Basic issues of nutrition
I. Macronutrients
Macronutrients include proteins, lipids and carbohydrates
1.Proteins
A. Characteristics
Proteins are nitrogen-containing substances that are made up of amino acids.
In the human body proteins are being degraded and resynthesized continuously. Synthesis
of proteins requires the presence of all necessary amino acids during the process.
Amino acids are classified as
- essential (or indispensable)- the body cannot adequately synthesise them and
must obtain them from the diet
- non-essential (or dispensable)- the body can make them
Biosynthesis or intake of some non-essential amino acids such as glutamine, arginine
and cysteine may be inadequate in meeting physiological requirements during illness, surgery
or injury.
An appropriate intake of dietary proteins is depending on both amount and quality of proteins
from food.
a. Amount of proteins in food
Good sources of proteins are
- Animal products: Meat, poultry, fish, eggs, milk and dairy products
- Plant products: Soybeans, beans, peas, lentils, nuts and seeds
b. Quality of food proteins
It is influenced by how the essential amino acid content matches the requirement of the
human body as well as how easily the protein is digested and absorbed into the body for
utilization.
The protein quality of a given food can be determined by the Protein Digestibility-
Corrected Amino Acid Score (PDCAAS), which evaluates protein quality based on both the
amino acid requirements of humans and their ability to digest the food.
Food proteins that have large amounts of all essential amino acids are often referred to as
high-quality proteins and include foods of animal origin as well as soybeans.
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Plant proteins sources usually have all of the essential amino acids, but 1 to 3 might be in
low amount. Inclusion over the course of a day of diverse plant products in the diet which do
not have the same essential aminoacids in low quantities is helping to have an appropriate
intake of aminoacids; such combinations include legumes and cereals (e.g. beans and rice) or
legumes and seeds (e.g,chickpeas and sesame seeds in hummus).
B. Health effects
Proteins play important functions in the body
- Proteins are the main structural constituents of the cells and tissues of the body,
sustaining their maintenance and reparation
- Proteins are necessary for growth and development of the body
- Are used to produce hormones, enzymes, haemoglobin, some neurotransmitters
- Proteins can also be used as energy (4 kcal/g), but they are not the primary choice
as an energy source.
Protein deficiency generally occurs together with deficiencies in dietary energy and
other nutrients as a result of insufficient food intake. It leads to stunting, poor musculature,
oedema, thin and fragile hair, skin lesions, hormonal imbalances, decreased immunity.
C. Recommendations
- 0.8-1.5 g proteins/kg of body weight
- 10-15% of daily energy intake should be brought by protein intake
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2. Carbohydrates
a. Characteristics
Table 1.Carbohydrates-types and dietary sources
Type Examples and characteristics Dietary sources
Monosaccharides Glucose, fructose, galactose Glucose is found in fruits
Fructose is found in fruits,
honey
Galactose is found in the
composition of lactose from
milk
Disaccharides Sucrose (consisting of glucose and Sucrose (Table sugar) occurs
fructose) naturally in sugar beet, sugar
Lactose (disaccharide consisting of cane and fruits
glucose and galactose) Lactose is found in milk and
Maltose (consists of 2 molecules of dairy products
glucose) Maltose is found in malt and
starch derived syrups
Oligosaccharides Formed of 3-9 units of Grains, beans, lentils
monosaccharides
-Fructo-oligosaccharides,
- Malto-oligosaccharides
Starch Amylose, amylopectin, maltodextrins Cereals, bread, pasta, potatoes,
polysaccharides beans, pulses
Non-starch In-soluble fibres (cellulose) and Fruits, vegetables, beans, lentils,
polysaccharides soluble fibres (pectins, hemicelluloses, grains
(dietary fibre) gums, inulin)
The glycemic index (GI) is a value assigned to foods based on how slowly or how
quickly those foods cause increases in blood glucose levels (using glucose as standard).
It is influenced by the characteristics of the food (type of contained carbohydrates, the
presence of other nutrients such as fat, protein, fibres, method used for cooking and
processing).
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The GI can be
- Very low (up to 40) -e.g. raw apples, milk, beans, lentils, boiled carrots
- Low (41-55) – e.g. noodles and pasta, banana, yoghurt with fruits
- Intermediate (56-70)- e.g. table sugar, honey, pineapple
- High (more than 70)-e.g. bread, French fries, boiled or smashed potatoes
b. Health effects
-The carbohydrates are an important source of energy (4 kcal/g)
- They contribute to energy storage
Glucose can be converted to glycogen, a polysaccharide, which is stored in the liver and the
muscles and is a readily available source of energy for the body.
- The brain and the red blood cells need glucose as an energy source (Glucose may come
directly from dietary carbohydrates, from glycogen stores, or from the conversion of certain
amino acids resulting from protein breakdown)
- The dietary fibres have important effects on health- assure the gut health and prevention of
constipation, polyposis and colon-rectal cancer, they assure satiety and contribute to weight
management; they decrease the absorption of cholesterol and can slow the absorption of sugar
and help improve blood sugar levels
C. Recommendations
- 55-75% of the total daily energy intake should be brought by carbohydrates
- maximum 10% of the total daily energy intake should be brought by sugar
- intake of 25-30 g dietary fibres/day
3. Lipids
A. Characteristics
There are several types of dietary lipids
-triglycerides, which consist of a glycerol backbone with fatty acids esterified on each of the
three hydroxyl groups of the glycerol molecule (90% of the lipids found in food)
- phospholipids
- sterols
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1. Triglycerides, which consist of a glycerol and fatty acids
Fatty acids have a backbone made of carbon atoms and can be classified based on the number
of carbon atoms, and in the number of double bonds between them.
a. Classification base on the number of carbon atoms
-Short-chain fatty acids (SCFA) are fatty acids with up to 6 carbon atoms
-Medium-chain fatty acids (MCFA) have 7 to 12 carbon atoms
-Long-chain fatty acids (LCFA) 13 to 21, and very long chain fatty acids (VLCFA) are
fatty acids with more than 22 carbon atoms.
b. Classification based on number of double bonds in their carbon chain.
-Saturated fatty acids (SFA) contain no double bonds
- Monounsaturated fatty acids (MUFA) contain one double bond
-Polyunsaturated fatty acids (PUFA) contain more than one double bond
PUFA can be further categorised into
Omega-6 (or n-6) fatty acids have the first double bond at the sixth carbon atom
Omega-3 (or n-3) fatty acids have the first double bond at the third carbon atom
c. Unsaturated fatty acids can also be classified as "cis" (bent form) or "trans" (straight
form), depending on whether hydrogen is bound on the same, or on the opposite side
of the molecule. Most naturally occurring unsaturated fatty acids are found in cis form.
Trans fatty acids (TFA) can be divided in two groups: artificial TFA (industrial)
obtained through partial hydrogenation of oils (margarines) and natural TFA (in small
quantities in beef and cow milk because of the process which takes place in the
stomach of the ruminanst).
B. Health effects
- Lipids are a source of energy (9 kcal/g)
- Lipids assure homoeothermic of the body, protect the organs and have a structural role for
the nervous system
- Cell membrane are mainly made of phospholipids, triglycerides and cholesterol
- Lipids are carriers and favourites absorption of lipid soluble vitamins in the body
- Depending on the type of lipids they can have several biological functions (see examples in
Table 2)
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Table 2. Lipids
Type Examples Dietary sources Health effects
SFA Myristic Mainly in animal Negative health effects on the
Palmitic products (e.g. cheese, lipid profile and cardio-
Stearic meat, butter), but palm vascular system if the daily
and coconut oil have a intake is exceeding the
high content, too recommendations
MUFA Oleic acid High content in olive Positive health effects on
and canola oil, avocado cardio-vascular system
Omega-6 Linoleic acid LA can be found in oils LA is an essential fatty acids
(LA) and seeds (can not be synthesised in the
Arachidonic acid body) and contributes to the
(AA) AA can be derived synthesis of prostaglandins or
from LA leukotrienes involved in
many physiological processes
such as blood clotting,
wound healing and
inflammation
Omega-3 Alpha linolenic ALA is found in seeds, ALA is an essential fatty
acid (ALA) vegetable oils acids (can not be synthesised
Eicosapentaenoic (especially canola and in the body) and contributes
acid (EPA) flaxseed), walnuts, to the synthesis of
Docosahexaenoic green leafy vegetables, prostaglandins or
acid (DHA) and beans. leukotrienes involved in
many physiological processes
ALA can be conversed such as blood clotting,
in EPA and DHA, but wound healing and
this conversion seems inflammation.
limited
EPA and DHA are Omega 3 acids contribute to
found in oily fish such the development of brain and
as salmon, herring, retina, prevent different
mackerel, anchovies, forms of cancer,
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tuna, and sardines inflammation and
immunological diseases
Trans fatty Elaidic Mainly in partially Negative health effects on
acids hydrogenated oils cardio-vascular system TFA
(margarins) adversely affect blood lipids
and increase subsequent
CVD risk.
Phospolide Lecitine Egg yolk, soya, sun- Component of the cell
flower seeds membrane
Sterols Colesterols Cholesterol is Cholesterol influence
synthesised in the membrane’s fluidity and
body, mainly in liver. permeability, is precursor of
All animal products vitamin D, adrenal and sex
contain cholesterol and steroid hormones, and bile
themain dietary sources salts.
of cholesterol are If the quantity of cholesterol
cheese, eggs, fatty in the body is too big this has
meat (the risk on health bad influence on the lipid
is higher for foods profile in the blood and the
which contain high risk for cardio-vascular
amounts of both diseases.
cholesterol and
saturated fatty acids)
Fitosterols can inhibit the
Fitosterols Fitosterols can be intestinal absorbtion of
found in grains, cholesterol, but have a low
legumes, seeds absorption generally.
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d. Recommendations
Table 3. Lipids- dietary recommendations (WHO)
Children and adolescents Adults
Total lipids 30-40% of the total energy 15-30% of the total energy
intake/day intake/day
Saturated fatty acids <=10% of the total energy <=10% of the total energy
intake/day intake/day
Poliunsaturated fatty acids 5-15% of the total energy 6-10% of the total energy
intake/day intake/day
n-6 4-13% of the total energy 5-8% of the total energy
intake/day intake/day
n-3 1-2% of the total energy 1-2% of the total energy
intake/day intake/day
n-6: n-3 5:1 -10:1
Monounsaturated fatty acids No restrictions, but in the limit The difference
of the total lipids intake
Trans fatty acids <2% of the total energy <1% of the total energy
intake/day intake/day
Cholesterol <300 mg/zi <300 mg/zi
II. Micronutrients
- Water soluble vitamins (C, vitamins from group B),
- Lipid soluble vitamins (A,D,E,K)
- Minerals
Characteristics of water-soluble vitamins:
- They easily dissolves in water and drain away with cooking water and are
destroyed by exposure to light, heat or oxygen during processing
- Most are readily absorbed in the jejunum
- Water-soluble vitamins are easily absorbed and just as easily excreted in the urine
- Human body stores very small amounts of each of these vitamins.
- Because of their limited storage, daily intake is important.
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- Deficiency symptoms appear relatively quickly
- Lower risk of toxicity
Characteristics of lipid-soluble vitamins
- Fairly stable at normal cooking temperatures
- The fat-soluble vitamins are absorbed through the small intestine with dietary fat
and are excreted slowly
- Fat-soluble vitamins are stored in liver and fatty tissue
- Can accumulate to toxic levels if large amounts ingested
Table 4. Examples of functions of vitamins
Vitamin Function Main sources
A Gingival health Milk
Maintains mucous membranes of the Carrots
mouth Dark green vegetables
D Mineralization (calcification) of the RUV
bones, teeth Fortified milk
Growth of the jaws Oily fish
K Part of the “extrinsic” clotting system → Dark green leafy vegetables
II, VII, IX, X Liver, eggs (yellow)
C Periodontal and gingival health Aids in Fruits and vegetables
wound healing Necessary for collagen
production
Prevents bleeding gums
Tiamine (B1) Deficiency leads to changes in oral Green vegetables
Riboflavin (B2) mucous membranes Milk, yogurt, cheese
↓ Liver
angular chelitis and glossitis
Folic acid Helps the structures of the face develop Dark green vegetables
correctly Liver
↓ Whole-meal bread
Essential during pregnancy
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Table 5. Examples of functions of minerals
Mineral Function Main sources
Calcium Mineralization of the teeth and bones Milk, cheese, yogurt
Phosphorus Energy production, metabolism, bone Milk, cheese, meats, whole
development grains, eggs, legumes
Potassium Muscle contraction, nervous Milk, cheese, whole grains,
transmission vegetables
Zinc Tissue repair, normal metabolism, Seafood, liver, meats,
wound healing whole grain cereals
Chromium Glucose metabolism → release of Cheese, whole grain cereals,
energy meats.
Fluoride During tooth development, fluoride is Fluoridaded water
incorporated into the tooth structure Tea, seafood, broccoli
making the tooth strong and decay
resistant.
Copper Haemoglobin synthesis, nervous Seafood, liver, nuts.
transmission
Iron Haemoglobin synthesis, energy Liver, red meats
metabolism Eggs (yellow)
A deficiency in iron results in Leafy green vegetables
glossitis (a red, painful tongue)
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