Nutrition.pptx community health nursingnskncksa

Nutrition
Presented by
Deepa Manandhar
Lecturer
Community Health Nursing

introduction
• Defined as the science of food and its relationship to health.
It is concerned primarily with the part played by nutrients in
body growth, development and maintenance. The word
Nutrient is used for specific dietary constituents such as
proteins, vitamins and minerals.
•Nutrition is the process whereby living organisms utilize food
for maintenance of life, growth, the normal functioning of
tissues and organs and, the production of energy.

Classification of food
1. Classification by Origin
• Foods of animal origin
• Foods of plant origin
2. Classification by chemical composition
• Proteins
• Fats
• Carbohydrates
• Vitamins
• Minerals

Classification of food
3. Classification by predominant function
• Body-building foods
-milk, meat, poultry, fish, eggs, pulses groundnuts etc.
• Energy giving foods
- Cereals, sugars, fats and oils.
• Protective foods
- Vegetables, fruits milk.

Nutrients in diet
Macronutrients: Proximate principles which form
the bulk of the diet.
Carbohydrate
Fats
Proteins

Nutrients in diet
Micronutrients: vitamins and minerals which are
required in small quantities.

Energy yield
Energy yield of macronutrient
Nutrient Energy yield
Carbohydrate 4 Kcal per gram
Proteins 4 Kcal per gram
Fats 9 Kcal per gram

Balance diet
In balance diet
Protein should constitute 10-15% of total daily
energy intake
Fats should constitute 15-30% of total daily energy
intake
Carbohydrate should constitute remaining 50-70%
of total daily energy intake

proteins
• Proteins are complex organic nitrogenous compounds.
Amino acid:
• Proteins are made up of simpler substances which are the
building blocks of proteins, called amino acids.
• 24 amino acids are stated to be needed by the human body,
out of which ‘9’ are essential because the body cannot
synthesize them in amounts corresponding to its needs,
therefore they must be obtained from dietary proteins.

Amino acids
Essential Amino acids
 Leusine
 Isoleusine
 Lysine
 Mithionine
 Phenylalanine
 Threonine
 Valine
 Typtophan
 Histidine

Sources of proteins
1. Animal sources
- Eggs, Fish, meat, milk and milk products.
2. Plant sources
- Pulses, cereals, nuts, beans, oil seed etc.

MCQ
Qualitative assessment of protein can be done by:
a. Net protein Utilization
b. Protein Energy ratio
c. Amount of protein consumed daily
d. Weight gained on a monthly basis
ANS: a

Net protein utilization
(NPU)
 Is the proportion of ingested proteins that is retained
in the body under for the maintenance and growth
of the tissue.
 NPU is best indicator of protein quality for
recommending the dietary protein requirement.
 NPU provides a complete expression of protein
quality.

MCQ
Reference protein is:
a. Milk
b. Meat
c. Egg
d. Pulses
ANS: c

Net protein utilization
(NPU)
Reference protein:
A theoretical concept of the perfect protein which is
utilized in the body with 100% efficiency.
Note:
Egg protein contains all the nine essential amino
acids and in right proportion.
NPU of egg is 96. Since egg is ‘reference protein’, its
NPU is taken as 100 for comparison

fats
Fats are composed of carbon, hydrogen and oxygen
elements. They are an important source of energy.
They are classified as:
( a) Simple lipids : eg, Triglycerides
(b) Compound lipids ; eg, Phopholipids
(c) Derived lipids: eg, cholesterol

Fatty acids
Saturated fat
 Tends to increase blood cholesterol levels.
 Found mainly in meat and dairy products, as well as some
vegetable oils such as coconut and palm oils. Butter is high
in saturated fat.
Unsaturated Fatty acid :
Polyunsaturated fat
Monounsaturated fat

Fatty acids
Unsaturated Fatty acid :
Polyunsaturated fat
 tends to lower blood cholesterol levels
 found mostly in plant sources (sunflower, soy bean, cotton seed)
Monounsaturated fat
 tends to lower LDL cholesterol (the “bad” cholesterol)
 found in both plant and animal products, such as olive oil,
peanut oil and in some plant foods as avocado.

Fatty acids
Essential Fatty Acid: are those that cannot be
synthesized completely in human body; they can only
be supplemented from the food.
 Most important EFA: Linoleic acid, which serves as
a basis for production of other EFA.
 EFA deficiency lead to ‘phernoderma’ (toad skin):
rough rash like eruptions on the back and side of
arms and legs, back and buttocks.

Fatty acids
 EFA deficiency lead to ‘phernoderma’ (toad skin):
rough rash like eruptions on the back and side of
arms and legs, back and buttocks.

vitamins
•Vitamins may be defined as organic compounds categorized
as essential nutrients. They are required by the body in very
small amounts.
•Vitamins can be classified into two groups:
 Fat soluble : vitamin A, D, E, K
 Water soluble : vitamin B and C

vitamins
Functions and sources Deficiency
Vitamin A
(Retinol,
Retinoid,
Carotenoid)
 For new cell growth, healthy skin, hair, tissues
and vision in dim light
 It supports growth, especially skeletal growth
 Sources: dark green and yellow vegetables and
yellow fruits such as broccoli, Spanish, pumpkin,
carrot and in animal sources such as liver cheese
whole eggs.
Xeropthalmia
Vitamin D
(Ergocalciferol,
Cholecalciferol)
 Promotes intestinal absorption of calcium and
phosphorus
 Sources: the skin can synthesize vitamin D if
exposed to sunlight. Other sources are milk
(fortified), cheese,liver etc
Rickets
Osteomalacia

mcqs
First clinical sign of Vitamin-A deficiency is:
a. Night blindness
b. Conjunctival xerosis
c. Bitot`s spot
d. Keratomalacia
ANS: b

Vitamin A deficiency
All ocular manifestation of vitamin A deficiency
are collectively known as “Xerophthalmia” (most
common in children aged 1-3 years)
First clinical sign of vitamin A deficiency:
Conjunctival Xerosis
First clinical symptom of vitamin A deficiency:
Night blindness

Vitamin A deficiency
Conjunctival Xerosis: characterized by a dull and
dry appearance of the conjunctiva with slight
wrinkling.

Bitot`s spot: triangular, pearly-white or yellowish,
foamy spots on the bulbar conjunctiva on either side
of the cornea.

vitamins
Vitamin E
(tocopherol)
 Anti-sterility factor and anti oxidant
 Vitamin E is also important in the formation of red
blood cells
 Important for wound healing and immune system of
body
 Sources: vegetable oils, sunflower seed, almonds,
egg yolk
Testicular
degeneration
Habitual abortion
Hemolytic anaemia
in new born
Vitamin C
(Ascorbic
acid)
 Antioxidant vitamin needed for the formation of
collagen to hold the cells together and for healthy
teeth, gums and blood vessels and improve iron
absorbtion.
 Sources: amala, lemon, kiwi fruit, orange, broccoli,
green and red peppers.
Scurvy
Delayed wound
healing
Vit B1
(Thiamin)
 Needed for energy metabolism and proper
functioning of nervous system
 Sources: whole grains, soybeans, legumes nuts,
peas.
Beri-beri
Wernicke
Korsakoff
syndrome

vitamins
Vit B2
(Riboflavin)
 Acts as a coenzyme in protein and energy
metabolism and promotes healthy skin and
eyes.
 Sources: dairy products, fish, meat grains
broccoli
ariboflavinosis causes
stomatitis of the mouth and
tongue, cheilosis (chapped and
fissured lips) and a scaly rash
on the genitalia.
Vit B3
(niacin)
 Promotes healthy skin, gastrointestinal and
nervous system functions, helps in DNA
synthesis and repair
 Sources: liver, poultry, milk, green leafy
vegetables.
Pellagra
Vitamin B6
(pyridoxine)
 Plays important role in metabolism of
protein, carbohydrate and fats, proper
functioning of blood and central nervous
system.
Pheripheral neuropathy
Vitamin B12
(cynocobalamine)
 Helps in synthesis of DNA and normal
functioning of nervous tissue
Megaloblastic anaemia

vitamins
Vitamin B5 (Pantothenic
acid)
Burning feet syndrome
Vitamin B7 (biotin) Dermititis
Vitamin B9 (Folic acid) Megaloblastic anaemia,
Neural tube defects

minerals
Minerals
• Minerals are inorganic elements, essential to body because
of their role as catalyst in biochemical reaction. The major
minerals that are essential for the body are calcium, chlorine,
iron, magnesium, potassium, sodium.

MCQ
Niacin deficiency can result in:
a. Pellagra
b. Anemia
c. Peripheral neuropathy
d. Beri beri
ANS: a

MCQ
Which of the following vitamin deficiency diseases
occurs in maize eating population:
a. Megaloblastic anaemia
b. Night blindness
c. Pellagra
d. Beriberi
ANS: c

Pellagra
Characterized by 4 D`s
 Diarrhoea
 Dementia
 Dermatitis
 Death
Skin rash in Pellagra may appear as pigmented and scaly in
areas exposed to sunlight.
Especially neck when it is known as ‘Casal`s Necklace’

Pellagra
Common in maize eating population.
 Limiting amino acid in maize is tryptophan.
 60mg Tryptophan is converted to 1 mg of Niacin in the body.
 Excess leucin in such populations appear to interfere in
conversion of tryptophan to niacin.

MCQ
Oral iron pill or iron injections must be taken along
with:
a. Vitamin A
b. Vitamin C
c. Essential fatty acid
d. Vitamin D
ANS: b

MCQ
Lowest iron content is present in:
a. Liver
b. Milk
c. Meat
d. Fish
ANS: b

Nutrition.pptx community health nursingnskncksa

Nutrition.pptx community health nursingnskncksa

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