1. Nutrition for Health Professions Lecture 7 Mr. Adham I. Ahmed “BSN, RN, MCN” University of Palestine Health Sciences College Associate Degree Program

2. Mr. Adham Ahmed Proteins

3. Mr. Adham Ahmed3 Objectives  State the functions of proteins in the body  Identify the elements of which proteins are composed  Describe the effects of protein deficiency  State the energy yield of proteins  Identify at least six food sources of complete proteins and six food sources of incomplete proteins

4. Mr. Adham Ahmed4 Facts  Of the six nutrient groups, only proteins can make new cells and rebuild tissue.  Proteins are the basic material of every body cell.  Proteins are the only nutrient group that contains nitrogen.  Proteins are composed of amino acids.

5. Mr. Adham Ahmed5 Amino Acid  Nitrogen containing compound of which protein is composed.  There are twenty amino acids. essential  Nine are considered essential.

6. Mr. Adham Ahmed6 Amino Acids Essential Histidine Isoleucine Leucine Lysine Methionine Phenylalanine Treonine Tryptophan Valine

7. Mr. Adham Ahmed7 Amino Acids Nonessential Alanine Arginine Asparagine Aspartic acid Cysteine Cystine Glutamic acid Glutamine Glycine Hydroxyproline Proline Serine Tyrosine

8. Mr. Adham Ahmed8 Classification Complete High quality Contains all nine essential amino acids Incomplete Low quality Lacks one or more amino acid Cannot build tissue without help

9. Mr. Adham Ahmed9 Classification Complementary Proteins Occurs when a combination of incomplete proteins are eaten in the same day to make a complete protein Examples: corn and beans, rice and beans, bread and peanut butter, bread and split pea soup, bread and cheese, bread and baked beans, macaroni and cheese, cereal and milk

10. Mr. Adham Ahmed10 Classification Complementary Proteins

11. Mr. Adham Ahmed11 Food Sources Animal food sources Complete proteins Meats, fish, poultry, eggs, milk, cheese Plant food sources Incomplete proteins Corn, grain, nuts, sunflower seeds, sesame seeds, and legumes

12. Mr. Adham Ahmed12 Food Sources Analogues Meat alternatives made from soy protein and other ingredients to simulate various kinds of meat Tofu is a soft cheeselike food made from soy milk

13. Mr. Adham Ahmed13 Your client is concerned because her daughter is a vegetarian and does not eat meat. Your client states, “My daughter does not eat meat, so I know she doesn’t get any protein. She is damaging her body.” How do you respond?

14. Mr. Adham Ahmed14 Although animal foods are the best sources of complete proteins, foods that provide incomplete proteins can be combined to make complete proteins. The best sources of incomplete proteins are legumes, corn, grains, and nuts. Soy protein and tofu are nutritious meat replacements.

15. Mr. Adham Ahmed15 Functions  Building and repairing body tissue  Regulating body functions Metabolism and digestion Fluid and electrolyte balance Development of antibodies  Providing energy Each gram of protein provides 4 kcal

16. Mr. Adham Ahmed16 Digestion and Absorption Mechanical digestion Begins in mouth Teeth grind food into small pieces Chemical digestion Begins in stomach Hydrochloric acid prepares stomach Enzyme pepsin reduces proteins to polypeptides

17. Mr. Adham Ahmed17 Digestion and Absorption Chemical digestion Polypeptides: ten or more amino acids bonded together trypsinchymotrypsin carboxypeptidaseIn the small intestine, three pancreatic enzymes (trypsin, chymotrypsin, carboxypeptidase) continue chemical digestion and absorption through the villi

18. Mr. Adham Ahmed18 Metabolism and Elimination  Amino acids are broken down, the nitrogen-containing amine group is stripped off (deamination).  Ammonia is produced.  Liver picks up ammonia and converts it to urea.  Kidney filters out urea and excretes it.  Remaining parts are used for energy or converted to carbohydrate or fat and stored as glyocogen or adipose tissue.

19. Mr. Adham Ahmed19 Dietary Requirements  Determined by size, age, sex, and physical and emotional conditions. 0.8 g each kilogram of body weight  The National Research Council of the National Academy of Sciences considers the average daily requirement to be 0.8 g of protein for each kilogram of body weight.

20. Mr. Adham Ahmed20 Dietary Requirements To determine your requirement Divide body weight by 2.2 (the number of pounds per kilogram) Multiply the answer obtained in the first step by 0.8 (grams of protein per kilogram of body weight)

21. Mr. Adham Ahmed21 Your client weighs 170 pounds. What is the client’s daily requirement for protein?

22. Mr. Adham Ahmed22 170 pounds  2.2 pounds/kg = 77.27 kg 77.27 kg  0.8 grams of protein = 61.81 g Answer: 62 grams of protein

23. Mr. Adham Ahmed23 Protein Excess  Saturated fats and cholesterol may contribute to heart disease  Connection to colon cancer  Substitute for essential fruits and vegetables

24. Mr. Adham Ahmed24 Protein Excess  Increased demand on kidneys 15-20% of one’s daily kcal intake  National Research Council recommends that protein intake represent no more than 15-20% of one’s daily kcal intake and not exceed double the amount given in the table of Recommended Dietary Allowances.

25. Mr. Adham Ahmed25 You are the nurse and your client asks you whether or not taking daily protein supplements will help build muscles, strengthen nails, and control weight. How do you respond?

26. Mr. Adham Ahmed26  “Bulking up” athletes Lifting weights, not supplements, builds muscle  Growing fingernails Fingernails have never been affected by extra protein  Spare body protein in weight loss Dieters need a balanced diet using the guidelines of the Food Guide Pyramid

27. Mr. Adham Ahmed27 Nitrogen Balance  Nitrogen intake equals nitrogen excreted.  Positive nitrogen balance exists when nitrogen intake exceeds amount excreted.  Negative nitrogen balance exists when more nitrogen is lost than taken in.

28. Mr. Adham Ahmed28 What conditions cause a positive nitrogen balance? …a negative nitrogen balance?

29. Mr. Adham Ahmed29 Positive nitrogen balance Pregnancy Growth periods Building muscle Rebuilding tissue after trauma/illness

30. Mr. Adham Ahmed30 Negative nitrogen balance Fever Injury Surgery Burns Starvation Immobilization

31. Mr. Adham Ahmed31 Protein Deficiency  Muscle wasting occurs  Albumin (protein in blood plasma) causes edema  Loss of appetite, strength, weight  Lethargy, depression, slow wound healing

32. Mr. Adham Ahmed32 Protein Energy Malnutrition (PEM)  Lack protein and energy-rich foods.  Found in developing countries with shortages of protein and energy-rich foods.  Stunted growth and mental retardation may occur.

33. Mr. Adham Ahmed33 Marasmus  Affects very young children.  Results from severe malnutrition (lack of protein, vitamins, and minerals).  Emaciated, no edema  Hair is dull and dry; skin thin and wrinkled.

34. Mr. Adham Ahmed34 Kwashiorkor  Sudden or recent lack of protein- containing food; affects children and adults.  Fat accumulates in liver, and lack of protein and hormones results in edema, painful skin lesions, and changes in pigmentation of skin and hair.  High mortality rate

35. Mr. Adham Ahmed35 Differentiate between marasmus and kwashiorkor by identifying three differences between the two conditions.

36. Mr. Adham Ahmed36 MarasmusKwashiorkor Weight decreasedWeight within normal limits Visceral proteins within normal limits Visceral proteins decreased Immune function within normal limits Immune function decreased Dull, dry hairReddish color hair Emaciated, wrinkled appearance Edema, puffy appearance

37. Mr. Adham Ahmed37 Conclusion  Proteins contain nitrogen.  They build and repair body tissues, regulate body processes, and supply energy.  Each gram of protein provides 4 kcal.  Composed of amino acids.  Nine of the amino acids are essential for growth and development.