THE MEANING AND IMPORTANCE OF NUTRITION

Nutrition is the study of food and how the body makes use of it.
 It deals not only with the quantity and quality of food consumed but also with the process
of receiving and utilizing it for the growth and renewal of the body and for the
maintenance of the different body functions.

Function of Nutrition
The basic function of nutrition is to maintain life by allowing an individual to grow and be in a
state of optimum health. The following are reasons why nutritional science is applied to nursing
care:
 the recognition of the role of nutrition in preventing diseases or illnesses;
 the concern for adapting food patterns of individuals to their nutritional needs within the
framework of their cultural, economic, and psychological situations and styles; and
 the awareness of the need in specified disease states to modify nutritional factors for
therapeutic purpose.

Nutrients are chemical substances found in food.

o They perform diverse roles in the body such as to provide heat and energy, to build and
repair body tissues, and to regulate body processes.
o Since nutrients are found primarily in natural foods, adequate intake of these nutrients is
necessary to carry out physiological functions.

Nutrients are classified according to the following:

1. Function - Those that form tissues in the body are body building nutrients while those
that furnish heat and energy are fats, carbohydrates, and proteins.
2. Chemical properties - Nutrients are either organic or inorganic
3. Essentiality - Nutrients are classified based on their inorganic significant contribution
to the body's physiological functioning.
4. Concentration - Nutrients are either in large amounts or in little amounts. Food when
taken and digested nourishes the body. It is a vital need without which a person cannot
live. It is likewise culturally acceptable as it supples heat and energy, builds and repairs
body tissues, and regulates body processes.

PROCESS OF DIGESTION
DIGESTION
- Defined as the process of breaking down food into substances like carbohydrates,
proteins, fats and vitamins. The GI tract is a chain of hollow organs connected in a long,

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 twisting tube from the mouth to anus. This consist the mouth, esophagus, stomach,
intestines and anus.

Parts of the Human Digestive System

Mouth: where the digestion begins by breaking down to pieces by chewing. Food mixes with
saliva, and broken down into a form that the body can absorb.
Throat: also known as the pharynx, transfer food from the mouth to the esophagus and warms,
moisten and filters air before food is moved into trachea.
Esophagus: a muscular tube extending from the pharynx to the stomach. Through a series of
contractions known as peristalsis food goes to stomach.
Stomach: is a sac like organ with tough muscular walls. It holds, mixes and grind foods. The
stomach secretes acid and powerful enzymes that carry on the process of breaking down food
Small intestine: is a long loosely in the abdomen when spread out, would be more than 20 feet.
It is made up of three parts; duodenum, jejunum and ileum.

The stomach and small intestine are supported by three organs in digesting food
1. Pancreas: secretes enzyme into a small intestine which break down protein, fat and
carbohydrates from food

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2. Liver: produces and secretes biles and helps in digestion and the absorption of fats and fat
soluble vitamins. The liver also cleanses and purifies the blood comes from the small intestine
which contains the nutrients absorb from food
3. Gallbladder: is a pear shape reservoir located just under the liver. Bile made in the liver
travels to the gallbladder through a cystic duct for storage. During meals the gallbladder
contracts and sends the bile to the small intestine.
4. Large intestine: is a long muscular tube approximately 5 to 6 foot that connects to the rectum.
Stool from the digestive process passes through the colon by means of contractions or peristaltic
movements.
5. Rectum: is an 8 inch chamber that connects the colon to the anus. It receives stool from the
colon and holds this stool until defecation
6. Anus: where the digestive tracts end. It is responsible for the control in the elimination.

Basis of Nutrition
Role of Nutrition in health promotion
Food alone cannot make us healthy. Other factors that influence health status include
1. Physical or mental conditions
2. Environment e.g poverty and work conditions
3. Lifestyle e.g stress, sedentary lifestyle
4. Heredity or genetic
5. Mental attitude and beliefs regarding health.

NUTRIENTS
 Nutrients are the substance present in the food.
 It is needed for the energy, growth, maintenance of body and repair of body tissues, and
regulation of body function.
 The energy value of the food refers as calories. The body is in energy balance when the
number of calories is equal to the number of calories used.
 Good nutrition is essential throughout infancy, childhood and adolescence. Since this
period of life is most crucial of growth and development

Nutrients is divided into 6 categories

1. Water 4. Fats
2. Carbohydrates 5. Vitamins
3. Proteins 6. Minerals

Dietary Ideals

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o Adequacy  provide the amount of energy to
 Enough energy and nutrient maintain a healthy body weight
o Balance o Moderation
 Do not emphasize one nutrient of food  Promotes adequacy and calorie control
type at the expense of another o Variety
o Calorie control  Improves nutrient adequacy

PINGGANG PINOY is a dietary ideal

Dietary References Intake
- references value for the intake of nutrients. It can
be used for planning, and assessing diets for
healthy population and a way of presenting
recommended nutrients intake. It includes:
A. Recommended Dietary Allowance
(RDA)
B. Adequate Intake (AI)
C. Estimated Average Requirement Intake
(EAR)
D. Tolerable Upper intake level (TUI)

DEFINITION OF RDA and AI

RDA: the average daily dietary nutrient
intake level sufficient to meet the nutrient
requirement of healthy individuals in
particular stage or group

AI: the recommend average daily intake level

based on observed or experimentally determined
approximations or estimate nutrient by age group
of apparently healthy people that are assumed
adequate.It is used when there is not enough to
scientific evidence to calculate an RDA.

Energy (Calories)

The body burns food just like a gasoline burn in a

car engine. The unit used to measure energy on
food is called calories. The nutrients that provides
calories are carbohydrates, proteins, and fats
Calorie sources
1 gm of proteins= 4 calories

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 1 gm of carbohydrates = 4 calories
1 gm of fates = 9 calories

Fat contributes more than twice than the amount of calories as rich as carbohydrates and
proteins.
Nutrition facts Panel
 Food label must identify the serving size for which nutrition information is
presented

Household and Metric measures

I teaspoon = 5 millimeters
1 tablespoon = 15 ml
I cup = 240 ml
1 fluid ounce = 30 ml
1 ounce = 28 grams

MACRONUTRIENTS

CARBOHYDRATES
into glucose and galactose upon digestion. It is composed of glucose and fructose.
2. Lactose (milk sugar) is found in milk and milk products except cheese.
3. Maltose is not found free in foods.
C. Polysaccharides are composed of many molecules of simple sugars. They are commonly
known as complex sugars. They include the following:
1. Starch
2. Dextrins
3. Cellulose
a. Soluble - found in fruits and legumes, barleys, and oats which delay gastrointestinal
transit and glucose absorption, and lower blood cholesterol.

b. Insoluble - found in wheat brans, corn brans, whole grain breads, cereals, and
vegetables which accelerate gastrointestinal transit, increase fecal weight, slow down
starch hydrolysis, and delay

4. Pectins
5. Glycogens (animal starch)

Digestion of Carbohydrates
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1. Mouth
a. Enzyme - amylase (an enzyme of the saliva, secreted by the parotid glands, acts on starch to
begin its breakdown to dextrins and maltose)
b. Action - usually, however, the food does not stay in the mouth long enough for much of this
change to be completed, so that food is conveyed into the stomach mostly in starch form.
2. Stomach
a. Enzyme - none for the carbohydrates
b. Action none; above action by ptyalin may continue to a minor degree

3. Small Intestine
a. Enzyme - pancreatin enzyme, amylopsin, converts starch into dextrins and maltose
b. Intestinal juice - contains three disaccharides-sucrose, lactose, and maltose (which act on their
respective disaccharides-sucrose, lactose and maltose to produce monosaccharides-glucose,
galactose, and fructose)
Functions of Carbohydrates
1. The principal function of carbohydrates is to serve as a major source of energy for the body.
The breakdown of carbohydrate storage in the body of a man weighing 70 kg is shown on the
next page.
Liver glycogen 110gm
Muscle glycogen 245gm
Extra-cellular blood sugar 20gm
Total 375 gm 1,460 calories

This 375 gm of glucose provides energy sufficient for only about 13 hours of moderate activity.
Therefore, carbohydrates must be ingested regularly and at moderately frequent intervals to meet
the energy demands of the body,
2. Carbohydrates exert a protein-sparing action.
3. The presence of carbohydrates is necessary for normal fat metabolism.
Thus, the anti-ketogenic effect of carbohydrate prevents the damaging effects of ketone
formation and accumulation.
4.Cellulose and closely related insoluble, indigestible carbohydrates and in normal elimination.
5. They also supply significant quantities of proteins, minerals, and B vitamins.
6. Lactose remains in the intestine longer than other disaccharides, and this encourages the
growth of the beneficial bacteria, resulting in a laxative action.

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7. Glucose has specific influences; it is indispensable for the maintenance of the functional
integrity of the nerve tissue and it is the sole source of energy for the brain
Sources of Carbohydrates
1. Whole grains rich in iron, thiamine, niacin, and other nutrients are important sources of
carbohydrates. In the manufacture of wheat flour and refined cereal, the germ and outer layers of
the grain are removed resulting in the significant losses of iron and B complex vitamins. These
are enriched specifically with the addition of thiamin, riboflavin, niacin, and iron.
2. Sweet potatoes and white potatoes are important contributors to carbohydrate intake from the
vegetable and fruit groups because they are daily items in many diets.
3. Milk is unique in that it is the only dietary source of lactose. Each cup contains 12 gm.
4. Sugars and sweets are important sources of carbohydrates next to breads and cereals, and cane
and beet sugars, honey, maple foods syrup jellies jams and candies. "Empty calories are which
do not contain any amount of other nutrients aside from carbohydrates.
Health Effects of Starch and Fibers
1 Weight control 4. Diabetes
2. Heart disease 5. Gastrointestinal health
3.Cancer
Digestion and Absorption of Carbohydrates
Mechanism

 Mouth and Salivary Glands

The salivary glands secrete saliva into the mouth to moisten the food. The salivary
enzyme begins digestion
 Stomach acid inactivates salivary enzymes halting starch digestion
 Small intestine and pancreas
Pancreas produces an amylase that is release through pancreatic duct into the
small intestine

Regulation of Blood glucose

Must know:
 Hypoglycemia a person may become dizzy and weak
 Hyperglycemia a person may become fatigued
 Diabetes- a disorder characterized by hyperglycemia

How does the sugar regulate?

 Glucose cannot enter into the cell without the INSULIN

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  When the blood glucose starts to fall too low, the hormone GLUCAGON is
released into the bloodstream and triggers the breakdown liver GLYCOGEN into
single glucose molecules

FATS OR LIPIDS
 Fats are organic compounds composed of carbon, hydrogen, and oxygen.
 Triglycerides or fats and oils are fatty acid esters of glycerol.
 They belong to class of fats and fat-related compounds called lipids.
 Fats constitute 34% of the energy in the human body.
 They include substances such as fats, oil, waxes, and related compounds that are greasy
to the touch and insoluble in water.
 They provide a more concentrated source of energy compared to carbohydrates. Some fat
deposits are not used and are considered structural fat. They hold the body organs and
nerves in position and protect them against shock and injury.

Roles of Body Fats

1. Provide energy
 Fats are the body`s chief form of stored energy
2. Cell membranes
 Fats form the major material of cell membrane
3. Insulation
 Fats insulate against temperature extremes by forming a fat layer under the skin
4. Muscle fuel
 Fats provide much of the energy to fuel muscular work
5. Raw materials
 Fats are converted to other compounds , such as hormones , bile, and make the
Vitamins A, D, E, K to be absorb by the body

Sources of Fatty Acids

Saturated Unsaturated
Animal Fat Plant Oil
Beef Mutton Vegetables oil Corn
Seafoods Egg Peanut Cotton
Red meat Poultry Soybean Olives
Dairy Cauliflower Olive oil

Digestion of Fats
Digestion process of Fats
Organ Enzyme Activity
Mouth None Mechanical mastication

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 Stomach No major enzyme
Small amount of gastric
lipase, tributyrinase
Small intestine Gall bladder emulsifier
Pancreatic lipase
Mechanical separation of fats
as protein and starch digested
out
Tributyria (butter fat) to fatty
acid and glycerol
Emulsifies fats
Triglycerides to diglycerides
and monoglycerides in turn,
then fatty acids and glycerols.

Food Sources
A. Visible fats include lard, butter, margarine, shortenings, salad oils, and visible fats of meat.
B. Invisible fats are those available in milk, cheese, eggs, nuts, and meat.
Margarine and shortenings are made from relatively less expensive vegetable oils such as
cottonseed oil, soybean oil, corn oil, and coconut oil by the introduction of hydrogen into fat
molecule under carefully controlled conditions. Margarine is then further processed by churning
the cultural milk to give the flavor of butter. It is usually fortified with vitamins A and D.
High in Saturated Fatty Acids:
 Whole milk, cream, ice cream, cheese made from whole milk, egg yolk
 Medium fat or fatty meats; beef, lamb pork, ham Bacon, butter, coconut oil, lamb fat,
lard, regular margarine, salt pork, hydrogenated shortenings
 Chocolates, chocolate candies, cakes, cookies, pies, rich pudding

High in Polyunsaturated Fatty Acids:

 Vegetable oils, safflower, corn, cotton seed, soybean, sesame, sunflower
 Salad dressings made from the above oils: mayonnaise, French dressings
 Special margarine: liquid oil listed first on label
 Fatty fish: salmon, tuna, herring.

The essential fatty acids are not manufactured in the body and must be supplied in the diet.
 Linoleic acid
 Linolenic Acid

Health Effects of Lipids

1. Heart disease - Elevated blood cholesterol is a major risk factor for cardiovascular disease.
2. Risks from saturated fats - Lauric, myristic, and palmitic acids 2 raise blood cholesterol levels.
Stearic acid does not.
3. Benefits from monounsaturated fats Olive oil lowers risks of 3 heart disease.

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4 Benefits from omega-3 polyunsaturated fats Omega-3 polyunsaturated fats lower blood
cholesterol and prevent heart disease. EPA sources like fish, eaten once a week, can lower blood
cholesterol and the risk of heart attack and stroke.
5. Cancer - Fat does not instigate cancer development but can 5 promote it once it has arisen.
6. Obesity- High-fat diets tend to store body fat ably. Daily Allowances No specific
recommendation for the level of fat intake has been made by the Food and Nutrition Board. The
requirement for linoleic acid is low and easily met. For infant formulas, linoleic acid should
supply 3% of the calories.
Mayonaise 1 tbsp 12
Pie 1 pc 15
Butter 3 pats 18
Bread-cereal 4 servings 3
Egg 1 pc 6
Meat, poultry, fish (lean) 4 oz 10
Milk 2 cups 18

CHOLESTROL CONTENT OF FOODS

 If an individual has risk factors for heart disease, he/she should not consume more than
200 mg of cholesterol a day
 Cholesterol is only found in animal products.
 Cholesterol content of Dairy Products

Dairy Products Portion Cholesterol (mg) Total fat (g) Saturated fat (mg)
Milk (non fat) 1 cup 4 0 0
Milk (low fat 1 cup 10 3 2
Milk (whole) 1 cup 33 8 5
Yogurt (non fat) 1 cup 10 0 0
Yogurt (whole) 1 cup conv29 7 5
Cheddar cheese 1 oz 30 9 6
Cottage cheese 1 cup 10 2 2
(low fat)

PROTEINS
 The term protein is taken from the Greek word protos meaning primary ranking first, or
occupying the first position.
 Proteins are more complex compounds of high molecular weights and structured in
specific arrangements and numbers of their simpler building units, amino acids.

Classification of Proteins

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A. Simple proteins are those which yield only amino acids upon hydrolysis. They include the
following:
1 Albumins are soluble in water and coagulated by heat.
2. Globulins are insoluble in water, soluble in dilute salt solution, and coagulated by heat.
3. Glutelins are insoluble in neutral solvents but soluble in weak acids and alkalis; they
are coagulated by heat.
4. Prolamins are soluble in 70% to 80% alcohol but insoluble in absolute alcohol, water,
and salt solutions.
5. Albuminoids are insoluble in all neutral solvents and in dilute acids and alkalis.
6. Histones and protamines, which are basic polypeptides, are soluble in water but not
coagulated by heat; they are found in the nuclei of cells.
B. Compound proteins, conjugated proteins or proteins are combinations of simple proteins and
some other non-protein substance called a prosthetic group attached to a molecule. They perform
functions that a constituent could not properly perform by itself. These proteins include the
following:
1. Nucleoproteins are combination of simple proteins and nucleic acid. Deoxyribonucleic
nucleoproteins are necessary for the synthesis of proteins in the cytoplasm.
2. Mucoproteins and glycoproteins are combination of a protein and large quantities of
complex polysaccharides such as membranes. mucin found in secretion from gastric
mucous
3. Lipoproteins are compounds of a protein and a triglyceride or other lipids such as
phospholipids or cholesterol found in cell and organelle membranes.
4. Phosphoproteins are compounds of phosphoric acid joined in ester linkage to protein
found in casein of milk.
5. Chromoproteins are compounds of proteins and non- protein pigments found in
flavoproteins, hemoglobin, and cytochromes
6. Metalloproteins are compounds or metals (Cu, Mg, Zn, and Fe) attached to proteins
found in ferritin, hemosiderin, and transferin.
C. Derived proteins are products formed in the various stages of hydrolysis of a protein
molecule.
Chemical Stages of a Protein
A. As indicated by its name, an amino acid has a chemical structure that combines both
acid and base (amino) factors.
 This important structure gives amino acids a unique buffering capacity.

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  This acid-base nature of amino acids also enables them to join one another to form the
characteristic chain structure of protein. The amino (base) group of one amino acid joins
the acid (carboxyl) group of another. This characteristic chain structure of amino acids is
called a peptide linkage. Long chains of amino acids that are linked in this manner are
called polypeptides.
B. Essential and non-essential amino acids
1. Essential amino acids cannot be synthesized by the body and are necessary in the diet.
Examples: Threonine Leucine Isoleucine Valine Lysine Methionine Phenylalanine Tryptophan
2. Non-essential amino acids can be manufactured by the body and therefore, are not as
necessary for consideration in the diet.
Examples: Glycine Cystine Alanine Tyrosine Aspartic acid Serine Glutamic acid Arginine
Proline Histidine Hydroxyproline
C. Complete and incomplete proteins
1. Complete proteins are those that contain all the essential amino acids in sufficient quantity and
ratio to supply the body's needs. These proteins are of animal origin-meat, milk, cheese, and
eggs.
2. Incomplete proteins are those deficient in one or more of the essential amino acids. They are
of plant origin-grains, legumes, seeds, and nuts.
Digestion of Protein
1. Mouth
a. Enzyme - none
b. Action - only mechanical mastication

2. Stomach
a. Enzyme pepsin, produced first as inactive precursor to pepsinogen, then activated by
the hydrochloric acid
b. Action - converts protein into proteoses and peptones
c. In infants, enzyme rennin converts casein into coagulated curd. C.

3. Small intestine (Alkaline)

a. Pancreas
a.1 Trypsin (produced firstasinactive precursortrypsinogen and then activated by
enterokinase) converts proteins, proteoses, and peptones into polypeptides and
peptides
a.2 Chymotrypsin (produced first as inactive precursor chymotrypsinogen and
then activated by active trypsin) converts proteoses and peptones into
polypeptides and dipeptides; also coagulates milk.

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 a.3 Carboxypeptidase converts polypeptides into simpler peptides, dipeptides,
and amino acids.
b. Intestine
b.1 Aminopeptidase converts polypeptides into peptides and amino acids.
b.2 Dipeptidase converts dipeptides into amino acids.
Functions of Proteins
1. Proteins are used in repairing worn-out body tissue proteins (anabolism) caused by the
continued wear and tear (catabolism) going on in the body.
2. Proteins are used to build new tissue by supplying the necessary amino acid building blocks.
3. Proteins are a source of heat and energy. One gram of protein contains 4 calories.
4. Proteins contribute to numerous essential body secretions and fluids, enzymes, and proteins.
5. Proteins are important in the maintenance of normal osmotic relations among the various
body fluids.
6. Proteins play a vital role in the resistance of the body to diseases.
7. Dietary proteins furnish the amino acids for a variety of metabolic functions.
Sources of Protein
1. Complete protein foods meat, fish, poultry, egg, milk, cheese
2. Legumes, nuts
3. Breads and cereals

Requirement for Human Nutrition A

. Quality of protein fundamental to health and life
B. General daily recommendation of the Food and Nutrition Board
1. Adult - 0-9 g/kg BW
2. Children - Growth needs vary according to age and growth patterns.
3. Pregnancy - Rapid growth requires an increase of 30 g over that of a non-pregnant
woman.
4. Lactation - It requires an increase of 20 g.

Measures of Protein Quality

A. Biologic value (BV) - It measures the effectiveness of protein quality in supporting the body's
needs.

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B. Net protein utilization (NPU) - It also measures how capably a protein is used by the body.
The difference is that NPU measures retention of food nitrogen consumed while BV measures
food nitrogen absorbed
C. Protein efficiency ratio (PER) - It measures the increase in weight of a growing animal and
compares it with the intake.
Health Effects of Protein
1. Heart disease - Foods rich in animal protein tend to be rich in saturated fats.
2. Cancer - Studies suggest a relationship between high intake of animal protein and some types
of cancer like cancer of the prostate gland, pancreas, kidneys, breast, and colon.
3. Osteoporosis- Calcium excretion rises as protein intake increases.
4. Weight control - Protein-rich foods are also rich in fat which can lead to obesity with
associated health risks.
5. Kidney disease- Excretion of end products of protein metabolism depends on a sufficient fluid
intake and healthy kidneys. A high-protein diet increases the work of the kidneys.
Protein-Energy Malnutrition (PEM)
 Protein-energy malnutrition is a condition resulting from insufficiency of protein or
energy or both in the diet.
 Acute PEM occurs in children who are thin for their height. Chronic PEM occurs in
children who are short for their age.

There are two forms of PEM:

1. Marasmus - Severe deprivation of food over a long period of time characterized by
insufficiency of protein and energy intake.
2. Kwashiorkor - This condition reflects an abrupt and recent deprivation of food which develops
rapidly a consequence of protein deficiency or an illness like measles.

MICRONUTRIENTS
VITAMINS
The word vitamin comes from the Latin word vita meaning life and the suffix amine,
which is a nitrogen compound. It was discovered later that not all vitamins contain nitrogen;
nevertheless, "vitamin" has been used pervasively and has become a common word.
Terms associated with vitamin
1. Precursors or provitamins
2. Performed vitamins
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3. Avitaminosis
4. Hypervitaminosis
5. Vitamin Malnutrition
6. Vitamin-like compounds
7. Antivitamins or vitamin antagonist

NOMENCLATURE OF THE VITAMINS

Original Name Current Name
Vitamin A (Anti-infective) Vitamin A (retinol)
Vitamin B1 (Anti-beriberi) Vitamin B1 (thiamine)
Antineuritic Riboflavin
Vitamin C (B2) Niacin (nicotinic acid, niacinamide)
Pelagra preventive factor Vitamin B6 (Pyridoxine)
Vitamin B Complex Vitamin B12 (Cyanocobalamin)
Folasin (Folinic acid)
Pteroylglutamic acid)
Biotin
Vitamin C Ascorbic Acid
Vitamin D Vitamin D (calciferol)
Vitamin E Vitamin E (tocopherol)
Vitamin K Vitamine K (menaquinone and
phylloquinone)

Classification of Vitamins on the Basis of Solubility

1. The fat-soluble vitamins A, D, E, and K in association with lipids are found in foods.
2. The water-soluble vitamins are B complex and vitamin C.

General Properties and Stability

Besides solubility properties, fat-soluble vitamins differ from water-soluble vitamins based on
the following factual criteria:
1. Fat-soluble vitamins generally have provitamins.
2. Because they can be stored in the body, deficiencies are slow to develop
3. They are not absolutely needed daily from food sources.
4. They are generally stable, especially in ordinary cooking methods.

On the other hand, water-soluble vitamins have the following general characteristics:
1. They must be supplied every day in the diet.
2. They do not have precursors.
3. They are not stored significantly in the body and any excess is excreted in the urine.
4. Deficiency symptoms develop relatively fast.
5. Being water-soluble, they are most likely to be destroyed in ordinary cooking

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A. Fat-Soluble Vitamins

a. Vitamin A (retinol)
 Physiologic functions
o Vision cycle
o Epithelial tissue
o Growth and bone development
o Reproduction
 Deficiency
o Poor adaptation or night blindness
o Eye lesion
o Growth retardation
o Lower resistance to infection
o Faulty skeletal and dental development
o Keratinization of epithelial lining
 Food sources
o Animal sources-liver, egg yolk, milk, cream, butter
o Dilis, clams, mussels
o Green and yellow veggies

b. Vitamin D (Calciferol)
 Physiologic functions
o Absorbs Calcium and phosphorus
o Essential for normal growth and development
 Deficiency
o Tetany
o Rickets
 Food sources
o Fortified margarines, butter, milk, cheese, liver , egg yolk

c. Vitamin E (tocopherol)
 Physilogic functions
o Antioxidant function
o Helps sustain tissue integrity
 Food sources
o Plants sources- germ oils of wheat, corn, soybeans
o Animal sources- egg yolk, butter, milk
d. Vitamin K (phylloquinone, menadione)
 Physiologic functions
o Necessary for maintenance of prothrombin level in blood plasma.

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  Deficiency
o Hemorrhagic disease in NB
o Delayed blood clotting time in adult
 Food sources
o Liver, dark green leaves, wheat bran, vegetable oils

B. Water-soluble vitamins
a. Vitamin C (ascorbic acid)
 Physiologic functions
o Converts folic acid into its active form, folinic acid
o Aids in healing wounds and bone fractures
o Prevents megaloblastic anemia and pinpoint hemorrhages also called petechiae
hemorrhages
o Build body resistance against infection
o Improves iron absorption
 Deficiency
o Scurvy
o Lowered resistance to infections

b. Vitamin B- Complex
B-complex vitamins
A. Group 1: Classic Disease Factors
1. Thiamine (B1)
Help maintain healthy appetite, good muscle tone, especially of the I tract and normal
functioning of nerves
Deficiency
 Loss of appetite, weakness, easy fatigability, indigestion, beriberi (nutritional
polyneuritis)

Food sources-Lean pork, pork liver

2. Thiamine (B2)
Helps maintain healthy skin, tongue and mouth, normal vision and proper growth and
development
Deficiency- ariboflavinosis
Food sources- cheese, milk, eggs, liver, whole grains, legumes, leafy green vegetables and
seeweeds.

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3. Niacin (nicotinic acid)
 Acts as a hydrogen and electron accept.
 Energy metabolism
 Fatty acid synthesis/oxidation
 Protein synthesis/catabolism
Deficiency- Pellagra
Food sources- liver, lean meats, fish and poultry, milk and cheese eggs, legumes, nuts, whole
grains, green vegetables

B. Group II: More discovered coenzymes factors

1. Pyridoxine (Vitamin B6)
Essential role in many of the complex biochemical processes by which foods are
metabolized by the body
Essential for the formation of tryptophan and for the conversion of tryptophan into
nicotinic acid

Food sources- vegetable oils of corn, cottonseed, linseed, olive peanut

2. Pantothenic acid
Essential for CHO, CHON and fat metabolism
Help maintain normal growth, healthy skin and integrity of the central nervous system

Deficiency- insomnia, muscle cramps, tingling sensation of the extremities and vomiting
Sources- liver, meat, eggs, milk, cheese and legumes

3.Lipoic acid
Sulfur-containing fatty acid and is not a true vitamin because it can be synthetized in
adequate amounts in the body. However, it is like the other vitamins.
4. Biotin
Food sources- liver and other glandular organs, meat, egg yolk, milk, legumes and nuts
C. Group III: Cell growth and Blood Forming factors
1. Folic acid

Essential for the formation of both RBC and WBC in the bone marrow and for the maturation
Deficiency- megaloblastic anemia and other blood disorders
Sources- liver, kidney beans, lima beans, fresh, dark green leafy vegetables.
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2. Cobalamin (B12)
Essential for normal metabolism and growth of all cells, especially those in the GI tract, bone
marrow and nervous tissue.
Essential for CHON, CHO and fat metabolism and is associated with folic acid absorption and
metabolism
Deficiency- Pernicious anemia
Sources- animal protein contains significant amounts of B12

D. Group IV: other related factors

1. Inositol
It occurs in meat and meat extractives, muscle and glandular organs, brain, legumes and nuts,
fruits, vegetables and grains.
Abundant in diet
2. Choline
It is a lipotropic agent.
Needed for fat transport as a constituent of phospholipids.
Helps in the transmission of nerve impulses
Sources- egg yolk

MINERALS
Minerals pertain to the elements in their simple inorganic form.
There are 21 mineral elements now known to be essential in nutrition.

Mineral Nutrition is defined as the naturally occurring inorganic nutrient found in the soil and food
that is essential for the proper functioning of animal and plant body. Minerals are vital elements
necessary for the body. Both the plants and animals require minerals essentially. For example, Zinc
is necessary for the manufacture of protein and for cell division.

A. GROUP 1: Major Minerals

1. Calcium
Food sources- kuhol, seaweeds gamet, malunggya leaves, saluyot, carabao milk, dilis, sardines,
cheese, dried fish

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Effect of deficiency-
Retarded growth
Rickets
Osteomalacia
Tetany

Effect of excess
Hypercalcemia

2. Magnesium
3. Sodium
4. Potassium
5. Phosphorus
6. Sulfur
7. Chlorine

B. GROUP II: TRACE MINERALS

1. Iron
2. Copper
3. Iodine
4. Manganese
5. Cobalt
6. Zinc
7. Molybdenum

PHYSIOLOGIC VALUE OF FOOD

FOOD
Food refers to the solid and liquid materials taken into the digestive tract that are utilized to
maintain and build body tissues, regulate body processes, and supply heat, thereby sustaining
life.
Food is composed of various compounds, both organic and inorganic, so that any food is either a
chemical compound or a mixture of chemical compounds. These compounds and elements can
be grouped as either organic and inorganic.
Organic compounds are proteins, lipids, carbohydrates, and vitamins.
Inorganic elements are water and minerals.
The three major nutrients-carbohydrates, proteins, and fats- stand quite apart from the other
requirements of the body such as vitamins and minerals since the former are needed in

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comparatively larger quantities. Vitamins and minerals act as catalysts which prompt the three
major nutrients to interact.

METABOLISM
The word metabolism is derived from the Greek work Metabolismos which means to change or
alter.
Greek Word from the metabolismos which means to change or alter. Metaboli is th The word
Energy is the force or power that enables the body to do its work. ln nutrition, however, energy
pertains to the chemical energy locked in foodstuffs brought about by metabolism.
ENERGY FROM FOOD
The Calorie
The unit of energy commonly used in human nutrition is the kilogram calorie (kcal) or simply
calorie. It is the unit of measurement for the energy that the body gets from food.
1,000 small calories = 1 kilocalorie or calorie
Calories are not eaten. They are by-products of carbohydrates, proteins, and fats that are oxidized
in the body. One kilocalorie is the amount of heat energy required to raise the temperature of 1
kilogram of water by 1 "C.
1 Fuel factor of carbohydrate = 4 calories per gram
2 Fuel factor of fat =9 calories per gram
3. Fuel factor of protein = 4 calories per gram

The total calorie content (total energy) available from food can be measured by a device called a
bomb calorimeter.

The Joule

The joule is the measure of energy in the metric system

1 calorie (kilocalorie) - 4.184 joule (kilojoules)
Example:
1 cup of milk - 170 kcal
170 kcal * 4.184 kjoules = 711.28 kjoules

Calculation of Food Value

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 The energy value of one tablespoon of sugar (15 grams) is approximately 60 calories (15 * 4).
Most foods, wever, are complex and contain proteins, fats, and carbohydrates. For example, one
cup of milk contains approximately:
12 gms carbohydrates * 4 cal/gm =48 kcal
8 gms proteins *4 cal/gm = 32 kcal
10 gm fats * 9 cal/gm = 90 kcal
Total = 170 kcal
From this information, the percentage of each nutrient can be calculated. To calculate the
percentage of kcalories from fat, for example, divide the 90 fat kcal by the total 170 kcal.
90 fat kcal / 170 kcal = 0.529 or 0.53 0.53 = 53%

COMPONENTS OF ENERGY EXPENDITURE

Basal Metabolism
Basal metabolism, also known as the required energy expenditure (REE), is the measure of
energy needed by the body at rest for all its internal chemical activities which is approximately 1
calorie per kilogram of body weight per hour for an adult. It is the minimum amount of energy
needed by the body at rest in the fasting state. It also indicates the amount of energy needed to
suction the life processes: respiration, cellular metabolism, circulation, glandular activity, and the
maintenance of body temperature. It accounts for more than one-half of calorie requirements for
most people. The basal metabolic rate (BMR) is the rate of basal metabolism in a given person at
a given time and situation. It constitutes one-half of the calorie requirements of an individual.

Conditions Necessary for BMR Test

To ensure accuracy:
1. The subject must be in fasting or post-absorptive state, at least 12 hours after the meal. (The
test is usually taken in the morning).
2. The subject must be awake, lying quietly, and free from physical fatigue, nervousness, or
tension as this causes an increase in heat production
3. The environmental temperature should be between 20 °C -25 °C so that the subject can
maintain his/her body temperature.
Values obtained in this test which are within the plus or minus 10% are still considered normal.
Calculation of BMR
1. A simple method for the calculation of the BMR is to use the rule of thumb 1 kcal per kg per
hour for adult male and 0.9 kcal per kg per hour for adult female. Thus, an individual whose
ideal body weight (IBW) is 50 kg has a basal metabolic energy need of 1,200 kcal per day (50 *
1 kcal * 24 hrs). This value, however, may not be applicable for obese or lean individuals.
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Example: Male, 75 kg = 1 kcal * 75 * 24 =1,800 kcal
Female, 65 kg = 0.9 kcal 65 * 24 = 1,404 kcal
2. Another method is the Harris-Benedict formula, developed in 1909, which uses information
on weight, height, age, and sex.
Example:
Males
REE = 66 + [13.7 x wt(kg)] + [5 x ht(cm)] - [6.8 - age(yr)]
Females
REE = 655 + [9.6 wt(kg)] - [1.8 x ht(cm)] - [ 4.7* age(yr)]
3. One more method used in obtaining the metabolic or fat-free body size is called the biologic
body weight raised to the 3/4 power.

Once the metabolic body size is known based on weight in kilograms, the figure is multiplied by
70, a value which applies to all animals.

A 50-kg man's REE = 18.8 * 70 = 1,326 kcal

The last method is developed by WHO/FAO/UNU in 1985. It uses the following equation:
16 x wt (kg) - 879 = REE
Thus, a 50-kg man has a REE of 1.459 kcal.

Factors that affect the basal metabolic rate (BMR)

1. surface are- the greater the body surface area or skin area the greater the amount of heat loss
and in turn the greater the necessary heat produced by the body. Muscle tissue requires more
oxygen than adipose tissue.

2. Sex- Women, in general, have a metabolism of about 5% to 10% less than that of men even
when they are of the same weight and height. Women have a little more fat and less muscular
development than men.

3. Age- the metabolic rate is highest during the periods of rapid growth, chiefly during the first
and second years and reach a lesser peak through the ages of puberty and adolescence in both
sexes.

4. body composition - A large proportion of inactive adipose tissue lowers the BMR Athletes
with great muscular development show about 5% increase in basal metabolism over non-athletic
individuals.

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 5. State of nutrition - A decrease in the mass of active tissue such as in the case of
undernourishment or starvation causes a lowered metabolism often as much as 50% below
normal.
6. Sleep - During sleep, the metabolic rate falls approximately 10% to 15% below that of
waking levels. This decreased rate is due to muscular relaxation and decreased activity of the
sympathetic nervous system.
7. Endocrine glands The endocrine glands, which secrete hormones into the blood stream, are the
principal regulators of the metabolic rate. The male sex hormones increase the BMR about 10%
to 15% and the female sex hormones a little less.
8. Fever - It increases the BMR about 7% for each degree rise in the body temperature above
98.6 °F.
Computation of DBW (Desirable Body Weight)
1 Ador Dionisio's Method
Height For every 5 feet, allow 100 lbs for female and 110 lbs for male. Then multiply the
additional inches by 2.
Age Multiply any age between 25 and 50 by 2 then divide by 5.
Example: Male, 45 years old, 5'4" tall
Height = 5 feet = 110 lbs
=4 inches x2 = 8 lbs
118lbs
Age= (45 years)x2 = 18 lbs
5
DBW= 118lbs + 8 lbs = 136lbs

2. Tannhauser’s method
Measure height in cm and deduct 100. From the different take off its 10%
Example:
Male, 45 years old, 5’4” tall
Height = 5’4” = 162.56 cm
162.56-100 =62.56cm
10% of 62.56 cm =6.256
62.56-6.256 =DBW (kg)
DBW (kg) = 56.7 kg or 126 lbs

Physical Activity
Calorie requirements depend on the type and amount of exercise. The more vigorous the
physical work, greater the calorie cost. The kind of physical activity and the amount spend
determine the amount of energy the body uses.

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Table 34- Calorie expenditure of various types of activities
Types of activities Calorie
Sedentary activities 80-100
Light activities 110-160
Moderate activities 170-240
Heavy Activities 250-350

Specific Dynamic Action of Food

CHO or fat increase the heat production of about 5% of the total calories consumed.

Estimation of Daily energy requirement of an adult

The daily energy reqt. Of an adult is commonly estimated by adding together the reqts for basal
metabolism, physical or muscular activity and the specific dynamic action (SDA) of food.:

1. Determine the DBW in kg of the individual

2. Determine the basal needs:
Male= 1.0 kcal /kilo of DBW/hr x 24
Female =0.9 kcal/kilo of DBW/hr x 24

3. Subtract 0.1 kcal/kilo of DBW/hours of sleep

4. Add the activity increment
5. Add the SDA (10% of basal need + activity increment)
6. Sum equals the approximate daily calorie reqt.

Estimation of total energy need

The total energy of an individual is the composite of energy necessary to replace basal metabolic
needs, energy expenditure for physical activities, thermogenic effect of food, and other factors.

The total energy need of an adult may be determined using one of the methods on the following
pages

1. The most practical and rapid method od estimating energy need is based on DBW according to
occupation. This method is often used in clinics and hospitals.

Table 36
BDW according to occupation
Occupation or FEMALE MALE
activity
Kcal/lb Kcal/kg Kcal/lb Kcal/kg
Bed patient 12 25 14 30
Light work 14 30 16 35
Moderate work 16 35 18 40

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 Heavy work 18 40 20 44

Example: 50kg man x 40 (moderately active) = 2,000 kcal/day

2. The second method of estimating the energy need is the factorial method. It uses the
following equation:

Basal energy (a) + physical activity (b) + thermogenic effect of food (c)= total energy need

a. calculate the basal metabolic rate using any of the four methods discussed earlier.
b. Determine the energy need for physical activity (PA) by using the short method. (Table 34).
c. Add the basal energy cost and activity cost
d. Calculate the thermogenic effect of food. For the mixed diet adequate in protein, add 10% of
the subtotal. For the average filipino diet ued 6%.
e. Add the basal energy, physical activity and thermogenic effect of food.

Example:

a. Basal metabolic rate using the Harris and Benedict formula REE
=66.5 + [13x50 kg] [5.0x 157 cm] – [6.8 x 35 (age)]
66.5 + 685 + 785-238
299 kcal
= basal metabolic needs

b. Energy need from PA

=total PA kcal x 50 (wt in kg)
=17.24 kcal x 50 kg
862 kcal for PA

c. Basal energy cost and activity cost

= 1,299 kcal + 862 kcal
=2, 161 kcal

d. thermogenic effect of food

=basal energy + physical cost x 6%
=(1,299 kcal + 862 kcal )( 0.06)
=2,161 x0.06
=130

e. Basal energy cost, activity cost, and thermogenic effect of food

=1,299 kcal + 862 kcal +130kcal = 2,291 kcal

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3/ The daily energy need can also be determined by referring to the recommended dietary
allowances for filipinos
Table 38 ( Recommended daily energy intake for adults
Age Men Women
20-31 2580 1920
40-49 2450 1820
50-59 2320 1730
60-69 2060 1540
70-79 1810 1340

4. The fourth method is recommended by FA/WHO/UNO (1985).

To get the energy need, multiply REE by the type of activity.

Table 39- Energy need based on type of activity

Type of activity Men Women
Very light 1.3 1.3
Light 1.6 1.5
Moderate 1.7 1.6
Heavy 2.1 1.9
Very heavy 2.4 2.2

Example:
Basal metabolic needs of a 50 kg man is 1,459 kcal x 1.7 (moderate )= 2,480 kcal

Energy balance
The amount of energy taken in by an individual should be equal to the amount of energy
expended during the day.
(any of the following may use)
1. Tannhauser’s method
Height in cm =157 cm
(factor) 100
57 kg
( 10% of answer obtained to adjust weight to suit the filipino standard) 5.7
= 51.3 or 51kg

2. for 5 feet, allow 100-105 lbs 9 female); 105-110lbs (male) for each additional inch, add 5 lbs
5’2’= 105 +10 = 115 lbs

The values above apply to adults with small frame.Add 5 lbs for medium frame and 10 lbs for
large frame.

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