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MACRONUTRIENT

S for MPH
students
Professor Tefera Belachew (MD, MSc,
PhD)
Jimma University
ABH Campus
August , 2016

Learning Objectives
By the end of this session the learners will be able to
:

Understand the relation ship between consumption of


energy(macronutrients) and health consequences
Explain the key interventions that prevent theses
consequences.
Be able to explain the scientific reasons underpinning
the relationship between consumption of various types
of macronutrients and health outcomes
Identify food sources of macronutrients and use this
knowledge in delivering counselling and in nutrition
education

Macronutrients: - are nutrients that are


required by our body in larger quantities on
a daily basis and need to be broken down to
smaller units for use by the body.

They include carbohydrates, lipid and proteins.

All of them contribute to the energy pool of the


body

Macronutrients contribute to the energy


pool of the body
Carbohydrates
(45-65%)

Energy Pool
of the body
(100%)

Proteins
(10% - 35%)

Fats
20% - 35%

Cont

While each of these macronutrients provides calories, the


amount of calories that each one provides varies.

Carbohydrate provides 4 calories per gram.


Protein provides 4 calories per gram (5.2 kcal/gram is removed as
metabolizable energy).
Fat provides 9 calories per gram.

Besides carbohydrate, protein, and fat the only other


substance that provides calories is alcohol. Alcohol
provides 7 calories per gram.
Alcohol, however, is not a macronutrient because we do
not need it for survival.

CARBOHYDRATE
S

CLASSIFICATION OF CARBOHYDERATES

Glycaemic index

Food sources of Carbohydrates

Free sugars are found from: fruits, juices, confectionery,


Soft drinks, , milk, sugar, sugar cane, honey and yogurt, Cereal
grains, Legumes & dried fruits, vegetables, processed foods
(pasta), jams, pastries, breads, candies fruits like banana, dates, and
sweet potato

Starch is found from: starchy foods (like cereals and legumes


and potatoes), Other foods like fruits, vegetables, beans, nuts, seeds

OligoSacharides are found from : Garlic, onion, Whole


grain cereals and legumes (beans and peas)

Non starch polysaccharides are found from: Fruits,


vegetables, Whole grain cereals and legumes

WHY DO WE NEED CARBOHYDRATES TO


We need this amount of carbohydrate because:
SURVIVE?

45% - 65% of calories should come from carbohydrate


Carbohydrates are the bodys main source of fuel.
All of the tissues and cells in our body can use glucose for
energy.
Carbohydrates are needed for the central nervous system, the
kidneys, the brain, the muscles (including the heart) to
function properly.
Carbohydrates can be stored in the muscles and liver and later
used for energy(glycogen).
Carbohydrates are important in intestinal health and waste
elimination (e.g.. Dietary fiber).

Dietary fiber

Fiber refers to certain types of carbohydrates that our


body cannot digest (oligosaccharides and non-starch
polysaccharides).

These carbohydrates pass through the intestinal tract


intact and help to move waste out of the body.

Diets that are low in fiber have been shown to cause


problems such as constipation and hemorrhoids and to
increase the risk for certain types of cancers such as
breast cancer and colorectal cancer.

Cont

Diets high in fiber; however, have been shown


to decrease risks for heart disease, obesity, and
they help lower cholesterol.
Foods high in fiber include fruits, vegetables,
and whole grain products.

Nutrient

Sources

Water insoluble dietary fibers


-glucans (a few of which are water soluble)
Cellulose

cereals, fruit, vegetables (in all plants in general)

Chitin

in fungi, exoskeleton of insects and crustaceans

Hemicellulose

cereals, bran, timber, legume

Hexosane

wheat, barley

Pentosane

rye, oat

Lignin

stones of fruits, vegetables (filaments of the garden bean),


cereals

Xanthan

production with Xanthomonas-bacteria from sugar substrates

water soluble dietary fibers


Fructans
Inulin

replace or complement in some plant taxa the starch as


storage carbohydrate
in diverse plants, e.g. topinambour, chicory, etc.

Polyuronide
Pectin

in the fruit skin (mainly apples, quinces), vegetables

Effect of dietary fiber on breast Cancer


Systematic review

Sourec: Annals of Oncology, Jnaury, 2012

Insoluble fibre has more effect on weight

Fiber and Colorectal Cancer: review of evidence

Source:

How does fiber prevent different health


problems? (Proposed Mechanisms)
Cancer (Colonic, breast..)
Prevents secondary bile acid circulation
Decrease intestinal transit time and contact of
carcinogens with intestinal cells
Fermentation product butyrate has apoptotic
effect
Decreases absorption fats and sugars

Cont

Dietary Fiber prevents Constipation,


Hemorrhoids & Diversticulosis by:

Increasing perystalsis making stool bulk

Decreasing straining to pass stool

Carbohydrate digestion

a. Digestion of starch and disaccharides

-Chemical
salivary Amylase
(Ptyalin) &
Pancreatic
amylase
-Mechanical;biting action of
the teeth

Starch,
Dextrin,
Mouth and

small
intestine

Lactose

Lactase

Glucose
+
Galactose

Sucrase

Sucrose

Glucose
+
Fructose

From the small


Maltoseintestine
Maltase
Glucose +Glucose
Absorbed by simple
diffusion

Absorbed by active transport


mechanism coupled with sodium

b. Digestion of oligosaccharides, resistant starch and nonstarch

polysaccharides

Oligosaccharides (eg. Raffinose, Stachyose)


and non-starch polysaccharides resistant

starch

Escape digestion in the


upper gut (small intestine

They get fermented in the

colon by anaerobic bacteria

Production of
gases likes co2,
methane and
hydrogen
sulphide

Production of
short chain fatty
acids (SCFA)

Acetate

Propionate
Butyrate

Increased faecal Biomass


resulting in increased

peristalsis

Metabolism of Carbohydrates
Glucose 6-Phosphate

Glycolysis

Fructose-6-phosphate
Fructose1, 6-diphosphate

3-Dihydroxy Acetone phosphate

Glyceraldehyde-3 phosphate

bGlyceraldehyde 3-phosphatephosphate
Acetyl

CoA

Crebs Cycle

CO2+ Energy+H2O

Food Sources

Free Sugars: Dates, soft drinks, sugar , Juices,


honey
Oligo saccharides: Garlic, onion, beans , peas,
Whole grain cereals: vegetables beans , peas,
whole grain cereals, fruits
Non-Starch Poliy saccharides: Beans , Peas,
Whole grain cereals, Whole grain legumes

PROTEINS

Proteins

The name was derived before a century from a Late


Greek prteios , of the first importance.
Proteins are the second most abundant components
of the body
Proteins are composed of carbon, hydrogen, oxygen
and nitrogen.
The unique feature of proteins in terms of composition
is that 16% of their weight is nitrogen.
They could also contain other elements like Sulphur,
Phosphorus, Iron and Cobalt.

Proteins

The basis of protein structure is the amino acid, of which 22 have


been recognized as constituents of most proteins
All Amino acids have amino group(NH2) and Carboxylic
Group(COO2)
H
R

COOH

NH2

But, they are differentiated by the remainder of the molecule (R)


as shown in the figure.
Those amino acids that cannot be synthesized in the body and need
to be taken from food are essential (indispensable) amino
acids.

Cont..

Absence Essential a.a.from the diet leads to poor growth


performance by a growing animal. Essential amino acids are
labelled by (**) sign in the following table .
22
Selenocysteine

Pyrrolysine

WHY DO WE NEED PROTEIN TO SURVIVE ?


We need protein for:
Growth (especially important for children, teens,
and pregnant women)
10% - 35% of calories should come from protein,
when carbohydrate is not available
Tissue repair
Immune function
Making essential hormones and enzymes
Preserving lean muscle mass
Synthesis of enzymes, hormones all antibodies
Control Fluid movement in the body
Buffer(PH control): Due to the carboxyl or acid
group (-COO) and amino or basic group (- NH 2 )

Why proteins

Carriers
Carry lipids, vitamins, minerals and oxygen in the body
Act as pumps in cell membranes, transferring compounds
from one side of the cell membrane to the other
Other Roles

Blood clotting by producing fibrin which forms a solid clot


Vision by creating light-sensitive pigments in the retina

Using Amino Acids to Make Other Compounds

Neurotransmitters are made from the amino acid tyrosine.


Tyrosine can be made into the melanin pigment or thyroxine.
Tryptophan makes niacin and serotonin.

Classification of proteins
I.

Based on chemical composition.

a)Simple protein - yield amino-acids upon complete


hydrolysis
E.g.: - albumin - in eggs, zein of corn
b. Compound/conjugated proteins
Protein + Non protein
E.g.: - Hgb
(Protein + hem) - Blood

Cont..
II. Based on Nutritional Value:- This classification depends
on the essential amino acids content of the protein.
a. Complete proteins: Contain all the essential amino acids
in the proportion that is required to support growth and
maintain tissues. E.g. Almost all animal proteins except
gelatine (lack four essential A.As.). They are denoted as
complete because they resemble body protein (Egg &
Milk).
b. Incomplete Proteins: This refers to proteins that do not
contain all essential amino acids in the proportion that is
required to maintain growth and tissue repair.

III.

Based on Conformation of the Protein: This refers to the three dimensional

shape of the protein in its natural state. Based on this proteins are classified as:

a. Globular proteins
-Tightly folded poly peptide chain - spherical or globular shape
-Mostly soluble in water
E.g.: - Enzymes, antibodies, and many hormones, Hgb

b. Fibrous proteins
-Polypeptide chains arranged in parallel manner along an axis
-Tough & in soluble in water
E.g.: - Collagen of tendons & bone matrix
- Keratin of hair, skin, nails and
- Elastin of blood vessels

IV. Based on their Chemical Structure


A. Primary structure :
refers to the sequence of amino
acids in the polypeptide chain of proteins held by

peptide bond.

Eg. Ala---gyc---Phenala---histd---tyr---trp
B.

Secondary Structure: This refers to the folding


of the polypeptide chain upon itself resulting in
alpha helix (right twisted or left twisted) and or
B-pleated sheet. This structure is held strong by
intra molecular hydrogen bonding.

1. Alpha helices
OR
2. B-Pleated Sheath

C. Tertiary Structure: This refers to the three dimensional arrangement


of the protein structure (whether it is folded upon
itself giving rise to globular proteins or whether its
straight chain of poly peptides resulting in fibrous
protein).
This structure is maintained by the sulphide bond.

Fibrous protein

Globular protein

D. Quaternary structure- aggregation of individual


globule stabilized by electrostatic bonding eg.
Hemoglobin

Is eating Raw Meat nutritionally


beneficial?

If we have to cook, what type of


cooking is recommended?

Nitrogen Balance
Definition: Nitrogen balance refers to the situation where
nitrogen intake from food is equal to nitrogen excretion.
This occurs in a healthy non-growing adult person taking
adequate amount of energy from carbohydrates.

In some situations Nitrogen excretion may be greater than


nitrogen intake, this is called negative nitrogen balance.

Other situations where nitrogen excretion is less than


nitrogen intake from food are called positive nitrogen
balance.

Factors affecting nitrogen equilibrium


Positive Nitrogen balance
-Pregnancy
-Lactation
-Growth
-Recovery from Illness (Convalescent stage)

Nitrogen intake = Nitrogen Excretion (nitrogen balance)


?

Negative Nitrogen balance


1. Starvation
2. Devastating illness
3. Protein energy malnutrition

Protein Quality

Since individual nitrogen-balance measures are cost


ineffective and time consuming, other scientific methods
should be examined to determine what protein quality their
food choices offer.

These methods are called :

Biological Value (BV),


Protein Digestibility (PD)
Net Protein utilization (NPU),
Protein Efficiency Ratio (PER),
amino acid score and
Protein Digestibility Corrected Amino Acid Score(PDCAAS), for
determining the relative quality from food-source proteins.

Methods of assessing Protein


Quality

I. BIOLOGICAL VALUE(BV)

The BV is an accurate indicator of biological activity of protein,


measuring the actual amount of protein deposited per gram of
protein absorbed.

BV measure of protein quality expresses the rate of efficiency


with which protein is used for growth.

As a rule-of thumb, high BV-proteins are better for nitrogen


retention, immunity and are superior for reducing lean tissue loss
from various wasting states than proteins with a low BV score

Generally, high BV-proteins are more anti-catabolic than low BVproteins.

Biological Value = Protein ingested- fecal N2-urinary N2


Protein Ingested-Fecal N2
PROTEIN BV*
BV=
/Absorbed)x100
Protein(Retained
source
BV
Egg

93.7

Milk
Fish
Beef
Soybeans
Rice, polished
Wheat, whole
Corn
Beans, dry

84.5
76.0
74.3
72.8
64.0
64.0
60.0
58.0

*Biological Value[BV]=proportion of protein retained in the human body for maintenance and or
growth.

Soy is a complete protein but why does it rank low?

Soy is generally recognized as the best single plant-source food with a complete amino
acid profile.

Why then did Soy, the top plant-source protein, rank only mid-scale below fish and
beef?

Soy is a low BV-protein, lacking a high volume of sulfur-containing amino acid


methionine. The sulfur containing amino acids (cysteine being the other one) are
particularly important for:

protein synthesis/growth,

proper immune system function, and

the body's production of glutathione (GSH).

GSH is one of the most important anti-oxidants found in the body and protects cells
and serves to detoxify a variety of harmful compounds such as hydrogen peroxide,
carcinogens, reactive oxygen species (ROS), and many others.

In particular, GSH is partly responsible for keeping low density lipoproteins (LDL)
from oxidizing and clogging our arteries. Several studies have shown soy protein to be
inferior to whey for the production of GSH and improvements in immunity.

II. Amino acid score(Chemical Score)

The concentration of the limiting - amino acid per gram


of protein of the food being tested and expressed as
percentage of the concentration of this amino acid in a
gram of protein of reference food or scoring protein.

In calculating the chemical scores of proteins, a


limiting amino acid is used.

A limiting amino acid is the one that is found in


smallest quantity in that food.
E.g.
lysine in cereals, methionine in legumes and
tryphtophan in corn.

Cont
Amino acid(Chemical) score=
Mg of a limiting aa in 1 g.of the test protein X100
Mg of a limiting aa in1 gram of the reference protein

* It is agreed that if the chemical score is >70%, the


protein is labelled to have good quality and if it is
less than70% it is labelled to poor quality.

III. PROTEIN EFFICIENCY RATIO(PER) :


Protein Efficiency Ratio (PER) measures the weight gain of
experimental growing rats when being fed the test protein
PER =
wt gain (g)
Protein intake (g)
PER*
Whey Protein
3.6
Milk Protein
3.1
Casein
2.9
Soy Protein
2.1
*Any protein that has a higher PER value than 2.7 is considered an
excellent quality protein.

III. NET PROTEIN UTILIZATION(NPU) METHOD


The NPU method of evaluating protein quality reflects percentages of a
food protein retained. The amount of protein eaten versus the
amount of protein retained is reflected by the NPU*-rating method
as noted below for selected foods:
Eggs
94%
Milk
82%
Brown Rice
70%
Meats[most] 65-57%
Soybeans(alone)
61%
Legumes[alone]
50-60%
Whole Grains 50-60%

*Net Protein utilization (NPU) =Proportion of protein intake that is


retained.
NPU= (Retained/ Ingested)x100

IV. PROTEIN DIGESTIBILITY CORRECTED AMINO ACID


SCORE (PDCAAS METHOD)- PDCAAS Scale

Digestibility-Corrected Amino Acid Score(PDCAAS)is the


latest method for calculating protein quality, accounting for the
digestibility of a food protein from it's amino acid profile
content.

The PDCAAS method utilizes an amino acid requirement


profile derived from human subjects.

PDCAAS is a new method to compare the quality of various


proteins based on the amino acid requirements of humans

A PDCAAS can't be higher than the "Complete Score" of 1.0. Soy


protein Isolates, Whey Protein Isolates, and Egg Whites are the only
proteins scoring a complete "1.00" PDCAAS rating.
Proteins
PDCAAS
SOY
1.00
WHEY 1.00
EGG
1.00
Beef
0.92
Pea
0.73
Oats
0.57
Peanut
0.52
Rice
0.47
Corn
0.42
Wheat Gluten
0.25

Protein Digestibility (PD) Method For Single & Combined Foodproteins Source Approximate Adult Digestibility
Corn, Soy, Milk
1.00
Egg 0.97
Milk
0.97
Corn-Soy blend
0.92
Indian Rice Diet + Milk
Corn, Beans, Milk
Wheat, Refined
0.89
Soy Protein, Isolated
Wheat + Soy Protein----->

0.92
0.90

Fish Flour + Millet +


Peanut Flour------------>

0.87

Rice, Polished
Corn + Beans
Wheat, Whole
Soybeans
Maize

0.82
0.78
0.76

0.88

0.84
0.79

Protein Digestibility (PD)=Proportion of protein absorbed.

0.87

Protein Digestion

Absorption

Depends on proteins food source


Animal proteins are 90-99%
absorbed.
Plant proteins are 70-90% absorbed.
Soy and legumes are 90% absorbed.

Average digestibility = 91%

Absorption of proteins

some small peptides are absorbed (mostly di- &

tripeptides)

H + gradient-driven symport
absorbed peptides hydrolyzed to amino acids by cytosolic
peptidases
Amino acids reach portal blood via facilitated diffusion
across contraluminal membrane of mucosal cells

Mechanism same as monosaccharide systems (Na+ amino


acid co-transport mechanism)
Specific transmembrane carrier proteins(Acidic, Basic
and Neutral carriers)

Metabolism of Proteins
Protein

Glucose

Protein Digestion

Both ketogenic & glucogenic aa


Amino acid

Glycolysis

Deamination
Carbon
Skeleton

Pyruvate

Ketogenic aa

NH2

Acetyl CoA
Urea Cycle

Krebs Cycle
Co2+H2o +
Energy

Glucogenic aa

Glucogenic Amino acids

RDA
AGE, yrs.

Gram of protein/kg g/1000 kcal

0-0.5
0.5-1.0

2.2/per kg weight

Category

INFANTS

2/ per kg weight

For adults :
-in general intake of 0.8 gram of protein/kg
of body weight is adequate.
-Muscle building exercise 2gram/kg/day

RDA
Category

Age in years

Gram per day

g/1000 kcal

CHILDREN

1-3
4-6
7-10

2.3
3.0
36

17.7
16.7
15.0

Male

11-14
15-18
19-22
23-50
51+

44
54
54
56
56

15.7
18.0
18.0
20.7
23.3

FEMALE

11-14
15-18
19-22
23-50
51+

44
48
46
46
46

18.3
22.9
21.9
23.0
25.6

+30
+20

PREGNANT
LACTATING

Foodsource
sources
Animal
foodsof

proteins

Beef, Lamb, pork (Brown meat)


Fish, chicken (Whit meat)
poultry,meat substitutes, cheese, milk,

Plant source foods

nuts, legumes, Soya bean cereals and legumes (beans,


pea, chickpea, broad bean).

*How can we improve the quality of protein

from plants?

LIPIDS

Lipids
Classification
Nutritionally important lipids are classified into 3 main
groups on the basis of their Chemical structure.
Simple lipids - include fats and oils (Triglycerides)
Compound lipids - includes Phospholipids, lipoprotein
Derived lipid - includes fatty acids and sterols.
* Some authorities classify lipids as structural lipids (Phospholipids),
Metabolic lipids (fatty acids, lipoproteins and sterols) and storage
lipids (triglycerides).

WHY DO WE NEED FAT TO SURVIVE?


Although fats have received a bad reputation for causing
weight gain, some fat is essential for survival.
We need this amount of fat for:
Provides energy(20% - 35% of calories should come
from fat)
Energy storage (fat is the most concentrated source of
energy)
Serve as a vehicle for the absorption of lipid soluble
vitamins ( like vitamins A, D, E, K, and Carotenoids )
Providing cushioning for the organs
Providing taste, consistency, and stability to foods

Why do we need Cont

Prostaglandin, cytokine synthesis


Cell differentiation , growth and development
Cell membrane structure, myelination
Hormone synthesis
Bile acid synthesis
Provision of Essential Fatty Acids

*Humans cannot synthesize double bonds within the last nine carbons o

the methyl end (n) of any fatty acid chain. Fatty acids with double
bonds in those locations must therefore come from the dietand are
considered essential

A. Fatty Acids
Classification
1. Based on the Length of Carbon chain
a.

Short chain - 2 - 4 carbon atoms (eg. Butyric


acid)
b. Medium chain - 6-12 carbon atoms (Caprillic acid)
c. Long chain - 14-18 carbon atoms (palmitic acid,
stearic acid)
d. Extra long chain - more than 20 carbon atoms
(Arachidicacid)

2. Based on Degree of Saturation


Saturated FA: - The degree of saturation refers to the

number of double bonds between carbon atoms. If all of the


carbon atoms in a fatty acid are saturated with all
hydrogen atoms they can hold, no double bond can exists.

All short or medium chain fatty acids are saturated. Long


chain fatty acids may be either saturated or unsaturated. The
major saturated fatty acids are palmitic and stearic acids.

The carbon atoms are not saturated with hydrogen atoms


and the double bonds are formed between the carbon atoms
to satisfy natures laws that each carbon atom have 4 bonds
connecting it to other atoms.

Examples of Saturated FA and MUFA

Cont..
Monounsaturated FA: -

Monounsaturated fatty acids


contain only one double bond between carbon atoms. The most
prevalent MUFA in the diet is oleic acid.

Polyunsaturated FA (PUFA):They have two or more double bonds between carbon atoms. In
omega 3 PUFA, the first double bond occurs 3 carbon atoms
from the methyl carbon.
Important omega-3 fatty acids in nutrition are:
-linolenic acid (ALA),
eicosapentaenoic acid (EPA), and

docosahexaenoic acid (DHA).

Essential fatty acids

Humans cannot synthesize double bonds within the last


nine carbons of the methyl end (n) of any fatty acid chain.
Fatty acids with double bonds in those locations must
therefore come from the dietand are considered
essential

The two essential fatty acids are:

Linoleic acid (omega 6 fatty acid)


Alpha-linolenicacids (ALA) (Omega 3 fatty acid)

Both are (poly) unsaturated

Therefore, absolute requirements for fat in the diet


applies only to unsaturated fat

ALA is essential Omega 3-PUFAs

Omega 6 PUFAs

Hydrogenation

If an unsaturated vegetable fat is altered by adding


hydrogen atoms, which did not exist in nature, the fat
molecule is said to be "hydrogenated."
Hydrogenation transforms the shape of a fatty acid to a
"trans" form.
You can visualize this by imagining a boat-shaped
molecule being transformed to a chair-shaped
molecule.
This molecule does not occur in nature, and the body
has difficulty digesting it.

Hydrogenation

Vegetable Oil

Cis and Trans Fatty acids

Cont

This is the problem with margarine it contains


hydrogenated, trans-fatty acids.

Studies show this type of molecule to be more


associated with artery disease than the saturated
("hard") fat found in butter.
hydrogenated fat also is commonly associated with
junk food: potato chips. cookies, etc. It is very hard
to digest and is strongly associated with vascular
disease.

Avoid
Trans Fats!
Water
Amino Acids
Fatty Acids
Vitamins
Minerals
Phytochemicals

X
X
X
X
X
X
X

Consume ONLY those foods with a nutritional payoff -

NO EMPTY CALORIES!

Trans fatty acids

Naturally present in small amounts (<1%


of total calories) in animal food sources,
including human milk

Mainly introduced in the food chain by the


industrial process of hydrogenation

This process is used to make oils solid at


room temperature( margarine)

B. Triglycerides

A triglyceride molecule is composed of three


fatty acid molecules, sixteen to eighteen carbons
long, bound to each carbon of the three-carbonlong glycerol molecule.

It is in the fatty acid chains where saturation,


monounsaturation, polyunsaturation, and
hydrogenation occur.

Three fatty acids combine with a glycerol molecule to


form triglyceride.
A tryglyceride may be solid (fat) or liquid (oil) at room
temperature depending of the degree of saturation of fatty
acids and length of carbon chain of the fatty acids
constituting it

Lipoproteins

These are compound lipids that contain both


protein and various types and amounts of lipids.

They are 25-30 % proteins and the remaining as


lipids.

They are made mostly in the liver and are used to


transport water insoluble lipids throughout the
blood soluble fat protein complexes.

C. Lipoproteins
Chylomicrons
will
be
converted
low
desity
lipoprotein(LDL) and eventually to high density
lipoproteins(HDL) as they circulate around the
body

Chylomicron
Very low density Lipo protein(VLDL)
Low density Lipoprotein(LDL)
High density Lipo protein(HDL)

Lipoprotein Lipase lyses contents leading to the change from one form to the
other
Chylomicron

Very low
density Lipo
protein

Low density
Lipoprotein

High
density
Lipo
protein

HDL Transports lipids from tissues to the liver and decreases the risk of Chronic
degenerative diseases
LDL transports lipids from the liver to the tissues and increases the risk of Chronic
degenerative diseases

Cont

Consumption of Saturated fats increases


LDL level, while= increases risk factor
for CHD and other chronic non
communicable diseases

Consumption of PUFAs and MUFAs


increase the level of HDL = Protective
effect form CHD and other chronic non
communicable diseases

Normal ranges
Total Serum Cholesterol
<200mg/dL = desired values
HDL Cholesterol
With HDL cholesterol the higher the better.
<40mg/dL for men and <50mg/dL for women = higher risk
4050mg/dL for men and 5060mg/dL for woman = normal values
>60mg/dL is associated with some level of protection against heart disease
LDL Cholesterol
With LDL cholesterol the lower the better.
<100mg/dL = optimal values
Triglycerides
With triglycerides the lower the better.
<150mg/dL = normal

Lipid Digestion
Enzymes
Lingual lipase- Ebners + parotid Glands
Gastric lipase
Pancreatic lipase + Co-lipase

Other Chemicals
Bile salts
Cholcystokinin

Bile salts Emulsify micelles

Absorption of Lipids

Once the digestion of lipids is complete, they will be absorbed


through intestinal luminal cell membrane by simple diffusion.
The fate thereafter depends upon the size of fatty acid.

From the intestinal luminal cells, fatty acids with less than or
equal to 10 carbon atoms will be absorbed directly in to the
portal system as free fatty acids.

Fatty acids with larger chains of carbon(>=12), will be reesterified to form tryglycerides, cholesterol will be re-esterfied
into cholestrol ester, coated with phospholipids and proteins and
form Chylomicronsjoint lyphatic systemblood
circulation

Absorption of Lipids

triglycerides

Metabolism of Lipids
Triglycerides

Glycerol

Fatty acids

-Oxidation

Liver (gluconeogenesis)

Brain & other glucose


dependent cells (glycolysis)

Acetyl COA

Pyruvate

Krebs cycle
Co2+H2o+Energy

What should we eat?


Solidified vegetable oils OR liquid
evitable oils?

Public health problems due to


excess fat intake

The body can cope with a relatively small


intake of excess fats.

What constitutes an excess is in debate;


however, you can be sure that more than forty
percent of your calories from fat is an excess.

To get an excess of fat in your diet, you must


eat a junk-food and/or animal- source diet,
not properly balanced with plant-source food.

Food Sources Fats

There are three main types of fat, saturated fat, unsaturated


fat, and trans fat.
High Risk for CHD

Saturated fat (found in foods like meat, butter, lard, and cream)
and
trans fat (found in baked goods, snack foods, fried foods, and
margarines) have been shown to increase your risk for heart
disease.

Low Risk for CHD

Unsaturated Fat (FUFAS & MUFAS) (found in foods like olive


oil, avocados, nuts, and canola oil,vegetable oils, fish)

*Replacing saturated and trans fat in your diet with unsaturated fat has
been shown decrease the risk of developing heart disease.

Thank you!