Carbohydrates: Classification, Digestion and Importance in Nutrition

Omer S..
(MSc, in Nutrition) 1
Carbohydrates(CHO)
• They provide the largest single source of energy

in the diet and satisfy our instinctual desire for
sweetness
 4 kcal per gram
Omer S..(MSc, in Nutrition) 2

CHO…Cont’d
 There needs to be at least 3 C for a molecule to be
carbohydrate
 The hexoes (6 C sugars) and pentoses (5 C sugars) and

their polymers play an important role in nutrition
 They are represented by the formula (CnH2nOn)= (CH2O)
 CHOs are classified in to different categories based on

the number of single CHO unit and their functions

CHO…Cont’d
 Simple classification of CHOs that are important

in nutrition is based on the number of single
CHO molecules found in each chemical structure
This classification bases itself on:

The nutritional benefits of CHOs and
The r/ship that the consumption of a specific
CHO has with the dev’t of different diseases

Classification of CHO

CHO…Cont’d
 Characteristics mono & disaccharides
– Soluble in water, have crystalline structure,
– Sweet taste (called sugars) and all have the

same suffix- “ose”
– Monosaccharides have an empirical formula of

C6H12O6, but have d/nt structural formula

CHO…Cont’d
Characteristics polysaccharides
 They are:
– polymers of monosaccharides joined together

by glycosidic linkages
– Insoluble in water,
– Do not form crystals & do not taste sweet,
– No characteristic suffix

CHO…Cont’d
Monosaccharide's
1) Glucose:
 Sometimes called dextrose or grape sugar/blood
sugar
 Widely distributed in nature in animals and men
 End product of digestion of starch, sucrose
maltose & lactose
 Found in fruits, vegetables, honey, corn syrup

and molasses
 Major fuel source oxidized by cells for energy
CHO…Cont’d
 After meal, glucose is converted to glycogen and
excess glucose will be converted to triacylglycerol
and stored
 Absorbed actively coupled with sodium (glucose-

sodium coupled or co-transport mechanism)
 Is used as intravenous fluids (e.g. Dextrose normal

saline, Dextrose in water…etc.)

CHO…Cont’d
2) Fructose:
 Has same chemical formula as glucose and only
differ in their chemical groups arrangement
 Is the sweetest of all sugars
 Also known as levulose or fruit sugar
 Produced during digestion of sucrose

CHO…Cont’d
 Found in nectar of flowers, honey, and molasses
 Other sources include products such as soft drinks,

ready-to-eat cereals, and desserts that have been
sweetened with high-fructose corn syrup,
 Is absorbed by diffusion without any consumption of

energy

CHO…Cont’d
3) Galactose
 Is not found free in nature but is produced in

the body during the digestion of lactose
Also called milk sugar
 During lactation, glucose is converted to

galactose so that milk can be produced by
mammary glands

CHO…Cont’d
Disaccharides
1) Sucrose:
 Is made up of 1 glucose unit & 1 fructose unit
 White and brown sugars are almost 100 % sucrose
 Also found in maple syrup, molasses, sorghum and

corn syrups
 Also called table sugar and used at home in daily

diet
Glucose Fructose

CHO…Cont’d
2) Maltose
– Is made up of 2 glucose units
– Not consumed in large amount in the average

diet
– Maltose (malt sugar) is found in sprouting grains
– Is one of the commonly used sweetening agents

CHO…Cont’d
– Commercially produced by malting and fermentation
of grains and in the body during digestion of starch
– Is formed in the body as an intermediate product of

starch digestion
– Is found in beer, infant formulas, malted breakfast

cereals

CHO…Cont’d
• Adding a malt powder called power flours
(Amylase rich flours, ARF) will prevent
gelatinizing and increases viscosity of starch-
based infant foods and enables to make these
foods energy dense
• This idea can be used very well in the

preparation of energy dense complementary
foods to children less than 2 years

Fig. Condensation of 2 monosaccharides to form a disaccharide

CHO…Cont’d
3) Lactose (milk sugar)
– Only found in milk
– The amount is 6.8 gm/100ml and 4.8 gm/100ml

in human and cow’s milk, respectively
– When hydrolyzed, yields galactose and glucose

CHO…Cont’d
 Sugar alcohols
– Are not found free in nature, but are produced as
intermediate products during metabolism of CHOs
or are commercially prepared
– Are Sorbitol, Mannitol and Xylitol
– Used as sweetening agent for food products
– Absorbed more slowly, so no increase in blood

glucose and no stimulation of insulin
– No tooth decay b/c not used by dental flora

CHO…Cont’d
 Polysaccharides
– Are complex CHOs that contain as many as
60, 000 simple carbohydrate molecules
– Three types of polysaccharides are

important in nutrition:
• Starches
• Glycogen
• Fibers
CHO…Cont’d
1) Starch
– Storage form of glucose in plants
– Is the most abundant CHO throughout the world

in man’s diet
– Found in grains, tubers, and legumes

CHO…Cont’d
• The seeds of plants are richest storehouses of
starch
– Eg:- Corn, millet, rice, wheat are important cereal

grains,
- Dried peas & beans also contain starch up to 40%
• It is not soluble in cold water but when boiled with

water, they form viscous solution (pastes)

CHO…Cont’d
– When temperature raises, starch granules swell
& mixture becomes viscous
– This change is called “gelatinization”
– Cooking makes starch-containing foods more

palatable & more easily digestible

CHO…Cont’d
2) Glycogen
 A polysaccharide found in animals
 Storage form of glucose in the body
 Provides a rapid release of energy when needed
 Composed of thousands of glucose units and has

highly branched structure

 Is found in liver and muscle of animals
 Two third is in muscle for energy needs of

muscle cells and one third is in the liver, as
source of energy for any body cells.

CHO…Cont’d
3) Fiber
 Cellules, hemicellulose, pectin, gum and mucilage
 Contains as many as 12, 000 glucose units
 Is the structural constituent of the plant cell wall
 Humans and carnivores do not have the enzyme

to digest it
 Man gets it from ruminant animals (cow, sheep)
 Is also called dietary fiber or roughage
CHO…Cont’d
• 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 colon cancer
• 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
CHO…Cont’d
Digestion and Absorption of Carbohydrates
The ultimate goal of digestion and absorption of
sugars and starches is to break them into small
molecules-chiefly glucose-that the body can
absorb and use
The large starch molecules require extensive

breakdown; the disaccharides need only be
broken once and the monosaccharides not at all

CHO…Cont’d
 Digestion is the process of breaking down of foods
into nutrients to prepare for absorption
 Digestion of CHOs begin in the mouth
 In the mouth, the salivary enzyme amylase begins

to hydrolyze starch into short polysaccharides and
maltose
 In the stomach, acid continues to hydrolyze starch

while fiber delays gastric emptying and provides a
feeling of fullness (satiety)

CHO…Cont’d
 In the small intestine, pancreatic amylase among

other enzymes (maltase, sucrase, and lactase)
hydrolyzes starches to disaccharides and
monosaccharides
 In the large intestine, fibers remain and attract

water, soften stools and ferment

 Dextrins: short chains of glucose units that result
from the breakdown of starch
CHO…Cont’d
 Carbohydrate absorption
 Primarily takes place in the small intestine
 Glucose and galactose are absorbed by active

transport
 Fructose is absorbed by facilitated diffusion

CHO…Cont’d
 Carbohydrate metabolism
 CHO and fats are main sources of energy (ATP)
for animal cells
 Glucose is the principal sugar used by cells and

tissues
 It is usually obtained from:

Digestion of food
Dietary fructose and galactose
Liver glycogen

CHO…Cont’d
• Blood glucose out of balance: Hypoglycemia and
diabetes
– Some people have medical conditions in which

blood glucose levels can not be maintained at
appropriate levels
– The blood glucose response to the foods we eat

is known as the glycemic effect
CHO…Cont’d
• Glycemic Index-
– The rate of digestion and absorption of sugars
in foods is known as the glycemic index
– Foods whose sugars are readily digested and

absorbed have a high glycemic index
– Foods with slow rates of absorption have a

low glycemic index

CHO…Cont’d
 Lactose intolerance
 Inherited or acquired defect resulting in
inadequate secretion of lactase needed to break
down lactose to its simple sugars
 The undigested lactose produces symptoms

including abdominal pain, diarrhea & flatulence
 Begins early in life & becomes more prevalent

with age

CHO…Cont’d
Functions of carbohydrates
1) Energy supply:
 The main function of CHOs is to meet immediate
energy needs as glucose,
 Some is stored as glycogen in liver and muscles
 The rest is converted to fat and stored as adipose

tissue
 CNS is entirely dependent on glucose for energy
 Other tissues can utilize glycogen when blood sugar is

low
CHO…Cont’d
2) Protein-sparing action:
 When the CHO & fat content of diet is below the
desirable level, more protein is used for energy at the
expense of tissue building & maintenance
3) Helping the body use fat efficiently:

 Prevents the occurrence of ketosis due to
mobilization of lipids when energy supply from
CHOs is limited
4) Lactose enhances calcium absorption

CHO…Cont’d
5) As component of body substances and
compounds:
Heparin, nervous tissue, ribose in RNA & DNA
6) Encouraging growth of useful bacteria:

Some CHOs like oligosaccharides promote the
growth of important bacteria like lactobacillus &
bifidobacteria
CHO…Cont’d
7) Promoting normal functioning of the lower

intestinal tract:
Dietary fiber promote peristalsis and normal mov’t

of the food and waste products along the GIT and
prevent occurrence of diseases like constipation,
hemorrhoids, cancer and also coronary heart
disease

CHO…Cont’d
8) Improving the palatability of food/drink:
 In the form of sugar (sucrose), they are used
as sweetening agent and are added to many
kinds of foods like biscuits, soft drink, coffee,
tea, etc
9) Texturing and preservative:

 Sugars give textures to some foods,
 They are also endowed with the function of
preserving foodstuffs
 Starch and soluble fiber are also used in food
industry to improve texture
CHO…Cont’d
 Recommended daily allowance

 Carbohydrates can be synthesized in the body
from glucogenic amino acids by the process
called gluconeogenesis
 45% - 65% of calories should come from

carbohydrate
 To prevent ketosis, one should take 50-100 g of

carbohydrate
CHO…Cont’d
 Excessively consumed CHOs could be

converted to lipids and get stored leading to
obesity and related chronic diseases
 Dental carries is the commonest problem

that encounters frequent sugar consumers

CHO…Cont’d
Food sources of carbohydrates
 Free sugars (High CHO density): Syrups, cereal grains,

dried fruits, vegetables, processed foods (pasta), breads,
candies, fruits like banana, dates and sweet potato
 Oligosaccharides (medium CHO density): Garlic, onions,

legumes (peas, beans), fruits, molasses and vegetables
 Polysaccharides: fruits, vegetables, cereals and legumes,

whole grain cereals
 High CHO density: Bread, cereals, rice, pasta, vegetables

Proteins
• The basis of protein structure is the amino acid, of
which 20 have been recognized as constituents of most
proteins
• All Amino acids have amino group (NH2) and Carboxylic

Group (COO2)
• But, they are differentiated by the remainder of the

molecule (R) as shown in the figure

All amino acids have a carbon (known as
the alpha-carbon), with an amino group
(NH2) , an acid group (COOH), a hydrogen
(H), and a side group attached. The side
group is a unique chemical structure that
differentiates one amino acid from another.
Fig. Basic structure of amino acids

Pro…cont’d
• 10 % - 35 % of calories should come from protein
 About half of our body’s dry weight is contributed

by proteins
One third of our body’s protein is found in the

muscles
One fifth (bones & cartilages)
One tenth (skin and the rest)

Pro…cont’d
Composition
 Proteins are composed of C, H, O2 and N2
 16 % of their weight is nitrogen
 Could also contain other elements like sulphur,

phosphorus, iron and cobalt
 Plants synthesize proteins from nitrates and

ammonia in the soil

Pro…cont’d
 Not all amino acids need to be ingested from diet
on a daily basis
 Some amino acids could be synthesized in the

body from other nitrogen sources
 Those that can not be synthesized in the body are

called essential (indispensable) amino acids

Pro…cont’d
 Their absence from the diet leads to poor growth
performance by a growing humans and animals
 Those amino acids that could be synthesized by the

body from nitrogen source available in the body are
called non-essential (dispensable)

Pro…cont’d
 A combination of 2 amino acids by a peptide bond gives
dipeptide.
 when 3 amino acids are combined it is called tripeptide
etc.
 10 to 100 amino acids joined by a peptide bond is called
polypeptide.
 Hundred to several thousand amino acids joined together
by a peptide bond is called protein.
Pro…cont’d
Classification of proteins
I) Based on chemical composition
 Simple protein: yield amino acids upon complete
hydrolysis (e.g. albumin- in eggs).
 Compound/conjugated proteins: yield protein + non
protein.
Examples:
 Hgb (protein + hem)-Blood
 Casein (protein + phosphoric acid)- Milk
 Mucin (protein + CHO)- saliva
 Lipoprotein (protein + lipid)- Blood
Pro…cont’d
II) Based on nutritional value
 Complete protein: contains sufficient amounts of all the
essential amino acids.
 Considered as “high quality” protein.
(e.g. proteins of animal origin- egg & milk).
 Incomplete protein: does not contain all essential amino acids
(e.g.lysine in cereals, methionine in legumes and tryphtophan in
corn).
 Not sufficient for growth and health
 Considered a “low quality” protein
Pro…cont’d
 Soya bean has the best quality protein from plant family
 Most common food sources of proteins for the developing
countries are plants especially cereals and legumes
 Mixing of cereals and legumes will give a better quality
protein(complementary protein)

Pro…cont’d
III) Based on conformation of the protein
 This refers to the 3 dimensional shape of the protein in
its natural state
a) Globular proteins
 Tightly folded polypeptide chain- spherical or globular
shape
 Mostly soluble in water, salt solution & body fluids.
 e.g. Enzymes, antibodies, and many hormones,
hemoglobin.
Pro…cont’d
b) Fibrous proteins
 Polypeptide chains arranged in parallel manner along an
axis,
 Tough and insoluble in water and give strength to body
tissues.
 Examples:
Collagen of tendons & bone matrix
Keratin of hair, skin, nails and Elastin of blood
vessels
Pro…cont’d
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
 The sequence of amino acids in the protein is determined by
the genetic material (DNA) and it in turn determines
whether the protein is structural or functional
E.g. Ala---gly---phenala---histd---tyr---trp
b) Secondary structure:
Refers to the folding of the polypeptide chain upon itself
resulting in alpha helix or beta-pleated sheet.
This structure is held strong by intra molecular hydrogen
bonding.
Eg.

Pro…cont’d
c) Tertiary structure:
 This refers to the 3 dimensional arrangement of the
protein structure
Folded upon itself (globular proteins) or
Straight chain of polypeptides (fibrous proteins)
 This structure is maintained by the sulfide bond

d) Quaternary structure:
 This refers to the aggregation of individual polypeptide
chains by electrostatic bonding
 Hemoglobin is a typical example

Summary of protein structure

Pro…cont’d
 Digestion of proteins
 Proteins in foods do not become body proteins directly
 Instead, they supply the amino acids from which the

body makes its own proteins.
 When a person eats foods containing protein, enzymes
break the long polypeptides into shorter strands,
 The short strands into tripeptides and dipeptides, and,
 Finally, the tripeptides and dipeptides into amino acids.

Pro…cont’d
Mouth & esophagus – None
In the stomach:
 The major event in the stomach is the partial breakdown
(hydrolysis) of proteins.
 HCl denatures each protein so that digestive enzymes can
attack the peptide bonds.
 The HCl also converts the inactive form of the enzyme
pepsinogen to its active form, pepsin.
 Pepsin cleaves proteins-large polypeptides-into smaller
polypeptides and some amino acids.
Pro…cont’d
In the small intestine:
 Several pancreatic and intestinal proteases hydrolyze
polypeptides further into short peptide chains,
tripeptides, dipeptides, and amino acids.
 Then peptidase enzymes on the membrane surfaces of
the intestinal cells split most of the dipeptides and
tripeptides into single amino acids.

Pro…cont’d
 Cooking increases the digestibility of proteins
 Over heating can destroy some amino acids
 Cooking with water makes proteins more palatable

Pro…cont’d
 Absorption of Amino Acids/ proteins
 Proteins are absorbed by active transport mechanism
coupled with sodium.
 Most absorption in proximal small intestine.
 Less than 5 % of ingested N2 to feces

Pro…cont’d
Peptide absorption
 Peptides have different transport systems than amino
acids
 67 % of a.a. absorbed into mucosal cell in the form of
small peptides.
 Hydrolyzed by cytoplasmic peptidases in mucosal
cell.

Pro…cont’d
Protein metabolism
 Proteins are deaminated and the amino group goes to
urea cycle and the carbon skeleton will be involved in
the intermediary metabolic path way to liberate energy
 From the total of 9.2 kilocalorie that is available in
every gram of a protein, 5.2 kilocalorie/g will be lost as
metabolizable energy via the urea cycle.

Pro…cont’d
 A gram of protein gives only 4 kilocalorie .
 Therefore, proteins are not cost effective
sources of fuel to the body

• Liver is the primary site for uptake after meal.

Pro…cont’d
 ~20 % for protein/N compound synthesis.
– 14 % remains in liver
– 6 % plasma proteins
 ~57 % catabolized in liver
 ~23 % released to systemic circulation—primarily

branched a.a.

Pro…cont’d
NITROGEN BALANCE
• 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

Pro…cont’d
• Basically the source of nitrogen for our body is

the food that we eat.
• Nitrogen is excreted through urine, feces sweat
etc.

Pro…cont’d
Positive Nitrogen Balance (intake is > excretion)
• Pregnancy
• Lactation
• Growth
• Recovery from illness (convalescent stage)

Pro…cont’d
Negative Nitrogen Balance (intake is < excretion)
 Starvation
 Devastating illness
 Protein Energy Malnutrition

Functions of proteins

Functions of proteins…

Pro…cont’d
How much protein should we eat?
 People who require more protein include:
Infants, children, adolescents
Pregnant or lactating women

Pro…cont’d
Risks of eating too much protein
 High cholesterol and heart disease
Diets high in protein from animal sources are
associated with high cholesterol.
 Possible bone loss
High protein diets may cause excess calcium
excretion leading to bone loss.
 Kidney disease
High protein diets are associated with an increased
risk of kidney disease
Especially for people who may be susceptible to
kidney disease Omer S..(MSc, in Nutrition) 90
Pro…cont’d
Recommended Daily Allowance
 For adults in general intake of 0.8 gram of protein/kg of body wt is
adequate.
 RDA calculations for proteins should consider:
 Age, sex,
 Body size,
 Physiological and pathological conditions,
 The quality of the protein,
 Energy Intake – if energy is too low, protein will be used for
energy- not growth.

Pro…cont’d
 Exercise does not increase the demand for protein
provided the total energy intake is adequate.
 For exercise, the immediate source of energy is
glycogen, then lipid and then protein.
 However, in muscle building exercises some
recommend 2 g of protein/kg of body wt/day.

Pro…cont’d
Food sources of proteins
Milk
 Milk products
 Meat
 Poultry
 Fish
 Egg
 Vegetables
 Nuts
 Bread and cereals

LIPIDS
Definition:
 Are group of organic compounds that are insoluble in water
but soluble in alcohol, ether, chloroform and other organic
solvents.
 The majority (95%) of dietary lipids constitutes triglycerides
(fats and oils).
Generally, lipids:
 Are forms of stored energy in animals.
 Like carbohydrates, contain C, H and O2
Fats …cont’d
 Some have phosphorus and nitrogen.
 Lipids and oils b/c of similar solubility, are classified as

lipids.
 Lipids that are liquid at room temperature are called
oils.
 Lipids that are solid at room temperature are called fats.

Fats …cont’d
Classification:
 Nutritionally important lipids are classified in to 3 main
groups on the basis of their chemical structure.
 Simple lipids- include fats and oils.
 Compound lipids- includes Phospholipids, lipoproteins.
 Derived lipids- includes fatty acids and sterols.
 Some authorities classify lipids as Structural
(Phospholipids), Metabolic (fatty acids, lipoproteins, and
sterols) and Storage lipids (triglycerides).
Fats …cont’d
1) Fatty Acids (FA)

 Are composed of straight chain of carbon atoms with
hydrogen atoms attached and an acid group at one end.
 Most fatty acids have even number of carbon atoms, w/c
are 2-24.
 The two variables w/c determine the physical property of
lipids are the length of carbon chain and the degree of
saturation.
 Saturation affects the physical characteristics of the fat
and its storage properties.
Classification of fatty acids
a) On the basis of the number of C-chain as:
 Short chain: 2-4 carbon atoms (e.g. Butyric acid)
 Medium chain: 6-12 carbon atoms (Caprillic acid)
 Medium- and short-chain fatty acids are found in dairy
products.
 Long chain: 14-18 carbon atoms (Palmitic acid, stearic acid)
 Are found primarily in meat, fish, and vegetable oils.
 Extra long chain: more than 20 carbon atoms (Arachidic acid).

Classification of fatty acids…
b) Depending on the presence or absence of double bond
(degree of saturation)
I) Saturated FA:
 Are found mostly from animal foods.
 E.g. butter contains up to 60% saturated FAs while the
saturated FA content of animal meats varies from 28% in
beef to 46% in lamb.
 The only plant sources of saturated FAs are coconut oil and
palm oil/palm kernel.
Saturated FA…
 The degree of unsaturation refers to the number of
double bonds b/n carbon atoms.
 If all of the carbon atoms in FA are “saturated” with all
hydrogen atoms they can hold, no double bond can
exist.
 Such FAs are classified as saturated.
 All short or medium chain FAs are saturated.
 The major saturated FAs are palmitic and stearic acids.

Example of saturated fatty acid
Stearic acid, an 18-carbon saturated fatty acid

Classification of fatty acids…
II) Unsaturated FA
 Most unsaturated FAs are from plant origin.
 Vegetable oils like olive oil, sunflower oil, etc and fish
are rich in unsaturated FAs.
 Human breast milk is also rich in polyunsaturated FAs.
 Unsaturated FAs have one or more double bonds b/n
carbon atoms.
a) Monounsaturated FA:
 Contain only one double bond.
 The most prevalent MUFA in the diet is oleic acid.

Example of monounsaturated fatty acid
Oleic acid, an 18-carbon monounsaturated fatty acid

Unsaturated FA…
b) Polyunsaturated FA (PUFA):
 Have two or more double bonds
 Omega-3 and omega-6 are examples.
 In omega-3, the first double bond is found 3 carbon
atoms from the methyl carbon.
The most abundant omega-3 FAs are linolenic acid
(found in plants) and the fish oils eicosapentanoic
acid (EPA) & decosahexanoic acid (DHA).

Polyunsaturated FA (PUFA)…
 In omega-6, the first double bond occurs 6 carbon
atoms from the methyl carbon.
 Linoleic acid is one of the PUFAs commonly found in
both animal and plant foods.

Essential Fatty Acids
 These are fatty acids w/c can not be synthesized by the
body and must be consumed from outside sources.
 Linoleic (18:2 n-6)
– Arachidonic (20:4 n-6)
 Alpha-linolenic (18:3 n-3)
 Deficiency yields dermatitis
 Needed in cell membranes

Essential Fatty Acids…
 Linoleic acid (18:2) is an Omega-6 essential
polyunsaturated fatty acid.
 It is the shortest chain omega-6 FA, w/c is converted in
the body to Arachidonic acid (20:4).
 Arachidonic acid is a physiologically significant n-6 fatty
acid and is the precursor for prostaglandins and other
physiologically active molecules.
 Prostaglandin: controls smooth muscle contraction,
blood pressure, inflammation, and body temperature.

Health Effects of n-3 and n-6 F.A
Triglycerides
 Concentrated form of energy
 95% of dietary fat
 Glycerol + 3 fatty acids (esters)
 Exist as fats or oils
Short-chain tend to be oils at room temperature.
Unsaturated tend to be oils at room temperature.
 If all the 3 fatty acids forming the triglyceride are the
same, it is called simple triglyceride and if they are
different, it is called mixed triglyceride.

Triglycerides…
 If a triglyceride contains more long chain and saturated
fatty acids, it will be solid (fat) at room temperature
otherwise it will be liquid (oil).
 Liquid vegetable oils can be converted in to solid fats
by addition of hydrogen to the oils.
 This process is called hydrogenation and the principle is
applied in the production of margarine from vegetable
oils.
 Fat from Junk foods (margarine and other
hydrogenated foods such as potato chips, cookies, etc.)
is very hard to digest and is strongly associated with
vascular disease.
Phospholipids, Sterols and Lipoproteins
I) Phospholipids:
 Are structural compounds found in cell membranes.
 They form the fluid mosaic model of cell membrane
(plasma membrane).
 Their chemical structure constitutes 2 fatty acids,
nitrogen base, an acid phosphate and glycerol
molecule.

II) Sterols and Steroids
 Four-ring core
 Cholesterol (animal tissue)
– Cell membrane – particularly nerve tissue
– Precursor for bile acids, estrogens, androgens,
corticosteroids, & vitamin D.
– Sterols w/phospholipids make up only 5% of dietary
lipids.

Cholesterol
 Is the most studied sterol b/c of its epidemiological
linkage with atherosclerosis and coronary heart
disease.
 Atherosclerosis: a common arterial disease in w/c
raised areas of degeneration and cholesterol deposits
form on the inner surfaces of the arteries obstructing
blood flow.
 Excessive consumption of cholesterol increases the
serum cholesterol level that in turn facilitates
atheroma (fatty deposit in artery) formation in the
vascular structures.

Cholesterol…
 When the coronary blood vessels are involved, there
may be ischemia of the myocardium resulting in
ischemic heart disease.
 Ischemia: an inadequate supply of blood to a part of
the body, caused by partial or total blockage of an
artery.

Cholesterol…
 If the ischemia is excessive, it may result in violent
myocardial infarction and sudden death of the subject.
 Limiting the consumption of foods rich in cholesterol
such as: egg yolk, butter, cream, cheese, animal fat is
very important besides regular exercise to avert the
toll of morbidity and mortality resulting from such a
problem.

Lipoproteins
 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 via out the blood
soluble fat protein complexes.
 Elevated levels of certain types of proteins
(hyperlipoproteinemias) mark a high risk for the dev’t
of atherosclerosis.

Lipoproteins…
Based on their density, the lipoproteins are classified as:
a) High Density Lipoprotein (HDL):
 Primarily contain protein with small amounts of
triglycerides and cholesterol.
 HDL transports cholesterol from the tissues to the liver
to be metabolized.
 High serum levels of HDL are protective against
atherosclerosis.

Lipoproteins…
b) Low Density Lipoprotein (LDL):
 Composed mainly of cholesterol.
 LDL transports cholesterol from the liver to tissues.
 High serum level of LDL greatly increases the risk of
atherosclerosis.
 Diets that are high in saturated fatty acids are
associated with elevations in LDL cholesterol.

Lipoproteins…
C) Very Low Density Lipoproteins (VLDL):
 Contain primarily triglycerides with some protein and
cholesterol.
 VLDL transports endogenous triglycerides from the
liver to tissues.
 High serum level of VLDL increases the risk of
atherosclerosis.

Lipoproteins…
 Chylomicrons: composed mainly of triglycerides
encased in a protein and phospholipid coating.
 Transport absorbed triglycerides from the intestine to
the liver.
 High serum chylomicrons levels do not increase the risk
of atherosclerosis.

LDL Vs HDL

Digestion and absorption of fats/other lipids
 The most important problem in the digestion of lipids is
making them water-soluble.
 The hydrophilic parts of the lipids will remain facing the
outside water medium while the hydrophobic heads
turn inside making fat globules (micelles).
 Bile salts make lipids water-soluble and disperse them

increasing their surface area for the lipolytic enzymes
to act upon.
 This effect of bile salts is called emulsifying effect.

Digestion of lipids
 Mechanical and chemical (lingual lipase) digestion of
lipids begins in the mouth.
 By the time the food reaches the stomach, gastric lipase

takes care of 30% of the digestion of lipids.
 Pancreatic lipase breaks lipids into free fatty acids plus

glycerol or diglyceride plus fatty acid or monoglyceride
plus two fatty acids.
 A minimal amount of chemical digestion of fat occurs in

the stomach via the action of gastric lipase.
Absorption of lipids
 Once the digestion of lipids is complete, they will be
absorbed via 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
(FFA).

Absorption of lipids…
 However, fatty acids with larger chains of carbon, will
be re-esterified to form triglycerides, cholesterol will
be re-esterified in to cholesterol ester.
 This will be coated with phospholipids, proteins and
will form chylomicrons.
 Chylomicrons will be absorbed via the lacteals in to the
lymphatic system via w/c they join the systemic
circulation at the left subclavian vein.


 Once chylomicron joins the systemic circulation, it
circulates via the tissues and an enzyme called
lipoprotein lipase lyses contents of chylomicrons
resulting in their increased density and decreased
volume.
Lipid transport from the Gut
 Lipid from diet is reformed to TAG in enterocyte &
leaves as chylomicron.
 Chylomicrons enter blood for up to 14 hr after high fat
meal.
 Chylomicrons transported to all tissues while
undergoing hydrolysis.
Metabolism of lipids
 Once the lipids/triglycerides are hydrolyzed in to fatty
acids and glycerol, they will join the pathways depicted
by the following figure for their metabolism.

Functions of fats and other lipids
1. Are concentrated sources of energy, i.e. 9 kcal/g of
fat.
 Thus, relatively small amounts of high fat foods
contribute large amount of calories.
 When wt gain is a problem, it indicates that fat
intake is too low.
 For thin or underweight subjects, increasing fat
intake might help to achieve desirable wt status.
2. When deposited under the skin, function as insulator
of heat.
3. Improve the palatability of food.
Functions of fats…
4. Vehicle for the absorption of fat-soluble vitamins.
5. Support the viscera or organs
6. Reserves (storage forms) of energy in animals and
man.
7. Phospholipids are important structural materials in the
formation of cell membranes.
8. Cholesterol is important in the synthesis of bile salts in
the liver.
9. Lipoproteins are important transporters for lipid
substances in the plasma.
10. They form myelin sheath of nerves.
Problems of excessive and inadequate intake of
lipids
 Excessive intakes of lipids results in a positive energy
balance and obesity w/c in turn results in a number of
complications like atherosclerosis, hypertension and
diabetes mellitus.
 Inadequate or no intake of fat in other words results
in essential fatty acid deficiency manifested by itching,
skin abnormality and other health problems.
 Linoleic acid is an essential fatty acid.

Problems of excessive and inadequate intakes…
 Once we have linoleic acid from food, arachidonic acid
can be synthesized in the body from linoleic acid.
 Different physiologically important chemicals like
prostaglandins, thromboxanes and leukotrienes are
synthesized from arachidonic acid.

Food sources of lipids
 Animal sources: Butter, meat (beef, pork and lamb),
egg, milk (these are mostly saturated) except those
from fish and chicken.
 Plant sources: Vegetables, fruits (Avocado), nuts,
margarine, soya bean, coconut, palm kernel, all
vegetable oils (these are mostly polyunsaturated).

Vitamins
Instructional objectives
At the end of this topic, learners are expected to:
 Describe the different types of vitamins and how they are
digested, absorbed and metabolized in the body.
 Describe the functions of vitamins in the body.
 Enumerate the food sources of vitamins.
 Describe the clinical manifestations of specific vitamin
deficiency.
 List the RDAs of vitamins and health problems related to
over/under intake of vitamins.

Vitamins…
Definitions
 Vitamins: are organic cpds needed in small amounts in
the diet of higher animals for growth, maintenance of
health and reproduction.
 They are indispensable, non-caloric organic nutrients
needed in tiny amounts in the diet.
 Vitamins differ from carbohydrate, fat and protein in
structure, function and food contents.
 Vitamins are similar to the energy-yielding nutrients in
that they are vital to life, organic and available from
foods.

Vitamins…
 Some vitamins like vitamin A and D are highly stored in
the liver and get released to their functional sites when
needed.
 Without vitamins, thousands of chemical reactions do
not occur.
 Most vitamins can not be synthesized in the body.
 Vitamin K and B12 are synthesized by intestinal
microorganisms though not in adequate amounts.

Vitamins…
 Other vitamins like pyridoxine (B6), vitamin D are
synthesized in the body.
 Facilitators – help body processes proceed; digestion,
absorption, metabolism, growth etc.
 Vitamins are not oxidized themselves (unlike energy
nutrients), but some help to liberate energy in a form
that the human body can use.
 Both deficiencies and excesses of the vitamins can
affect health.

Vitamins…
 Some appear in food as precursors or provitamins.
 These, once in the body, are chemically changed to one
or more active forms.
 Example: Vitamin A precursor- carotene
Active form- retinal
 Thus, in measuring the amount of a vitamin in the
food, it is often most accurate to count, not only the
amount of the true vitamins, but also the vitamin
activity potentially available from its precursors.

Classification of vitamins
 One method of classifying vitamins is based on the
basis of their solubility.
 Hence, existing vitamins are classified as lipid soluble
and water-soluble.
1) Water soluble vitamins
 Found in vegetables, fruit and grains, meat.
 Absorbed directly into the blood stream
 Not stored in the body and toxicity is rare.
 Alcohol can increase elimination, smoking, etc. cause
decreased absorption.

Classification of vitamins…
2) Fat soluble vitamins
 Found in the fats and oils of food.
 Absorbed into the lymph and carried in blood with
protein transporters (chylomicrons).
 Stored in liver and body fat.
 Can become toxic if large amounts are consumed.
 These are vitamins A, D, E and K.

Water soluble vitamins
A) Thiamin (vitamin B1)
 The role of thiamine in disease first came to light in
Asia a few centuries ago.
 The Dutch physician Christian Eijkman linked Beriberi
to dietary factors in the early twentieth century.
 He speculated that the high consumption of white
rice/polished rice among Asian populations was one
reason why the disease was more common in Asia.
 It was later discovered that thiamine, a water-soluble
nutrient found in whole grains, was missing from
white rice.

Thiamin…
 Deficiency is the cause of Beriberi, a condition marked
by mental impairment, muscle wasting, high blood
pressure, and heart problems, w/c was common
among Asian sailors and prisoners before the
nineteenth century.
 Thiamine is primarily used to prevent and treat
impaired mental function and Beriberi, indicating the
impairment of the Nervous system and the
cardiovascular system.

Thiamin…
 Thiamin pyrophosphate (TPP), a combination of two
molecules of phosphoric acid and B1, is the coenzyme
form of this vitamin.
 TPP is critical in several metabolic functions, including
the removal of carbon dioxide rxns, w/c in turn are
impt in the conversion of amino acids, CHOs and fats to
energy.
 It is also necessary for the conversion of CHOs to fat.
 TPP is needed for the synthesis of acetylcholine, a lack
of w/c causes inflammation of the nerves and memory
loss.

Thiamin…
 Thiamin is needed to metabolize alcohol, but the
absorption of the nutrient is hindered by excessive
alcohol intake.
 This puts alcoholics at risk for symptoms associated
with thiamine deficiency.
 Such a deficiency in alcoholics results in brain problems
known as Wernicke-Korsakoff syndrome.
 This can result in permanent memory impairment,
motor problems, and psychosis.
 Vigorous exercise, excessive CHOs, alcohol, and diets
high in fat may also lead to thiamine deficiency
symptoms.
Thiamin…
Functions:
 Necessary for energy and CHO metabolism.
 Keeps mucous membranes healthy.
 Maintains normal function of nervous system, muscles,
and heart.
 Aids in treatment of herpes zoster.
 Promotes normal growth and development
 Treats Beriberi
 Replaces deficiency caused by alcoholism, cirrhosis,
infection, prolonged diarrhea, and burns.

Thiamin…
 To prevent the loss of the vitamin during food
processing:
Consume parboiled rice instead of polished or
white rice.
Cook foods in minimum amount of water or
steam.
Avoid high cooking temperatures and long heat
exposure.
Thiamine is stable when frozen and stored.

Deficiency
 First observed in the Far East among polished white
rice eaters.
 It is also a common problem in the refugees of Somalia
in Ethiopia.
Mild deficiency:
 Loss of appetite, fatigue
 Gastrointestinal disorders (n, v & constipation)
 Mental problems, such as rolling of eyeballs,
depression, memory loss, difficulty concentrating, rapid
heartbeat.
 Muscles become tender and atrophied.

Deficiency…
Gross deficiency:
Is common in severely ill alcoholics
Pain or tingling in arms or legs
Decreased reflex activity
Fluid accumulation in arms and legs
Heart enlargement
Gastrointestinal symptoms (constipation, n & v).

Prevention
 Any one of the following meets thiamine requirements
of a country:
If the staple cereal is not over milled.
If the staple cereal is fortified with vitamin B1.
If adequate amounts of alternative foods rich in
thiamine are available.
 Thiamine requirement of an individual are satisfied if his
diet does not contain disproportionate amounts of the
ff:
Refined, unfortified cereal
Refined sugar
Alcohol
Recommended Daily Allowance
 Its intake depends on the amount of calorie intake
from CHOs.
 The requirement is therefore 0.5mg/1000 kcal.
 The therapeutic dose is b/n 3-8 g daily.
Age RDA
0-6 months 0.3mg
6-12 months 0.4mg
1-3 years 0.7mg
4-6 years 0.9mg
7-10 years 1.0mg

RDA…
Males Females
Age RDA Age RDA
11-14 yrs 1.3mg 11-50 yrs 1.1mg
15-50 yrs 1.5mg 51+ yrs 1.0mg
51+ yrs 1.2mg pregnant 1.5mg
Lactating 1.6mg

Food Sources
 The best dietary sources of thiamine are whole-grain
cereals and meat; however it is found in all of the ff
foods:
Plant Sources
Whole-grain products, rice bran, brewer’s yeast
Chickpeas, beans, soybeans

Sunflower seeds, wheat germ
 Flour, rye and whole-wheat.
Animal Sources
 Salmon steak, pork, beef kidney, beef liver

B) Riboflavin (vitamin B2)
 A water-soluble vitamin that is important for energy
production, enzyme function, and normal fatty acid
and amino acid synthesis.
 Flavin mononucleotide (FMN) and flavin adenine
dinucleotide (FAD) are the coenzyme forms.
– Easily destroyed by ultraviolet light and irradiation
– Not destroyed by cooking.

Riboflavin…
 Water-soluble vitamin B2 is not stored in ample
amounts, with only minute reserves in the liver,
kidneys, and heart.
 Hence, a constant supply is needed.
 Deficiency in this vitamin does not occur in isolation,
but is part of a multiple-nutrient deficiency.

Functions:
Acts as component in 2 co-enzymes needed for
normal tissue respiration.
Aids in release of energy from food.

Functions…
 Maintains healthy mucous membranes lining
respiratory, digestive, circulatory and excretory tracts
when used in conjunction with vitamin A.
 Preserves integrity of nervous system, skin, eyes.
 Promotes normal growth and dev’t.
 Aids in treating infections, stomach problems, burns,
alcoholism, liver disease.

Functions…
 Necessary for the regeneration of glutathione (a
substance needed for antioxidant activity).
 Used as treatment for migraines, cataracts, and sickle
cell anemia.
 Activates pyridoxine.

Deficiency symptoms
 Cracks and sores in corners of mouth
 Inflammation of tongue and lipids
 Eyes too sensitive to light and easily tired.
 Itching and scaling of skin around nose, mouth,
scrotum, forehead, ears, scalp.
 Trembling, dizziness, insomnia, slow learning
 Itching, burning and reddening of eyes
 Damage to cornea of eye.

Angular Stomatitis

Recommended Daily Allowance (RDA)
 The optimum dosage for migraine headaches is 400 mg
daily.
 In case of cataracts, dosage should not exceed 10 mg
daily.
 Intake of 0.6 mg/1000 kcal is sufficient.
Age RDA
0-6 months 0.4mg
6-12 months 0.5mg
1-3 years 0.8mg
4-6 years 1.1mg
7-10 years 1.2mg
RDA…
Males Females
Age RDA Age RDA
11-14 yrs 1.5mg 11-50 yrs 1.3mg
15-18 yrs 1.8mg 51+ yrs 1.2mg
19-50 yrs 1.7mg Pregnant 1.6mg
51+ yrs 1.4mg Lactating 1.8mg (1st 6 mons)
2nd 6 months (1.7mg)

Food sources
Plant:
 Wheat germ, green leafy vegetables
 Brewer’s yeast
Animal:
 Organ meats (beef, kidney)
 Chicken
 Almonds
 Cheese

C) Niacin (vitaminB3 )
Niacin is the common name for two compounds:
Nicotinic acid, w/c is easily converted to the
biologically active form, and
Nicotinamide (or niacin amide).

Niacin…
 It should not be confused with the toxic drug, nicotine,
found in tobacco and cigarettes.
 Niacin is a water-soluble vitamin that participates in
more than 50 metabolic functions, all of w/c are
important in the release of energy from CHOs.
 B/c of its pivotal role in so many metabolic functions,
niacin is vital in supplying energy to, and maintaining
the integrity of all body cells.
 Niacin also assists in antioxidant and detoxification
functions, and the production of sex and adrenal
hormones.

Niacin…
 Niacin deficiency, known as pellagra, affects every cell,
and is cxrized by dermatitis, diarrhea, and dementia.
 People entirely depend on maize diet are at risk of
developing niacin deficiency.
 Synthesized in liver from tryptophan—60 mg
tryptophan yields ~ 1 mg niacin.
Functions:
 Maintains normal function of skin, nerves, and
digestive system.
 Reduces cholesterol and triglycerides in blood.
 Corrects niacin deficiency.
Functions…
 Treats vertigo (dizziness)
 Prevents premenstrual headache
 Treats pellagra
 Niacin lowers total blood cholesterol and raises HDL
cholesterol
 Aids in release of energy from foods (carbohydrates,
lipids and proteins)
 Helps synthesis of DNA

Functions…
 Becomes component of 2 co-enzymes (NAD and
NADH), w/c are both necessary for utilization of fats,
tissue respiration and production of sugars.
 Involved in the manufacture of sex and adrenal
hormones.

Niacin…
Deficiency:
 A disease of 4 D’s (diarrhea, dermatitis, dementia &
death)
Early symptoms:
 Muscle weakness, general fatigue, loss of appetite
 Headaches, nausea and vomiting,
 Swollen, red tongue
 Skin lesions, including rashes, dry scaly skin, wrinkles,
coarse skin texture
 Dermatitis (affecting the sun exposed areas)
 Diarrhea, irritability, dizziness
Niacin…
 Late consequences of severe deficiency called
pellagra:
 Dementia (progressive deterioration of intellectual
functions such as memory that can occur while other
brain functions such as those controlling movement
and the senses are retained)
 Death

Pellagra – Casal’s Necklace

Pellagra

Recommended daily allowance (RDA)
Age RDA Males
0-6 months 5mg Age RDA
6-12 months 6mg 11-14 yrs 17mg
1-3 years 9mg 15-18 yrs 20mg
4-6 years 12mg 19-50 yrs 19mg
7-10 years 13mg 51+ yrs 15mg

RDA…
Females
Age RDA
11-50 years 15mg
51+ years 13mg
Pregnant 17mg
Lactating 20mg

Niacin toxicity
 Naturally occurring niacin from foods causes no harm,
but large doses from supplements or drugs produce a
variety of adverse effects, most notably "niacin flush.“
 Niacin flush occurs when nicotinic acid is taken in
doses only 3 to 4 times the RDA.
 It dilates the capillaries and causes a tingling sensation
that can be painful.
 The nicotinamide form does not produce this effect-
nor does it lower blood cholesterol.

Niacin toxicity…
 Large doses of nicotinic acid have been used to help
lower blood cholesterol and prevent heart disease.
 Such therapy must be closely monitored.
 People with the ff conditions may be particularly
susceptible to the toxic effects of niacin:
Liver disease, diabetes, peptic ulcers, gout,
irregular heartbeats,
Inflammatory bowel disease, migraine
headaches, and alcoholism.

Niacin…
Food sources:
1) Plant sources:
 Brewer’s yeast
 Peanuts
 Sunflower seeds
2) Animal sources:
 Salmon, pork, chicken, white meat
 Beef liver, tuna, turkey, veal

D) Pantothenic acid (vitamin B5)
 Found in a wide variety of food sources and exerts
influence in a number of body functions.
 Vitamin B-5 is converted in to coenzyme A, its only
known biological form.
 Coenzyme A is involved in the acetylation of
substances such as choline, the oxidation and synthesis
of fatty acids and other substances, and the
metabolism of carbohydrates, fats and proteins.
 It is also necessary for optimum adrenal function and
has anti-stress properties.

Pantothenic acid…
Functions:
 Decarboxylation of pyruvate to form acetyl CoA—
energy production from CHO, fat & protein.
 Condensation of acetyl CoA with activated CO2 to form
malonyl CoA as the first step in fatty acid synthesis.
 Prosthetic group for acyl carrier protein.
 Used for the support of adrenal function and in
rheumatoid arthritis.

Pantothenic acid…
Deficiency and toxicity:
 Deficiency is reported in severe malnutrition together
with the other B-vitamins.
 Vomiting, fatigue & weakness are symptoms
 Increased need:
– Alcoholism
– Diabetes mellitus
– Inflammatory bowel disease
 No toxicity to date

 No RDA has been established.
 Estimated safe intake is given below:
Age Estimated safe intake
0-6 months 2mg/day
6 months-3yrs 3mg/day
4-6 years 3-4mg/day
7-9 years 4-5mg/day
10+ years 4-7mg/day
 Pregnancy and lactation may increase the need by
one-third.

Pantothenic acid…
Food sources:
Brewer’s yeast Meats, all kinds
Corn Peanuts
Eggs Peas
Lentils Soybeans
Liver Wheat germ
Sunflower seeds
Whole grain products

E) Pyridoxine (vitaminB6 )
 Vitamin B-6 occurs in three forms-pyridoxal,
pyridoxine, and pyridoxamine.
 All three can be converted to the coenzyme PLP
(pyridoxal phosphate).
 Because PLP can transfer amino groups (NH2) from an
amino acid to a keto acid, the body can make
nonessential amino acids.
 The ability to add and remove amino groups makes PLP
valuable in protein and urea metabolism as well.

Pyridoxine…
 The conversions of the amino acid tryptophan to niacin
or to the neurotransmitters serotonin, dopamine,
melatonin, and norepinephrine also depend on PLP.
 PLP is also involved in the synthesis of heme (the non
protein portion of hemoglobin), nucleic acids (such as
DNA and RNA), and lecithin.
 Research in the last decade has revealed that vitamin
B-6 influences cognitive performance, immune
function, and steroid hormone activity.
 Unlike other water-soluble vitamins, vitamin B-6 is
stored extensively in muscle tissue .

Pyridoxine…
 The food additive monosodium glutamate (MSG), used
often in Chinese cuisine, may be problematic to people
deficient in vitamin B-6.
 The vitamin is needed to metabolize MSG.
 Pts with carpal tunnel syndrome are often deficient in
vitamin B-6.
 This is a painful condition in w/c the median nerve b/n
the bone and ligament in the wrist is compressed.
 Vitamin B-6 may be a viable treatment for this
condition.

Pyridoxine…
 Alcohol destroys the vitamin.
 Some drugs like Isoniazid (INH) increase the renal
excretion of the vitamin; therefore, pts taking INH
should be supplemented with the vitamin to avoid
peripheral neuropathy that results.

Pyridoxine…
Food sources:
 Avocados, bananas, bran, brewer’s yeast, carrots,
 Flour (whole wheat), lentils, rice, salmon, soybeans,
 Sunflower seeds, tuna, wheat germ.
Functions:
 Participates actively in many chemical rxns of proteins
and amino acids,
 Helps normal function of brain,
 Promotes normal red blood cell formation,
 Maintains chemical balance among body fluids,

Functions…
 Helps in energy production and resistance to stress,
 Treats some form of anemia,
 Treats isoniazid poisoning,
 Used in treatment of the ff conditions (asthma,
premenstrual syndrome, carpal tunnel syndrome,
depression, morning sickness, and kidney stones),
 Acts as co-enzyme for metabolic functions affecting
protein, CHOs and fat utilization,
 Promotes conversion of tryptophan to niacin or
serotonin.

To prevent reduction in the potency of the
vitamin:
 Avoid cooking foods that contain the vitamin in large
amounts of water,
 Freezing vegetables results in a 30 to 56% reduction of
the vitamin,
 Canning vegetables results in a 57 to 77% reduction of
vitamin B-6.

Deficiency
 Symptoms of vitamin B-6 deficiency are non-specific
and hard to reproduce experimentally.
Nervous system manifestations:
Weakness, mental confusion, irritability,
nervousness,
Insomnia, poor coordination walking, hyperactivity,
Depression, convulsions,
 Anemia, skin lesions, discoloration of tongue, kidney
stones, cracked lips, eczema.

Pyridoxine…
At risk groups:
 Breastfed infants born with low status
 Elderly
 Excessive alcohol consumers
 Renal pts w/dialysis losses
 Persons on drug therapies like isoniazid,
anticonvulsants, corticosteroids, etc.

 The therapeutic dose is b/n 50-100mg.
Age RDA
0-6 months 0.3mg
6-12 months 0.6mg
1-3 years 1.0mg
4-6 years 1.3mg
7-10 years 1.4mg

Recommended daily allowance…
Males
Age RDA
11-14 yrs 1.7mg
15+ yrs 2.0mg
Females
Age RDA
11-14 yrs 1.4mg
15-18 yrs 1.5mg
19+ yrs 1.6mg
 Pregnant (+2.2mg), lactating (+2.1mg)

Pyridoxine…
 Regular B-6 supplements are recommended if some
one is taking CAF, cycloserine, ethionamide,
hydralazine, immunosuppressants, isoniazid or
penicillamine.
 These decrease pyridoxine absorption and can cause
anaemia or tingling and numbness in hands and feet.
 Estrogen or oral contraceptives increase requirements
of pyridoxine.
 Tobacco decreases absorption. Smokers may require
supplemental Vitamin B-6.

F) Folic Acid (VitaminB9)
 Vitamin B-9, more commonly known as folic acid,
functions together with a group of related water-
soluble compounds, collectively called folacin, in many
body processes.
 Its primary coenzyme form, THF (tetrahydrofolate),
serves as part of an enzyme complex that transfers one
carbon compound that arise during metabolism.
 This action helps convert vitamin B-12 to one of its
coenzyme forms and helps synthesize the DNA
required for all rapidly growing cells.

Folic Acid…
 It is critical to cellular division because it is necessary in
DNA synthesis.
 Folic acid, also known as folacin or folate, maintains
the cell’s genetic code and transfer inherited traits
from one cell to another.
 It is vitally impt for the foetal dev’t of nerve cells, and a
folic acid deficiency during pregnancy has been linked
to several birth defects.
 Supplements of folic acid should be considered by all
women of childbearing age.

Folic Acid…
 Folic acid is a common vitamin deficiency.
 Vitamin B-12 should always be included in a folacin
supplement program because the folacin
supplementation can mask an underlying Vitamin B-12
deficiency.
 Also, Vitamin B-12 reactivates folic acid in the body and
a Vitamin B-12 deficiency can cause a folic acid
deficiency.
 At greatest risk for a folate deficiency are the elderly,
women taking birth control pills, long-term antibiotic
pts, and alcoholics.

Folic Acid…
Folate and neural tube defects:
 Folate has proven to be critical in reducing the risks of
neural tube defects.
 Neural tube defects: malformations of the brain, spinal
cord, or both during embryonic dev’t that often result
in lifelong disability or death.
 The brain and spinal cord develop from the neural
tube, and defects in its orderly formation during the
early wks of pregnancy may result in various CNS
disorders and death.

Folate and neural tube defects…
 The two main types of neural tube defects are spinal
bifida (literally, "split spine") and anencephaly ("no
brain").
 Folate supplements taken one month before
conception and continued via out the 1st trimester of
pregnancy can help prevent neural tube defects.
 For this reason, all women of childbearing age who are
capable of becoming pregnant should consume 400
micrograms of folate daily.

Folate and neural tube defects…
 This recommendation can be met via a diet that
includes at least 5 servings of fruits and vegetables
daily.
 Furthermore, b/c of the enhanced bioavailability of
synthetic folate, supplementation or fortification
improves folate status significantly.
 Women who have given birth to infants with neural
tube defects previously should consume 4 milligrams
of folate daily before conception and via out the 1st
trimester of pregnancy.

Folic Acid…
Food sources:
 Barley, beans, brewer's yeast, calves' liver
 Fruits, chickpeas, lentils
 Green, leafy vegetables
 Peas, rice, soybeans, split peas, sprouts
 Wheat, wheat germ
 Orange juice, oranges.

Functions
 Promotes normal RBC formation.
 Maintains nervous system, intestinal tract, sex organs,
WBCs, normal patterns of growth.
 Regulates embryonic and foetal dev’t of nerve cells.
 Promotes normal growth and dev’t.
 Treats anaemia due to folic acid deficiency occurring
from alcoholism, liver disease, haemolytic anaemia,
pregnancy, breast-feeding, oral contraceptive use.
 Acts as co-enzyme for normal DNA synthesis.
 Functions as part of co-enzyme in amino acid and
nucleoprotein synthesis.
Deficiency symptoms
 Haemolytic and megaloblastic anaemia in w/c RBCs are
large and uneven in size, have a shorter life span or are
likely to have cell membranes rupture
 Irritability, weakness, lack of energy
 Sleeping difficulties, paleness, sore red tongue
 Neural tube defect in the foetus if deficient in pregnant
woman
 Mild mental symptoms, such as forgetfulness and
confusion
 Diarrhea

Folic acid…
 Haemolytic anemia: anemia that results from the
destruction of red blood cells and may be caused by
bacteria, genetic disorders, or toxic chemicals.
 Megaloblastic anemia: a form of anemia in w/c the
RBCs are unusually large because they have failed to
mature properly.

Recommended Daily Allowance (RDA):
Age RDA
0-6 months 25mcg
6-12 months 35mcg
1-3 years 50mcg
4-6 years 75mcg
7-10 years 100mcg

RDA…
Males Females
Age RDA Age RDA
11-14 yrs 150mcg 11-14 yrs 150mcg
15+ yrs 200mcg 15+ yrs 180mcg
Pregnant 400mcg
Lactating, 1st 6 mos 280mcg
2nd 6 mos 260mcg

Folic Acid…
 Pregnant women need to be supplemented with folic
acid at least 1 month before and 3 months after the
onset of pregnancy with the dose depending on the
level of risk they are in.
 High risk: a woman who had hx of a foetus with neural
tube defect or her relatives had the same hx,
 Low risk: women without such a hx.

G) Cobalamin (Vitamin B-12)
 Vitamin B-12 is found in animal foods.
 It is necessary for processing CHOs, protein, and fats in
the body.
 It affects the growth and repair of all the cells,
particularly nerve cells.
 The stomach parietal cells secrete a special digestive
hormone that increases the absorption of vitamin B-12
in the terminal ileum called intrinsic factor.

Vitamin B-12…
 Vitamin B-12 is called extrinsic factor.
 This vitamin is stored in the body tissues, so a
deficiency can take yrs to appear.
 It plays a role in the activation of amino acids during
protein formation.
 In combination with folic acid, it is necessary for the
synthesis of DNA and for maintaining the myelin
sheath that surrounds nerve cells.

Vitamin B-12…
A vitamin B-12 deficiency can result from:
 Inadequate diet as in the case of vegans (absolute
vegetarians)
 Disease like infection with fish tapeworm called
Diphyllobothyrium latum
 Lack of IF in the small intestine as in the case of surgical
removal of the parietal cells of the stomach
 Surgical removal of the terminal ileum
 There is some indication that 35% of people who are
HIV positive are also deficient in the vitamin.

Vitamin B-12…
 Whether this deficiency is the result of mal-absorption
or interactions with the drug AZT is not clear.
 Deficiency of vitamin B-12 and other nutrients will
facilitate and worsen the progression towards AIDS.
 In laboratory studies, vitamin B-12 has been shown to
halt the replication of HIV.
 Vitamin B-12 currently stands as assuring and
important addition to the treatment for this disease.

Vitamin B-12…
Food sources:
 Vitamin B-12 is found from foods of animal origin
which include:
Beef, beef liver,
Eggs,
Kidney
Milk, milk products
Sardines
Liver
 Note: Vitamin B-12 is not found in vegetables.

Vitamin B-12…
Functions:
 Promotes normal growth and dev’t
 Treats some types of nerve damage.
 Treats pernicious anemia (a severe form of anemia,
found mostly in older adults, that results from the
body's inability to absorb vitamin B-12).
 Treats and prevents vitamin B-12 deficiencies in people
who have had a portion of the GIT surgically removed.
 Prevents vitamin B-12 deficiency in vegan vegetarians
and persons with absorption diseases.

Functions…
 Acts as co-enzyme for normal DNA synthesis.
 Promotes normal fat and CHO metabolism and protein
syntheses.
 Promotes growth, cell dev’t, blood-cell dev’t, and
manufacture of covering to nerve cells, maintenance of
normal function of nervous system.

Vitamin B-12…
Deficiency:
 Impaired brain and nervous system function;
demylination of nerve fibers in CNS.
 Diarrhea
 Smooth, beefy red tongue
 Tingling and burning sensations
 Impaired mental functioning
 Inability to replicate cells lining mouth and GIT

Deficiency…
 False positive pap smear
 Pernicious anaemia (megaloblastic anaemia), with the
ff symptoms:
Fatigue, profound weakness, especially in arms and
legs,
Sore tongue, nausea, appetite loss, wt loss, bleeding
gums, numbness and tingling in hands and feet,
Difficulty maintaining balance, pale lips, pale tongue,
pale gums, yellow eyes and skin,
Shortness of breath, depression, confusion and
dementia, headache.

Recommended Daily Allowance (RDA):
 Recommended dosage for detected deficiency states is
2000 mcg daily for 1 month, then 1000 mcg daily.
 Vegetarians are advised to obtain at least 100 mcg of
B-12 each day.
Age RDA Pregnant (+2.2mcg)
0-6 mons 0.3mcg Lactating (+2.6mcg)
6-12 mons 0.5mcg
1-3 yrs 0.7mcg
4-6 years 1.0mcg
7-10 yrs 1.4mcg
11+ years 2.0mcg
H) Vitamin C (Ascorbic Acid)
 Vitamin C has an antioxidant function.
 Antioxidant: a substance that inhibits the destructive
effects of oxidation, e.g. in the body or in foodstuffs.
 It helps to prevent many serious diseases such as heart
disease and cancers of the lung, throat, mouth,
stomach, pancreas, cervix, rectum and breast.
 It plays a major role in collagen formation, and in
amino acid metabolism and hormone synthesis.
 Humans cannot synthesize – most mammals
synthesize from glucose.

Vitamin C…
Food sources:
 Common sources of vitamin C are Citrus Fruits and
Green Leafy Vegetables:
Broccoli, cabbage, grapefruit, green peppers
Guava, kale, lemons
Oranges, papayas, potatoes, spinach, strawberries
Sweet and hot peppers, tomatoes, mangos

Vitamin C…
Functions:
 Promotes healthy capillaries, gums, and teeth.
 Helps heal wounds and broken bones.
 Prevents and treats scurvy.
 Treats anaemia, especially for iron-deficiency anaemia.
 Treats urinary-tract infections.
 Helps to form collagen in connective tissue and tissue
repair.
 Increases iron absorption from intestines.

Vitamin C…
Functions...
 Contributes to hgb and RBC production in bone
marrow.
 Blocks production of nitrosamines.
 Participates in oxidation-reduction reactions.
 Needed for metabolism of phenylalanine, tyrosine,
folic acid, iron ( converts folic acid from inactive to
active).
 Helps utilization of carbohydrates, synthesis of fats and
proteins, preservation of integrity of blood vessel walls.

Food Preparation Tips to Conserve Vitamin C:
 Eat food raw or minimally cooked.
 Shorten cooking time by putting vegetables in very
small amounts of water.
 Avoid prolonged standing of food at room
temperature.
 Avoid overexposure of food to air and light.
 Avoid soaking vegetables.

Vitamin C…
Deficiency:
 Scurvy: muscle weakness, swollen gums, loss of teeth,
tiredness, depression, bleeding under skin, bleeding
gums
 Shortness of breath, digestive difficulties
 Easy bruising, swollen or painful joints
 Nosebleeds
 Anaemia: weakness, tiredness, paleness
 Frequent infections
 Slow healing of wound and reopening of surgical
wounds.
Vitamin C…
Recommended daily allowance (RDA):
Age RDA Age RDA
0-6 mons 30mg 4-6 yrs 45mg
6-12 mons 35mg 7-10 yrs 45mg
1-3 yrs 40 mg 11-14 yrs 50mg
15+ yrs 60mg
 Pregnant (70mg)
 Lactating (1st 6 months)- 95mg, 2nd 6 months- 90mg

Fat soluble vitamins
1)Vitamin A:
 Beta-carotene is a pro-vitamin A, found in plants.
 The body converts beta-carotene to vitamin A.
 Retinol is the precursor to active forms of vitamin A.
 These forms include retinal, w/c is used in vision and
reproduction, and retinoic acid, needed in growth and
genetic differentiation.
 Extreme deficiencies result in blindness, serious
damage to the immune system, and death.

Vitamin A…
 Vitamin A is used as an immune enhancer in viral
diseases.
 Supplements of this vitamin led to a 50% decrease in
mortality from measles in developing countries.
 High doses during pregnancy are dangerous, and can
result in birth defects.
 If a pregnant woman develops Xerophthalmia,
administration of low dose ( 5,000 IU ) twice in a day
for 2 wks be done.

Vitamin A…
 Carotenes are the pigments w/c provide colour in
plants and flowers.
 Some carotenes can be converted into vitamin A in the
body.
 While beta-carotene has the greatest pro-vitamin A
activity, there are other carotenes that are much more
powerful antioxidants.
 These include alpha-carotene and lycopene, w/c have
well-noted anti-cancer effects.

Vitamin A…
Food sources
A)Plant sources:
 Vitamin A is generally found in GLVs, yellow orange
fruits in the form of B-carotene.
 Apricots, fresh
 Papaya, mango, asparagus, broccoli
 Cantaloupe, carrots, kale
 Red palm oil, mustard greens, pumpkin, spinach,
 Sweet potatoes, watermelon

Vitamin A…
B) Animal sources: found in the form of retinol.
 Liver, fish liver oil
 Milk, egg
Functions:
 Aids in treatment of many eye disorders, including
prevention of night blindness,
 Promotes bone growth, teeth dev’t, and reproduction.
 Helps form and maintain healthy skin, hair, and
mucous membranes.
 Builds body's resistance to respiratory infections.

Vitamin A…
Functions...
 Helps treat acne, impetigo, boils, and carbuncles, open
ulcers when applied externally.
 Essential for normal function of retina.
 Combines with purple pigment of retina (opsin) to form
rhodopsin, w/c is necessary for sight in partial
darkness.
 Necessary for growth of bone, testicular function,
ovarian function, embryonic dev’t, regulation of
growth, differentiation of tissues.
 Has anti oxidant function

Vitamin A…
Deficiency:
 Night blindness
 Lack of tear secretion( due to destruction of goblet cell)
 Changes in eyes with eventual blindness if deficiency is
severe and untreated
 Susceptibility to respiratory infection
 Dry, rough skin
 Changes in mucous membranes
 Weight loss, poor bone growth
 Weak tooth enamel, diarrhea, slow growth

 RDA for vitamin A is expressed in retinol equivalents
(RE).
 One RE = 1 mcg retinol or 6 mcg beta-carotene.
Age Retinol Equivalents (IU)
0-6 months 375RE (2,100IU)
6-12 months 375RE (2,100IU)
1-3 years 400RE (2,000IU)
4-6 years 500RE (2,500IU)
7-10 years 700RE (3,300IU)

RDA…
Males Retinol Equivalents (IU)
11+ years 1,000RE (5,000IU)
Females
11+ years 800RE (4,000IU)
 Pregnant 800RE (4,000IU)
 Lactating (1st 6 months)- 500RE +2,500IU, 2nd 6
months 500RE +2,500IU

Vitamin A…
Overdose/toxicity:
 Bleeding from gums or sore mouth, bulging soft spot
on head in babies (infants), sometimes hydrocephaly
("water on brain"),
 Confusion or unusual excitement, diarrhea, dizziness,
double vision, headache, irritability, dry skin, hair loss,
 Peeling skin on lips, palms and in other areas, seizures,
vomiting, enlarged spleen and liver
The symptoms will be reversed when ingestion of
the vitamin is stopped.

2) Vitamin D (1,25, Dihydroxychole Calciferol)
 Vitamin D is a vitamin that has the dual identity of
being a fat-soluble vitamin and a hormone.
 As a vitamin it promotes calcium absorption from the
intestines, calcium resorption from the bone, and
calcium deposition into osseous tissue.

Carbohydrates: Classification, Digestion and Importance in Nutrition

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Omer S..

• They provide the largest single source of energy

 4 kcal per gram

Omer S..(MSc, in Nutrition) 2

 The hexoes (6 C sugars) and pentoses (5 C sugars) and

 They are represented by the formula (CnH2nOn)= (CH2O)

 CHOs are classified in to different categories based on

Omer S..(MSc, in Nutrition) 3

 Simple classification of CHOs that are important

This classification bases itself on:

Omer S..(MSc, in Nutrition) 4

Omer S..(MSc, in Nutrition) 5

– Soluble in water, have crystalline structure,

– Sweet taste (called sugars) and all have the

– Monosaccharides have an empirical formula of

Omer S..(MSc, in Nutrition) 6

– polymers of monosaccharides joined together

– Do not form crystals & do not taste sweet,

Omer S..(MSc, in Nutrition) 8

 Found in fruits, vegetables, honey, corn syrup

 Absorbed actively coupled with sodium (glucose-

 Is used as intravenous fluids (e.g. Dextrose normal

Omer S..(MSc, in Nutrition) 10

 Is the sweetest of all sugars

 Also known as levulose or fruit sugar

 Produced during digestion of sucrose

Omer S..(MSc, in Nutrition) 11

 Found in nectar of flowers, honey, and molasses

 Other sources include products such as soft drinks,

 Is absorbed by diffusion without any consumption of

Omer S..(MSc, in Nutrition) 12

 Is not found free in nature but is produced in

Also called milk sugar

 During lactation, glucose is converted to

Omer S..(MSc, in Nutrition) 13

 White and brown sugars are almost 100 % sucrose

 Also found in maple syrup, molasses, sorghum and

 Also called table sugar and used at home in daily

Omer S..(MSc, in Nutrition) 15

– Not consumed in large amount in the average

– Maltose (malt sugar) is found in sprouting grains

– Is one of the commonly used sweetening agents

Omer S..(MSc, in Nutrition) 16

– Is formed in the body as an intermediate product of

– Is found in beer, infant formulas, malted breakfast

Omer S..(MSc, in Nutrition) 17

• This idea can be used very well in the

Omer S..(MSc, in Nutrition) 18

Omer S..(MSc, in Nutrition) 19

– The amount is 6.8 gm/100ml and 4.8 gm/100ml

– When hydrolyzed, yields galactose and glucose

Omer S..(MSc, in Nutrition) 20

– Used as sweetening agent for food products

– Absorbed more slowly, so no increase in blood

– No tooth decay b/c not used by dental flora

– Three types of polysaccharides are

– Is the most abundant CHO throughout the world

– Found in grains, tubers, and legumes

Omer S..(MSc, in Nutrition) 23

– Eg:- Corn, millet, rice, wheat are important cereal

• It is not soluble in cold water but when boiled with

Omer S..(MSc, in Nutrition) 24

– This change is called “gelatinization”