The Macronutrients

Carbohydrates
• Organic Compounds (CHO)
• Saccharides – Starches/sugar
• The major source of energy,
80-100%
• The major source of energy
 Carbohydrates Groups
Monosaccharides – Simplest form of CHO, can be
absorbed directly into the bloodstream from the
small intestines
• Glucose – The the principal form in which CHO is
used by the body, the only sugar form to provide
energy for the brain, neurons and developing RBC.
Can be stored by the muscles in the form of glycogen.
• Fructose – Sweetest simple sugar.
• Galactose – From lactose only. Galactosemia.
 Carbohydrates Groups
Disaccharides – Made up of two monosaccharides. Must
undergo hydrolysis to be absorbable
• Sucrose – Table sugar. Converted to glucose and galactose
upon digestion. Made up of glucose and fructose.
• Lactose – from milk. Converted to glucose and galactose
upon digestion. Less soluble and less sweet than sucrose.
Remains in intestines to promote growth of useful bacteria
• Maltose – from hydrolysis of starch. Converted to glucose.
Found in cereal and malt beer. Less sweet than glucose
and sucrose.
 Carbohydrates Groups
Polysaccharides – Composed of many simple sugar molecules. Complex
sugars.
• Starch – Most significant polysaccharide. Converts into glucose but
takes a long time, thus, supply energy for a long duration.
• Dextrin – intermediate products in the breakdown of starch
• Cellulose – non-digestible.
a. Soluble – delay glucose absorption and lower blood cholesterol.
b. Insoluble - increases fecal weight, slow down starch hydrolysis and
delay glucose absorption. Cereal veges and whole grain bread.
 Carbohydrates Groups
• Pectin – non-digestible, colloidal polysaccharides, gel-like.
Used for treatment of diarrhea, absorbs bacteria and
toxins in the intestines. Binds cholesterol and limits the
absorption to the blood.
• Glycogen – Animal starch. Formed from glucose, stored in
liver and muscle. Meats and seafood. Glucagon converts
glycogen to glucose.
 Carbohydrates Sources
• Whole Grains: rich in iron, thiamine, niacin
• Sweet/white potatoes, banana, dried fruits, corns and
lima beans
• Cane/beet sugar, honey, maple syrup, candies
 Fats
• CHO, Lipids
• 34% of energy in the body
• Holds organs and nerve as protection from injury
• For consistent body temperature
• Facilitates the absorption of fat-soluble vitamins
ADEK
• Delays onset of hunger
• Contributes flavor and palatability
 Fats
• High in saturated fatty acid: Whole milk, ice cream,
egg yolk, fatty meats, coconut oil, chocolate
• High in polyunsaturated fatty acid: vegetable oil,
soybean, sunflower, salmon, tuna
The essential fatty acids:
1. Linoleic acid: Omega 6, corn oil, soybean, poultry fat
2. Linolenic acid: Omega 3, canola oil, wheat germ,
nuts and seeds, also found in human milk, shellfish and
fish. Can be converted to DHA, prevents heart disx,
HPN.
 Fats Classifications
1. Simple Lipids: Neutral fats,
triglycerides
 Fats Classifications
Compound Lipids: various combinations of fat

1. Phospholipids – fatty acids, phosphoric acids

nitrogenous base
• Lecithin – most widely distributed, found in
liver, egg yolk, corn oil
• Cephalin – for thromboplastin formation
• Sphingomyelin – found in brain and nerve
tissue as component of myelin sheath found
in egg yolk and liver
 Fats Classifications
2. Glycolipids – compounds of fatty acid combined
with CHO and N base
• Cerebrocides – for fat transport on nerve
tissue and cell membranes
• Gangliosides – made up of glucose, galactose
and amino sugar
3. Lipoproteins – contains cholesterol, neutral fat
and fatty acids
 Fats Classifications
Deprived Lipids – simple derivatives of fat digestion
1. Fatty Acids – The basic structural units of fat
2. Saturated – seafood, red meat, dairy, egg, poultry
3. Unsaturated – vegetable oil, soy bean, peanut, olive,
cauliflower
Sources
Saturated fat – animal fats
Monounsaturated fat – oleic acid, peanut oil
Polyunsaturated fat – Vegetable oils (Linoleic acid)
 Fats Classifications
4. Glycerol – inconvertible with CHO,
10% of the fat
5. Steroids – Cholesterol. Found in the
brain, nerve tissues, bile, blood, liver.
 Protein
• Protos: primary
• The vital part of a living tissue/ CHON
Functions of CHON
1. Repairs worn out tissue: Anabolism, due to continuous wear
and tear: Catabolism
2. Builds new tissues
3. Source of heat and energy
4. Contributes to bodily secretions and fluids (hormones,
enzymes, mucus, sperm cells)
5. For immune cells: plasma globulin/gamma globulin for specific
antibody
 Protein Classifications
Simple CHON: only yields amino acids upon hydrolysis
1. Albumin: water soluble, coagulated by heat
2. Globulin: water insoluble, dilute salt solution soluble, CBH
3. Glutelin: insoluble in neutral solvents, soluble in weak acids,
CBH
4. Prolamines: soluble to 70-80% alcohol, insoluble in absolute
alcohol, water and salt solution
5. Albuminoids: insoluble in all neutral solvents, dilute acids and
alkali
6. Histones & Protamines: soluble by water, not CBH
 Protein Classifications
Compound CHON: conjugated CHON/ proteids, CHON + non-CHON
substances, AKA prosthetic group
1. Nucleoproteins: CHON + Nucleic acid
2. Mucoproteins & Glycoproteins: CHON + complex
polysaccharides (Mucin), found in secretions of gastric mucous
membrane
3. Lipoprotein: CHON + Triglyceride/phospholipid/cholesterol
4. Phophoprotein: Phosphoric acid + ester linkage to CHON
5. Chromoprotein: CHON + non-CHON pigment found in
flavoprotein, Hgb
6. Metalloprotein: CHON + Metal (Cu, Zn & Fe), found in ferritin,
hemosiderin, trasferin
 Protein Chemical Stages
1. Essential AA: cannot be synthesized in the body.
Threonine, Leucine, Isoleucine, Valine, Lysine,
Mthionine, Phenylalamine, Tryptophan
2. Non-Essential AA: can be manufactured in the body.
Glycine, alanine, aspartic acid, glutamic acid, proline,
hydroxyproline, cysteine, tyrosine, serine arginine,
ristidine
I. Complete CHON: contains all essential AA (Meat,
Egg, Cheese)
II. Incomplete CHON: Deficient in 1 or more AA
(Grains, legumes, nuts)
Protein Requirement
Adult: 0 to 9g/ kg BW
Child: according to age
Pregnancy: 30g
Lactation: 20g
 Protein Effects
1.CHON is rich in saturated fat = heart
disease
2.↑ CHON will increase the risk of prostate,
pancreatic, kidney, breast and colon CA
3.↑ CHON = ↑ Ca excretion
4.↑ CHON = ↑ fat = ↑ weight
5.o↑ CHON = ↑ kidney workload
 Protein-Energy Malnutrition
Malnutrition resulting from insufficient CHON intake.
Acute PEM = thin fort their height
Chronic PEM = Short for their age
1. Marasmus: severe deprivation of food over a long period
of time
2. Kwashiorkor: abrupt and recent deprivation of food, the
consequence for CHON deficiency caused by illness
(Measles)
The Micronutrients
 Vitamins
Vita – Life
Amine – Nitrogen Compound

• Organic compounds found in food,

which are essential in the growth,
repair and function of tissues.
• Precursors – Provitamins
- Compounds, can be converted to active
vitamins
- Carotene, Cryptoxanthin (for Vit. A)
- Ergosterol (Becomes Vit. D)
• Preformed vitamins – Naturally occurring
vitamins
- Inactive in form
• Avitaminosis – Lack of vitamins
• Hypervitaminosis – Vitamin toxicity
- Excessive accumulation of vitamins
• Antivitamins – Vitamin
antagonists
- Dicumerol (for Vit. K)
- Avidin (for Biotin)
- Thiaminase (for Vit. B1)
 Vitamin A (Retinol)
• Provitamin A – Precursor carotene
• Found in green and yellow plants
• Large storage on liver
• Vit. E preserves Vit. A
• Retinal – Prosthetic group of
photosensitive pigments
• For Synthesis and maintenance of
epithelial tissues
 ↓ Vitamin A (Retinol)
• Keratinization
• Night blindness
• Eye Lesions (Bitot’s Spot), severe
↓ = Xerophtalmia
• ↓ Immune response
• Phrynoderma
Bitot’s Spot
Xerophthalmia
Phrynoderma
 Vitamin A (Retinol) Toxicity
• Severe headache
• Enlargement of spleen &
Liver
• Cessation of Menstruation
• Hypercarotenemia
Hypercarotenemia
 Vitamin D (Calciferol)
• Formed in skin
• Absorbed in the small
intestines č Ca and P
• Stored in the Liver
 ↓ Vitamin D (Calciferol)
• Tetany
• Rickets
• Delayed closing of
fontanels
• Osteomalacia
Rickets
 Vitamin D (Calciferol) Toxicity
• Polyuria
• Wt. Loss
• Bone demineralization
• Calcification of soft tissues
• Uremia
• Hypercalcemia
Calcification of Soft Tissues
 Vitamin E (Tocopherol)
• Antioxidant
• Stored especially on adipose
tissues
• Prevents formation of peroxides
• Enhances Vit. A
• Sustain Tissue integrity
 ↓ Vitamin E (Tocopherol)
• Hemolysis of RBC
• ↑ Urinary excretion of
Creatine
• ↓ Excretion of Creatinine
 Vitamin E (Tocopherol) Source
• Nuts, legumes
• Egg yolk, Butter, Milk
• Mayonnaise
 Vitamin K
Types
• K1 – Phylloquinone
• K2 – Menaquinone
• K3 – Menadione
 Vitamin K
• Synthesized by normal
intestinal bacteria
• Maintenance and synthesis
of prothrombin and
proconvertin
• Phosphorylation
 ↓ Vitamin K
• Hemorrhagic disease (NB)
• ↓ Clotting time
 Vitamin K Toxicity
• Hemolysis
• Albuminuria
• Kernicterus
 Vitamin K Sources
• Dark green leafy Veges
• Tomato
• Egg yolk
• Soybean oil
Water Soluble
Vitamins
 Vitamin C (Ascorbic Acid)
• Large amount in adrenal
tissues
• Cell Binders
• Converts Folic Acid to
Folinic Acid
 Vitamin C (Ascorbic Acid)
• Prevents megaloblastic anemia
• Prevents petechiae
• Production of Adenocortico
hormones
• Tyrosine and Phenylalamine
metabolism
 Vitamin C (Ascorbic Acid)
• ↑ Fe absorption
• Brain metabolism
• Antioxidant
 Vitamin C (Ascorbic Acid)
• Food should be quickly cooked
and covered
• small amounts of boiling water
only
• (X) NaHC03
 ↓ Vitamin C (Ascorbic Acid)
• Irritability
• Generalized malaise
• Anorexia
• ↓ Immunity
• Palor
• Scurvy
Scurvy
Vitamin B-
Complex
 Vitamin B-Complex
• Boiling meat = 15 to
40% loss of vitamin B
• Frying = 40 to 50%
• Roasting = 30 to 60%
 Vitamin B-Complex
• pH of food
• Time of cooking
• Temperature
• Quantity of water used
and discarded
Group I: Classic
Disease Factors
 B1 (Thiamine)
• Coenzyme factor Thiamine
Pyrophosphate
• Good muscle tone of GI tract
• Normal functioning of nerves
• ↑ Appetite
 ↓ B1 (Thiamine)
• Poor reflexes
• Easy fatigability
• Gastric Atony
• Severe Constipation
• Numbness of extremities
• Nutritional Polyneuritis
Infantile Beri-Beri
 Infantile Beri-Beri
• Aphonia
• DOB
• Whining cry
 Wet VS Dry Beri-Beri
Wet
• Causes problems in
circulatory system and edema
Dry
• Causes nerve and muscle
problems
 ↑ Thiamine
• Pregnancy
• Lactation
• Fever
• Infections
• Alcoholism
• Hyperthyroidism
 B1 (Thiamine) Sources
• Lean pork
• Pork liver
• Organ meats
• Egg yolk
• Unpolished rice
• Whole grains
• Legumes
 B2 (Riboflavin)
• Conversion of tryptophan
to Niacin
• Maintains skin, mouth,
tongue
• NaHCO3 destroys B2
 ↓ B2 (Riboflavin)
• Ariboflavinosis
• Seborrheic dermatitis
• Vascularization of cornea
• Glossitis
• Cheilosis
Seborrheic dermatitis
 B2 (Riboflavin) Sources
• Cheese, Milk, Eggs, Liver
• Whole grain, green leafy
veges
• Seaweeds
 Niacin (Nicotinic Acid)
• For energy metabolism
• Fatty acid synthesis
• CHON synthesis
 ↓ Niacin (Nicotinic Acid)
• Indigestion
• Pellagra
• Angular stomatitis
• Bilateral Dermatitis
Pellagra
 Niacin (Nicotinic Acid) Toxicity
• Hypermotility
• ↑ Acidity of the stomach
• Respiratory paralysis
 Group II: Recently
Discovered Co-Enzyme
Factors
 B6 (Pyridoxine)
• Pyridoxal Phosphate (Active
form)
• Formation and conversion of
tryptophan
• ↓ = depression, conjunctivitis
 Pantothenic Acid
• Integrity of CNS
• ↓ = Insomnia, tingling
sensation, cramps,
vomiting
 Lipoic Acid
• Conversion of pyruvic acid
to Acetyl Coenzyme A
 Biotin
• Synthesis of purines,
pyrimidines and fatty
acids
 Group III: Cell
Growth and Blood
Forming Factors
 Folic Acid
• Essential for the formation &
maturation of RBC and WBC on
the bone marrow
• Synthesis of DNA & RNA
• Lost in high temperatures
 ↓ Folic Acid
• Poor growth
• Megaloblastic Anemia
• Glositis
• GI Disturbance
• Impaired absorption
 Folic Acid Sources
• Kidney beans
• Asparagus
• Spinach
• Broccoli
• Potato
 B12 (Cobalamin)
1. Methylcobalamin
2. Adenosycobalamin
3. Hydroxycobalamin
4. Cyanocobalamin
 B12 (Cobalamin)
• Myelin Formation
• 70% is retained during
cooking
• ↓ = Demyelination of nerve
fibers of spinal cord
• Pernicious Anemia
Minerals
Macronutrients essential at levels
of 100 mg or more per day
• Calcium
• Chloride
• Phosphorus
• Sulfur
• Magnesium
• Potassium
Macronutrients essential at levels
higher than a few mg per day
• Iron
• Fluorine
• Zinc
• Copper
• Iodine
• Chromium
• Cobalt
 Micronutrients essential, but
amounts needed for humans cannot
be estimated at present
• Silicon
• Vanadium
• Tin
• Selenium
• Manganese
• Nickel
• Molybdenum
Minerals present in humans, but
the function is unknown
• Strontium
• Bromine
• Gold
• Silver
• Aluminum
• Bismuth
• Arsenic
• Boron
Group I: Major Minerals
 Calcium
• Combies with Phophate =
Calcium phosphate (teeth and
bones)
• Promotes blood coagulation
• Regulation of regular heart rate,
muscle contraction and
relaxation
 Calcium Absorption
• Better absorption when:
a. Pregnant
b. Lactating
c. Growth
• There is decreased absorption in old
age
• Low gastric pH favors absorption
 Calcium Absorption
• High intake of meat will ↑ the
excretion of calcium
• Ca and P ration
a. Infants = 1.5:1
b. Adults = 1:1
• Oxalic and Phytic acids interfere
with absorption of Ca
 Calcium Absorption
• Oxalic acid is present in: Kulitis,
Kamias, Alugbati, Tamarind, Spinach
• Phytic acid is present in: Oatmeal,
Wheat bread
• Excess fat from poor fat digestion
may form soaps with Ca, seen in
steatorrhea
 Calcium Absorption
• Laxatives (decreases)
• Lack of exercise
• Mental stress and emotional
instability
• Alcohol
• Caffeine ↑ urinary excretion of Ca
 Ca deficiency
• Retarded growth
• Rickets
• Osteomalacia
• Tetany
• Ca Excess = Hypercalcemia
 Magnesium
• About 50% is present in the bones
• Regulates blood phosphorus level
• Necessary for normal conduction of
nerve impulses, for contraction of
muscles
• ↑ stability of Ca in the tooth enamel
 Magnesium Sources
• Nuts
• Soybeans
• Meat
• Sea foods
• Cocoa
• Green plants
• Whole grains
 ↑/↓ Magnesium
• ↓ = Hypomagnesemic tetany
• ↑ = Hypermagnesemia, Hypotension,
arrhythmia, cardiac arrest, Coma, ↓
tendon reflex
 Sodium
• 50% found in extracellular fluid, 10%
intracellular and 40% in bone crystals
• Responsible for maintaining fluids and
electrolyte balance & acid-base balance
• Maintains normal muscular excitability and
irritability
• Major extracellular cation
• Stimulates muscle contraction
 Sodium Sources
• Carrots
• Spinach
• Celery
• Peas
• Monosodium Glutamate
• Patis, Toyo
• Catsup
• Processed food
 ↑/↓ Sodium
• ↓ = Hyponatremia, caused by
dehydration, excess H2O intake,
blood loss, diarrhea vomiting, ↓
sodium diet, Fluid volume deficit
• ↑ = Hypernatremia, edema, HPN,
Kidney Disease, fluid volume
excess
 Potassium
• Major intracellular cation
• Maintains fluid and electrolyte balance
• Maintains activity of skeletal and
cardiac muscles
• Acts as muscle relaxant
• Important for CHON and CHO
metabolism
 Potassium Sources
• Meat
• Legumes
• Milk
• Raw and dried fruits
• Fruit juice
• Dark green vegetables
• Unrefined cereal
 ↑/↓ Potassium
• ↑ = Hyperkalemia, caused by the
failure of the kidney to excrete excess
K
• Toxicity = Weakening of cardiac
muscles, confusion, poor respiratory
function, numbness of extremities
 Phosphorus
• Component of bones and teeth
and of every cell
• Regulates pH
• The principal intracellular Anion
• enables phosphorylation
• ↑ = toxicity, erosion of the bones
 Phosphorus sources
• Cheese
• Milk
• Dairy products
• Meat
• Poultry
• Fish
• Eggs
• Dried beans
 Chlorine
• Major anion in the extracellular fluid
• CSF has the highest concentration
• Found in the GI secretions as HCL
• Found in sweat
• Maintains fluid/Electrolyte balance
• ↓ = Alkalosis, caused by vomiting,
diarrhea or tube drainage
Group II: Trace Minerals
 Iron
• 60 to 70% in the Hgb, 5% as myoglobin,
26% found in liver, spleen an bone
marrow
• Necessary for Hgb formation
• Component of tissue enzyme needed for
conversion of beta-carotene to Vit. A,
synthesis of purine, anti body
production and collagen synthesis
 Iron
• Increased fiber and ingestion
of caffeine will interfere with
Fe absorption
• Ascorbic acid enhances Fe
absorption
 Iron Types
1.Heme Iron – Found only in
meat, more efficiently absorbed
by the body
2.Non-Heme Iron – Found in
veges, cereals & eggs.
 Iron sources
• Organ meats
• Enriched rice
• Rice bran
• Green leafy veges
• Seaweeds
• Peanut
 ↑/↓ Iron
• ↓ = Anemia
a. Nutritional – Poor quality sources and
processing
b. Hemorrhagic – Blood donation, delivery,
parasitism
c. Vit B12 deficiency – caused by lack of
intrinsic factor = inadequate formation of RBC
• Pallor, dizziness, insomnia, anorexia
 ↑/↓ Iron
• ↑ = Hemosiderosis - ↑ Fe in the body
• caused by – excessive intake and failure
of body to regulate absorption
• Common – Cooks in iron pots and
multiple BT
• Hemochromatosis – Genetic, ↑
absorption of Fe
 Copper
• Stores in liver, brain, heart and
kidney
• Essential for formation of Hgb
• Promotes absorption of Fe in the GIT
• Promotes integrity of myelin sheaths
• Helps in bone formation
 Copper Sources
• Organ meats
• Shell fish
• Cocoa
• Nuts
• Fish
• Eggs
• Beans
 ↑/↓ Copper
• ↓ = Depigmetation of skin and hair, CNS
abnormalities, hypotonia, hypothermia,
skeletal mineralization in infants & children
• ↑ = Wilson’s Disease – Excessive
accumulation of copper
 Iodine
• 70 to 80% found in thyroid gland,
others in ovary, muscles and blood
• For the synthesis of thyroxine
• Source: seafood, seaweed, iodized
salts
• ↓ = Goiter (enlargement), Cretinism,
Myxedema
 Manganese
• Concentrated in liver and kidneys,
small amounts in retina, bones and
salivary gland
• Increases storage of Thiamine
• Sources – Nuts, GLV, fruits, dried
legumes, tea, non leafy veges
 Zinc
• 80% in RBC, 4% WBC and platelets
• Present in RNA
• Related to insulin, glucagon, ACTH, GH,
gonadotropin and testosterone
• Accelerates wound healing and
maintains normal sense of taste
• Sources – Milk, nuts, legumes, meat
Group III: Other Trace
Minerals
 Fluorine
• Concentrated in teeth and bones, traces in
thyroid gland and skin
• Promotes more stable compound in dentin
and enamel of teeth, prevents bone loss
• Souces – Water
• ↓ = Dental Carries
• ↑ = Fluorosis, osteosclerosis, ↓ growth,
poisoning
 Selenium
• Depends content on the soil where the food
was grown
• Reduces and/or prevents Vit E deficiency
• Component of glutathione
• Sources – Organ meats, cereals,dairy
products
• ↑/↓ = Muscle pain/tenderness, pancreatic
degeneration, hemolytic anemia
 Chromium
• Raises abnormally low FBS
• Improves faulty uptake of sugar by the body
• Stimulates the synthesis of fatty acids ang
cholesterol in the liver
• Sources – Corn oil, clams, cereal, veges,
meat
•
Water and Electrolyte
Balance
 Water
• 60 to 70% of total body weight
• 10% loss will cause illness, 20% loss will
result to death
• Normal adult = 45 L of water, 2/3 inside the
cells, 1/3 outside the cells
• Universal solvent
• Acts as lubricant for joints and the viscera
of the abdominal cavity
• Regulates body temperature
 Water intake
• Metabolic water – result of
oxidation of food (14g./100cal)
• Intoxication – over hydration
without Na, Excess IV fluid.
Anorexia, vomiting, convulsion,
coma, death
 Water excretion
•Fluid loss – sweat, breathing,
defecating, urination, tears,
suction, bleeding, burns,
wound/skin disease
• Dehydration – From increased
environmental temperature or
extreme heat
Pregnancy and Lactation
 Terms
• Kcal – Kilogram calorie
• Calorie
– standard unit in measuring heat.
- The byproducts when CHO, CHON and
fats are oxidized in the body
• 1 kcal = heat energy require to raise the
temp of 1 kg of water to 1˚C
 Terms
• Fuel factor of CHO – 4 cal/g
• Fuel factor of Fat – 9 cal/g
• Fuel factor of CHON = 4 cal/g
• 1000 cal = 1 kcal
• Joule – The measure of energy in the
metric system
• 1 cal (kcal) = 4.184 J (kJ)
 Calculation of food value
• The energy value of 1 tbsp. of sugar (15 g) is
approximately 60 cal.
• Most foods however, are complex and contain
CHON, fat, and CHO.
• 1 cup of milk =
12g CHO
8g CHON
10g Fat
Total = ?
 Calculation of food value
• From this information, the
nurse can calculate the
percentage of each nutrients. To
calculate the percentage of kcal
from fat, CHO and CHON, divide
the value by the total kcal.
 Pregnancy and Lactation
• Pregnancy lasts from 37 to 40
weeks.
• 80,000 kcal = the energy cost of
storage plus maintenance
• 300 kcal/day
• Energy intake should be 36
kcal/kg of pregnant wt./day
 Weight gain in pregnancy
• 1st trimester – small gain (1.5 to 3 lbs)
• 2nd trimester – more rapid gain (0.8 lb/wk)
• 3rd trimester – slower rate (0.8lb/wk)
• A sudden gain in wt after 20th wk = water
retention and onset of pre-exlampsia
• Underwt. – LBW infant, and infantile death
• Overwt. – HPN, GDM, ↑ risk of neural tube
defect
 Recommended Wt. Gain
• Underwt = BMI <18.5 (28 to 40 lbs)
• Healthy Wt. = BMI 18.5 – 24.9 (25 to 35 lbs)
• Overwt. = BMI 25 – 29.0 (15 to 25 lbs)
• Obese = BMI > 30 (15 lbs)
• Wt gain patterns
a. UW = 1st trimester - 5 lbs, 1 lb/wk
b. N = 1st trimester – 3 ½ lbs, 1 lb/wk
c. OW = 1st trimester -
 CHON Allowance
• N = 1.1 g/kg BW
• Pregnant adolescent = + 9.5 g/day
• Total = 900 to 950 g for 9 mos
• To provide storage for Nitrogen
• Protection from complications of Pregnancy
• Growth of uterus, placenta, mammary
tissues, hormonal preparation for lactation
• Milk, meat, eggs, cheese, poultry & fish.
 Allowances
• Calcium
• N = 16 to 18 – 240 mg/day
• 19 and over = 205 mg/day
• Lactating = 250 mg/day
• Pregnant = N + 0.5 to 0.9 mg/day
• + Vit D to calcify fetal bones and
teeth
 Allowances
• Iron
• 16 above = 27 mg/day
• 65 and over = 10 mg/day
• Pregnant = 1st – 27 mg/day
2nd – 34 mg/day
3rd – 38 mg/day
• Lactating = 30 mg/day
• 700 to 1000 mg for the whole pregnancy
period
 Allowances
• Vit. K = 2 to 5 mg parenterally to the mother
= 1 to 2 mg to infant