Nutrition
1. Define calorific value of food with examples.
Definition: Calorific value is defined as the amount of energy obtained from 1 g of food-
stuff (Table 12.1).
Table 12.1: Calorific values of different foods
Name of the foodstuff Calorific value (cal/g)
Carbohydrates 4
Proteins 4
Lipids 9
Alcohol 7
2. Define respiratory quotient with examples.
Definition: Respiratory quotient (RQ) is defined as the ratio of volume of carbon dioxide
generated to the oxygen used up during a given time (Table 12.2).
Table 12.2: Respiratory quotient of different foods
Type of food Respiratory quotient
Carbohydrates 1
Proteins 0.8
Fats 0.7
3. Define basal metabolic rate (BMR). What is the unit of expression of BMR? Add a note
on factors affecting the same.
Definition: Basal metabolic rate (BMR) may be defined as the energy required by an awake
individual in resting, postabsorptive state (12 hours after last meal).
Average BMR is 24 kcal/kg/day or 34 kcal/m2/h.
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Factors Affecting BMR
• Age: BMR of children is much higher than adults
• Sex: Women normally have lower BMR than men
• Surface area: BMR is directly proportional to the body surface area
• Climate: In colder climates, the BMR is high and in tropical climates it is proportionately low
• Fever: During febrile states, BMR is high
• Hormones: Thyroid hormones increase BMR.
4. Define specific dynamic action (thermogenic effect of food) with examples.
Definition: Specific dynamic action (SDA) may be defined as the extra heat produced other
than the energy normally generated from a particular amount of food. This 'extra heat' is
derived from energy reserves of the body. It is used for the metabolic interconversions of
food in the liver before it can be used by the body (Table 12.3).
Nutrition
Table 12.3: SDA of different foods
Type of diet Specific dynamic action (SDA)
Proteins 30%
Carbohydrates 15%
Fats 5%
Mixed diet 10%
5. What are dietary fibers? Why are they important?
Definition: Dietary fibers are non-digestible/non-absorbable carbohydrates in diet. Aver-
age intake of these should be 15–25 g/day. For example, cellulose, hemicellulose, lignin,
pectin, etc.
Functions of Dietary Fibers
• Increase peristalsis and prevent constipation
• Increase bile acid excretion
• Increase cholesterol excretion
• Prevent colon cancer
• Improve glucose tolerance
• Act as an antioxidant.
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Adverse Effects of Fiber
Consumption of large quantities of fiber can:
• Affect the absorption of certain nutrients
• Can cause flatulence and discomfort due to fermentation of some fibers by intestinal bacteria.
Sources of Dietary Fiber
The sources of dietary fibers are fruits, leafy vegetables, whole wheat legumes, rice bran, etc.
6. Define glycemic index with examples. What is its significance?
Definition: It is a measure of increase in blood glucose after consuming 50 grams of food as
compared to that seen after consuming 50 grams of glucose [glucose tolerance test (GTT)].
Area under GTT curve after 50 g of test meal
× 100
Area under GTT curve after 50 g of glucose
Nutrition
Significance: Diabetics should consume food with low glycemic index. Foods like ice cream,
milk, legumes, peas, beans, peanuts have low index; potato, bread, rice, fruits have high
glycemic index.
7. Write a note on nitrogen balance.
Definition: It is a state when a person's daily intake of nitrogen is equal to its daily excretion.
Classification
I = Intake, U = Urinary, F = Fecal, S = Sweat concentration of nitrogen.
i. Negative nitrogen balance: It occurs when a person's excretion of nitrogen exceeds his
daily intake and is often associated with muscle wasting (I < U + F + S). For example,
• Kwashiorkor and marasmus
• Corticosteroid therapy
• Cancer and uncontrolled diabetes.
ii. Positive nitrogen balance: It occurs when a person's nitrogen intake is more than excretion
(I > U + F + S). It is often associated with muscle growth. For example,
• Growing children
• Pregnant woman
• Recovery from illness.
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8. Write briefly on parameters used to assess nutritional value of proteins.
Parameters used to assess nutritional value of proteins are given in Table 12.4.
Table 12.4: Parameters to assess the nutritional value of proteins
Parameter Definition Significance
Biological value (BV) Percentage of absorbed protein retained in the body Index of quality of
Nitrogen retained protein
× 100 BV of egg—94
Nitrogen absorbed BV of milk—84
Net protein utilization Percentage of ingested nitrogen retained in the body Index of quality of
(NPU) protein
Nitrogen retained
× 100 NPU of egg—91
Nitrogen ingested NPU of milk—75
Protein efficiency ratio It is the gain in body weight in grams per gram of protein Index of quality of
Nutrition
(PER) ingested protein
Gain in body weight in gram PER of egg—4.5
× 100 PER of milk—3.0
Protein intake in gram
Chemical score (CS) Gives an idea about essential amino acid (AA) content of Index of quality of
a protein protein
mg of AA per gram of test protein CS of egg—100
× 100 CS of milk—65
mg of same AA per gram of reference protein
9. What is balanced diet? What are the factors to be considered, while prescribing a bal-
anced diet?
Definition: It is a diet, which contains different types of food in an amount that meets the
daily requirement for calories and nutrients for optimal growth and development.
Factors to be Considered, While Formulating the Balanced Diet
• Measure body weight
• Obtain BMR and add the extra requirement depending on physical activity
• Calculate total calorie requirement
• Add specific dynamic action—10% of total requirement
• Provide carbohydrate:protein:fat = 60:20:20.
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Calculation of Energy Requirement Depending on Physical Activity
• Calculate BMR
+ 30% of BMR for sedentary work
+ 40% of BMR for moderate work
+ 50% of BMR for heavy work
• Then add 10% of the above total as SDA
• Make it to nearest multiple of 50.
Example 1: Calculate the energy requirement (BMR = 34–37 kcal/m2/h) of a male sedentary
worker with a body surface area of 1.7 m2.
Energy requirement at basal level = 34 × 1.7 × 24 = 1,387.2 kcal
For sedentary work, 30% of above value = 416.16
Total = 1,387.2 + 416.16 = 1,803.36 kcal
SDA = 10% of the total calorie requirement = 180.34 kcal
Nutrition
Total energy requirement = 1,803.36 + 180.34 = 1,983.70 kcal/day = 2,000 kcal/day.
Example 2: Calculate the energy requirement of a 55 kg male doing moderate work
(BMR = 24 kcal/kg/day).
Energy requirement at basal level = 24 × 55 = 1,320 kcal/day.
For moderate activity, add 40% of above value = 528 kcal
Total = 1,320 + 528 = 1,848 kcal/day
SDA = 10% of the total calorie requirement = 184 kcal
Total energy requirement = 1,848 + 184 = 2,032 kcal/day = 2,050 kcal/day.
10. What is food guide pyramid?
Definition: It is a schematic representation of five food groups that provide all the neces-
sary nutrients in recommended quantities. Foods that are at the base of pyramid can be
taken more than those at the top (Fig. 12.1). The five basic food groups are:
i. Grains.
ii. Vegetables.
iii. Fruits.
iv. Meat and dairy products.
v. Sugar and fat.
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Fig. 12.1: Food guide pyramid
11. Define and classify protein energy malnutrition. Enlist the features of kwashiorkor and
marasmus.
Nutrition
Definition: Imbalance between the supply of nutrients and energy and the body's demand
for them to ensure growth and maintenance of specific functions.
The extreme forms of protein energy malnutrition (PEM) are kwashiorkor and marasmus
(Table 12.5).
Table 12.5: Features of marasmus and kwashiorkor
Sl No Features Kwashiorkor Marasmus
1. Age group affected Older children in 2nd or 3rd year of life Infants below 1 year of age
2. Defect Protein deficiency Decreased calorie intake
3. Muscle wasting Muscle wasting is masked by edema Emaciated child, with gross wasting
of muscle and subcutaneous tissue
4. Mental changes Child is listless, apathetic and lethargic Irritable
5. Edema Present Absent
6. Appetite Decreased Good
7. Serum albumin Markedly decreased Normal or mildly reduced serum pro-
teins
12. Write briefly about obesity.
Definition: It is a disorder characterized by accumulation of excess body fat. Overeating
and reduced physical activity can lead to sustained deposition of fat.
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Classification Based on BMI
Body mass index: It is defined as a ratio between weight in (kg) and square of the height in
meters (W/H2). It is used for identification and grading of obesity.
• Pre-obese: 25.00–29.99
• Obese class I: 30.00–34.99
• Obese class II: 35.00–39.99
• Obese class III: ≥ 40.
Causes of obesity
• Excess food intake: High-fat diet
• Sedentary lifestyle
• Genetic factors: Leptin (controls body fat) has got a role in development of obesity
• Environmental and endocrine factors.
Nutrition
Complications of obesity: Hypertension, diabetes mellitus, coronary artery disease, etc.
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