1. Nutrition and Diets Chapter 11
Health Science 2

2. What is Nutrition?
Most people know there is a fundamental relationship between food and good health
Many do not know what nutrients are needed
Many are not able to choose proper foods for optimum health

3. In short Nutrition: all body processes relating to food
Nutritional status: state or condition of one’s nutrition
Nutrition plays a large role in the physical, mental, emotional, and psychological processes of our bodies

4. Effects of Good Nutrition
Healthy appearance
Good attitude
Proper sleep and bowel habits
High energy level
Enthusiasm and freedom from anxiety

5. Nutritional Effects on Genetics
Research has determined that nutrition can affect a person’s gene expression in relation to many different diseases.
-e.g. obesity, heart disease and cancer.

6. Nutrition and Psychology
Behavior affects what we eat
But what we eat may also affect our behavior!
E.g. Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. Gesch et al in the British Journal of Psychiatry (July 2002)

7. Nutrition and Epidemiology
This is the study of how often diseases occur in different populations and why.
Much of our evidence relating diet and disease comes from large epidemiological studies of different populations.
e.g. Studies of Ancel Keys in the 1950s that led to the link between saturated fat and coronary heart disease.

8. Cross Cultural Epidemiological Studies of Coronary Artery Disease
Ancel Keys - studies starting in the 1950s highlighted the differences in the prevalence of CAD across the globe. CAD was unusual in Japan, Crete and Corfu while it was very common in Finland, the USA and the Netherlands.
He demonstrated a link between blood cholesterol levels and CAD and dietary saturated fat.

9. Chronic Diseases
According to the World Health Organization (WHO), “the growing epidemic of chronic diseases affecting both developed and developing countries is linked to diet and lifestyle changes.”

10. Chronic Diseases that are Related to Nutrition
Obesity
Diabetes
Cardiovascular Diseases
Cancer
Osteoporosis and Bone Fracture
Dental Disease

11. Nutrition and Obesity The main determinant of the obesity epidemic is:
The imbalance between low energy expenditure due to physical inactivity and high dietary calories.
Action: Increase physical activity and reduce intake of high fat foods and sugary drinks.

12. Nutrition and Diabetes
Escalating rates of type 2 diabetes due to:
Obesity and physical inactivity
Diabetes leads to increased risk of heart disease, kidney disease, stroke and infections
Action: Maintenance of healthy body weight along with exercise.

13. Nutrition and Cardiovascular Disease
Major killers worldwide. Due to a great extent to:
Poor nutrition and
physical inactivity
Leads to: atherosclerosis
Action: Reduce the intake of saturated fats, take enough fruits and vegetables, and less salt. Increase physical activity.

14. Nutrition and Cancer Tobacco is the number one cause of cancer.
But dietary factors contribute significantly to certain types of cancer
Maintenance of a healthy weight will reduce the risk for cancers of the esophagus, colorectum, breast, endometrium, and kidney.

15. Nutrition and Cancer
Limiting alcohol intake will reduce risk frok cancers of the mouth, throat, esophagus, liver and breast.
Adequate intakes of fruit and vegetables will further reduce risk for oral cavity, esophagus, stomach and colorectal cancer

16. Nutrition and Osteoporosis
Adequate intakes of calcium (500 mg or more) and Vitamin D intakes helps reduce the risk as does exposure to sunlight and physical activity.

17. Dental Disease Cavities are prevented by:
Limiting the frequency and amount of consumption of sugars and by appropriate exposure to fluoride.

18. Essential Nutrients Chemical elements are found in food
Used by the body to perform many different body functions
Nutrients are divided into six groups

19. Essential Nutrients Carbohydrates Lipids (fats and oils) Proteins
Vitamins
Minerals
Water

20. Essential Nutrients: Carbohydrates
major source of readily available energy
Commonly called starches or sugars
Cheaper source of energy because they are found mainly in plants
Made of carbohydrates, hydrogen and water
Main sources of carbohydrates are breads, cereals, noodles, pasta, crackers, potatoes, peas, beans, fruits, sugar, and syrup
Cellulose is the fibrous, indigestible form of plant carbohydrate. It provides bulk in the digestive tract, causing regular bowel movements.

21. Essential Nutrients: Lipids (Fats)
Three of the most common lipids found in both food and the human body are triglycerides (fatty acids), phospholipids, and sterols (cholesterol)
Lipids are the most concentrated form of energy but are more expensive than carbohydrates
Also function to maintain body temperature by providing insulation, cushion organs and bones, and aid in the absorption of fat-soluble vitamins
Main sources include butter, oils, cream, meats, cheese, dairy products, and egg yolk
Saturated fats are solid at room temperature
Unsaturated fats are soft or oily at room temperature

22. Essential Nutrients: Cholesterol
A lipid (sterol) found in body cells and in animal products
Used in the production of steroid hormones, Vitamin D, and bile acids. It is also a component of the cell membrane
Common sources are: egg yolk, fatty meats, shellfish, butter, creams, cheeses, whole milk.
Cholesterol is also manufactured by the liver
Lipoproteins – cholesterol is transported in the bloodstream by two carrier molecules called lipoproteins:
HDL – high density lipoprotein that transports cholesterol back into the liver and prevents it from accumulating in the arterial walls
LDL – low density lipoprotein transports cholesterol to arterial walls where it causes plaque build-up, leading to atherosclerosis

23. Essential Nutrients: Proteins
Basic components of all body cells. Essential for building and repairing tissue, regulating body functions, and providing energy
Made up of “22 building blocks”, called amino acids. Nine of these amino acids are essential to life
Complete proteins – contain the nine amino acids that are essential to life
-found in meats, fish, milk, cheese, and eggs
Incomplete proteins – contain any of the remaining thirteen non-essential amino acids
-found in cereals, soybeans, peas, corn, and nuts
How does this affect vegetarians (especially vegans)?

24. Essential Nutrients: Vitamins
Organic (living) compounds that are essential to life
Involved in metabolism, tissue building and repair, regulation of body processes, digestion, and blood formation and clotting
Vitamins are classified as water soluble or fat soluble
Water soluble vitamins – dissolve in water and are not stored in the body.
-Includes B-Vitamins, Vitamin C, and Folic Acid
Fat soluble vitamins – dissolve in fat (not in water) and are stored in the body.
-Includes Vitamins A, D, E, and K

26. Essential Nutrients: Minerals
Inorganic (nonliving) elements found in all body tissues
Functions include:
-regulate body fluids (Sodium, Potassium)
-contribute to growth (Calcium, Phosphorus, Magnesium, Zinc)
-helps build tissues (Magnesium, Sulfur, Iron)
-formation of RBC’s (Iron, Copper)
-maintains heart rhythm (Calcium, Potassium)

27. Essential Nutrients: Water
Found in all body tissues
Essential for the digestion (breakdown) of food
Makes up most of the blood plasma, and cytoplasm of cells
Helps the body tissues to absorb nutrients
Moves waste materials through the body

28. Utilization of Nutrients
Digestion – the process by which the body breaks down food into smaller parts, changes the food chemically, and moves the food through the digestive system.
Mechanical Digestion – food is broken down by the teeth and moved through the digestive tract by a rhythmic, wave-like motion of the muscles, called peristalsis.
Chemical Digestion – food is broken down by digestive enzymes secreted by the mouth, stomach, small intestines, and pancreas.

29. Utilization of Nutrients
Absorption
The process by which blood or lymph picks up the digested nutrients. The nutrients are then carried by the circulatory system to every cell in the body
Most absorption of nutrients occurs in the small intestine
Metabolism
The process in which nutrients are used by the cells
Nutrients are combined with oxygen and energy and heat are released
Basal Metabolic Rate (BMR) – the rate at which the body uses energy just for maintaining its own tissue, without doing any voluntary work.

30. Maintenance of Good Nutrition
Good nutrition is the best way of achieving and maintaining good health
The US Department of Agriculture Developed a food guide called “My Pyramid” (See Figure in text – page 303)
If food is not appealing, people will not eat it even if it is healthy; consider variety, taste, color, aroma, texture, and general likes and dislikes

31. Guidelines for Good Eating Habits
Make smart choices from every food group (See Table 11-4 in text – p. 304)
Find a balance between food and all physical activity – minutes of physical activity per day
Limit fats, saturated fat, and cholesterol. Eat lean meats and low fat dairy
Choose nutritionally rich foods – high in nutrition but low in calories

32. Guidelines for Good Eating Habits
Don’t sugarcoat it – use sugar in moderation
Reduce salt intake – flavor foods with herbs and spices
Check food labels and calculate the calories per serving and the amount of fat
Remember that alcohol can be harmful to your health

33. Weight Management Weight in relation to height for
Males – for the first 60 inches of height, an individual should weigh 106 lbs. For each inch over 60 inches, 6 lbs. should be added.
-a 74 inch man should weigh _____ lbs
Females - for the first 60 inches of height, an individual should weigh 100 lbs. For each inch over 60 inches, 5 lbs. should be added.
-a 68 inch woman should weigh _____ lbs

34. Weight Management Weight in relation to height for
Large-boned individuals – increase the weight by 10% for large-boned males or females
Small-boned individuals - decrease the weight by 10% for small-boned males or females

35. Weight Management
Body mass index (BMI) – is a calculation that measures weight in relation to height and correlates this with body fat.
-determined by dividing a person’s weight in kilograms by height in meters squared
-Ideal range –
-A BMI of less than 18.5 indicates the individual is underweight
- A BMI of more than 25 indicates the individual is overweight

36. BMI
Chart

37. Measuring Food Energy
Food varies in the amount of energy they contain. The amount of heat produced during metabolism is the way the energy content of food is measured.
The heat is measured by a unit called kilocalorie (kcal), or just calorie
Carbohydrates – provide 4 calories per gram
Proteins – provide 4 calories per gram
Fats – provide 9 calories per gram
Vitamins, minerals, and water do not provide any calories

38. Weight Management 1 pound of body fat equals 3,500 calories.
A general guideline to maintain weight is that a person needs to consume 15 calories per pound per day.
-How many calories does a 120 lb person need to take in per day to maintain this weight?
15 X 120 = 1,800 calories a day
-If a person decreased her caloric intake by 500 calories a day, how much weight would she lose in a week?
500 X 7 = 3,500 calories = 1 pound

39. Therapeutic Diets
Modification of normal diet used to improve specific health condition
Normally prescribed by physician and planned by dietitian
May change nutrients, caloric content, and/or texture
May seem strange and even unpleasant to patient

40. Regular or Standard Diet
Balanced diet
Usually used for ambulatory patients
May have slight calorie reduction
Decreased or omitted: rich desserts, cream sauces, salad dressings, and fried foods

41. Liquid Diets
Clear and full liquids to be used only for short periods of time
Liquid foods at body temperature
Clear: carbohydrates and water
-apple juice, fat-free broth, plain gelatin, ginger ale, tea
Full: clear liquids plus other liquids
-strained soups and cereals, fruit juices, yogurt, ice
cream, pudding
Uses such as the following: surgery, digestive problems, to replace lost fluids, and in preparation for X-rays of the digestive tract

42. Soft Diet
Similar to a regular diet, but foods require little chewing and are easy to digest
Avoid meat, shellfish, coarse cereals, spicy foods, rich desserts, fried foods, raw vegetables, fruits, and nuts
Uses: after surgery, patients with infections, digestive disorders, and chewing problems

43. Diabetic Diet
Used for patients with diabetes mellitus who often take insulin
Exchange lists are used to choose foods on exchange lists
Avoid sugar-heavy foods such as candy, soft drinks, desserts, cookies, syrups, honey, and jellies

44. Calorie-Controlled Diets
Low-calorie — used for patients who are overweight; avoid or limit high-calorie foods
High-calorie — used for patients who are underweight, have anorexia nervosa, hyperthyroidism, or cancer. Avoid high-bulk foods such as green salads, watermelon, and fibrous fruits

45. Low-Cholesterol Diet Restricts foods containing cholesterol
Used for patients with atherosclerosis and heart disease
Limit foods high in saturated fats, such as beef, liver, pork, egg yolk, cream cheese, shellfish, and whole milk

46. Sodium-Restricted Diets
Otherwise known as low-sodium or low-salt diets
Used for cardiovascular diseases, kidney disease, and fluid retention
Avoid or limit addition of salt; avoid salt-rich foods such as smoked meats, some fish, pickles, olives, sauerkraut

47. Protein Diets
Protein-rich foods such as meats, fish, milk, cheese, and eggs
High-protein for children and adolescents for additional growth, pregnant or lactating women, surgery, burns, fevers, infections
Low-protein for certain kidney or renal diseases and allergic conditions

48. Bland Diet
Easily digested foods that do not irritate the digestive tract
Used for patients with ulcers, colitis, and other digestive diseases