Nutrition Symposium / Orthodontic Courses by Indian Dental Academy

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INDIAN DENTAL ACADEMY

Leader in continuing dental education
www.indiandentalacademy.com

NUTRITION AND ORAL
HEALTH
Presenters
Dr. Prathima Sreenivasan
Dr. Giridhar Naidu S

Under the able guidance of
Prof Dr. Gopakumar R

Dept. Oral Medicine & Maxillofacial Radiology
A.B.Shetty Memorial Institute Of Dental Sciences
Deralakatte, Mangalore

Om Bramhmarpanam bramha havi
Bramhagna bramhanahutam
Bramhaiva tena gantavyam
Bramha karma samadhinaa
Food:
Food is what is taken to supply the necessary
nutritive elements.
Diet:
Diet is a prescribed course of eating and drinking
in which the amount of food as well as the times at
which it has to be taken are regulated by the
physician for therapeutic uses.
Nutrient:
It is a constituent of food or a diet that must be
supplied in suitable amounts.

Nutrition:
It is the science of foods, the nutrients and other
substances therein; their action,interaction and
balance in relationship to health and disease.,the
process by which the organism ingests, digests,
absorbs, transports and utilizes.

Malnutrition:
Impairment of health resulting from a deficiency
excess or imbalance of nutrients.

NUTRIENTS

MACRONUTRIENTS MICRONUTRIENTS

Carbohydrates
Fats
Proteins
Water
Dietary Fibers
Minerals
(Micro &Macro)

Vitamins
PROTEINS
Structure
Catalysts
Regulation
Transportation
Clotting of blood
Antibodies
Contractile proteins
Osmotic balance
Chemical messengers

CARBOHYDRATES
Energy source
Regulate protein metabolism
Derivatives like glucoronic acid
glycerol & glycogen
Pentose sugars form nucleic
acids

LIPIDS
Energy source
Cell membrane constituent
Biologic metabolites
Glycolipids and lipoproteins
Precursors of cholesterol,steroids, hormones,
Flavor and satiety

Protein Calorie Malnutrition
Growth phase (Rat experiments)
Shaw & Griffith - smaller molars, delayed eruption
Di Orio Increased caries susceptibility
Menaker & Navia Atrophy of salivary glands
Nakamoto & Muller Retarded mandibular development

Post growth phase (Primate experiments)
Decreased amylase, sIgA
Atrophy of human parotid
Necrotizing Ulcerative Gingivitis
Delayed wound healing
Cytologic defects

VITAMINS (Vital Amine)

Vitamin A Cellular differentiation,
integrity,growth,
antikeratinizing, vision

Xerostomia, Enamel
Hypoplasia, Tooth
eruption,cancer
Vitamin D Calcium & Phosphorous
metabolism

Cementum & dentin
Vitamin E Antioxidant

Vitamin K Clotting factors

Bleeding in surgery
VITAMINS
Vitamin C Collagen synthesis,
adrenal cortical hormones
Scurvy,
Enamel & dentin
defects
Vitamin B
complex
Coenzyme in many
biological reactions,
DNA synthesis
Glossitis, angular
cheilitis, RAS,
Ulceration, Infection,
keratinocyte
maturation
MINERALS

Calcium Bone, tooth formation
, blood clotting,
muscle, nerve.
Bone density,
hypoplasia
Phosphorous Bone tooth formation rare
Iron Hemoglobin Anemia glossitis,
chelitis
Zinc Wound healing, Taste, smell,wound
healing,
Fluorine Bone, tooth formation Susceptibility to
dental caries
MINERALS

Copper Antioxidant, iron
absorption
anemia
Selenium antioxidant Predisposition Cardiac
disease
DIETARY FIBERS
They are complex polysaccharides
Components cellulose, lignin & non cellulosic
polysaccharides
Physical Properties
Water binding
Bile acid binding
Cation binding
Sources
Cereals & millets, Gums, fenugreek, pulses, fruits
vegetables


Physiologic effects
Increase fecal bulk
Decreases nutrient digestion and absorption
Reduce glycemic response
Hypocholestrolemic effect


WATER

Constitutes 50-60% of body weight
Universal solvent/ medium for all metabolic reaction
Temperature regulation
Dissociates into H & OH
Lubrication between cells

NUTRITIONAL VALUE
Energy requirement:
The level of energy intake in relation to expenditure
which is most likely to prolong active life.
Energy for basal metabolism
Energy for physical activity
Energy expended during digestion and absorption of
nutrients

Basal Metabolism:
Minimum amount of energy needed to regulate and
maintain the involuntary essential processes.

BMR:
Number of kilocalories expended by the organism per hour

SDA:
Specific dynamic action is the expenditure
of calories during the digestion and absorption
of food.

Calories:
Quantity of energy required to raise the
temperature of 1kg of water by 1 C
Recommended Daily Allowance

Carbohydrate 50-70%
Protein 1gm/kg/day
Fat 20%
Vitamin A
Beta carotene
750mcg
3000mcg
Vitamin D 2.5mcg
5 mcg
Vitamin E 10mg
Vitamin K 45mcg
Vitamin C 40mcg
Thiamine 0.5mg/1000 C
Recommended Daily Allowance
Riboflavin 0.6mg/1000 kcal
Naicin 6.6mg/1000 kcal
Pyridoxine 2mg
Pantothenic acid 10mg
Folate 100mcg
Cyanacobolamine 1mcg
Iron 0.9mg
2.8mg
Iodine 150mcg
Calcium 400-500mg
Fluorine 0.5 0.8mg/lt
Zinc 15mg
BALANCED DIET
A balanced diet is one which includes all the
essential food groups and allows the body to
function at an optimal level free from disease and
malaise.

A balanced diet constitutes the following

-

Protein 15 %

Carbohydrates 60%
Fats 25-30%

Dietary Fiber

FOOD PYRAMID
NORMAL INDIAN DIET

Cereals:
Rice, wheat
Millets

Jowar, bajra, ragi
Animal Foods

Eggs, milk , fish , meat
Vegetables and
pulses
Roots and tubers, green leaves
Fruits
Banana, mango, musambi, grapes, apples,
oranges, dates
Beverages
Coffee,tea,cocoa,alcohol
Fats and oils
Butter, ghee, dalda
Condiments
Cardamom, garlic, chilies, turmeric pepper
ASSESSMENT OF NUTRITIONAL STATUS

History
Anthropometry
Clinical examination
Biochemical evaluation
Assessment of dietary intake
Vital and health statistics
Ecological studies

Excess nutrition

Normal nutrition

Primary DEFICIENCY Secondary

Tissue Depletion

Biochemical Lesion

Clinical Signs
HISTORY
Weight change
Immunologic disorders
TMJ pain
Xerostomia
Steroid therapy
Head and neck cancer
Osteoporosis
Herbal medication eichinacea, ephedra
ANTHROPOMETRIC
Weight
Height and length
Skin fold measurements
Other body measurements
BMI and Dentate status
Body Mass Index : body weight in kg
height in mts
< 21 natural teeth - obese
< 11 natural teeth underweight


DIETARY SUPPLEMENTS
Dietary supplement Act,1994

Products intended to supplement the diet
contains a vitamin,mineral,amino acid or other
botanicals.
Does not represent conventional food.
Ingested in the form of capsule,
powder,softgel etc
FOOD FORTIFICATION
Fortification is a public health measure aimed at
reinforcing dietary intake of nutrients with additional
supplies to prevent or control nutritional disorders in a
given area.

Example
fortification of salt with iodine.
fortification of wheat with vitamins.

Supplement Oral use Forms
Caffeine Ergogenic aid Beverage
Capsaicin Pain relief for
tooth ache and
trigeminal
neuralgia
Chillies, topical
ointments
Garlic Treatment and
prevention of
oral candidiasis
Supplement Oral use Forms
Green tea Decreases risk
of dental caries,
cancer
prevention
Beverage

Lysine Prevents
recurrence of
aphthous ulcers,
herpes labialis
Tablets, Topical
applications
Vitamin C Integrity of
gingiva,
improved
healing
Citrus fruits,
tablets
ANTOXIDANTS IN VEGETABLES & FRUITS
Indoles
Carotene
Lycopene

Reactive species Antioxidant
Singlet oxygen Vit A, E , beta carotene
Superoxide free radical Vit E, Beta carotene
Peroxyl free radical Vit E, C.
Hydrogen peroxide Catalase, Glutathione
peroxidase
Lipid peroxides Glutathione peroxidase
Free radical Chain reaction

PUFA-OO PUFA-OOH

TOCOH TOCO
PUFA-H

Vit Cox Vit cred PUFA-OOH
GS-SG GSH H2O2 GSH

Superoxide catalase
Dismutase
H2O GS-SG
Superoxide PUFA-OH
DISEASE AND NUTRITION
Anemia
Diabetes Mellitus
Cardiac Disease
Cancer
Liver disease
Renal Disease
AIDS
Acid Peptic Disease
NUTRITION IN ANEMIA
Supplements
Iron
Vitamin B complex
Protein, red meat
Vitamin C

Avoid:
High fat
Spicy food

OBESITY
Overweight:
10- 20 % above desired weight
Obese :
Excessive amount of adipose
Hypercellular
Hypertrophied

Risk for
Cardiac Diseases
Diabetes Melitus
NUTRITION IN DIABETES MELLITUS

Risk factors
High cholesterol
Sedentary life style

Supplements
Regular meal pattern
Protein
Adequate carbohydrate
Fibers

NUTRITION IN CARDIAC DISEASE
Risk factors:
High salt intake
Low potassium, calcium,
High cholesterol
Alcohol

Supplement
Omega 3 FA
Soybeans
Fruits and Vegetables
Dietary fiber

DIETARY MODIFICATIONS

DASH Dietary Approaches to Stop Hypertension
Control diet- reduced fruits and vegetables
Fruit and vegetable diet
Combination diet
BP- 11.4/5.5mm of Hg
Cholesterol lowering
Hydrogenated oils, sugar- reduce
Fish, soluble fiber - increase
Sodium Controlled 2gms/day
NUTRITION IN CANCER
Risk Factors:
Alcohol
Fat
Pickled & smoked food
Arsenical, lead, cadmium
Additives like saccharin, flavonoids

Supplement
Fruits and vegetable
Dietary Fiber
Water
Vit E and selenium
Phytoestrogen
NUTRITION IN RENAL DISEASE
Risk factors
High protein
High sodium
Excess fluid intake
High cholesterol

Supplements
Kilocalories carbohydrates
Potassium, calcium, phosphorous
Vitamins

NUTRITION IN LIVER DISEASE
Risk factors
High protein
High fat
Alcohol

Supplements
Adequate protein
Reduced fat
Higher carbohydrate
Micronutrients

NUTRITION IN AIDS

Cachexia
Hormonal imbalance
Immunologic changes

Supplements
High calorie diet
Frequent meals
Vitamins and minerals
NUTRITION IN ACID PEPTIC DISEASE

Risk factors
High food quantity
Milk
Seasonings
Coffee
Citric acid fruits
Alcohol


Thank you all !

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