO / FAO . These two organizations identified the components of Food to meet
the needs of healthy people in the developing world. Take care when designing
the prevailing dietary habits and cultural level of individuals in the region and
have been developed on the basis that they meet the Persons needs which
practicing intermediate activities
Steps to use food rationing:-
- Recording the all food that eaten by the individual for three full days, to record all
that has been eaten from ( basic meals, snacks, and between the main meals),
taking into account not to omit any food eaten by the person
- Analysis of food items that recorded in the previous list to their basic elements
(essential elements for healthy food) using food analysis tables.
- compare the previous analysis with the recommended dietary Allowed (RDA) The
appropriateness of eating what foods actually eat with what an individual should
eat from a healthy diet
- Record high nutrient ratios in treated meals as well as nutrient ratios
The low earned by the individual
- Modification of the diet in based on what has been monitored from the need for
some nutrients and according to elements which required to be addressed
according to age, body, gender and type of work.
pplication (1
A 65-year-old woman who took 60 grams of protein did she have to eat
Recommendations with commentary.
17
Application (2
A person aged 18 years of vitamin A,
900) Micrograms on the first day,
1200 (Micrograms on the second day
1000) Micrograms on the third day,
Calculate the average intake of vitamin A during the three days with a comparison of the
recommendations with the suspension.
Vitamine A
Average daily intake
Recommendations
Percentage = average daily intake / recommendations ×100
Evaluation
comment:-----------------------------------------------------------------------------------------------------
Choose three food items, comparing them with recommendations (RDA)

Then he commented on that.
Element

Recommendations
Percentage = average daily intake / recommendations ×100
Evaluation
Compare daily intake from

Protein (60 g)
calcium (600 mg)
niacin (8 mg)
with the recommendations of woman are aged (35) year with comment.
Protein calcium Nuisine
Recommendations
Percentage = average daily intake / recommendations
×100
Commented:----------------------------------------------------------------------------------------------------
Post-test:
Explain the uses of dietary requirements table?
18
Fourth Unit
The daily requirement of nutrients
B – Justifications :-
This unit is designed to identify how to calculate the daily requirements of
different nutrients
C- Central idea :-
calculate the person requirements of nutrents
D- Instruction:-
1- Look at the overall overview well
Collection.
Calculation of daily nutrient requirements as well as daily calorie intake
requirements
if the number of calories needed by someone = 3200 calories a day
how calculate his daily requirements of fat ?
19
The daily requirement of nutrients
How to calculate the calories: -

For the purpose of calculating the body needs calories (energy) follow follows
1-Body weight × 13.75
2- Length × 5
3- Age × 6.76
Then combines the results and added his 66
Example: - a person weighing 60 kg and a length of 171 cm and 19 years old. Calculate
calories for that person
The solution :
60 × 13.75 = 825 calorie
171× 5 = 855 calorie
19 × 6.76 =128.44
---------------
Total = 1808.44
66 Terms have been added to this amount for each
---------------------------
1874.44 calories

Then , observed the degree of activity to the person per week
If the person is weak Activity (1- 3 days per week) multiply with 1.375
If the average person Activity (3-5 days per week) multiply with 1.55
If Activity High-person (6-7 day per week) multiply with 1.725
If a person very high activity twice a week) multiply with 1.9
For example, if we take the previous example and the person Activity is moderate
So we multiply the number of calories that this person needed with ( 1.55)
1874.44 × 1.55 = 2905.382 calories / day .
Another way to calculate the energy that a person needs per day,
Multiply (body weight × 2.2 or 3.3).
Calculate the amount of fiber needed: -

The amount of fiber can't account by certain mathematical way, but estimated the
*amount of fiber needed for a normal person with 25 -35 g / day
*And it estimated the amount of fiber needed for a sports person to 35 - 45 g / day
20
How to calculate the amount of fat needed: -
To calculate the person requirements per day of fat we follow
Multiply the calories × 20% (the fact that the proportion of energy that should be
available from fat accounts for 20% of the total energy needed by the person) and then
dividing the result by the 9
For example, if the number of calories needed by someone = 4000 calories a day.
4000 × 0.20 = 800 calories
800 ÷ 9 = almost 88 grams of fat needed by this person per day
Required quantities of vitamins: -
Vitamins Natural person Sport person
Vitamin c 60 120 mg 1000 - 3000 mg
Vitamin B1 30 - 100 mg 30 - 120 mg
Vitamin B2 10 - 50 mg 30 - 120 mg
Vitamin B6 10 20 mg 20 80 mg
Vitamin B12 30 - 100 mg 120 175 mg
Vitamin A 5000 IU 10000 - 15000 IU
Vitamin D 400 - 600 IU 400 - 800 IU
Vitamin E 300 - 500 IU 400 - 800 IU
Vitamin K 80 - 100 µ g 80 - 100 µ g
There are other ways to calculate the requirements of energy, protein and fat:
Where it is appropriate diet program mode, and the requirements are calculated as follows:
If the total number of calories that person needs per day is 2100 calories. Calories should
be divided according to the following
58 % of total calories obtained from carbohydrates
30 % of total calories obtained from fat
12% of the calories obtained from proteins .
account of carbohydrate calories 0.58 × 2100 = 1218 calorie
grams number of carbohydrates : 1218 / 4 = 304.5 g
account of fats calories : 0.30 × 2100 = 630 calorie

grams number of fats : 630 / 9 = 70 g .
account of protein calories : 0.12 × 2100 = 252 calorie .

grams number of proteins : 252 / 4 = 63 g
304 g of carbohydrates and 70 g of fats and 63 g of proteins
21
These quantities are distributed to food alternatives .
Article food number of calories Quantity
Milk 80 150 calorie 12 g carbohydrates , 8 g protein , 8 g fat
Vegetable 25 5g carbohydrates , 2 g protein
Fruits 60 15g carbohydrates
Starches 80 15 g carbohydrates , 3 g protein , 1 g fat
Meat and Substitutes 35 45 7 g protein , 0.13 g fat
Fasts 45 5 g fat
Sweets Calories vary 15 g carbohydrates , protein and fat varies
Alternative Number Carbohydrate Protein Fat
Low fat milk 2 24 16 16

Vegetables 4 20 8
Fruits 4 60
Total grams number of carbohydrates -------
104
To determine the number of grain alternatives (starches)

304 104 = 200
Alternatives Number of carbohydrate
200 / 15 = 13
Shall be as follows 9 alternatives of grain 4 alternatives of sugars ( sweets) .
Grain 9 135 27 9
Sugars (sweets) 4 60
The total grams of proteins ---------
51
To determine the number of meat alternatives
We calculate the grams number of remaining protein
63 51 = 12
Alternatives Number of Meat = 12/ 7 = 1.714 approximately 2
The meat 2 14 14
------
The total grams of Fats 39 (40)
We calculate the grams number of remaining fats
70 40 = 30
Alternatives Number of fats = 30 / 5 = 6
Post-test:
If the total number of calories a person needs per day is 2,100 Calories. Can you
calculate his daily needs of carbohydrates, fats and protein?
22
fifth Unit
Carbohydrates
B – Justifications :- This unit is designed to identify the types of carbohydrates, the
importance of carbohydrate to the body, the vital functions of
carbohydrates digestion and absorption of carbohydrates,
C- Central idea :- Definition of carbohydrates
The role of carbohydrates in the life of living organisms
Division of carbohydrates
Digestion, absorption and metabolism of carbohydrates
Sources of carbohydrates
Collection.
After the student has studied the module, the student is able to
Find out what carbohydrates are and what are the types of carbohydrates
knowledge the role of carbohydrates in the body's vital functions
knowledge the method of digestion, absorption and metabolism of carbohydrates
knowledge the sources of carbohydrates and daily needs of carbohydrates
.
Third :- Pre test :- Explain the vital role of carbohydrates in the body
23
Carbohydrates
What are Carbohydrates:-
Types of Carbohydrates:-
Simple Carbohydrates
– monosaccharides
– disaccharides
Complex Carbohydrates
– oligosaccharides
– polysaccharides
• glycogen
• starches
• Fibers
Simple Carbohydrates
Monosaccharides: Single Sugars:-
Glucose
– carbohydrate form used by the body, referred to as blood sugar
– basic sub-unit of other larger carbohydrate molecules
found in fruits, vegetables, honey
24
Fructose
– sweetest of the sugars
– occurs naturally in fruits & honey, fruit sugar
– combines with glucose to form sucrose
Galactose
– combines with glucose to form lactose, milk sugar
Disaccharides :-
Sucrose (table sugar)
– glucose + fructose
Lactose (milk sugar)

– glucose + galactose
Maltose (malt sugar)

– glucose + glucose
25
Joining and Cleaving Sugar Molecules:-
Oligosaccharides
– short carbohydrate chains of 3 - 10 monosaccharides
– found in legumes and human milk
– Examples:
• raffinose
• stachyose
Polysaccharides:-
• long carbohydrate chains of monosaccharides linked by glycosidic bonds

– alpha (a) bonds (starch)
– beta (b) bonds (found in fiber)
–
26
Complex Carbohydrates
Starch
amylose
– plant storage form of carbohydrate

– long branched or unbranched chains of glucose
• amylose
• amylopectin
amylopectin
Glycogen
– highly branched chains of glucose units
– animal storage form of carbohydrate
• found in LIVER and MUSCLE
• Humans store ~ 100g in liver; ~ 400g in muscle
negligible source of carbohydrate in the diet (meat)
Glycogen
Fiber
Dietary Fiber
– non-digestible carbohydrates (chains of monosaccharides) and lignin that are
intact and intrinsic in plants (includes oligosaccharides)
Functional Fiber
– isolated, non-digestible carbohydrates that have beneficial physiological
effects in humans
Fiber
• dietary fiber found in all types of plant foods
• refining removes fiber from whole grains and other foods
27
types of non-starch polysaccharides include:-
cellulose
hemicelluloses
pectins
gums & mucilages
b-glucans
chitin & chitosan
lignans
Digestion & Absorption
1. Mouth
• chewing
• salivary amylase
2. Stomach
• fibers remain in the stomach longer, delays gastric emptying
Small Intestine
• pancreas secretes enzyme pancreatic amylase
• enzymes located on the cell membranes of the intestinal epithelial cells complete
digestion
28
Small Intestine:-
• only monosaccharides can be absorbed
– glucose & galactose absorbed by ACTIVE TRANSPORT
– fructose absorbed by FACILITATED DIFFUSION
• all three monosaccharides travel in the portal vein to the liver
• three fates of glucose at the liver
– Energy, storage as glycogen, released to blood
29
Large Intestine
• resistant starches and fibers may be digested by bacteria
– produces short chain fatty acids
absorbed by the intestine and used for energy (dietary fiber yields about 2 kcal/g
Lactose Intolerance:-
• occurs as a result of insufficient lactase & low lactase activity
• lactose molecules from milk remain in the intestine undigested
• lactose intolerance ¹ milk allergy
• undigested lactose digested by bacteria producing irritating acid and gas
– symptoms include , bloating, abdominal discomfort, diarrhea
• individuals who consume little or no milk products may be at risk of developing
nutrient deficiencies
• dairy options: yogurt, aged cheddar, small quantities of milk (~ ½ cup), acidophilus
milk, cottage cheese
• best to consume with other foods and spread intake throughout day
• gradual increases in milk intake may cause intestinal bacteria to adapt
Functions of Carbohydrates:-
1) Energy
• glucose fuels the work of most of the bodys cells
– preferred fuel of NERVOUS TISSUE (the brain, nerves) and RED BLOOD CELLS
(RBC)
• excess glucose is stored as GLYCOGEN in liver and muscle tissue
2) Sparing Body Protein
• if diet does not provide enough glucose, then other sources of glucose must be
found
• if carbohydrate intake < 50 - 100 g, body protein will be used to make glucose
• an adequate supply of carbohydrate spares body proteins from being broken down
to synthesize glucose
3) Preventing Ketosis (Anti-ketogenic)
• carbohydrates required for the complete metabolism of fat
• incomplete fat metabolism produces KETONES
• an adequate supply of carbohydrate (> 50 100 g per day) prevents KETOSIS
Fiber:-
• beneficial for weight control by contributing to satiety & delay gastric emptying
• soluble fibers lower blood cholesterol to help reduce risk of cardiovascular disease
• minimizes risk of and helps control Type II Diabetes
• insoluble fibers help promote intestinal health by enlarging stool size and
easingpassage of stool
30
Soluble Fiber:-
• examples include gums, pectins, mucilages, some hemicelluloses
• functions:
– delay gastric emptying
– slow transit through the digestive system
– delay glucose absorption
– bind to bile, help decrease cholesterol
• food sources: fruits
Insoluble Fiber:-
• examples include cellulose, hemicellulose
functions:
– speed transit through the digestive tract
– delay glucose absorption
– increase fecal weight and soften stool to ease passage
– reduces risk of hemorrhoids, diverticulitis and appendicitis
food sources: cereal grains, legumes, vegetables, nuts
Fiber: Too much of a good thing :-

Excessive amounts of fiber may lead to:
– displacement of other foods in the diet
– intestinal discomfort
– interference with the absorption of other nutrients
Regulation of Blood Glucose:-

Optimal functioning of the body is dependant on keeping levels of glucose within
certain parameters.
Elevated blood glucose = Hyperglycemia
Low blood glucose = Hypoglycemia
The ENDOCRINE SYSTEM is primarily responsible for regulating blood glucose. The
two main hormones are INSULIN and GLUCAGON.
31
Regulation of Blood Glucose
How much carbohydrate do I need?
AMDR (Adults)
45 - 65% of total average energy intake
RDA for Carbohydrates (Adults) = 130 g per day
Daily Value (2000 cal diet) = 300 g per day
AI for Fiber (Adults)*
– Men: 38 g per day
– Women: 25 g per day
Sugar = max 10% of energy intake
*Note: after age 50, recommendations decrease to 30 and 21 g per day for men and
women respectively.
Post-test:
Briefly demonstrate digestion, absorption and metabolism of
carbohydrates
32
Sixth Unit
Proteins
B – Justifications :- This unit is designed to identify proteins and their importance to the
body, the sources of proteins, the daily needs of proteins
C- Central idea :- Proteins and their types
Essential amino acids and non-essential amino acids
Function of proteins and how the body uses proteins
The daily needs of proteins
Different sources of proteins
Collection.
After the student has studied the contents of this module, he will be
able to
Definition of proteins
Knowledge the types of amino acids in the protein substance
Knowledge of the vital functions of the protein in the body
Determination of daily protein requirements
Identify important sources of protein and whether they are plant or
animal type
Third :- Pre test :- Explain the vital role of proteins in the body
33

Proteins
Proteins:- its organic material it is contain on (carbon , hydrogen, oxygen, sulfur and
nitrogen) is contain of nitrogen approximately 16%.
Proteins
monomer = amino acids 20 different amino acids
polymer = polypeptide protein can be one or more polypeptide chains folded & bonded
together large & complex molecules complex 3-D shape.
 Structure
 central carbon amino group
 carboxyl group (acid)
 R group (side chain) variable group different for each amino acid
confers unique chemical properties to each amino acid like 20
different letters of an alphabet can make many words (proteins)
34
Effect of different R groups: Nonpolar amino acids
 nonpolar & hydrophobic
Why are these nonpolar & hydrophobic
Effect of different R groups: Polar amino acids .

 polar or charged & hydrophilic
Why are these polar & hydrophilic
The amino acids

 It is the structural unit of proteins , and its the simplest image of decomposition
the proteins during digestive process by digestive enzymes to proteins
 Amino acids are divided depending on the ability of the body to the composition:
 Essential amino acids: is that the body can 't composition, obtained from the food
35
 Non-essential amino acids: is that the body can configure it according to his needs
from protein sources or non protein sources and are therefore not necessary to get
them from the food.
Functional division of proteins:
 1-Stimulus Proteins : include enzymes
 2-Transport proteins: such as hemoglobin and transferrin
 3-Storage protein: such as protein "ferritin" which stores iron in the liver
 4-Movement proteins: such as myosin, actin and
 5-Toxic proteins: such as diphtheria and chollstrdam.
 6-Protective proteins: such as antibodies
 7-Regulatory proteins: such as hormones that regulate metabolizable interactions
 8- Structural proteins: such as keratin, collagen
 9- Informatics Proteins: such as DNA, RNA.
The ideal protein:- Egg protein, which is used as a measure for determining the quality of
other food proteins, containing all the essential amino acids in quantities commensurate
with the needs of the body
protein Marginal amino acid Nutritional value
Eggs There is no 100 %

Meat Sulfur amino acids 80 %
Fish Amino acid - Tryptophan 75 %
Rice Amino acid - Lysine 75 %
Cows milk Sulfur amino acods 60 %
The daily needs of proteins:-

 The daily requirement of protein , vary from one individual to another in order to
The factors that affect on the daily needs of proteins: the employment the protein
in the construction and maintenance of the body
 1. The quality of protein
 2. susceptibility protein to digestive
 Digestion coefficient =Nitrogen intake - (nitrogen in the stool - nitrogen in the stool when not eating protein)
Nitrogen intake in food
 3. Age
Age (month) The need for protein in grams / kg of body weight
Less than 3 month 2.4

3-6 1.85
6-9 1.62
9 - 11 1.44
36
4-Physiological Status
 The needs of ordinary human of protein 0.8 g / kg of body weight . And the sports
person, needs to 1-1.5 g / kg of body weight
 The protein needs, increase during pregnancy and lactation to meet the needs of
the fetus or infant
 5. Composition of food in the meal
Provide a sufficient amount of carbohydrates in the diet leads to the optimal use of
protein to do in the main role of building and tissue regeneration , either low-
carbohydrate means increased need for protein for energy saving
 6. Health Status
Increases the need for protein in pathological conditions such as bleeding, burns, wounds
and surgical operations, and on the contrary, decreases the need of protein for kidney
patients .
Food quantities that meet the daily requirement of protein :-
The daily ration of protein foods in the food pyramid (2-4)rations it is sufficient to daily
requirement of adult from protein , which is about 60 g protein per day
 The health damage resulting from inadequate protein in food:-
 The human get many malnutrition disease when less than the amount of protein in
the food to become inadequate to meet the daily requirement of the body,
especially of the essential amino acids.
 kwashiorkor disease:-
 Is the case of protein deficiency in the quantity and quality of children is one of the
most prevalent malnutrition diseases in poor countries.
 Marasmus Disease:-
 The disease ,arising from protein and calories deficiency infected which the Child
gets by wasted and weaken muscles ,and occurs in cases of famine.
 Oedema disease:-
 Is the first symptom of Protein deficiency where less the liver's ability to configure
the protein (albumin) and decreases the level in the blood, and the water was
Spreads in the tissues
Vital functions of protein in the body:-
Necessary for growth and renewal and maintenance of tissues
Provides the body of important amino acids
Contribute to the body's energy needs
37
Formation of enzymes
The proteins maintain the water balance in the body
The proteins can regulate the acidity of the milieu (environment )in which they exist
The proteins help in the formation of antibodies
The proteins help in the formation of hormones
Formation of transport proteins
Formation of Vision pigments .
A special case of the amino acid phenylalanine:-
 this amino acid enters in the formation of Aspartame
 This amino acid can be a cause of mental disability cases are called "Vinyl Kituoraa"
PKU
 the international organizations , which interested in the health, Recommended by
detection tests of Metabolism phenylalanine for children immediately after birth
and before eating breast milk .
Post-test:
A- Explain the factors that affect the daily needs of protein?
B- What protein-rich foods we use in daily diets ?
38
seventh Unit
Fats (Lipids)
B – Justifications :- This module is designed to identify the composition of fat, fat varieties,
nutritional role of fat, the effect of lipid level on the body's vital functions
C- Central idea :- Chemical composition of fat

Importance of Fat and fatty acids
Nutritional role of fats
Collection.
After the student has studied the contents of this module, he will be
able to
Knowledge the types of fats and essential fatty acids and non-essential fatty acids
Nutritional functions of fats
Health problems caused by high levels of fat in the diet
Third :- Pre test :- Classify the fat according to its composition
39
Fats (Lipids)
Lipids:
are a groups of chemical compounds, it's the widespread in nature of it has solubility
Property in organic solvents such as ether, chloroform and benzene, but insoluble in
water. It also contains in composition on the fatty acid or more.
The nutrition and chemists scientists use the lipids term to include all fats and similar
materials In order to avoid confusion that gets in this side
Lipids are classified based on the installed ,any according to functional groups in it:-
1-Fatty acids
2-Fats and oils
3-Candles
4- phospholipids
5-Sterols
Can also be classified into:-
Simple lipids: They contain on fatty acids and citrate , such as fats, oils and candles
Compound Lipid: It is fats, united with other chemical groups such as phospholipids
Complex Lipid: It's complex compounds from lipid and protein such as lipoprotein.
Derivative Lipid: consists of two previous groups such as the fat acids and sterols.
Fatty acids:-
are carbonic organic compounds , rarely found freely in nature but exists in the form of
esters of glycerine . These compounds vary in terms length of the molecules and the
number of carbon atoms and the number of saturated bonds and their location within the
compound
That the length of the string carbonate ranges from 4-24 carbon atoms, are generally the
same even number
The fatty acids in nature to be kind, including:-
Saturated fatty acids: These acids have chemical composition CH3 (CH2)n COOH and most
important of these acids (Stearic acid and Palmitic acid). Fatty acids be distributed in
varying proportions in nature in the sources that exist, for example, palmitic acid found
by almost 50% of the total fatty acids in any type of fat , and found in fat of the human
body relativity 21-25%. the Stearic acid, it is found in 25% in Cow fat, but in fat of the
human body by 2.2 8.4 %.
Animal foods considered the essential source in providing of saturated fatty acids and in
addition to the ability of the human body in its production.
Unsaturated fatty acid: This acid is characterized by double bond or more, The most
important of these acids ,oleic acid, it's one of the more fatty acids prevalent in nature
and found in more fats by 30% or more of the total fatty acids, as well as the linoleic acid
and Arachidonic acid accost frequently in nature
It has become hard in practice at the present time that the three fatty acids (linoleic,
arachidonic, olieic) it's the Essential Fatty Acids for the growth of some animals and show
symptoms of deficiency when the diet does not contain these acids (linoleic and arachidonic).
40
Medical research has proved that the human body also needs to such acids and show
symptoms of eczema when the baby food that does not contain these acids. The baby will
be needed to (1.3 -2 %)of the energy in the form of olieic acid, and given the importance
of this acid in the composition of the tissue to be eating more than the minimum
requirements of (2 - 4%) of the total consumed energy so as not to appear deficiency
symptoms
Functions unsaturated fatty acid in the body:
1- have a role in reducing the concentration of cholesterol in the blood
2- These acids combine with cholesterol configuration cholesterol esters , which form
part of phospholipids and lipoproteins
3-to decrease olieic acid leads to cracking and stiff skin
Medical research has confirmed that the body can 't composition these essential fatty
acids, so it must be provided in the food. The unsaturated fatty acids are found in
vegetable oils and in whale liver oil
Fats and oils:
Is an esters to the glycerol Alcohol with fatty acids. It such as carbohydrates, contains on
carbon, oxygen, hydrogen, but the ratio of oxygen is less than carbohydrates, and called
a general Triglycerides, and the simplest of these Triglycerides where fatty acids are
identical
glycerol + three fatty acids( the same or different) Water +Triglycerides
Types of fats and oils differ in their physical , chemical and nutritional characteristics such
as the difference in the melting point, the interaction, and the content of mineral
elements. Some tests are used to identify on the certain fats such as Iodine Number of
fat
This figure is known as the amount of iodine can be absorbed by 100 grams of fat, and
that this figure gives an idea of the extent and rate of unsaturation located.
The fats that contain saturated fatty acids do not react with iodine
There is also another examination called Saponification Number,
where the addition of an alkaline material to fatty acids, be with fatty acid soap, and
called this interaction Saponification
may be the fats in the Food as a solid materials in the room temperature or liquid oil. In
general, the reason for the existence the some of fats in the solid state, and others are in
a liquid state due to the presence of saturated fatty acids and unsaturated fatty acids ,
and the proportion of each of them
Candles:
It esters of fatty acids with high molecular weights with alcohols (not glycerine ) with high
molecular weights, too.
And that many of these substances spread in nature and there is a large margin in the
outer shell of the plants and fruit as well as found in the skin and secretion of certain
insects. Candles do not have great importance in human food, and most important
candles (Lanolin or wool grease and beeswax).
phospholipids:
41
These lipids containing on the phosphoric acid with nitrogen base, it is the compounds
which that physiological importance, the alcoholic group(OH) it's associated by bond
ester with side chain containing phosphorus and nitrogen.
This lipids comes after the importance Triglycerides and are found Frequently in all cells
and tissues , it's differ in the percentages that they contain from phospholipids , the brain
contain on 35% from the dry weight of this compounds but the Muscles contain 2% of the
dry weight .
the most important classes of these compounds as phosphosphnicosaad have important
functions in the human body, it is an important component of nerve tissue and brain
Sterols:
It is a solid alcoholic compounds, it's consists the esters with fatty acids and the all
contain
on the carbon ring.
CH3
R
CH3
OH
The R varies according to different the compounds, these compounds have the great
significance and the most common and importance ( Cholesterol), it's found in the blood
of a Supreme mammals. That the level of cholesterol in the blood should be no more than
200 mg / 100 cm. And a lot of evidence to suggest that maintaining the level of
cholesterol has impact in reducing the incidence of heart disease, after scientists assumed
the existence of a relationship between the consumption of cholesterol and heart
disease. And the production of cholesterol depends on what there is of it in the body and
therefore, it is affected by the quantities of food intake within him as the proportion of
high-fat in food leads to increased production of cholesterol in the body.
The organization of the concentration of cholesterol in the blood depends on destroying
rate and to excretion the rate of addition to the production rate, part of it excretion with
bile was re-absorption section of it in the intestines and excretion the rest in the faeces
after reduced by the bacteria, that the more part of the cholesterol convert in the liver to
fatty acids bile
Nutritional role of fat:
The Fat have special importance in nutrition due to the multiple benefits, including
physiological functions :
1. constitute a fundamental and important source of energy as it gives twice as much to
give it proteins or carbohydrates from the calories.
2. The fat have separation role to prevent loss of body heat as it works to prevent
radiation or heat loss
3. used as an intermediary for the transfer of the soluble vitamins in it.
4. have an important role in the absorption of calcium and beta carotene and thiamine
5- have special protection in the importance of the internal viscera
6- provide the body with essential fatty acid which can't be installed the body .
42
7- slow stomach emptying process and thus slow down the process of digestion and thus
delay the feeling of hunger
8- improvement of sensory qualities of the food
Fat levels in food:
That fat consumption in developing countries constitute 6-10% of the total energy
provided by food, while fat content up to 44% of the total energy in the diet of individuals
in developed countries, and depending the fat level in the food on the economic level,
but the opposite way of the carbohydrates are directly proportional with the level of
living, In spite of that, the fat consumption is don't considered a feature in rich
communities because the problem is not the availability of food for energy, as much as
the health risks of obesity, heart disease, and since the advent of saturated fatty acids
and cholesterol theory and its relationship to heart disease at the beginning of the fifties
of the last century .The developed societies culturally tended to change the pattern of
food consumption and Specifically Reduce the saturated fatty acids and cholesterol
consumption, And compensation for the increase of polyunsaturated fatty acid
consumption of plant-source Not yet so they can be to estimate the physiological needs
of fat, but it is recommended that the fat available for at least 20-25% of the energy in
food, that essential fatty acids constitute 1% of the total energy at least, taking into
account the balance between the amounts of saturated fatty acids and unsaturated fatty
acids. The most important sources of fat in food is butter and cream, vegetable oils and
fat various meats.
Cholesterol:-
a. Because all animals make cholesterol, if you eat any animal product, including
MEAT, POULTRY and FISH, you will be consuming some extra or unneeded
cholesterol.
b. Other foods high in cholesterol are:
◦ Egg Yolks
◦ Liver / Organ Meats
◦ Some Shellfish
LDLs and HDLs :-
a. A certain amount of cholesterol CIRCULATES in the blood. It does not float through
the bloodstream on its own, but in chemical packages called LIPOPROTEINS.
There are two major kinds of lipoproteins:
1. LDLs (Low-Density Lipoprotein)
2. HDLs (High-Density Lipoprotein)
Low-Density Lipoproteins: Losers
a. Takes cholesterol FROM the LIVER to wherever it is needed in the body.
b. If too much LDL cholesterol is circulating, the EXCESS amounts of cholesterol can
BUILD UP in ARTERY walls.
c. This buildup INCRESEASES the risk of HEART DISEASE or STROKE.
d. Thus, LDL cholesterol has come to be known as BAD CHOLESTEROL
43
LDLs are like the Delivery Men.
When LDLs have too much cholesterol to cart around, it builds up in the arteries and
starts to clog them up
High-Density Lipoproteins: Heroes
a. Picks up excess cholesterol and takes it BACK to the LIVER, keeping it from causing
harm.
b. Thus, HDL cholesterol has come to be known as GOOD CHOLESTEROL.
HDLs are like the Garbage Men.
The HDLs go around and pick up all the excess cholesterol clogging up the arteries and
take it back to the liver.
Post-test: Talk about nutritional role to the unsaturated fatty acid in the body?
44
Unit eighth
The Minerals
B – Justifications :- This unit is designed to identify metal elements, their classification, their
importance to the body
C- Central idea :- Classification of mineral elements according to their level in the body
Vital Importance of mineral elements
Symptoms of lack of minerals in the body.
Daily requirement of metal elements , and their sources
Collection.
After the student has studied the contents of this unit , he will be able to
Knowledge the types of minerals

The functions of minerals
Deficiency Symptoms and increase of minerals
The daily needs of major minerals as well as daily needs of trace minerals
Food sources
Third :- Pre test :- What are the general functions of metal elements?
45
The Minerals
All organisms need to be a certain amount of mineral elements to grow the body
naturally. The human intake these elements within the daily diet, and metals are 4% of
the total body weight and can be divided the minerals into two main groups according to
amounts presence in the body:
3. The first group Major elements: namely that are available in large quantities
in the human body is greater than 0.005% of the body weight, and this group
includes elements calcium, phosphorus, sodium, potassium, sulfur and
chlorine
4. The second group of Trace elements: namely that resides in the body a few
amounts, less than 0.005% of body weight. This group includes the elements
iron, iodine, copper, manganese, cobalt, zinc, Molibdnyum.
A set of elements their function not accurately determine, such as Zinc, aluminum,
bismuth, cadmium,
Functions:-
In fact the Minerals do not lead a certain role for each of them individually, but has many
common functions with each, may need more than one item to perform a specific job or
could ease one the other effect, and the most important functions that relate to save the
balance of PH in the body, as well as the Minerals intervention in the synthesis of many
enzymes which needed to conduct biochemical reactions.
Calcium: -
It is one of Minerals that largest presence in the body, There is in the form of phosphate
or calcium carbonate, there are about 99% of it in the bone and tooth , while there the
rest in soft tissues and body fluids by 10 grams united with the protein ,either in the
blood it is available by 10-100 mg in serum
Functions in the body: -
The main functions of calcium in confined
1. Calcium is essential for the growth and building the skeleton
2. contribute effectively in the blood clotting process, as calcium is one of the three main
factors for thrombosis
Calcium + Thermpoplactin + Bruthermeben Veiberan + clotting
3. Calcium is essential in muscle contraction organization the heartbeat
4. It is necessary for the health of nerves and control of the nervous system
5. It is necessary to regulate the permeability process through the walls of the cells and
tissues as well as it is necessary to maintain the basal pH balance of the body
6. maintains the integrity of the body of children and prevent the rickets disease.
Calcium absorption and balance in the body: -
The Calcium that found in food, is absorbed in the small intestine and then be absorbed
by the walls of the intestine into the Circulatory and which absorbed the bones and teeth
especially in periods of growth. And the Parathyroid hormone, controls on the calcium
content in the blood and under these natural conditions , this hormone Regulates the
46
process of calcium conversion from the blood converted to bone and vice versa, the
kidneys secrete any amount of calcium in the blood of more than 11 mg / 100 ml in the
urine, and the calcium is absorbed is excreted through the feces. The individual must
always be in the case of a positive balance ( any the intake quantitative that exceeds than
missing quantitative)
Factors affecting the absorption of calcium: -
1. the presence of vitamin D and the impact of (Hcl ) acid secreted by the stomach, which
may facilitate the absorption of calcium process
2. The presence of protein in the food as well as lactose and Ascorbic acid help calcium
absorption
3. The amount of calcium in the food and food quality: When you increase the amount of
calcium in food intake, the absorption rate it less, so when the quantity of calcium low in
food the efficiently absorbed was increase .
Also, the quality of the food are the other controls of the absorption ratios, have found
that the calcium in the breast milk more absorbed than in cow's milk
4. the absorption of calcium at less from food if increased the phosphate rate in it ,
especially when decrease the proportion of vitamin D
Symptoms of deficiency: -
The Symptoms appear distinct and affect on the bones and teeth, and the deficiency of
calcium lead to following cases .
1. (Osteoporosis)appear especially when pregnant and lactating mothers, and is easy to
break the bone and the difficulty of fracture healing
2. Osteenalcia
3.the deficiency causes rickets
Increase calcium: -
When the absorption of calcium excessively , the proportion of calcium in the blood rises,
leading to calcification in the kidneys and other internal organs, This condition occurs in
children who are accustomed to eating artificial food subsidized excessive quantities of
calcium and vitamin D, as well as urinary stones in healthy individuals may consist due
Excess calcium in food .
Food sources:
Found in plant and animal food sources and the most important is the milk and milk
products(especially cheese) and fish as well as if you eat the whole soybean and
vegetables contain unacceptable quantities of it
Daily need of calcium: -
The Committee of Experts for organization WHO / FAO Recommends to take 400-500
mg / per day for adult. And between 600-700 mg / day for adolescents As for pregnant
women and breast feeding women are recommended to take 1000-1500 mg / day
Phosphorus:-
It follows Ca of the quantity in the body, and that 80% of the total phosphorus in the
body found in the bones and teeth, and the rest is in the cells, brain and blood.
47
Functions: -
1. enters in the composition of bone and tooth .
2. necessary to configure some biological compounds
3. help to keep base balance – acid in the blood
4. necessary for the operations of the Metabolizable of proteins, fats and carbohydrates
and vitamin B complex
5. necessary to perform the important vital functions, especially for energy generation in
the muscle, and that phosphorus is an important element in many enzymatic processes that
lead to the reduction of energy and its transition and especially by adenosine phosphate
Absorption of phosphorus: -
The phosphorus is absorbed from the intestine is un organic salts, and 70% of the
phosphorus intake in food is absorbed into the body and lead the presence of iron,
aluminum and magnesium in abundance to the deposition of phosphorus.
The phosphorus found in animal sources is more easily absorbed than phosphorus found
in plant foods, especially in cereals and pulses.
Preferably the food intake ,contains on the balanced levels of calcium and phosphorus, 2:
1 or 1: 1 in order to reach the degree of absorption to the maximum. The presence of
vitamin D also prefer to take advantage of it in the absorption process.
And that the body gets rid of 30-40% of the phosphorus is absorbed through the feces
and the rest is excreted through the urine and the rates was vary depending on the
content of food from him.
Food sources:
Phosphorus is available in all foods, especially animal (including protein) such as meat,
fish, milk, cheese, chicken and eggs. And the daily balanced diet usually provides 1500 –
1600 mg per person, and that this amount would be enough to fill the need for this
element.
Daily need: -
Estimated individual need of phosphorus from about 800 mg / day and increases during
pregnancy and lactation to 1200 mg / day
Sodium: -
There are mainly in the surrounding extracellular fluid is to be 93% of the blood salts, and
the body of adult human contains about 100 grams of sodium at form salts.
Functions: -
1. Organization of Osmotic pressure for blood plasma as the amount of sodium have an
impact on water retention in the body
2. maintain the acid-base balance in the blood
3. necessary for the Metabolizable of carbohydrates
Sodium absorption: -
The Sodium is rapidly absorbed in the small intestine and the body secreted about 90%,
which enters from sodium through urine and sweat on the form chloride and sodium
phosphate, the sweat consider a major source of sodium loss from the body in a hot
48
climate, may resulting from increased sweating , contraction of the muscle, weakness,
headaches and this condition may lead to fainting , it is better to use salt for the
prevention of these symptoms. As well as the body loses too much sodium in cases of
excessive vomiting and severe diarrhea, and the body is required to compensate for this
deficiency.
In some cases, the accumulation of fluid edema occurs in the tissues of the body,
especially when a lack of protein in the food, so you should limit the intake of salt. The
salt is the main source of sodium and chloride salt is the only human who uses it in his
food and usually in amounts ranging between 10-20 g / per day and provide the body
with this amount of about 5 g / day
Food sources: -
Important sources , the animal foods which added the salt on it such as cheese and
meat, as well as the fruits and vegetables consider of the rich sources in sodium are also
Post test :- Talk about deficiency symptoms and increase calcium
Ninth unit
49
The Vitamins
B – Justifications :- This unit is designed to identify the vitamins , Classification of Vitamins,
Importance of fat-soluble vitamins in the human body
C- Central idea :- Classification of vitamins and
Vital importance of fat-soluble vitamins in the human body
Symptoms of lack these vitamins Daily requirement
Collection.
Knowledge the types of vitamins

The functions of fat-soluble vitamins in the human body
Deficiency Symptoms of vitamins (A , D ,E K)
The daily needs of these vitamins
Food sources
Third :- Pre test :- Enumerate the functions of vitamin A ?
Vitamins
50
Is an organic material, which is necessary for the body and its different activities and that
any imbalance in the amount of essential vitamins cause an imbalance in the safety and
functions of the body.
The presence of vitamins in the human diet in small quantities , when compared to other
nutrients, and that these meager quantities are helping or organization to the vital
processes in the body such as growth or energy production.
Classification of Vitamins: -
The Vitamins usually divided into two groups according to their properties which
1. fat soluble vitamins: the vitamins which a soluble in fat, which is characterized by the
excess of which quantities can not for the body to get rid of them out, but are stored in
the liver, and the body is not totally dependent on food in financing them, but can ride
some of them himself
2. water soluble vitamins: a soluble vitamins in the water. And excess quantities of which
are disposed of outside the body through excretion in the urine, therefore the body
depends entirely on food intake to provide the necessary quantities as they are not
stored and so there is little risk of eating excessive amounts of them.
Researchers have managed to isolate nearly twenty vitamins from both groups and
identified various synthetic formulations and their functions in the body.
Fat-soluble vitamins: -
Vitamin A: -
This vitamin is found in animal foods but only vegetarian food they provide material
called carotene which is converted in the body (small intestine) to vitamin A, so they
called the Provitamine A.
Vitamin A is a fatty alcohol, resists high temperature conditions, but it is easily oxidized as
well as the hydrogenation process used in the fat manufacturing caused damaged,
vitamin A, which installed General (C20 H29 OH) is available in two forms, the first vitamin
A and which is found in the liver of marine fish known as retinol A1 . and the second
vitamin A2, which resides in the liver of freshwater fish.
Absorbed: -
Vitamin A is absorbed by the small intestine as it is soluble in fat, and the liver stores
about 95% of it, and the absorption of carotene depends on the type of food ,as the
carotene which found in vegetables absorb about 25-50% of it all. And that the lack of
protein in food leads to a lack of absorption to take advantage of it, and the presence of
fat in food helps absorbed.
Functions and deficiency symptoms: -
1- This vitamin is essential for the visual pigment in the retina cells,
2- It helps to form visual purple Radopsin in the retina, which controls the sight process,
3-united with the private protein which called opsin and are vision at night or in poor
light 4- vitamin A deficiency makes it difficult to see in the dark and so-called night
blindness.
5- the vitamin A is essential to maintain the epithelial tissue that covers the body
51
6-The others functions of vitamin A it plays an important role in the reproduction process
, nerve health and growth of bones and teeth, as well as prepare a catalyst for the growth
of new skin cells
hypervitaminosis :-
consumption of 30 -150 mg / day for several months by children lead to the emergence of
disease symptoms called increase vitamin A( hypervitaminosis), including the increase of
osteoporosis and ease of breakage and severe pain in bones and head, enlarged liver and
spleen and other symptoms of headaches, vomiting and disappear these symptoms when
you stop taking vitamin.
The increase carotene consumption will show other symptoms called Korotinma One of
the main symptoms of yellowing of the skin, and the fact that skin pigmentation in yellow
gets only after consumption a lot of carotene-rich vegetables and to more than a kilogram
per day.
Sources: -
The animal foods of the richest sources of vitamin A, such as cod liver oil, butter, cheese,
whole milk, the meat does not contain only a little of it amounts, as is the fruits and green
leafy vegetables, tomatoes and carrots from the rich sources of carotene and whenever
the dark vegetables increased color content of beta carotene.
Daily need of it: -
Requirements vary from vitamin A according to sex, age and activity measured in the
nutritional value of vitamin A (Ritniol) International unit, which is equivalent to 0.3
micrograms of vitamin A and 0.6 micrograms of beta-carotene. the experts Organization
of FAO / WHO recommends that an individual's gets amounted to 750 micrograms
Children needed 300 micrograms and increase this amount to 575 micrograms at the age
of 10-12 years. For pregnant women, the 750 micrograms enough in the second half of
pregnancy and increase this amount to 1200 micrograms for women breastfeeding.
Vitamin D (Cholecalciferol): -
Called anti-disease rickets materials name, vitamin D which include many vehicles, but
the most important vitamin D2 Ergocalciferole and vitamin D3 cholecalciferol which is
mounted chemical (C24H44 O) as that vitamin D3 is made by a lipid called
7 - Dehydrocholesterol beneath the skin and this article transformed by exposure to the
sun's ultraviolet rays to vitamin D utilized the body. So the vitamin D3 available in nature
while vitamin D2 is not available in nature but attend both industrially and the same
nutritional value.
The studies conducted in the early twentieth century showed that patients rickets
improve their condition when given a bit of cod liver oil, which contains vitamin D, which
was attended by laboratories are pure in 1931 in England.
Vitamin D is absorbed from the intestine with fat, therefore, reduce the diseases of
malabsorption reduces of the body take advantage of what is in the food of this vitamin.

52
1. helps to absorb calcium and phosphorus from the gastrointestinal tract and plays a key
role in bone formation and deficiency causes blocking the absorption of calcium,
phosphorus, and thereby hardening does not happen to the bones naturally
(Ossification), especially when developing the parties and if the shortage continues to
happen curvature of the bones and abnormalities in the skeleton, and necessary for the
pregnant mother to get adequate amount of the vitamin during pregnancy for the
purpose of storage in the liver of the fetus, which is sufficient as a source of vitamin at
birth. To get the recommended amount for adults of vitamin D amounted to 240 mL of
milk must consumption and eating 30 grams of butter and 50 g of dark color and 100
grams of other vegetables and 100 grams of fruit and vegetables pose these quantities
basically good food
2. Vitamin D affects the over secretion of hormones secreted by the thyroid gland above,
which works to increase the concentration of calcium in the blood.
Increase the amount of vitamin D: -
This vitamin poisoning signs appear when the consumption of large amounts of it for a
long time, especially in children, setting off the symptoms are similar increase above the
thyroid gland activity, such as the high level of calcium in the blood and bone
calcification.
Sources: -
Frequently in animal foods such as fish that live in salt water and cod liver oil is one of the
richest sources it provides 200 micrograms in 100 mL. And there in the liver, butter, eggs,
but in small amounts either the mother's milk and cow's milk it contains small amounts of
vitamin D, and that plant-based foods do not contain this vitamin.
And that the most important sources inside is what makes human skin when exposed to
sunlight UV
Daily need of it: -

That the baby needed modern birth outweigh the contents of breast milk and cows so
must refueling by the experts of organization FAO / WHO recommends to take 10
micrograms daily of Cholecalciferol for infants and children up to the seventh year of life
and in order to prevent rickets. But difficult to achieve in practice because of the difficulty
of giving the child food naturally contains all this amount of vitamin therefore must be
given ready-made or butter food with a bit of caution in order not to increase the
quantity of about 10 micrograms and so in order to prevent the emergence of cases of
poisoning (hypercalcemia). Also can give the child a capsule of vitamin D containing a
dose of 5 micrograms, which ensures the prevention of rickets disease.
After the age of seven years old, it is recommended to take 2.5 micrograms per day of this
vitamin. The individual's normally needs to be 2.5 or vitamin Cholecalciferol .
Vitamin E: -
53
Called ((Tocopherols) scientists have been able to discover the four compounds have
chemical properties and effectiveness of vital convergent properties of vitamin E, the type
(alpha, beta, gamma, delta-tocopherol) and was isolated another type of natural
resources is called Abeslon and these compounds are fish oils are not affected by heat all
of which play an important role in nature as to prevent the corruption of oils and fats.
and type alpha-tocopherol is the strongest in terms of effectiveness and most vulnerable
delta tocopherol type.
Still its role in human nutrition is a clear limit now been discovered cases vitamin in
humans due to the availability of food, except in the pathogenesis of malabsorption
cases, I have observed that play an important role in the prevention of infertility in mice
Food sources: -
Frequently in natural products, whether animal or vegetable, such as wheat, vegetable
oils, soybean and cotton seeds, corn where contain quantities estimated at between 87-
140 mg / g which also is available a few percentages in eggs, liver, milk, fruits and
vegetables and that breast milk contains a fold it contains cow's milk.
Vitamin K: -
It is a combination of natural materials that are characterized anti-bleeding, naturally
found in two forms of this vitamin are
Vitamin K1 is located in the green leaves and vitamin K2, which is formed of bacteria in
the human gut, as has been prepared like compound vitamin K and unsurpassed
efficiency named K3 (Menadione)
It is necessary to form substance (Prothrombine) in the liver, so it is essential to the
process of blood clotting and cause a deficiency to slow this process and the continuation
of bleeding, as well as the use of this vitamin to treat the condition known
(Hypoprothrombinemia) in children newly born and the child may be injected after birth
directly with vitamin K to regulate blood clotting factors in the body. The shortage occurs
because of a lack of sources or ill-absorbed.
Food sources: -
That plants with dark green leaves color is the most important sources, especially
spinach, is also considered grains and legumes from good sources, but there are small
percentages in animal sources
Daily needs: -
The individual's needs to the amount ranging from 10-20 mg / day. The children,
especially infants whom they need to 2-10 mg / day, and this amount is provided by the
mother's milk, preferably dealing with pregnant mother in adequate quantity and up to
2-5 mg / day for the purpose of storage in the liver of the fetus or given immediately after
birth dose estimated 1-2 mg / day and for several days to raise the ratio of prothrombin
in the liver and until the bacteria that supply the body with some vitamin growth
Post test :- Explain the deficiency symptoms and sources of vitamin D
54
tenth unit
Water soluble vitamins
B – Justifications :- This unit is designed to identify the Water soluble vitamins,
Importance of water -soluble vitamins in the body
D- Central idea :- water -soluble vitamins . Symptoms of lack these vitamins in the body
daily requirements and sources of these vitamins

Collection.
Knowledge the types of water - soluble vitamins
The vital functions of all these vitamins in the body
Deficiency Symptoms of these vitamins
The daily needs and the food sources of these vitamins
Third :- Pre test :- Explain the food sources of vitamins ( B1 , B2 , B6, and vitamin C?
55
Water soluble vitamins
Scientists have discovered more than a dozen of water solubility vitamins it's have
properties soluble in water , and although they differ in their chemical composition and
physiological impact, However they are placed in the same group because of solubility in
water,
The first group, the deficiency cause particular diseases, The second, group are classified
as Co- enzymes,The third group, which is necessary for the formation of blood
Vitamin B1 (Thiamine)
some time named (Aneuvine) was isolated this vitamin in 1926 in the form of pure
crystalline substance, and that this vitamin contains sulfur, which is damage in the
basement food if stored for a long time, unlike acid food ,as well as losing a large amount
during (Rosting) and dissolved in boiling water
Functions and deficiency symptoms:
*- It plays an important role in the metabolic processes of carbohydrates it turns into a
coenzyme (Co-enzyme) called Thiamine pyrophosphate (T.P.P),
*-which has an effective role in the oxidation processes and the formation of carbon
dioxide(CO2) in the body,
*- the vitamin B1 is essential for keeping the health of nerves and deficiency lead to
nervous tension and loss of appetite and insomnia with fatigue and general weakness
Food sources: -
Found in many foods and the yeast consider a rich sources of this vitamin, as well as liver,
kidney, eggs, meat, legumes, vegetables and whole grains are good sources, and lose a lot
of the vitamin when the milling process and when peeling rice, so would prefer whole
meal, rice is peeled as the source of this vitamin.
Daily need: -
The need for this vitamin is closely linked to the level of energy food, and the amount of
carbohydrate intake due to the fact that this vitamin is essential to take advantage of
carbohydrates in body , so usual to express the need for thiamine by mg / per 1000
calories.
The Committee of experts of the organization FAO / WHO recommends to eat 0.4 mg /
1000 Kilocalories to the adult, equivalent to 1.2 mg for men's and to the women to 0.9
mg/day
Vitamin C: -
Scorbic acid is a white crystalline substance with an acidic taste, fast soluble in water and
fast oxidation, especially when direct exposure to air and light and the presence of
cofactors, and is considered one of the most powerful reducing agent in living tissue.
When oxidized convert into a non-ascorbic acid pH (Dehydroascorbiacid)
Absorbed: -
This vitamin, absorbs directly from the intestine quickly commensurate with the food
content of it, And it raises the surplus in the urine , but some organs such as the liver and
the some of glands that have the ability to store the vitamin to meet the body's need for
56
a short period. And taking 1500 mg of vitamin ,sufficient for the processing of the body
with 100 mg / day and this amount (1500 mg) is sufficient to prevent the emergence of
rickets disease for 90 days on a diet free of vitamin and when the amount reduced to
about 300 mg, the symptoms of rickets begin to appear.
this vitamin plays an important role in the oxidation processes in the body, particularly
with respect to amino acids,
*- as well as it facilitates the conversion of folic acid to effective folinic acid
contribute effectively in the absorption of iron from the intestine
essential for the formation of teeth, bones and collagen synthesis
found a close relationship between vitamin C and common colds and flu ratios.
severe deficiency leads to scurvy disease, which affects children and the elderly. And
which is characterized by weak association material of cells and tissues with general
weakness, swelling and weakness in the gums, tongue and bleeding in the body
The Infants more susceptible to this disease because the milk consider the poor source ,
so you should give children who fed artificial feeding (Bottle- fed) additional amounts
estimated to be 35 mg per day in the form of fruit juice
Food sources: -
The citrus-rich sources, as well as the vegetables such as peppers, lettuce, and tomato
considered a good source, but the animal product its poor sources.
Daily need: -
the committee of experts of organization (FAO / WHO) recommends that the addresses of
the individual amounts to 30 mg / day, and can provide this amount to eat half an orange
or a grain of tomatoes or a small amount of vegetables and 30 mg equivalent to three
times the minimum which is (10 mg) of vitamin C while USA recommends,
recommendations
the following
Children 10-30 mg / day
Man of 40-60 mg / day
Women amounting to 30-60 mg / day
Pregnant women 60 - 8 mg / day
Lactating women 60-80 mg / day.
Vitamin B2: -
Vitamin B2 (Riboflavin) is a yellow crystalline substance Not affected by heat but is
influenced by light
plays an essential role in the metabolic processes and the oxidation processes where
he works as assistant Co- enzyme.
enters in the composition of blood hemoglobin.
essential for the growth and health of the skin
57
And deficiency leads to the appearance of skin symptoms are characterized by
inflammation and redness of the lips and Stomatitis, as well as inflammation of the
cornea and conjunctiva.
Food sources: -
There is in most of the food is the most important food sources are liver, heart, meat,
kidney, and yeast also available in eggs , green leafy vegetables, legumes, of it
Daily need: -
The recommended amount by the FAO / WHO have to do the amount of energy intake in
food . the committee of experts of organization (FAO / WHO) recommend at least 0.60
mg / 1000 Kilocalories daily vitamin.
Vitamin B 6: -
It is a white crystalline substance does not analyses by heat, and there are three naturally
pictures of it convergent in composition and have the same vital influence and these
compounds are (pyridoxine, pyridoxal and pyridoxamin).
This vitamin found as Co-Enzyme for a large number of biological processes those
relating to the metabolism of amino acids. And related to the composition of unsaturated
fatty acids (such as arachidonic) which is important for the growth of children.
vitamin deficiency leads to the appearance of skin patches around the eyes, nose and
mouth. As well as allergy symptoms may appear when the infants fed on industrial foods
lacking this vitamin and who loses during the sterilization process or boiling.
Food sources: -
Frequently this vitamin in yeast, liver, meats, whole grains to soybeans and some
vegetables.
Daily need: -
Ranging from the daily need of the individual's between 1.2 - 2.1 mg . the studies have
confirmed that the amount of vitamin depend on the amount of protein in the diet, it is
about 1.25 mg when food containing 100 g protein, but this amount increased to 2 mg
when the amount of protein in food 170 gm.
Vitamin B12: -
This is called the vitamin (Cyanocobalamin), it's a crystalline substance, complex
installation ,slowly degrade when exposed to solutions of pH.
It's only vitamin in nature that contains the mineral element is associated with cobalt
(Cobalamin). It was possible to isolate in pure in 1948, studies have shown that this
vitamin is not absorbed from the intestine, However, the availability of a special protein
called (Intrinsic factor) which is secreted by the stomach walls naturally, and it seems that
this intrinsic factor binds vitamin B12 and absorbs both together, nor this vitamin is
absorbed unless there is food in quantities greater than 25 mg.
It seems that pernicious anemia patients' infected by type of decomposition in the
mucous membrane lining of the stomach makes it stops the secretion of intrinsic factor
58
which impedes vitamin absorption process and Leads to the appearance of the symptoms
of pernicious anemia.
*-Has an essential role in the maturation process of the red blood cells (RBC).
*-Affects of the formation of white blood cells
*- Enters in the composition of many enzymes in the installation of some of the nucleic
acids
The main symptoms of deficiency. The pernicious anemia (anemia Edison), which is
characterized by maturation of red blood cells in the bone marrow.
Food sources: -
Available in most animal food sources, and can be synthesized by the intestinal bacteria
and you quantities not sufficient to meet the need of it so the human depends on food to
meet their needs, and the plants you can not make this vitamin as they do not use it.
And the liver is one of the richest food sources it contains 30-120 micrograms / 100
grams, as well as kidney, eggs, fermented foods. While the milk it contains 3-5 mg / 100 g
only.
Daily need: -
The organization FAO / WHO recommends that deals with the individual's 2 micrograms
per day of vitamin.
Niacin: -
Called hindrance to Pellagra disease it is found in the tissues of plants in the form of acid
(Nicotinic acid). The (Niacinamide) or nicotinamide is amed derived like Nicotinic acid
more soluble in water and is located in the tissues of animals.
Plays an important role in the vital oxidation and reduction processes to foodstuffs in
living tissues to provide energy to cells of the body ,as an Assistant Co-enzyme .
The symptoms of deficiency causing Pellagra disease, which is the communities disease
that feed on corn mainly. And is characterized by symptoms of niacin deficiency by
(dermatitis, dementia ,diarrhea)
Food sources: -
This vitamin available in animal sources especially the liver, kidneys, heart , it's found in
the liver about 16-17 mg / 100 g, and in the heart, it's found by 7.8 mg / 100 g, and found
in peanuts, whole grains and vegetables.
Daily need: -
It's difficult to determine the need for daily because the niacin being manufactured in the
body from the amino acid tryptophan, where 60 mg of tryptophan equivalent to one mg
of niacin. Therefore usual to express the food content of niacin by (Niacin equivalent).
And the organization FAO / WHO recommends eating 6.6 of Niacin equivalent per 1,000
Kilocalories ,So the daily need has been estimated by 14.5 mg for adult women and 19.8
mg of a man's.
Folic acid: - It Pteroyl glutamic acid (PGA) is characterized as a yellow substance
crystalline ,dissolve in water, and facilitates analysis by heat and sunlight and acids, and
59
there is another compound in nature It's (Folinic acid) united with glutamik acid convert
in the body into a strongest folitic acid, especially when there are vitamin C.
the function of this vitamin not accurately determine in the body, but it's have an
important role in the formation and maturation of red blood cells because the deficiency
leads to the emergence of a severe type of anemia of type (megaloblastic) which is
characterized by increase the number of blood cells which have a large size .
Also has an important role in the formation of nucleic acids and some of the important
processes in the body representation.
Food sources: -
The vegetables that dark color the rich sources of this vitamin such as spinach, and the
liver is one of the richest sources of this vitamin
Daily need: -
the organization of FAO / WHO recommends to take 400 micrograms per day per adult
and an increased need when pregnant mothers.
Biotin: -
It is a crystalline substance ,fast soluble in water, is not affected by the heat, but it is
influenced by oxidation factors and acids and alkali , and this vitamin contains sulfur
This vitamin enters as Co-enzyme in the process of metabolic acids in the body, and in
the installation of unsaturated fatty acids
The deficiency symptoms appear in the form of inflammation and dryness of the skin, as
well as neurological symptoms such as fatigue and insomnia.
Food sources:
The liver, yeast and eggs of the richest sources, as well as peanuts, soybeans
Daily need: -
Ranging from the daily need of the individual's between 50-60 micrograms and children
between 20-40 micrograms, and that a balanced diet provides the amount of up to more
than 50 micrograms daily
Choline: -
This vitamin has crystalline form, it's fast soluble in water, resists heat, and it is an
important part of phospholipid compounds present in nerve tissue.
Enters in the metabolic processes of many of the vital compounds.
Works as a carrier for fat (Lipotropic factor) ,
prevents the deposition of fat in the liver.
Has an important role in the delivery of nerve stimuli
Food sources: The eggs, meat, cereals, pulses, milk and vegetables from the rich sources
Post test :- Talk about functions and deficiency symptoms of vitamin B12 ?
60
Eleventh unit
Micro - Minerals
B – Justifications :- This unit is designed to identify the micro-minerals
C- Central idea :- study of micro-minerals (Iron , Iodine ,Zinc) and deficiency Symptoms of
these minerals ?
Collection.
Knowledge the types of micro minerals spicily the Iron , Iodine and zinc
Absorption of minerals and the vital functions of micro minerals in the body
Deficiency Symptoms of these minerals
The daily needs and the food sources of these minerals
Third :- Pre test :- define the micro minerals , and why these minerals called by micro
minerals
61
Micro – Minerals (Iron)
The amount of iron in the human body's nearly (3 -4) g, and there are more than( 33 ) %
of this amount in hemoglobin, and the rest of iron are found in other parts of the body,
and in spite of meager quantities from iron ,but consider the most important nutritional
elements , as it is of essential importance to the life.
Iron absorption: -
The iron absorbed from the stomach and in the Small intestine, is that most of the
absorption is in the upper part of the small intestine, and that the iron is absorbed in his
reduced image (ferrous ) more than its oxidized image (ferric), and it seems that the iron
is reduced to ferrous after digestion, and absorbed in the acidic media especially in the
presence of vitamin C and in the presence of certain compounds containing on the
reductive groups, But does not know how it's done exactly.Iron absorption increases
when increased the concentration of hemoglobin and during the growth and pregnancy ,
and the iron absorption decrease when presence of phytic acid and oxalic acid and when
increasing phosphate. Does not absorb only 10% of the iron in grains, vegetables and
legumes only, and slightly more than the proportion of iron which absorbs from other
foods to 15% in fish and 30% in the animal meat. The body stores the equivalent of 15%
of the total iron intake, especially in the liver and is used when the body lack of
resources , the rest of iron goes into the blood to form hemoglobin in red blood cells. The
blood cells that analytic and what they hemoglobin, which is replaced every 120 days and
iron released from this process is not emptied out of the body, but mostly is secondly
used to configure hemoglobin new red blood cells , and the body loses only a small
amount of iron absorbed an estimated by one mg only a day through sweat, surface skin
cells, hair, urine and in faeces, while women losing approximately 14-28 mg during
menstruation so a daily average loss of 1 – 2mg .
Functions: -
1- enters in the installation Hemoglobin and Myoglobin
2- necessary for the transfer of oxygen and carbon dioxide
3- enters in the composition of some enzymes that act as catalysts in the oxidation and
reduction processes in the body.
Symptoms of deficiency: -Iron deficiency in the body known as anemia, deficiency occurs
either due to lack of iron in the food intake or when the pathogen cases which affecting
on the absorption of iron in the body.
Food sources: - all foods that intake by the Human provide significant amounts of iron,
but exceed the needs of the body. the rich sources of Iron (liver, dry yeast, kidney, green
vegetables yellow), also available in whole grains, fruits, and milk is considered poor
sources of iron.the daily food which intake by human, contains about 12-15 mg of iron ,
and this amount would be enough adult male needs but not enough to the women and
adolescent girls.
Daily need: -Daily need of iron is estimated at (5-9) mg for men but the women are
estimated need for 14-28 mg, and should be the amount of iron which intake during
62
pregnancy and lactation, same to the recommended amount for women who are not
pregnant and non-lactating of childbearing age, provided that you have stocks enough
iron . As for the babies, the iron needs increase before the end of the sixth month, so it's
best to give the baby food containing iron since the fourth month of life.
Iodine
That iodine is widespread in nature, and the body of human contain about 50 mg of
iodine, and that a necessary part of the hormone (Thyroxine) which regulates the growth
operations and the balance of the water and the metabolic of carbohydrates and regulate
all construction processes in the body.
Absorbed: Iodine-absorbed by Ionic form of intestine or united with the protein , but
quickly oxidizes in thyroid gland into iodine and after you take thyroid gland necessary
amount, which estimated at about 30% of it and the rest is excreted with urine.
When deficiency the iodine in the body due to deficiency the food intake or drinking
water or other reasons, the thyroid gland is trying to compensate by increasing the
secrete activity, and this leading to largest of thyroid gland , and so called simple or
endemic goiter. This disease is wide prevalence in the mountainous areas, and deficiency
the Iodine leads to reduce the level of food metabolic and stupidity and idiocy.
Food sources: - The best sources of iodine it's sea water, fish, vegetables which grown in
iodine-rich soil. Can be used food salt by adding 0.01% of potassium iodide or iodate .and
the salt output is called Iodized salt , and the milk and eggs consider a good sources of
iodine, while cereals and pulses, it contains a low amount of iodine.
Daily need: -The daily requirement of iodine is estimated at 0.14 mg for adult men and
0.10 mg for adult women, and the children in the growth period and pregnant and
lactating mothers stage they need more than that amount . By time and a half .
Zinc
The zinc found in the all living organisms and is one of the important elements in human
nutrition, the adult human body contains about 1.4 - 2.3 g of zinc, it's enters in the
composition of many enzymes in the body, which is necessary in the gas transfer process
(carbon dioxide) in the mouth and in the concentration of hydrochloric acid ( Hcl) .
Symptoms of deficiency are occurred rare, they include a deficit in growth.
Absorbed: -The body may absorb harmful quantities too much of zinc as a result of acidic
foods which cooked in iron pots.
Food sources :The animal food such as ,(liver , milk, eggs, meat ) consider a rich sources
of zinc. Also found in whole grains but lose large amounts of it during milling.
Daily need: - the daily need of a man estimated of about 2.2 mg / day and the needs of
children in the role of growth and pregnant and lactating mothers to more of that .
Post test :- what is the deficiency Symptoms of Iodine , and what is the daily needs
from this element to the human
63
Twelve unit
Nutritional needs during the stages of life

B – Justifications :- This unit is designed to Knowledge the nutritional needs during the
stages of life
C-Central idea :- Studying the nutritional requirements during the different life stages
of human
Collection.
Knowledge the daily nutritional needs to the Infant
Knowledge the daily nutritional needs to the Weaned child
Knowledge the daily nutritional needs of children at the age of 2-6 years
Knowledge the daily nutritional needs of
Third :- Pre test :- comparison between the Breast-feeding and Bottle feeding
64
Nutritional needs during the stages of life
Infants
The breast milk is the best food for the newborn baby, and in developing countries are
the children who do not get the mother milk , he suffering of delay in growth , and
malnutrition diseases
Breastfeeding: -
The feeding process is subject to certain instinct and specific physical factors, from the
Physically speaking the breast feeding process which control of it the endocrine glands ,
and by vehicle of hormones group such as prolactin, which stimulates the secretion of
milk , when the child suckle from the breast , and the stimulation by breast touching
stimulates the secretion of prolactin which leads to the milk secretion, and the first days
after birth are considered essential in order to entrench breastfeeding . the child should
be placed on the breast at the earliest opportunity after the birth, and the more frequent
feeding the newborn from the mother's breast leads to production greater amounts of
milk ,and this is preferred to allow of the infant- at feeding on demand, and is not bound
to a specific system . found that children who are breastfed at frequent intervals they
grow and increase in weight better than children who are breastfed at spaced intervals.
As well as the frequent close contact between the child and the mother creates an
atmosphere emotionally and encourages the establishment of a good relationship
between the mother and the child and helps to continue the breastfeeding .
Breast-feeding: It is the practical way to feed children, in addition ,they Provide all the
nutritional and psychological needs of the child, it is a cheap source and
inexpensive.
Bottle feeding: it is expensive process and free of immune factors, and committed many
mistakes in the preparation, installation and in the sterilize the bottle ,
and cause infection to the infant by frequent diarrhea and malnutrition .
*- The studies have confirmed that breastfeeding is very important, even if for a short
period because it protects the child ,through feeding on the colostrum( the first milk is
excreted after birth and that appears before the regular milk production) and this
colostrum is useful to a large extent, because it content on antibody, so it protects the
children from diarrhea, measles and cough whooping .
*- at first , begin secretion of normal milk even begin the breastfeed. That the amount
of milk needed by the baby is increasing with the increase growth, and that most of
the mothers they secretion enough amounts of milk to satisfy the nutritional needs
of the child during months 4 to 6 the first of his life,
65
*- we can know, what obtained the child from milk , by weighting before and after
feeding ,so we can account the energy which obtained in the day, and the regular
increase in the weight of the child consider evidence on the success of breastfeeding.
And the best thing for the child it's continue the feeding process for as long as
possible , the specialists in nutrition recommended to continue the breastfeeding for
a period at least one year.
Weaning:-
It meaning, prevent the child off taking breast milk. where the babies grow at different
rates and their needs vary, but it generally, the mother must begins give the child the
additional food to be completed the mother's milk at age 4 - 6 months.
Where the child at this age need to be more of the foods that contain on the iron and
vitamins to achieve good growth.
as well as this additional food which give to the child, must continue breastfeeding as
long as possible and regardless of the quality of the food, and by introducing additional
food to the baby the mother begin to accustom the child to a new style of eating and she
begin a gradual weaning process.
*-to provide the supplementary food for the baby at an early age reduces the child's
dependence on the mother's milk and this leads to early weaning in addition to the
child's unwillingness to reduce these foods.
*- the child is exposed in particular to malnutrition and diarrhea during the period of
weaning, in the weaning the mother should be gradually give the child a diet of pure
food once a day and then increase the number of meals ,this food can be the basis of is
grain, vegetables, fruits, milk and Potatoes, and prefer add a little sugar to the food in
order to become a sweet taste
he child accustomed gradually on these foods can be added more nutrients to the food
which eat by the family, here should be added slowly, such as fish, eggs, meat, and so the
child gets used to the different tastes and flavors of foods.
*- Because the child now be has some teeth, so, do not need to mash the food , but offers
him a half-mashed and this will encourage the child to the chew , and when the child
starts his desire to get more food must be given that and leaves the estimation of
quantities according to the child's appetite and needs
can track the safety of nutrition by comparing the length and weight of the child with
standard length and weight of the children in the same age.
Feeding children at the age 2-6 years:
Slowing growth in this period and up to the age of adolescence, so the growth rates are
lower than they were in the first year of life, this period is characterized by irregular
growth, and this affect on the child's appetite to eat.
66
The increase in weight ranging from 1.8 - 2.3 kg per year which is equivalent to 300 grams
per month. And that the child's in pre-school years of grows relatively more in length and
becomes longer and thinner.
Nutritional needs during this stage of life: -

1. Energy: -
the best indicator to determine the energy needs of this age is overweight. The
demand for energy great at this stage, the child in the age of five year consumes 5% of
the total energy to the basic metabolic and nearly 25 % of the physicist activity. And
during this stage the baby weight ranges between 13-20 kg.
The proposed daily allocations estimated at 100 calories / kg BW / day for children age
1 - 3 years . and then landing requirements to 90 calories / kg of body weight / day for
children aged 4 - 6 years. And these needs vary greatly among children may need a
half or double of assessed needs.
2- Fat:
is one of the important sources of nutrition in children because they contain essential
fatty acids for growth, but would prefer not a lot of them
3- Protein: -
The protein consider an essential component of the growth, the decisive factor in
determining the needs of the child is the child's growth pattern.
The allocations estimated by 23 g / day for children at age 1 – 3 year and by 30 g /
day for child at age 4- 6 years.
4- Calcium:
The minerals needs depends on the rate of growth, Between the age of 1 - 6 years,
the calcium Stores in the body by 75-150 mg / day, and determine the daily needs of
approximately by 800 mg / day.
5- Iron:
The importance of iron is necessary to form hemoglobin, and the needs of iron
was estimated with about 15 mg of a child aged 1 -3 years, and then decrease
these needs to 10 mg to the child at age 4- 6 years.
6- Vitamins:
Vitamins allocations be higher during this phase, and vitamin deficiency symptoms
appear more clearly in children, including adults in the case of the food shortage in
the provision of vitamins in the family diet, so, prefer to provide additional
amounts of vitamin A, D, C.
67
Adolescence Feeding
the nutritional needs of adolescents are changing significantly during this age because of
the rapid explosion(spurt) in growth that occur during the puberty.
At this stage, the chronological age is not wholesome to identify food needs, and appear
instead the role of physiological age, which takes into consideration the individual
differences between the girls and boys because of differences in the basic Metabolic
rates. The body at this stage is growing very rapidly until maturity the reproductive
organs , and this is occur in early age in the girls while the boys are delaying about them,
so, the nutritional needs of girls are different from the needs of the boys at this age.
*- The growth is responsible for the increase in weight and height , whereas the length
estimated by 20 cm and the weight gain is equivalent to 19 kg.
In fact there are no sufficient information about nutritional needs at this stage of life,
and the recommendations and requirements based on speculation only , at this stage the
adolescents are slanting to getting away from the family and the usual family-style.
*-while in the adolescent girls, the obesity and anemia are consider of the most
important problems of malnutrition at this stage, as well as the problems of the thyroid
gland that may appear in adolescent girls in some parts of the world .
Food needs:
Energy: -
increasing the energy needs in this stage ,and the energy needs are rising from 1300
calories in the age 3 years for up to 2500 calories at the age of ten years , and after this
age we show un individual differences between girls and boys, so, we show the energy of
the boys increasing until become 3100 calories at the age of 13-15 years and then rises
to 3600 calories at the age of 16-19 years, comparison with 3200 calories only at the age
of 25 year, while the girls their consumption less from energy where estimated by 2600
calories in the age of 13-15 years and declined to 2500 calories at the age of 16-19 years
comparison with 2200 calories only, at the age of 25 year.
Protein:
the adolescent needs of protein, be large due to the construction of the muscle tissues
and increased the blood volume, and must be exist in food by proportions which
needing it the body in order to prevent depletion it at least to generate energy until by
form in part , so , the needs to be increasing the proteins gradually from 40g to 70 g per
day at the age of 12 years for boys and more than 85 grams per day at the age of 13-15
years and to 100 grams per day at the age of 16-19 year, comparison with 70 grams for
adults only.
As for the girls needs from protein estimated with 80 grams per day in the age of 13-15
year and about 70 grams per day in the age of 16-19 year.
Minerals :-
68
Adolescents needs from minerals are Increasing and in particular(calcium), the
requirements about 1.4 grams per day for boys in the age of 13-19 year, and girls
requirements are estimated by 1.3 grams per day in the same age. as well as increase the
requirements of Iron where estimated to 13-15 mg per day at the age of 13-19 year for
boys while the girls requirements from Iron be higher than this amount.
Vitamins :-
There is a particular need for vitamin D to ensure calcium and phosphorus absorption and
bone formation, as well as the increasing need for vitamin B, especially when the boys to
provide the growing demands for energy metabolic and to assist in muscle growth .
Post test :- Talk about the energy needs at the age 2-6 years?
69
Thirteen and Fourteen Unit
Nutrition for pregnant women

B – Justifications :- This unit is designed to Knowledge the nutritional needs of pregnant
women
C-Central idea :- Studying the nutritional requirements of pregnant women , and
Physiological changes in pregnancy
Collection.
Knowledge the daily nutritional needs to the pregnant women
Third :- Pre test :- why is occur an increase in pregnant women weight?
70
Nutrition for pregnant women
The feeding of pregnant women has an important influence on the pregnant women
health and child health to ensure the maximum opportunities for growth and
development of the fetus and stay alive, and there are interventions should be done even
before the child is made in the mother's uterus. The medical studies it confirmed that the
mother's health is closely linked with the child's health, and malnutrition of pregnant
women leads to giving low birth weight , as these studies also confirmed that the birth
weight in developed countries Greater than the birth weight in poor countries
From the first moment of pregnancy and until the end of the first months of the child's
life , the child to stick to his mother he takes all growth requirements from his mother,
so the healthy nutrition of the mother before pregnancy ,consider an important factor it
affect the fetus nutrition , and the body of the pregnant is subjected to hormonal and
physiological changes ,and this change is impose on the pregnant women were received
proper balanced diet.
Physiological changes in pregnancy:-

the pregnant she passing since the first day of pregnancy with developments and multiple
changes, and most importantly ,increase the blood flow to the uterus and placenta ,for
providing the fetus of oxygen and nutrients and this flow of up to 500 cc per minute in
the last month of pregnancy ,comparison with the 52 cc per minute during the third
month of pregnancy, as well as changed the efficiency of kidney to put products of
metabolism. And appearance some symptoms of diseases such as high blood pressure
and diabetes .
So should be doing the periodic tests for pregnant women in order to ensure the safety
of the pregnant woman and the fetus, and give him health guidance on nutrition during
the pregnancy period and how to get adequate food and rest , also should receive a
pregnant woman from the worker in the field of maternal and child care ,appropriate
advices about how to prepare for breastfeeding and infant care
The increase in pregnant weight: -
The rate of increase of weight during pregnancy, ranging from 11 - 12.5 kg, and that this
increase is distributed to the various tissues of the body, that is better to increase in the
weight of the pregnant it's 3.6 kg during the twenty-first week and then increase the
weight about 450 grams per week to reach to the increase 12. 5 kg throughout the
pregnant women body .
The basic metabolism rate increase by 20% in the last three months of pregnancy, and
the pregnant , stores energy in the form of fat in the physical tissue when feeding be
good, this amount of fat is estimated at about 4 kg which is equivalent to 35000
71
kilocalories ,and this is consider a reserve sufficient to breastfeed the child for a period of
4 months by rate about 300 kilocalories per day.
When the food was a little during the pregnancy the increase in weight are also a little ,
may be the average of increase only 6.5 kg comparison with the 12.5 kg in normal
pregnancy, and most of this increase is due to the weight of the fetus and placenta, and
therefore the real increase in the weight of the mother to be a little . The mother who
breastfeeds her child used this increase for milk production, and constantly to
breastfeeding, the fat energy in the body it converted the to produce milk. And most
mothers who do not breastfeed, they have maintained a stock of this energy and become
unable to restore normal weight easily ,and there is a tendency to obesity with repeated
pregnancy.
Food needs
The pregnant during pregnancy period she need to more food , and she need to have a
balanced diet and this depends on a variety of food, and in fact, and what the mother
eating varies from one community to another, depending on dietary habits to
community and what is available of local foods , Whatever the case, the mother should
be distributed additional food on three or four meals a day instead of the main one meal.
Nutrients The rate of increase of the pregnant from the The rate of increase of the
age of 19-23 years pregnant from the age of 23 years and more
Energy (Calories) 14 % 15 %
Riboflavin 21 % 25 %
Vitamin A 25 % 25 %
Thiamine 27 % 30 %
Vitamin C 33 % -
Calcium 50 % 50 %
Folic acid 100 % 100 %
Protein 65 % 65 %
Energy: -
The U.S.A food allocations, recommends an increase of 300 kilocalories per day during
pregnancy, but experts committee of organization FAO/WHO recommended an increase
of 150 kilocalories per day during the first three months of pregnancy and an increase of
350 kilocalories per day during the last six months and this means an increase of 285
kilocalories per day during pregnancy. Thus, the total energy needed to meet the
additional needs of the pregnant is about 80000 kilocalories, and the activists mothers
they need more energy. And the others mothers ,reduce of activism somewhat during
the pregnancy , and for this to not be needed to the extra energy, amounting to 80000
72
kilocalories, and the pregnant mother should try to reduce its activity during this period,
as it helps to retaining the energy has a special importance where food is scarce
Protein: -
The pregnant woman needs of protein it increases to confront the requirements of
growth the fetus and the increase in Mother tissue, and approximately 950 grams of
protein storing in the tissues of the fetus and placenta during pregnancy stages ,mostly
during the last six month of pregnancy, and it's equivalent to 5 grams per day.
the experts committee of organization FAO/WHO has recommended an increase of ( 9 g)
per day, while the proposed allocations equivalent (29 g) per day . And the total protein
needs to be (38 g) per day, preferably protein be of good quality, such as milk, eggs and
meat
Calcium: -
found at birth the fetus stores from calcium is amounted to (23 g) mostly were stored
during the last month of pregnancy, and the fetus gets from the mother about 50 mg per
day during the third month and increase the quantity to 120 mg per day during the
seventh month, even up to 450 mg per day during the last month, that calcium needs
were estimated by balancing studies, and estimated by 1000 - 1200
Iron: -
The pregnant woman may need large amounts of iron and especially during the last six
months, and the menstruation stops provides more than 5 mg of iron storing in the fetal
tissues and in the mother's blood, and during the last stage of pregnancy, the blood
volume in pregnancy is increased by ratio 32% or more, at the same time there is an
increase in plasma volume by 40%, and the concentration of hemoglobin in the blood
during the normal pregnancy is 11 g / 100 cc from the blood , and this ratio is considered
normal , for dilution of blood that gets during this period and it is called the
physiological anemia in pregnancy . The needs of iron during the pregnancy was
estimated at 565 mg, the experts commission of organization FAO/WHO recommended in
the amount of 14 mg daily if the animal foods proportion constitute 25 % of the total
energy and the total recommended amount of 19 mg daily if they animal foods
,proportion constitute 10 -25 % of total energy
and recommended to take 28 mg daily if they animal foods proportion accounted for less
than 10% of the overall total energy, and these amounts are necessary for the storage of
iron in the liver of the fetus enough for three months after birth, and when you do not
iron provide adequately in food with no stocks enough in mother the needs up of 30-60
mg per day.
Vitamins:
73
The pregnant need in particular to the increasing amounts of vitamins A, B. C.D ,the rich
foods include legumes, vegetables, meat and fruit, as well as the need to large amounts
of folic acid
Post -test :- Explain the needs of protein to the pregnant women?
Fifteen Unit
Nutritional requirements of the Lactating Female
B – Justifications :- This unit is designed to Knowledge the nutritional needs of Lactating
women
C-Central idea :- Studying the nutritional requirements of Lactating women from
different nutrients

Collection.
Knowledge the daily nutritional needs to the Lactating women
Third :- Pre test :- there are some factors affecting milk production , enumerate these
Factors?
74
Nutritional requirements of the Lactating Female
=Lactation is nutritionally demanding especially for the mother who is nursing her infant
exclusively for several months .
Milk production is affected by
1- frequency of sucking
2- Maternal hydration
3- Prolactin hormone
Energy:-
RDA for energy is 500 Kcal grater during the first and second 6 months of lactation. obese
and overweight , may not need to add the entire extra calories required .
Explanation
Production of 100 ml of milk requires by 85 Kcal expenditure.
In the first 6 months of Lactation:-
• during the first 6 months of lactation , the average milk production is 750 ml/ day .
So total energy required daily for milk, production
= 750 × 85 / 100 = 637.5 Kcal/day
• Deposited fat in pregnancy will provide the following calories .
3000 g fat × 9 = 27000 kcal
So if pregnancy fat deposits are utilized in the first 6 months (180 day) of lactation ,
then DAILY energy extracted from these store
= 27000/ 180 = 150 kcal/day.
By subtracting 150 kcal from the 637.5 kcal 637.5 150 = 487.5
the additional daily energy needed during the first 6 months of lactation
will nearly equal 500 kcal / day .
In the second 6 months of lactation:-
• Average milk volume produced daily = 600 ml
• So DAILY energy required for milk production daily
• = 600 × 85 / 100 = 510 kcal
Since stores of fat deposited in pregnancy have been used in the first trimester.
So the lactation mother will need an additional
500 kcal/day in the first and second 6 months 0f lactation
75
• It is advisable to maintain energy intake at 1800 kcal / day to drink an ample amount
of fluids (2 3 L / day ) , especially in hot weather .
*Breastfeeding mothers can lose as much as one pound / week , and still supply an
adequate amount of milk .
• Protein : additional 10 - 25 g / day
• Carbohydrate : is estimated to be 210 g / day
Fat requirement:-
The Fats constitute 25 30 % of total energy intake, polyunsaturated fatty acid
(PUFA) are present in all cell membranes .The fats essential for brain and retina
development of the infant and fetal brain, half of (PUFA) are omega 6 FA , and half are
omega 3 FA
The main sources of omega 3 FA are:-
1- Cold water fish
2- Flax seed oil
3- Walnuts
4- Supplements
• 2 -3 meals with fish per week can provide the pregnant female with
adequate amount of DHA .
*: Recent researches suggest restricting certain type
of fish during pregnancy and lactation (due to mercury content) .
*: The only unrestricted source of cold water fish is
sardines
Whom to Supplement ?
1- the severely undernourished mothers with
underweight and low milk volume.
2- Vitamin D supplements to mothers not exposed to
the sun
3- Calcium supplements in case of inadequate intake
(1300 mg) for pregnant and lactation females.
4- Vitamin B12 in vegetarians and those with
Malabsorption .
Because amenorrhea is common in breastfeeding women , no supplemental Iron is
needed during lactation
Post- test :- explain the energy requirements In the first 6 months of Lactation?
76
Sixteen Unit
Nutritional needs of the elderly
B – Justifications :- This unit is designed to Knowledge the nutritional needs of elderly
C-Central idea :- Studying the nutritional requirements of elderly ,and some of general
guidelines for improving food behavior

Collection.
Knowledge the daily requirements of different nutrients to the elderly
Third :- Pre test :- give some of general guidelines for improving food behavior for
the elderly ?
77
Nutritional needs of the elderly
Energy :-
With age the energy needs less gradually at this stage the calories of the man is equal to
or less than 2547 calories, and women equal to or less than 2039 calories, The reason for
the decline in the nutritional needs of the elderly this is due to two reasons:
*-first: the lack of physical activity,
*- Secondly: the low proportion of muscle tissue, which reduces the rate of energy
consumed for Basal Metabolism
And the energy needs vary from person to person depending on body size, activity level,
nature or atmosphere in which the person lives.
Proteins:
Daily allotment of food recommended for anyone largest age of 51 years is that:
the man 63 grams and women 50 grams and is approximately the same provisions for
young people . Because the protein allowances for the elderly and young people equal,
but the amount of calories for the elderly less, so must gave large amounts of proteins
to the elderly in the daily diet are with a note, not over as the increase of the protein
increases the burden to ask urea.
Fats:-
Fat. as is the case for other age group, there is no daily food allowance for fat, but the
digestion and absorption of fat may be slow in the elderly.
Carbohydrates:-
Preferably the reduction of simple sugars with increasing complex sugars consumption for
the elderly, because the processed foods from the kinds of carbohydrates are usually
good sources of other nutrients, and because their use could add fiber element to the
food, which helps them to get rid and avoid constipation as they contain calories less of
other foods that are sources of monosaccharides.
Vitamins
can to get the elderly need from vitamins if they eat different types of food in the sense
that food contains elements of the four groups.
Is affordable enough for vitamin (D) during aging (5 micrograms per day) for both sexes ..
There are several reasons for the increased need for vitamin (D) of the most important:
*-The vegetables and fruits are usually not part of the food but the elderly eating it ,
78
*- some of them do not eat brown bread and grain , as well as to avoid some foods which
exposes them to infection with symptoms of Vitamin deficiency
*- some of them take laxatives, which works to reduce the body's absorption and take
advantage of vitamins .
*-Lack of exposure to the sun and stay in the home or the hospital does not get vitamin D.
*- Not drinking milk increases the chances of exposure to a lack of vitamin D.
vitamin A
the elderly, need to eat nutrients backed vitamin (A) consider a few , but care should be
taken to eat sufficient quantities of food rich in this vitamin
Vitamin (E), vitamin (C)
must secure sufficient quantities of them for the elderly and their importance in order to
increase the body's immunity.
Vitamin B12:-
Increasing the need for this vitamin in the elderly with rheumatoid atrophic gastritis,
which results in a lack of acid secretion in the stomach. Due attention to severe vitamin
(B12) in the elderly because the lack of vitamin D deficiency in the body is not reflected
down its concentration in the blood, but an increase in homocysteine and
methylmalonate acid concentration.
It has been found that many of the elderly people with symptoms of dementia which
suffer from vitamin B12 deficiency.
There are some vitamins that older people need (less to a thiamine, riboflavin, niacin) .
Minerals
Sodium:-
Less intake of sodium quantities during aging than 1300 mg to 1200 mg per day for both
sexes, where intake of sodium has been linked to high blood pressure level. High level of
sodium in the blood affects on the thirst receptors in the brain, making the person feel
thirsty and addresses a large amount of water come out with urine.
Therefore advised not to increase in sodium intake to no more than 2300 mg, the highest
level to take affordable (Tolerable Upper Intake Level) (UL) of sodium.
Chlorine:-
should be decrease of intake quantities of chlorine during aging stage to 2000 mg or
1800 mg per day for both sexes ,where excessive intake of chlorine may result on high
blood pressure in some individuals.
79
So it is advisable not to eat the increase in chlorine for 3600 milligrams per day, the
highest level to carry affordable of chlorine.
Calcium:-
the daily needing of calcium of the body estimated by 800 milligrams ,and not
recommended to raise this standard, because the ability of the elderly to absorption of
calcium less with age, as well as he gets them an increase in loss of bone mass, and the
loss of calcium in the urine.
Zinc:-
The Zinc intake is often less than the recommended, may be due to lack of zinc in the
body resulted from the some health status or as a result of taking certain medications
that reduce the absorption or increase of ejected. also that the increase of zinc intake
may lead to irritation of the digestive system, and a lack of iron, copper, and increased
cholesterol in the blood (Hypercholesterlemia) , also reduces the functions of the immune
system
You must also take into account that the elderly susceptible to a lack of zinc, calcium, so
you must provide in food and cover their needs them.
Iron:-
The anemia is not common and widespread among the elderly, as it was believed in the
past, but still get him some, especially those who do not have access to foods rich in iron,
such as liver, meat, as well as not eating enough of the fruits and vegetables ,which rich
by vitamin (C) and that helps the absorption of iron.
Fiber and water
Elderly people should get on foods rich in fiber such as vegetables, fruits, brown bread,
cereals, which helps them to avoid constipation and avoid other problems, as well as
drinking water is very important to them, then they have eight cups of water a day.
Health problems:-
a lot of people exposed in the last years of life for the injury to one or more of the health
problems associated with the food their condition .including .
* Deficiency of the protein and energy
* Obesity
* Cardiovascular disease
* Lack natural immunity and aging
* Structural device affected in the elderly
* Hormonal balance disorder
* Gastrointestinal tract disorders
General guidelines for improving food behavior for the elderly:-
*-Eating regularly, preferably the Small Consecutive meals
*- Investigated the favorite foods, and methods that provide voltage processing food.
*- Experience new foods, not only to eat normal food or canned .
80
*-Prepare a feast from time to time, perhaps a steak, or fresh fruit .
*- Eat in place or move a sunny place, and set the table in Attractive place.
*- Preparing food.
*- If possible eating with friends, relatives, or in a popular area .
*- Participation in the responsibilities of cooking with members of family .
*- The use of public means had to shopping, and care of the daily requirements
*-Maintaining on the body activatey.
Experience a new way to prepare food.
*-Method of cooking oven and boiled and avoid cooking the complex foods
*-Try to pick a time to prepare food by hand for some time, and that when the level of
activity reduces .
We must not forget two main factors:-
*-The first post elderly meal, to encourage him to eat, one of the reasons for the lack of
eating.
*-Second, take him for a walk, moving and exposed to sunlight necessary for the health of
bones.
Post test : give simple idea about the daily needs to the elderly of vitamin B12?
81
Seventeen Unit
Vitamin A and Beta-Carotene
B – Justifications :- This unit is designed to Knowledge the roles of vitamin A in the Body,
and symptoms of vitamin A deficiency
C- Central idea :- Studying the Important of vitamin A in the body And studying the
of this vitamin deficiency symptoms
Collection.
Knowledge what is the Retinoids
Knowledge the functional roles of vitamin A and deficiency symptoms of this
Vitamin, causes of deficiency
Knowledge the daily requirements of vitamin A and recommendations.
Third :- Pre test :- explain the role of Vitamin A in Vision?
82
Vitamin A and Beta-Carotene
• Also known as retinol, retinal, retinoic acid
• Vitamin A is found in the body in compounds known as retinoids: retinol, retinal,
and retinoic acid.
• These have functional roles in vision, healthy epithelial cells, and growth.
• Vitamin A deficiency is a major health problem in the world.
• Toxicity is often associated with abuse of supplements.
• Plant foods provide carotenoids, such as beta-carotene, some of which have
vitamin A activity.
• Animal foods provide compounds that are easily converted to retinol.
• Retinol binding protein (RBP) allows vitamin A to be transported throughout the
body.
• Roles in the Body :-
• Vitamin A in Vision
• Helps to maintain the cornea
• Conversion of light energy into nerve impulses at the retina
• Rhodopsin is a light-sensitive pigment of the retina that contains a
protein called opsin.
 Vitamin A in Protein Synthesis and Cell Differentiation
• Through cell differentiation, vitamin A allows cells to perform specific
functions.
• Epithelial cells
– Epithelial tissues on the outside of the body form the skin.
– Epithelial tissues on the inside of the body form the mucous
membranes.
 Vitamin A in Reproduction and Growth
• Sperm development in men
• Normal fetal development in women
• Growth in children
• Remodeling of the bone involves osteclasts, osteoblasts, and
lysosomes.
– Osteoclasts are cells that destroy bone growth.
– Osteoblasts are cells that build bones.
– Lysosomes are sacs of degradative enzymes that destroy bones
 Beta-Carotene as an Antioxidant
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• Beta-carotene helps protect the body from diseases, including cancer.
Vitamin A deficiency:-
 Vitamin A deficiency is a lack of vitamin A in humans. It is common in developing

countries but rarely seen in developed countries
 Night blindness is one of the first signs of vitamin A deficiency.
 Night blindness is the difficulty for the eyes to adjust to dim light. Affected
individuals are unable to distinguish images in low levels of illumination. People
with night blindness have poor vision in the darkness, but see normally when
adequate light is present.
 Because vitamin A is stored in the body, it would take a year or more to develop a
deficiency in the presence of inadequate intake.
 Infectious Diseases
 Impaired immunity correlates with vitamin A deficiency in children.
 The goals of worldwide health organizations include vitamin A supplementation.
Night Blindness
 First detectable sign of vitamin A deficiency
 Inability to see in dim light or inability to recover sight after a flash of bright light
 Vitamin A Deficiency
 Blindness
• Xerophthalmia is blindness due to vitamin A deficiency.
• Xerosis is the first stage where the cornea becomes dry and hard.
• Keratomalacia is the softening of the cornea.
 Keratinization
• Epithelial cells secrete a protein called keratinthe hard, inflexible
protein of hair and nails.
• Changes in epithelial cells results in keratinization, rough, dry and scaly
skin.
 Deficiency disease is called hypovitaminosis A.
 Xerophthalmia
Which is a medical condition in which the eye fails to produce tears
that leads to conjunctival dryness and damage, complete blindness
can also occur since Vitamin A has a major role in phototransduction.
 Phototransduction
Is a process by which light is converted into electrical signals in the
cells of the retina of the eye
 Vitamin A deficiency also diminishes the ability to fight infections.
In countries where children are not immunized, infectious disease
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like measles have higher fatality rates.
 Even mild, subclinical deficiency can also be a problem, as it may.
- Increase children's risk of developing respiratory and diarrheal
Infections.
- Decreasegrowth rate.
- Slow bone development.
- Decrease probability of survival from serious illness.
Causes of vitamin A deficiency :-
The major cause is diets which include few animal sources of pre-formed vitamin A
Breast milk of a lactating mother with vitamin A deficiency contains little vitamin A,
which provides a breast-fed child with too little vitamin A.
In addition to dietary problems, there are other causes of vitamin A deficiency
Iron deficiency can affect vitamin A uptake.
Excess alcohol consumption can deplete vitamin A
A stressed liver may be more susceptible to vitamin A toxicity.
Hypervitaminosis A
Hypervitaminosis A refers to the effects of excessive vitamin A) specifically retinoid)
intake
Hypervitaminosis A occurs when the maximum limit for liver stores of retinoids is
exceeded.
The excess vitamin A enters the circulation causing systemic toxicity.
Betacarotene (is an organic compound which is a strongly-coloured red-orange pigment
abundant in plants and fruits. β-Carotene is also the substance in carrots that colours
them orange) a precursor of vitamin A, is selectively converted into retinoids, so it does
not cause toxicity.
Other effects:-
Birth defects
Liver problems
Skin discoloration
Hair loss
Excessive skin dryness
Angular cheilitis is an inflammatory lesion at the labial corner of the mouth, and often
occurs bilaterally. The condition manifests as deep cracks or splits. In severe cases, the
splits can bleed when the mouth is opened and shallow ulcers or a crust may form.
Retinoids:-
The retinoids are a class of chemical compounds that are related chemically to vitamin A.
Retinoids are used in medicine, primarily due to the way they regulate epithelial cell
growth.
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Retinoids have many important and different functions throughout the body including
Roles in vision
Regulation of cell proliferation and differentiation
Growth of bone tissue
Immune function
Activation of tumor suppressor genes.
Vitamin A Toxicity
 Can occur with concentrated amounts of the preformed vitamin A from
animal foods, fortified foods, or supplements.
 Consuming excessive amounts of beta-carotene from supplements can be

harmful.
 Bone Defects
• Increased activity of osteoclasts causes weakened bones and
contributes to osteoporosis and fractures.
Signs of acute toxicity include
 Nausea
 Vomiting
 Headache
 Blurred vision
 Loss of muscular coordination.
 Birth Defects
-Teratogenic risk is possible, resulting in abnormal fetal development and
birth defects.
-Vitamin A supplements are not recommended the first trimester of
pregnancy.
 Not for Acne
- Massive doses for teens are not effective on acne.
- Accutane is made from vitamin A, but is chemically different. It is toxic
during growth and can cause birth defects.
- Retin-A fights acne, the wrinkles of aging, and other skin disorders.
 Toxicity disease is called hypervitaminosis A

 Chronic toxicity symptoms include liver abnormalities.
 Acute toxicity symptoms include blurred vision, nausea, vomiting, vertigo,
headaches, and pressure in the skull.
 Upper level for adults: 3000 μg/day.
Vitamin A Recommendations
Vitamin A Recommendations (2001 RDA)

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 Expressed as retinal activity equivalents (RAE) because sources include all forms of
retinoids and beta-carotene.
 RDA men: 900 μg RAE/day.
 RDA women: 700 μg RAE/day
Vitamin A in Foods:-
 Retinol is found in fortified milk, cheese, cream, butter, fortified margarine,
and eggs.
 Beta-carotene
• Spinach and other dark green leafy vegetables (chlorophyll pigment
masks the color)
• Deep orange fruits like apricots and cantaloupe
• Deep orange vegetables like squash, carrots, sweet potatoes, and
pumpkin
• White foods are typically low in beta-carotene.
 Vitamin A is poor in fast foods and foods with the xanthophyll pigments
(beets, corn).
 Liver is rich in vitamin A.
Post- test :- what are the main Causes of vitamin A deficiency?
87
Eighteen and Nineteen Unit
Vitamin D
B – Justifications :- This unit is designed to Knowledge the roles of vitamin D in the Body,
and deficiency symptoms of this vitamin
D- Central idea :- Studying the Important of vitamin D in the body And studying the
deficiency symptoms and the Factors that contribute to
deficiency .Studying the rickets and types of rickets nutritiona

Collection.
Knowledge the functional roles of vitamin D and deficiency symptoms of this

Vitamin, causes of deficiency
Knowledge the daily requirements of vitamin D and recommendations.
Knowledge the role of vitamin D in the treatment of rickets
Third :- Pre test :- talk about to the role the Vitamin D in Bone Growth?
88
Vitamin D
• Also known as calciferol, 1,25-dihydroxy vitamin D (calcitriol), vitamin D 3 or
cholecalciferol, vitamin D2 or ergocalciferol
• Vitamin D is a nonessential nutrient that acts like a hormone in the body.
• The body can make vitamin D with help from sunlight.
• The plant version of vitamin D is called vitamin D2 or ergocalciferol.
• The animal version of vitamin D is called vitamin D3 or cholecalciferol.
• Once the vitamin enters the body it must become activated.
• Activation occurs through the action of the liver and the kidneys.
89
• Roles vitamin D in the Body
 Vitamin D in Bone Growth
• Helps to maintain blood levels of calcium and phosphorus
• Works in combination with other nutrients and hormones
– Vitamin A, vitamin C, vitamin K
– Parathormone and calcitonin
– Collagen
– Calcium, phosphorus, magnesium, and fluoride
 Vitamin D in Other Roles
• Immune system
• Brain and nervous system
• Pancreas, skin, muscles, cartilage, and reproductive organs
• Vitamin D Deficiency
 Factors that contribute to deficiency
• Dark skin
• Breastfeeding without supplementation
• Lack of sunlight
• Use of nonfortified milk
 Rickets
• Affects mainly children worldwide
• Deficiency symptoms
– Inadequate calcification of bones
– Growth retardation
– Misshapen bones including bowing of the legs
– Enlargement of the ends of long bones
– Deformities of ribs, rachitic rosary of rickets
– Delayed closing of fontanel thus rapid enlargement of the head
– Lax muscles (resulting in a protruding abdomen) and muscle
spasms
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 Osteomalacia
• Affects adults
• Soft, flexible, brittle, and deformed bones
• Progressive weakness
 Pain in pelvis, lower back, and legs
 Osteoporosis
• Loss of calcium from the bones due to inadequate synthesis of vitamin D
• Results in a reduced bone density
 The Elderly
• Deficiency is likely due to inadequate production and activation of
vitamin D, a decreased consumption of milk, and having little time in the
sun.
• There is an increased risk for bone loss and fractures.
 Vitamin D Toxicity
 More likely to be toxic compared to other vitamins
 Vitamin D from sunlight and food is not likely to cause toxicity.
 High-dose supplements may cause toxicity.
 Toxicity symptoms
 Elevated blood calcium
 Calcification of soft tissues (blood vessels, kidneys, heart, lungs, and
tissues around joints)
 Frequent urination
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 High blood calcium is called hypercalcemia and is often associated with
vitamin D excess
 Upper level for adults: 50 μg/day
 Toxicity disease is called hypervitaminosis D
 Vitamin D Recommendations (1997 Adequate Intake) and Sources

 AI 5 μg/day for adults 19-50 years old
 AI 10 μg/day for adults 51-70 years old
 AI 15 μg/day for adults if older than 70 years of age
 Vitamin D in Foods
 Fortified milk, butter, and margarine
 Cereals
 Chocolate mixes
 Veal, beef, egg yolks, liver, fatty fish and their oils
 Vegans may need fortification or supplements if they do not have
adequate sun exposure.
 Vitamin D from the Sun
 Synthesized in the body from cholesterol
 Can be obtained from tanning beds depending on type of UV radiation.
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Rickets
Rickets is a childhood disorder involving softening and weakening of the bones. It is
primarily caused by lack of vitamin D, calcium, or phosphate.
Vitamin D is a fat-soluble vitamin that may be absorbed from the intestines or may be
produced by the skin when the skin is exposed to sunlight (ultraviolet light of sunlight
helps the body to form vitamin D).
The absorbed vitamin D is converted into its active form to act as a hormone to regulate
calcium absorption from the intestine and to regulate levels of calcium and phosphate in
the bones.
If there is a deficiency of Vitamin D, the body is unable to properly regulate calcium and
phosphate levels. When the blood levels of these minerals become too low, it results in
destruction of the support matrix of the bones.
Sunlight as a source of vitamin D :-
Sunlight is important to skin production of vitamin D and environmental conditions
where sunlight exposure is limited may reduce this source of vitamin D.
Lack of vitamin D production by the skin may occur if a person is confined indoors, or
works indoors during the daylight hours, or lives in climates with little exposure to
sunlight
Adequate supplies of vitamin D3 can be synthesized with sufficient exposure to solar

ultraviolet B radiation
Melanin, clothing or sunscreens that absorb UVB will reduce cutaneous production of
vitamin D3
Rickets
In rickets, another mechanism in the body works to increase the blood calcium level. The
parathyroid gland may increase its functioning rate to compensate for decreased levels of
calcium in the bloodstream.
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To increase the level of calcium in the blood the hormone destroys the calcium present in
the bones of the body and this results in further loss of calcium and phosphorous from
the bones. In severe cases, cysts may develop in the bones.
What are the causes for deficiency of Vitamin D ?
Vitamin D deficiency could be caused due to numerous reasons
• Environmental conditions where sunlight exposure is limited like indoor
confinement or working indoors during daylight hours may reduce source of
vitamin D;
• Inadequate daily consumption - a lack of vitamin D in the diet, a dietary lack of
calcium and phosphorous may also play a part in nutritional causes of rickets, have
trouble digesting milk products, people who are lactose intolerant;
• Liver Failure;
• Dark Pigmentation.
• Problem of malabsorption called steatorrhea, in which the body is unable to absorb
fats, and they are passed directly out the body in the stool. The result of this
problem is that Vitamin D, which is usually absorbed with fat, and calcium are
poorly absorbed. This poor absorption can be a result of digestive disorders.
Steatorrhea could also lead to other deficiencies.
• Kidney Failure (congenital or acquired kidney disorders) - due to tubular acidosis in
which there is an increased amount of acid in the body;
Etiology:-
A. Lack of sunshine due to:
• 1) Lack of outdoor activities
• 2) Lack of ultraviolet light in fall and winter
• 3) Too much cloud, dust, vapour and smoke
B. Improper feeding
1) Inadequate intake of Vitamin D
• Breast milk 0-10IU/100ml
• Cows milk 0.3-4IU/100ml
• Egg yolk 25IU/average yolk
• Herring 1500IU/100g
2) Improper Ca and P ratio
C. Fast growth, increased requirement (relative deficiency)
D. Diseases and drug:
• Liver diseases, renal diseases
• Gastrointestinal diseases
• Antiepileptic
• Glucocorticosteroid
Pathophysiology –
Metabolism of vitamin D :-
Cholecalciferol (vitamin D-3) is formed in the skin from
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7-dihydrotachysterol. This steroid undergoes hydroxylation in 2 steps
• The first hydroxylation occurs at position 25 in the liver, producing calcidiol
(25-hydroxycholecalciferol), which circulates in the plasma as the most abundant of
the vitamin D metabolites and is thought to be a good indicator of overall vitamin D
status.
Pathophysiology :-
The second hydroxylation step occurs in the kidney at the 1 position, where it undergoes
hydroxylation to the active metabolite calcitriol (1,25-
dihydroxycholecalciferol - DHC). This cholecalciferol is not a vitamin, but a hormone.
Vitamin D: The Sunshine Vitamin:-

• Not always essential
– Body can make it if exposed to enough sunlight
– Made from cholesterol in the skin
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Calcitriol acts on regulation of calcium metabolism:
• Calcitriol promotes absorption of calcium and phosphorus from the intestine,
• increases reabsorption of phosphate in the kidney,
• acts on bone to release calcium and phosphate;
• Calcitriol may also directly facilitate calcification.
Calcitriol (1,25-DHC) acts as a hormone rather than a vitamin, endocrine and paracrine
properties .These actions increase the concentrations of calcium and phosphorus in
extracellular fluid
• The increase of Ca and P in extracellular fluid, in turn, leads to the calcification of
osteoid, primarily at the metaphyseal growing ends of bones but also throughout
all osteoid in the skeleton.
• Parathyroid hormone facilitates the 1-hydroxylation step in vitamin D metabolism
96
Pathogenesis :-
Vitamin D deficiency
Absorption of Ca, P
Serum Ca
Function of Parathyroid
Pathogenesis:-
PTH
High secretion
P in urine Decalcification of old bone
P in blood Ca in blood normal or low slightly
Ca, P product
Rickets
Pathogenesis:-
Low secretion of PTH
Failure of decalcification of bone
Low serum Ca level
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Types of Rickets Nutritional
Nutritional rickets results from inadequate sunlight exposure or inadequate intake
of dietary vitamin D, calcium, or phosphorus
Vitamin D dependent :-
• Vitamin D-dependent rickets, type I is secondary to a defect in the gene that codes
for the production of renal (1- 25(OH)D3 ) alpha-hydroxylase.
Vitamin D-dependent rickets, type II is a rare autosomal disorder caused by
mutations in the vitamin D receptor. Type II does not respond to vitamin D
treatment; elevated levels of circulating calcitriol differentiate this type from type I.
Vitamin D resistant :-
• Rickets refractory to vitamin D treatment may be caused by the most common
heritable form, known as vitamin D-resistant rickets or familial hypophosphatemic
rickets.
• Because of mutations of the phosphate-regulating gene on the X chromosome,
renal wasting of phosphorus at the proximal tubule level results in
hypophosphatemia. Normal levels of calcitriol are found in this disorder.
Other Conditions That Can Cause Rickets:-
• Medications
– Antacids
– Anticonvulsants
– Corticosteroids
– Loop diuretics
• Malignancy
• Prematurity
• Diseases of organs associated with vitamin D and calcium metabolism
– Kidney disease
– Liver and biliary tract disease
• Malabsorption syndromes
– Celiac disease
– Cystic fibrosis (rare)
Diagnosis:-
• Assessed according to the followings:
• 1. History
• 2. Physical examination
• 3. Laboratory findings
• 4. Roentgen-graphic changes
What's the treatment for rickets?
• The replacement of Vitamin D may correct rickets using these methods of
ultraviolet light and medicine. Rickets heals promptly with 4000 IU of oral vitamin
D per day administered for approximately one month.
98
• Parents are instructed to take their infants outdoors for approximately 20 minutes
per day with their faces exposed. Children should also be encouraged to play
outside.
• Foods that are good sources of vitamin D include cod liver oil, egg yolks, butter and
oily fish. Some foods, including milk and breakfast cereals, are also fortified with
synthetic vitamin D.
Treatment:-
Special therapy: Vitamin D therapy
A. General method: Vitamin D 2000-4000 IU/day for 2-4 weeks, then change to
preventive dosage 400 IU.
B. A single large dose: For severe case, or Rickets with complication, or those who
cant bear oral therapy. Vitamin D3 200000 300000 IU, im, preventive dosage
will be used after 2-3 months.
1 STAGE
• VITAMINE D VIDEIN 3 - 2000 IU 1 TIME\DAY 30 DAYS
2 STAGE
3 STAGE
Then profilactic dose 500 IU till the end of the second third year of life
1- Vitamin D
Fat-soluble vitamin used to treat vitamin D deficiency or for prophylaxis of
deficiency.
2- Cholecalciferol (Delta-D)
3- Vitamin D3 1 mg provides 40000 IU vitamin D activity
4. Calcium supplementation: Dosage: 1-3 g/day
• only used for special cases, such as baby fed mainly with cereal or infants under 3
months of age and those who have already developed tetany.
5. Plastic therapy: In children with bone deformities after 4 years old plastic surgery
may be useful.
Prevention:-
1- Pay much attention to the health care of pregnant and lactating women, instruct
them to take adequate amount of vitamin D.
2. Advocate sunbathing
3. Advocate breast feeding, give supplementary food on time
Post test :- Sunlight as a source of vitamin D, explain this ?
99
Twenty Unit
Obesity
B – Justifications :- This unit is designed to Knowledge the obesity and causes of obesity
C-Central idea :- Studying the types of obesity ,and the factors that affecting on obesity

Collection.
Knowledge the means of obesity
Knowledge the types of obesity
Knowledge the factors that affecting on obesity
How estimating body fat
Third :- Pre test :- define the overweight , obesity , and the morbid obesity ?
100
Obesity
overweight :- Is intended of the increase in weight for height at a rate ranged between
10 - 20% above Desirable body weight (DBW)
Obesity :- is intended to increase in weight for height at a rate of more than 20% above
the desirable body weight, which means the accumulation of excessive fat in the
body
Morbid obesity :- is intended to excessive in weight for height ,so that the body mass
index it ranges between 40 - 60 compared to the same index of 25-30 to
overweight and from 30-40 to obesity
The factors that affecting on obesity:
1- Age
2- sex
3- Repeat pregnancy and childbirth
4-An imbalance in the metabolism and action of hormones
5- Genetic factors
Social, economic and psychological factors -6

Imbalance in calories -7
8- Lack of physical activity with the spread of technology and sitting for long periods in
front of video games, the Internet and
watch TV
9- Low intake of fruits, vegetables and neglect breakfast
10- Some wrong health habits such as sleeping direct after eating and rely on fast food
and processed food .
Some of important terminology associated with obesity:-
Hyperplasia: - intended the number of fat cells that form in the body during life
Hypertrophy: - intended to increase the incident in the size of fat cells with age
Appestat or Set point : - intended to the normal weight held by the person who makes
it knows how many grams of fat needs to be obtained as a regulation system
to him without any additional effort exerted .
Desirable body weight (DBW) or Ideal body weight (IBW):-
Intended a healthy weight to person.
Body density:-
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Intended of it , the submerged body weigh comparison with the body weight
without water . Body density calculation is useful in providing information on
body fat .
YO Yoing dieting :-
Intended to it the meals that cause repeated cycles fluctuating between lack
body weight and increase in body weight . Installation of body fat:-
Estimated the body fat by weight is under the water
Android obesity :-
Intended to excess fat in the chest and abdominal area, and called on the body.
Apple-shaped body , and this type of obesity is distinctive for men
Gynoid obesity :-
Intended to excess fat accumulated in the lower part of the body in the pelvis, thighs
and buttocks area. And called on the body. Pear- shaped body. This type of obesity
is distinctive for women.
Lipoprotein lipase (LPL:-
An enzyme found in adipose tissue determines the amount of triglycerides which
moves in the plasma by fat cells. It is noted that an increase in the activity of this
enzyme is linked to obesity,
Result of dividing the perimeter the center of the body on the perimeter of the buttocks
(Waist-hip ratio):-
This result is calculated by dividing the perimeter of center of the body (measured at the
narrowest top of the navel area) on the perimeter of the buttocks (measured at the
maximum area for the emergence of the buttocks). When the division output less than
0.85 , the obesity with simple health risks. and When the division result is greater than
0.85 ,This is evidence on the accumulation of excess fat in the central area of the body
and around the abdominal area, taken the form of an apple .This means that there is the
case of food obesity, with significant health risks.
Examples
Example of Gynoid obesity:
If it was the perimeter the center of the body (waist) = 26 inches , and the
perimeter of the buttocks = 37 inches
Waist-hip ratio = 26/37 = 0.7 the health risks of obesity in this case be simple.
Example of Android obesity:-

If it was the perimeter the center of the body (waist) = 45 inches , and the
perimeter of the buttocks = 35 inches Waist-hip ratio = 45 / 35 = 1.8
means that the health risks of obesity are high in this case e result of dividing the
perimeter of the center of the body (waist) on the perimeter of the buttocks with a
102
significant health risk if increased from 0.8 in the case of women, and if increased from 1
in the case of men.
Rumen obesity:-
Intended of it , status the rumen obesity , where be the size of mid belt more than 100
cm in men and more than 80 cm in women. where accumulate the fat in the abdominal
area (rumen and around the navel) and around Onyx . Perhaps where the risk of obesity in
the rumen .Where that the function of fat cells in the abdominal area has own nature,
where it works at the increased secretion of glucose and insulin hormone in the blood , and
both play an important role in accelerating. Atherosclerosis.
Hypothyrodism Obesity:-
obesity , resultant from decrease the activity of pituitary gland that occur at proportion
less than 1% from who the obese . where the basal metabolic rate , decline due to lack
of hormone secretion (Thyroid ) resulting in retention of calories, which is usually
consumed in the basal metabolic.
Estimating body fat:-
Body fat can be estimated in several ways, for example, to the following
:
1. The method of body weight underwater or weight hydrostatic . because the estimating
body density , gives information on body fat, and lean mass
2- estimating body fat by using the electrical impedance machine by account the total
electrical conductivity, which is estimated muscle tissue and fat, based on
variations in electromagnetic waves. Used with electrodes to measure the
electrical resistance
3- estimating body fat from the following equation:
Body fat = Waist-hip/ Waist-thigh

Waist-hip = perimeter of the waist / perimeter of the buttocks
Waist-thigh = perimeter of the waist / perimeter of the thigh.
4. estimate body fat by chemical laboratory ways :
This is done by estimating the triglycerides and cholesterol in the blood. (T3). And
thyroxine (T4) .
5- estimating body fat by calculates Body Mass Index: -
Where are estimating body fat by knowing BMI rates
BMI = weight in kilograms / (length)2
6- estimate body fat by the Dietary index:

This is done by calculating the amount of fat intake, saturated fat intake, the
number of times to eat.
There are several strategies for dealing with obesity and overweight, including:-
Organization the meals and the followers of the .1
diet systems (food diet) -1 .2

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2. Exercise
3. Walking for half an hour a day at least
4. change the eating habits
5- use the appropriate drugs for weight reduction under the supervision of a specialist
doctor
6- conducting surgical operations to reduction the weight
Study the etiologic factors:-

These factors include the following:
1. Date of obesity in the family
2-The lifetime of beginning the obesity
3-the family history of the disease caused by obesity, such as high blood pressure,
heart disease, diabetes, cancer
4. The extent of the distribution of fat in the body
5- having endocrine diseases
6 - meals eaten with a focus on the amount of fat ,and the number of times to eat
7- lack of exercise
8- quality of drugs associated with the status of hyperphagia. ( glucocorticoids ,
amitriphyline , cyproheptadine , phenothiazines )
9- other factors, including
A - pregnancy, number of pregnancies
B the recent changes in muscle activity related to changes in lifestyle and rhythm
C psychological factors (anger, depression, guilt, worry, tension, anxiety, sadness,
a sense of inferiority, mental disorder)
10. Do not eat low-carbohydrates meals
11- Do not eat low-fat meals
12 - state of contentment overweight
13 - Lack of food awareness and food culture
14. Excessive intake of fatty foods
Post test :- who estimating body fat ?
104
Twenty one Unit
Nutritional Anemia
B – Justifications :- This unit is designed to Knowledge who definition the Anemia and what
are the main factors that contributing to anemia
C-Central idea :- Studying the causes of anemia, Population affected, Iron deficiency and
causes of iron deficiency anemia

Collection.
Knowledge the meaning of anemia
Knowledge the main Factors Contributing to Anemia
Knowledge the Iron Deficiency Anemia and causes of Iron Deficiency Anemia
Knowledge how Prevention and control on the anemia
Third :- Pre test :- define the Anemia and enumerate the main factors that
contributing to anemia?
105
Nutritional Anemia
Who definition:
a condition in which the Hb content of the blood is lower than normal as a result of a
deficiency of one or more essential nutrients, regardless of the cause of such deficiency.
Iron deficiency is the most frequent cause, less frequently folate or vit.B12.
Population affected:-
 Women of child bearing age
 Young children
 During pregnancy and lactation
Main Factors Contributing to Anemia:-
1- Iron deficiency
 Poor bioavailability of consumed iron
 Insufficient dietary iron intake
2- Chronic and recurrent infections that interfere with food intake and
absorption/utilization of iron
 Helminth infections, primarily Hookworm
 Chronic diarrheal disease
 HIV
 Malaria
Iron Deficiency Anemia:-
Global situation.
 Most common nutritional disorder in the world
 Lowers resistance to disease and weakens a child's learning ability and physical
stamina
 Significant cause of maternal mortality, increasing the risk of hemorrhage and
infection during childbirth.
 Nearly 2 billion people estimated to be anemic and millions more are iron deficient,
the vast majority are women.
Causes of Iron Deficiency Anemia:-
 Inadequate intake
 Poor bioavailability of dietary iron
 Excessive loss .
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 Increased demands
Detrimental effects:-
 Pregnancy
 Infection
 work capacity
Iron:-
 In human body.
 Functions.
 Sources.
 Absorption. (Conservation)
 Iron losses
Requirements of iron :-
Age group Daily iron needed in mg
Infants(5-12 m) 0.7
Children (1-12 y) 1
Adolescent(13-16 y) 1.8 males
2.4 Females
Adults ,males 0.9
Age group (Adult females) Daily iron needed in mg
Menstruation 2.8
Pregnancy(1st half) 0.8
(2nd half) 3.5
Lactation 4.2
Post-menopause 0.7
Stages of iron deficiency:-

 Decreased storage.
 Latent iron deficiency.
 Overt iron deficiency
Diagnosis of Anemia:-
Cut-off points for the diagnosis of anemia
Age groups g/dl (venous) MCHC
Adult male 13 34 %
Adult females, non -pregnant 12 34 %
Adult females, pregnant 11 34 %
107
Children,6m-6years 11 34 %
Children 6 to 14 years 12 34 %
Evaluation of iron status:-

 Heamoglobin concentration.
 Serum iron concentration( less than .5mg/dl)
 Serum ferritin.(less than 10mcg/l)
 Serum transferrin saturation (less than 16%)
Interventions to Control Anemia:-
 Depends on etiology
 For iron deficiency: supplementation and fortification
 For parasitic disease control: appropriate measures for prevention and
presumptive treatment
Prevention and control:-
1- Iron supplementation
2- Iron fortification
3- Other strategies:
-changing dietary habits.
- control of parasites.
- nutrition education.
4- Treatment of severe anemia
Promoting consumption of iron-rich foods:-

 Regular dietary intake of iron and folic rich foods for high risk groups.
 Health education to mothers attending antenatal and immunization clinics.
 Incorporation of iron rich food in weaning foods.
 Promotion of vit. C consumption.
 Promotion of growing iron rich foods in home gardens.
 Reduce consumption of tea especially for pregnant
Promoting consumption of iron and folic acid supplements:
 All pregnant women.
 Check use of supplements during immunization sessions.
 For monitoring distribution as well as consumption use mother and infant
immunization cards
Post test :- how Prevention and control on the anemia?

108
Twenty two and twenty three Unit
Feeding diabetes patient
B – Justifications :- This unit is designed to Knowledge the way of feeding diabetes patient
C-Central idea :- Studying the types of diabetes , Mechanical adjust the glucose balance in
the body

Collection.
Knowledge the types of diabetes
Knowledge the main stores to the glucose in the body
Knowledge the Mechanical adjust the glucose balance in the body
Knowledge the daily calories requirements to the diabetes patient
Third :- Pre test :- talk about the first type and the second type of diabetes
109
Feeding diabetes patient
Diabetes is generally defined as a composite chronic disease (syndrome), it is characterize
by high level of blood sugar, as a result of the combination of multiple environmental
and genetic factors ..., Note: the insulin hormone, a main organizer to the blood sugar ,
which is produced from special cells in the pancreas. When decrease the excreted this
hormone , or when this shortage accompanies an increase in the anti-reaction factors of
insulin, get disturbances in the metabolism of sugars , proteins , it and the fats, and
increase the level of sugar in the blood higher than the normal level, which reach to 126
mg / 100 ml in the fasting state, and more than 200 mg / 100 ml after two hours of eating
( according to identify the W H O).
Types of diabetes:
Diabetes types and classifications for many different considerations and views of the
division, and we mention here most importants these divisions; it is generally divided
1. The first type of diabetes, which is called (insulin-dependent diabetes): This type affects
children and adolescents, and young people, affects 1 of( 200 000) members of the
community, resulting in genetic factors that make the patient is affected by
environmental factors (viral infections) lead to autoimmune disease, so that the immune
system produces antibodies directed against the responsible for the secretion of insulin
and stimulate white blood cells of lymphoid cells in the pancreas to attack these cells and
destruction it , not return secrete insulin
2. The second type of diabetes (diabetes is insulin-dependent): the most widespread; it
represents 55-75% of all people living with diabetes, and affects 3 out of every 100 of
society, and this type usually affects adults of middle-aged and elderly , and is often
accompanied by obesity, heredity and a greater share of the former type, where the
infected body cells is responsive to insulin.
3. diabetes resulting from secondary causes: the sense that high blood sugar here
resulted from other causes secondary, and falls under this type bruises and injuries that
affect the pancreas directly, the effects of drugs, and other hormonal disorders, specific
reason and genetic diseases.
4. Pregnancy diabetes: a high sugar, which is diagnosed for the first time during
pregnancy results in hormonal metabolic changes associated with pregnancy.
And When reviewing any substance in the human body and the scrutiny of their work, we
find that the divine power manifested itself in employing them, and lend themselves to
the rest of the other body functions, Diabetes, for example, found in human blood by (5
110
grams) in the form of glucose, dissolved in about 5 liters of blood (average blood
volume total for humans), in the sense that glucose has a concentration of (1 g )glucose in
each liter of blood, well there are 20 grams of glucose in the fluid surrounding the cells
and tissues, and despite the fact that this amount of sugar is small, but they play a key
role in energy generation and the continuation of life , where these sugars provide about
50% of the total energy needed for the body, and is used on a continuous basis
throughout the day as a fuel for energy generation to the needs of the body's cells of
energy continuously without interruption.
There are three members very active in the body depend on glucose, which is:-
1. brain cells: - consumes only about 70% of the glucose in
the static for muscle movement and activity, and if
increase the proportion of glucose in the brain from
a certain extent ,here differ , quickly , cognition,
concentration and awareness centers, which leads to loss
of consciousness.
2. RBCs: - these cells using glucose to transport oxygen
from the lungs and connect it to the tissues at high
speed does not exceed seconds.
3. bone marrow cells - these cells have high activity in
restoring absorption the vast amount of water
(18 liter/ 24-hour) and other components of blood
after her nomination in refineries renal cortex and
pick what works for them.
Perhaps it clearly shows the amount of energy that you need these three members of the
glucose on a continuous basis, which requires from the body store the glucose in the form
of (glycogen) in two main stores:-
Muscle: containing on 350 grams, or about 6% by weight
of glucose for direct use when you need to active
movement
Liver: Contains on 100-150 grams glycogen turn into glucose
when need by other cells of the body such as the brain.
It is worth mentioning that diabetes (Diabetes Mellitus) called back to the ancient Greeks
where the word means (Diabetes) the flow of urine, and the word (Mellitus) means
honey, so the total word is means(diabetes)
The balance of sugar in the blood:-
Based on the foregoing, the amount of sugar in the body that ready for use of 5 grams of
blood +20 grams in the fluid surrounding the cells and tissues in addition to the sugar
stored in the image glycogen rate of 350 g in muscle, and 100-150 grams in the liver for a
total sugar Ready Reserve 525 g. However, the required amounts for glucose be
111
enormous in terms of 250-500 grams per day, or about 100-150 g / kg of body weight per
day, and this is 10-20 twice the amount of glucose in the blood and the fluid surrounding
the cells and tissues. This is enough for one or two hours only. However, free sugar ,and
stored sugar is not enough body needs for a period of 24 hours, it must be continuous
consolidation of food so the body does not depend on fat stock.
Can of food that has a direct impact on blood sugar, so it is important to understand the
effect of dietary habits and beliefs in this regard. Accordingly, it has to be organizing the
relationship between stored sugar and consumer sugar in the cases of hunger and satiety
as leads low the sugar in blood to the lower level, as in the cases of hunger or increasing
the dose of insulin or tablets of glucose lowering for determined percentage, so it has to
be measuring blood sugar before and after meals and when you exercise and when to
take medication, in order to identify the impact of these activities on blood sugar,
because the knowledge of the results of the tests will help the person and help the
doctor make some adjustments to his lifestyle daily, in order to maintain blood sugar
within the target range ,It requires a personal diet system ,by competent doctor or
dietitian with the installation of meals dates and composition ,to give the opportunity for
treatment in order to work effectively, and rationing eating the food which rich in sugars
or fats to improve control of diabetes.
Mechanical adjust the sugar balance in the body:-
Controls ,in the mechanical adjust the sugar balance in the body and level in the blood ,
number of hormones.
1- Insulin: - comes on top of these hormones, where he works alone in the direction of
Activated the glucose consumption in cells or stored in the liver, resulting
in a reduction the level of sugar in the blood.
2. glucagon hormone : - secrete of hormonal cells in the pancreas adjacent to the cells
that secrete insulin, and work counter to the action of insulin, where he
works to increase the level of sugar in the blood immediate increase
within minutes by the rapid extraction of glucose from stored glycogen in
the liver, and the lack of secretion leads to hypoglycemia.
3. adrenaline hormone : - produced by the gland over the kidney ( adrenal gland ) and
is working to increase the level of sugar in the blood immediate increase
within minutes by the rapid extraction of the glucose from the stock
glycogen in the liver.
4. steroidal hormone - produced by the gland crust above the kidney ( adrenal cortex)
, causing a slow increase in the level of sugar within hours or days by
converting protein to sugar compounds.
5. Growth Hormone: - secreted by the pituitary gland down the brain, causing a slow
increase in the level of sugar.
Accordingly, the hormone insulin on the one hand and the other four hormones on the
other hand, working as opposing forces, determined the mechanism adjust the sugar
balance in the body by balancing this counter-reaction, resulting in a mild sugar balance.
112
If overcame force on the other, the sugar balance breaks down, either increase or
decrease.
Nutritional needs of people with diabetes:-
It is very important for a diabetic to determine ratios of nutrients (carbohydrates,

proteins, fats, vitamins, minerals, fiber, and water) in meals , as well as determine the
daily that calories needs as follows:
1. The daily calories Requirements: -
determine the total daily calories requirements is of great importance to the patient with
diabetes through to determine the exact proportions of carbohydrates, proteins and fats
in the meals, usually the weight of the diabetes patient who deals with insulin less than
normal-weight, which requires increasing the daily calories to him to achieve the
equation to reach the ideal weight, however, take into account the distribution of
calories density on meals to be glucose available during the presence the insulin in blood,
it is necessary to the existence of a personal balance in diabetics to follow the weight
down, it is at least as important as urine test for the detection of sugar, as a general rule,
it is best be a weight in a diabetic is less than ideal weight by 5% .
And calculates the ideal weight for human by kg
= 50 kg + 0.75 (body length in centimeters - 150)
example: - Someone length of 170 cm, what is the ideal weight ?
Ideal weight = 50 + 0.75 × (170 -150)
= 50 + 0.75 × 20 = 50 + 15 = 65 kg
If was our old man of 40 years and a length of 170 cm, the ideal weight should be 65 kg, if
the obese and weighs 75 kg ,he must decrease the weight to 60 kg by diet . with lower
calories density, but if the thin and weighs 50 kg only, he must increase the weight him to
60 kg through a special diet of diabetes patients which infected with thinness,
Bearing in mind that in the tropics the calories of daily needs less than by 10% compared
to their counterparts in temperate zones.
Based on this, it advised the diabetic to eat meals containing balance amounts of the
calories triangle heads (proteins, fats and carbohydrates), so suffice calories density
barely so as to achieve the body of diabetics to keep its weight to be less than ideal
weight by 5%, because it is not in favor of the patient increase the intensity of his calories
,so as not to increase the need for insulin, for this for a diabetic obese. As for diabetes
patient with a normal weight must given calories enough to maintain this weight, but
113
the thin diabetics must be given calories sufficiently to increase the weight until a rate of
less than 5% of the ideal weight for him
2- Carbohydrates:-
Is not enough to determine the amount of carbohydrates in the diet of diabetics only to
control the disease, because the food after absorption from the intestine occurs his diet
conversion operations from which to fats and proteins convert into a carbohydrate, so
Eating, which consists mainly of proteins and fat almost -free carbohydrates ,
accompanied by formation of carbohydrates constantly in the body of these proteins and
fats, along with digestive enzymes that break down carbohydrates in the food into
glucose absorbed into the blood and then stored then in the liver and muscles to glycogen
by the insulin hormone, but for a diabetic, the lack of the insulin hormone leads to a
defect in carbohydrate metabolism.
Based on this you should get diabetics with normal weight on the amount of
carbohydrates ranging between 175-250 grams per day and should be the amount of
carbohydrates represent the range of 40-50% of total calories for a meal diabetes patient,
preferably calories derived from carbohydrates be distributed 65% of complex
carbohydrates, 35% of simple carbohydrates.
3- Proteins:
Determine the amount of protein per day for patients with diabetes in the range of 15-
20% of total calories, meaning that the patient gets on the meals rich of protein to
provide him with the amino acids needed to build tissues, as it does not lead to higher
blood sugar during absorbed by the intestine, as in the case of carbohydrates. the protein
rate earned by diabetes patients is higher than the average daily requirement of protein
for a natural person, which ranges between 10-15% of total calories. Preferably be a
source of protein from white meat, and the legumes is considered a therapeutic food for
diabetics especially Type II diabetes patients.
4- Fats :-
Estimated the amount of fat in the case of diabetics in the range of 30-40% of total
calories, and should be half the fat of plant origin to avoid the risk of heart disease, as
observed in saturated fatty acids ratio should not exceed 10% of total calories, and
prefers to use the unsaturated fatty acids instead of them, and are fat metabolism in the
body to provide him with energy, and when you neglect the treatment of diabetes, the
body will not be able to get energy from carbohydrates due to lack of the hormone
insulin and then it depends on fat for its energy needs, and as a result of the increasing
break of fat for energy generation accumulate the ketosis material including not allowed
to use tissues quickly in the blood and excreted in the urine. And the accumulation of
ketosis materials in the blood lead to (Coma- Diabetic Ketoacidotsis) and the ketosis
materials (an intermediate compounds in the natural representation of fat. It consists in
the liver and used tissues to provide energy). To prevent the accumulation in the blood is
advisable to give the patient about 100 g carbohydrate per day.
114
5- Vitamins:-
Diabetics need to take vitamins to protect him from the disease, is the most important
vitamin A, because the liver, which is the main store of this vitamin, crash when diabetics,
so it is advisable to give the diabetes patients 15,000 IU of vitamin A, is not
recommended increase upwards 10,000 IU of the pregnancy, and prefers to use the
vitamin of the (Emulsion form) for the occurrence of better absorption of him. Also
diabetic needs to vitamin B complex because the lack of it leads to lack of carbohydrate
metabolism is complete, and are advised to give diabetics 50 mg of this vitamin and an
average of 3 times a day, and focuses on the Vitamin B12 because it is necessary to
prevent job loss to the nerves (Diabetic neuropathy) in the case of Diabetics. Must be
given the diabetics patients about 50 mg of the (Biotin) because it improves metabolism
of glucose. And also given 50 mg of the (Inositol) because it is important to prevent of the
arteriosclerosis. The vitamin E is given to diabetic patients by 400 IU daily to overcome
the clotting of platelets and thus helps the patient is not exposed to a blood clot
complications that occur in the blood vessels. The vitamin C in view of the low level in
diabetes patients, insulin-dependent must be give the patient from 3000 -6000 mg / day ,
in order to maintain the strength of the capillaries,
6- minerals:-
Diabetic needs to following minerals to vital role in improving the efficiency of utilization
of insulin and regulate blood sugar levels.
A- chrome: given in the form of chromium picolinate, and that this compound is the
formulations that diet plays an important role in controlling the blood sugar level, which
is a composite of two articles, chrome, a metallic element which has increased the
efficiency of insulin, which adjusts the level of sugar in the blood, and piculinat , which is
derived amino acid that helps the body use of chrome, and taken in concentrations
ranging between 400-600 micrograms daily,
B- Zinc: It is recommended to take 50-80 mg per day, and for the highest degree of
absorption and take advantage prefers to use the image of zinc (Zinc gluconate Iozenges
or Optizine).
C- Manganese: It is recommended to use a concentration of 5-10 mg per day, preferably

alone dealing don't with calcium, as it is important in the reform of the pancreas as well
as it is a catalyst for the enzymes responsible for the metabolism of glucose, which is
usually less when diabetics.
115
d- Magnesium: the recommended quantities about (750) mg per day
e- Calcium: The recommended quantities (1500) mg of calcium daily.
f- Cupper: It have private importance in organization the process of metabolism of

proteins and important in many enzymatic systems, and it is taken accordance to the
information on the label.
7- fiber:-
Found that increasing the amount of fiber in the diet of diabetics delay by taken food
contain on the fiber such vegetable ,fruit and bread, reduce the digestion of
carbohydrates and this would reduce the level of sugar in the blood, as well as it gives a
feeling of fullness. Many researchers have shown that fiber are important in meal
diabetes patients because they lead to a reduction of the speed of absorption of nutrients
from the intestines, and these leading to a gradual rise not a surprise, as they increase the
cell's sensitivity to insulin and then they reduce the size of the dose which needed the
diabetics from insulin, and reduce the proportion of glucagon hormone in the blood and
improve the secretion of insulin by the pancreas, as well as its important role in achieving
a balance in the ratio of glucose in the blood and reduce the rate in the urine.
8. Water: Allows for a diabetic to take up water and liquids in quantities of free.
The distribution of the total calories daily meals for a diabetic:-
Necessary distribution the daily calories for a diabetic's on the daily meals to him,
whether that deal insulin injections or drugs by mouth or that food handles only, so as to
ensure off exist the glucose when the insulin exist in the blood to avoid occurs the
response reaction of insulin if the glucose did not exist, the following table shows how
distribution the total calories throughout the day (24 hours) on meals diabetes patients.
patient breakfast Between lunch between dinner before

breakfast lunch and going
and lunch dinner to
sleep
Patient deal insulin 2/7 - 2/7 - 2/7 1/7
The patient is 1/5 1/10 1/5 2/10 3/10 2/10
dealing drugs by
116
mouth
Patient, treatment 2/7 - 3/7 - 2/7 -
by food
So observed in the diets of diabetes patients ,planning to be protein, fat and

carbohydrate ratios distribution on daily meals so that the meal contains all the
elements, taking into account the lack of a meal consisting of carbohydrates or proteins
alone only.
Status: - someone who works accountant in company his length 170 cm and his age of 24
years, patient of diabetes,
Required : calculate the calories distribution to the daily meals.
The solution:
1. calculate the ideal weight of his following equation
Ideal weight = 50 + 0.75 × (170 -150) = 50 + 15 = 65 kg
2. The daily calories needs ?
The requirement calories = 30 calories per kg of ideal body weight, because that person
carries on business lightly so 30 × 65 = 1950 calories
3. The required quantity of proteins
The amount of proteins needed by the range of 1 - 1.5 grams per kilogram of ideal
body
weight average 1.25
So 1.25 × 65 = 81.25 g / day
4. calories income of proteins: Since there every 1 gram of protein provides 4 calories, so
you have the number of calories provided by protein
81.25 × 4 = 325 calories / day
5. calories income from non-protein substances: (carbohydrates and fats)
calories income of carbohydrates and fat = 1950 - 325 = 1625 calories / day
6. required calories from carbohydrates:
= (1950 × 45) ÷ 100 = 877.5 calories / day
On the basis that the calories provided by carbohydrates that should represent (40-50%)
of the total calories of daily needs, namely 45% on average
7. required amount of carbohydrates:
= 877.5 ÷ 4 = 219.33 g / day
Dividing the calories on the 4, fact that all one gram of carbohydrates gives 4 calories
when burned and metabolism.
8. required calories from fat:
= Sum of total calories - (calories derived from protein + calories derived from carbohydrates)
= 1950 - (325 + 877.5) = 747.5 kcal / day
9. required amount of fat:
= 747.5 ÷ 9 = 83.5 g / day
117
On the basis that one gram of fat provides 9 calories when burned and its representation
in the body.
10. If you were rounded required quantities of proteins, carbohydrates and fats become
as follows
81 grams of protein 219 grams of carbohydrates, while the amount of fat 84 grams.
Depending the calories distribution which resulting from carbohydrates at each meal
according to the type of insulin used for each diabetic to achieve the best system that
allows good utilization of carbohydrates, and when using insulin from moderate type or
slow-acting , calculated from 20-40 grams of carbohydrates for the afternoon or sleep, or
both time.
Diet for diabetics: -
1. Feeding obese diabetic: - to be reducing the daily total calories requirements for a
obese diabetic until the body weight reaches to less than ideal weight has about 5%, and
only reduce the weight of food diet, do not need to inject insulin in this case as long as it
is uncomplicated , and continue to follow the food diet until it reaches the patient's
weight to the desired weight, and then applied balanced food diet that achieves maintain
that equation weight (5% less than ideal weight), but if sugar emergence continued in the
urine despite access to the latter weight , the time becomes appropriate to use insulin or
glucose tablets treatment even lowers the sugar from the urine.
2. Feed skinny diabetic: - should increase the calories of daily total requirements for a
skinny diabetic even weight up to normal weight for him, then he must apply balanced
food diet to maintain this weight, but the skinny diabetic patient always require insulin or
treatment tablets sugar, or both, to adjust the ratio of sugar in his blood, and generally
must follow the food diet therapeutic fulfilled his meals with a high content of protein
and reduced amounts of fat and moderate amounts of carbohydrates, with vitamin B
complex.
3. Feeding diabetics with normal weight:
in this case must be applied the normal diet , with care to determine and adjust the
calories of total daily requirements to ensure the preservation of the stability of the
patient's weight, do not resort to treatment insulin injections or tablets sugar treatment,
except in the case of sugar continue Urine .
Post test :- there are number of hormones that control on the level of glucose in the
blood , mention this hormones?
118
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First Unit

The Importance of Good Nutrition-:

Organic Materials In organic Materials

Carbohydrates Proteins Fats Vitamins Macro element Micro el-

NFE Fibers True NPN Neutral fats W .S. V F .S .V Ca Cu

The Food Guide Pyramid :-

Food Sensitivity and the diseases Food borne:-

Post-test: A- Recall the basic functions of food

Third :- Pre test :-

Energy intake Versus Energy Output

.Net Energy (NE)

Digestible Energy Missing Energy in the waste

Metabolizable Energy Missing Energy in the urine

Net Energy Heat Increment

Third :- Pre test :-

If the individual takes less than 67 % He has a shortage of

If the individual takes higher than 100% He has an increase

Split different categories into tables

1- ( 0 0.5) newborns up to six months

1- Between (1) to (3) years.

2- Between the ages of (4) to (8) years.

1- two groups of adolescents from (9 - 13 years) And (14-18 years)

1- two groups of adolescents from (9 - 13 years) And (14-18 years)

Split different categories into tables

1- from age of (18) years or less

1- from age of (18) years or less

Evolution of dietary standards (requirements)

Adequate Intake (AI)

Tolerable Upper Intake Level (UL):-

Choose three food items, comparing them with recommendations (RDA)

Average daily intake

Compare daily intake from

How to calculate the calories: -

Calculate the amount of fiber needed: -

account of fats calories : 0.30 × 2100 = 630 calorie

account of protein calories : 0.12 × 2100 = 252 calorie .

304 g of carbohydrates and 70 g of fats and 63 g of proteins

Alternative Number Carbohydrate Protein Fat

Low fat milk 2 24 16 16

To determine the number of grain alternatives (starches)

What are Carbohydrates:-

Lactose (milk sugar)

Maltose (malt sugar)

• long carbohydrate chains of monosaccharides linked by glycosidic bonds

– plant storage form of carbohydrate

Fiber: Too much of a good thing :-

Regulation of Blood Glucose:-

How much carbohydrate do I need?

Why are these nonpolar & hydrophobic

Effect of different R groups: Polar amino acids .

Why are these polar & hydrophilic

The amino acids

Eggs There is no 100 %

The daily needs of proteins:-

Less than 3 month 2.4

C- Central idea :- Chemical composition of fat

Third :- Pre test :- Classify the fat according to its composition

Knowledge the types of minerals

Post test :- Talk about deficiency symptoms and increase calcium

Knowledge the types of vitamins

Functions and deficiency symptoms: -

Daily need of it: -

D- Instruction:- 1- Look at the overall overview well

Nutritional needs during the stages of life

1- ( 0 0.5) newborns up to six months

Lactose (milk sugar)

Maltose (malt sugar)

Post test :- Sunlight as a source of vitamin D, explain this ?

Post test :- who estimating body fat ?

Post test :- how Prevention and control on the anemia?