SAS 1: OVERVIEW OF NUTRITION AND HEALTH half of the healthy individuals in a

Basic Concepts in Nutrition and Diet Therapy given age and gender group.
FOOD  Tolerable Upper Intake Levels (UL)
 Nourishes the body. Anything eaten or drunk  Set of values reflecting the highest
which meets the needs for energy, building, average daily nutrient intake levels
regulation, and protection of the body. that are likely to pose no risk of toxicity
 Raw material from which our body is made to almost all healthy individuals in a
NUTRITION particular life stage and gender group.
 The science of foods and the nutrients and other 2. Estimated Energy Requirement (EER)
substances they contain, and their ingestion,  Enough energy is needed to sustain a healthy,
digestion, absorption, transportation, active life, but too much energy leads to obesity.
metabolism, interaction, storage, and excretion.  Set at a level of energy intake predicted to maintain
NUTRIENTS energy balance in a healthy adult of a defined
 Are components of food that are needed by the age, gender, weight, height, and physical activity
body in adequate amounts in order to grow, level.
reproduce and lead a normal, healthy life. 3. Acceptable Macro nutrients Distribution Ranges
FOOD CHOICES (AMDR)
Factors that influences personal food choices:  Considers prevention of chronic disease as wells as
-Preference nutrient adequacy when establishing
-Habits recommendations.
-Associations
-Ethnic Heritage and Regional Cuisines The DRI committee has determined that a diet that
-Values provides the energy yielding nutrients in the following
-Social Interaction proportions provides adequate energy and nutrients
-Availability, Convenience, and Economy and reduces the risk of chronic disease:
-Age, Body Weight and Image ❚ 45 to 65 percent of kcalories from carbohydrate
-Medical Conditions, Health and Nutrition ❚ 20 to 35 percent of kcalories from fat
THE NUTRIENTS
❚ 10 to 35 percent of kcalories from protein
6 CLASSES OF NURTIENTS: water, carbohydrates, fats,
proteins, vitamins, and minerals
Dietary Guidelines and Food Guides
 Organic Nutrients (Carbohydrates, Fats, Proteins,
OVERNUTRITION:
and Vitamins)
-over consumption of food energy or nutrients
 Inorganic Nutrients (Minerals and Water)
UNDERNUTRITION
- under consumption of food energy or
NUTRIENTS RECOMMENDATIONS
nutrients
1. Dietary Reference Intake (DRI)
 Set of standards that define the amounts of energy,
DIETARY IDEALS
nutrients, other dietary components, and
1. Adequacy
physical activity that best support health
a) Provides all essential nutrients, fiber, and
 4 DRI Categories
energy necessary to maintain health and body
 Recommended Dietary Allowances (RDA)
weight
 Set of values reflecting the average daily
2. Balance
amounts of nutrients considered
a) Providing foods in proportion to one another
adequate to meet the known nutrients
and in proportion to the body’s needs
needs
3. kCalorie (energy) control
 Adequate Intakes (AI)
a) Foods provide the amount of energy needed
 Set of valuers that are used as guides for
to maintain a healthy body weight-not more
nutrient intakes when scientific
or less.
evidence is insufficient to determine
4. Nutrient density
an RDA.
a) Measure of the nutrients a food provides
 Estimated Average Requirements (EAR)
relative to the energy it provides.
 The average daily nutrient intake levels
estimated to meet the requirements of

1
5. Moderation  Structure-function claims: statements that
a) Provision of enough, but not too much of a describe how a product may affect a
substance structure or function of the body; for example,
6. Variety “calcium builds strong bones.” Structure-
a) Consumption of a wide selection of foods function claims do not require FDA
within and among the major food groups. authorization.

USDA Food Patterns

ESTIMATED DAILY KCALORIE NEEDS FOE ADULTS

Sedentary
- describes a lifestyle that includes only the
activities typical of day-to-day life.
Active
- describes the lifestyle that includes physical
activity.

FOOD LABELS
 The ingredient List
 Nutrition facts panel
 The Daily values
 Claims on Labels
 Nutrient claims: statements that characterize
the quantity of a nutrient in a food.
 Health claims: statements that characterize
the relationship between a nutrient or other
substance in food and a disease or health-
related condition.

2
SAS 2: NUTRITION CARE PROCESS NCP Step 2: Nutrition Diagnosis
NUTRITION CARE PROCESS (ADIME) Purpose: Nutrition Diagnosis is a nutrition and dietetics
- systematic approach to providing high quality practitioner’s identification and labeling of an existing
nutrition care. nutrition problem(s) that the practitioner is responsible
- Consist of 4 distinct, interrelated steps for treating.
1) Nutrition Assessment Determining a Nutrition Diagnosis: Nutrition and
a) The dietitian/nutritionist collects and dietetics practitioners use standard nutrition diagnostic
documents information terminology to label the client’s nutrition diagnosis(es)
2) Nutrition Diagnosis through organized nutrition assessment data that are
a) Data collected during the nutrition guides the clustered for comparison with defining characteristics
dietitian/nutritionist in selection of the listed on the reference sheets.
appropriate nutrition diagnosis
3) Nutrition Intervention
a) The dietitian/nutritionist then selects the Terminology for Nutrition Diagnosis is organized in three
nutrition intervention that will be directed to domains (categories):
the root cause (or etiology) of the nutrition  Intake
problem and aimed at alleviating the signs and  Too much or too little of a food or nutrient
symptoms of the diagnosis compared to actual to estimated needs
4) Nutrition Monitoring/Evaluation  Clinical
a) Final step of the process is monitoring and  Nutrition problems that are relate to medical
evaluation, which the dietitian/nutritionist or physical conditions
uses to determine if the client has achieved, or  Behavioral-Environmental
is making progress towards the planned goals  Knowledge, attitudes, beliefs, physical
environment, access to food, or food safety
The Nutrition Care Process
NCP Step 1: Nutrition Assessment Communicating a Nutrition Diagnosis:
Purpose: Nutrition Assessment is a systematic approach  Nutrition and dietetics practitioners write a PES
to collect, classify, and synthesize important and relevant (Problem, Etiology, Signs and Symptoms)
data needed to identify nutrition-related problems and statement to describe each problem, the root
their causes. causes, and the assessment data that provide
Finding Nutrition Assessment Data: For individuals, data evidence for the nutrition diagnosis(es).
can come directly from the patient/client through
interview, observation and measurements, a health  (P) Problem or Nutrition Diagnosis Term
record, and the referring health care provider.  Describes alterations in the client’s
nutritional status.
Terminology for nutrition assessment is organized in five  (E) Etiology
domains (categories):  Cause/contributing risk factors linked to
 Food/Nutrition-Related History the nutrition diagnosis term by the words
 Anthropometric Measurement “related to”
 Biochemical Data, Medical Tests, and Procedures  (S) Signs /Symptoms
 Nutrition-Focused Physical Findings  Data or indicators used to determine the
 Client History client’s nutrition diagnosis
 Linked to the etiology by the words “as
Use of Nutrition Assessment Data: Nutrition assessment evidences by”
data, or indicators, are compared to reference standards,
recommendations, or goals.

3
Guidelines for Writing a Clear PES Statement:  Nutrition Counselling
When writing the PES statement, nutrition and dietetics  Supportive process characterized by a
practitioners can ask a series of questions that help collaborative counsellor-client relationship
clarify the nutrition diagnosis(es).  Coordination of Nutrition Care
 Consultation with, referral to, or coordination
Critical thinking skills: of nutrition care with other health care
P – Can the nutrition and dietetics practitioner resolve or providers
improve the client's nutrition diagnosis?  Population Based Nutrition Action
E – Evaluate whether the etiology for each problem  Interventions designed to improve the
is the specific “root cause” that can be addressed nutritional well being of a population.
with a nutrition intervention. If addressing the
etiology cannot resolve the problem, can the Use of Nutrition Intervention Terminology:
dietitian/nutritionist intervention at least lessen the Nutrition intervention is accomplished in two distinct
signs and symptoms? and interrelated steps: planning and implementing
S – Will measuring the signs and symptoms indicate if
the problem is resolved or improved? Are the signs Planning the nutrition intervention involves:
and symptoms specific enough to monitor ⎯ Prioritizing nutrition interventions based on
(measure/evaluate changes) and communicate urgency, impact, and available resources
resolution or improvement of a nutrition diagnosis? ⎯ Collaborating with the client to identify goals of
the intervention for each diagnosis
PES Overall – Do the nutrition assessment data support ⎯ Selecting specific nutrition intervention
the nutrition diagnosis, etiology, and signs and symptoms? strategies that are focused on the etiology
of the problem and that are known to be
effective based on best current knowledge
NCP Step 3: Nutrition Intervention
and evidence
⎯ Defining the time and frequency of care,
Definition: A nutrition intervention is a purposely including intensity, duration, and follow-up
planned action(s) designed with the intent of changing a
nutrition-related behavior, risk factor, environmental Implementation is the action phase and involves:
condition, or aspect of health status to resolve or ⎯ Collaborating with the client to carry out the
improve the identified nutrition diagnosis(es) or nutrition plan of care
problem(s). ⎯ Communicating the nutrition care plan
Determining a nutrition intervention: The nutrition ⎯ Modifying the plan of care as needed
diagnosis and its etiology drive the selection of a ⎯ Following up and verifying that the plan is being
nutrition intervention. The nutrition intervention is implemented
typically directed toward resolving the nutrition ⎯ Revising strategies based on changes in
diagnosis(es) by altering or eliminating the nutrition condition or response to intervention
etiology(ies).
NCP Step 4: Nutrition Monitoring and Evaluation
Terminology for Nutrition Intervention is organized in five
domains (categories) Definition: The purpose of nutrition monitoring and
 Food and/or Nutrient Delivery evaluation is to determine and measure the amount of
 Customized approach for food/nutrient progress made for the nutrition intervention and
provision whether the nutrition related goals/expected outcomes
 Nutritional Education are being met. The aim is to promote more uniformity
 A formal process to instruct or train a client in within the dietetics profession in assessing the
a skill or to impart knowledge to help clients effectiveness of nutrition intervention.
voluntarily manage or modify food, nutrition,
and physical activity choices and behavior to
maintain or improve health

4
Terminology for Nutrition Monitoring and Evaluation is SAS 3: CARBOHYDRATES AND LIPIDS
organized in four domains (categories) CARBOHYDRATES
 Food/Nutrition-Related History Outcomes - are organic compound (saccharides - starches
 Anthropometric Measurement Outcomes and sugars) composed of carbon, hydrogen, and oxygen.
 Biochemical Data, Medical Tests, and Procedure
Outcomes The dietary carbohydrates include the sugars, starch, and
 Nutrition-Focused Physical Finding Outcomes fiber. Chemists describe the
sugars as:
Collection and Use of Nutrition Monitoring and  Monosaccharides (single sugars).
Evaluation Outcome Data:  Disaccharides (double sugars). Starch and fiber are:
-This step consists of three components: *
monitoring, measuring, and evaluating the changes in  Polysaccharides—compounds composed of chains
nutrition care indicators. Practitioners monitor by of monosaccharide units.
providing evidence that the nutrition intervention is or is
not changing the client’s behavior or status. A. Monosaccharides
- Three monosaccharides are important in
nutrition: glucose, fructose, and galactose. All three
monosaccharides have the same number and kinds of
atoms but in different arrangements.
1. Glucose
a) most cells depend on glucose for their fuel to
some extent, and the cells of the brain and the
rest of the nervous system depend almost
exclusively on glucose for their energy.
2. Fructose
a) is the sweetest of the sugars.
3. Galactose
a) the third single sugar, galactose, occurs mostly
as part of lactose, a disaccharide also known
as milk sugar. During digestion, galactose is
freed as a single sugar

B. Disaccharides
- In disaccharides, pairs of single sugars are
linked together. Three disaccharides are important
in nutrition: maltose, sucrose, and lactose. All three
contain glucose as one of their single sugars
1. Sucrose (table, or white, sugar)
a) is the most familiar of the three
disaccharides and is what people mean
when they speak of “sugar.”
2. Lactose
a) is the principal carbohydrate of milk. Most
human infants are born with the digestive
enzymes necessary to split lactose into its
two monosaccharide parts, glucose and
galactose, so as to absorb it.
3. Maltose
a) is the third disaccharide, maltose, is a plant
sugar that consists of two glucose units.

5
 A. Polysaccharides Glucagon
- Unlike the sugars, which contain the three - is a hormone that is secreted by special cells
monosaccharides—glucose, fructose, and in the pancreas in response to low blood glucose
galactose—in different combinations, the concentration and that elicits release of glucose from
polysaccharides are composed almost entirely of storage.
glucose (and, in some cases, other
monosaccharides). The Release of Glucose from Glycogen
-Three types of polysaccharides are important
in nutrition: glycogen, starch, and fibers. - The glycogen molecule is highly branched
1. Glycogen with hundreds of ends bristling from each molecule’s
a) molecules are made of chains of glucose that surface. When blood glucose starts to fall too low, the
are more highly branched than those of starch hormone glucagon is released into the bloodstream
molecules. Glycogen is found in meats only to and triggers the breakdown of liver glycogen to single
a limited extent and not at all in plants. glucose molecules. Enzymes in liver cells respond to
2. Starch glucagon by attacking a multitude of glycogen ends
a) is a long, straight or branched chain of simultaneously to release a surge of glucose into the
hundreds or thousands of glucose units linked blood for use by all the body’s cells. Thus, the highly
together. branched structure of glycogen uniquely suits the
3. Fibers (Dietary fibers) purpose of releasing glucose on demand.
a) are the structural parts of plants and thus are
found in all plant derived foods—vegetables, LIPIDS
fruits, whole grains, and legumes. -Fat is a member of the class of compounds
called lipids. The lipids in foods and in the human body
include triglycerides (fats and oils), phospholipids, and
Regulation of Blood Glucose sterols.

- If blood glucose falls below normal, a person The Functions of Fats in the Body
may become dizzy and weak; if it rises substantially ● Energy stores. Fats are the body’s chief form of
above normal, the person may become fatigued. stored energy.
Diabetes, a disorder characterized by elevated blood ● Muscle fuel. Fats provide much of the energy to
glucose. Left untreated, fluctuations to the extremes— fuel muscular work.
either high or low—can be fatal. Blood glucose ● Padding. Fat pads inside the body cavity protect
homeostasis is regulated primarily by two hormones: the internal organs from shock.
insulin, which moves glucose from the blood ● Insulation. Fats insulate against temperature
into the cells, and extremes by forming a fat layer under the skin.
glucagon, which brings glucose out of storage ● Cell membranes. Fats form the major material of
when blood glucose falls (as occurs between meals). cell membranes.
● Raw materials. Fats are converted to other
Insulin compounds, such as hormones, bile, and vitamin D,
after a meal, as blood glucose rises, the as needed.
pancreas is the first organ to respond. It releases the
hormone insulin, which signals body tissues to take up  Triglycerides
surplus glucose  when people talk about fat—for example, “I’m
too fat” or “That meat is fatty”—they are
Simply put, insulin regulates blood glucose by: usually referring to triglycerides.
❚ Facilitating blood glucose uptake by the muscles  Fatty Acids
and adipose tissue.  When energy from any energy-yielding
❚ Stimulating glycogen synthesis in the liver. nutrient is to be stored as fat, the nutrient is
first broken into small fragments. Then the
fragments are linked together into chains
known as fatty acids.

6
 Saturated Fats others, such as vitamin D and the sex
 Solid at room temperature and can be found hormones (for example, testosterone), are
in meats, butter and dairy products. important, too.
 Unsaturated Fats  Sterols in Foods. Foods derived from both
 Liquid at room temperature and can be found plants and animals contain sterols, but only
in vegetable oils. those from animals—meats, eggs, fish,
 These fats increase the levels of good poultry, and dairy products—contain
cholesterol or the high-density lipoprotein significant amounts of cholesterol.
(HDL).
 Trans fatty acids Cholesterol Synthesis.
 An unhealthy substance that is made through - Like lecithin, cholesterol can be made by the
the chemical process of hydrogenation of oils. body, so it is not an essential nutrient. Right now, as
 Hydrogenation solidifies liquid oils and you read, your liver is manufacturing cholesterol from
increases the shelf life and the flavor stability fragments of carbohydrate, protein, and fat. Most of
of oils and foods that contain them. the body’s cholesterol ends up in the membranes of
 Trans fatty acids both raise the 'bad' (LDL) cells, where it performs vital structural and metabolic
cholesterol and lower the 'good' (HDL) functions.
cholesterol levels in blood, markedly Cholesterol’s Two Routes in the Body
increasing the risk of heart disease After it is made, cholesterol leaves the liver by two
 Essential Fatty Acids routes:
 Using carbohydrate, fat, or protein, the human 1. It may be incorporated into bile, stored in the
body can synthesize all the fatty acids it needs gallbladder, and delivered to the intestine.
except for two—linoleic acid and linoleic acid. 2. It may travel, via the bloodstream, to all the
 Both linoleic acid and linoleic acid are body’s cells.
polyunsaturated fatty acids. - The bile that is made from cholesterol in the
 Linoleic acid an Omega-6 fatty acid and linoleic liver is released into the intestine to aid in the digestion
acid an Omega-3 Fatty Acids and absorption of fat. After bile does its job, most of it is
 are found in small amounts in plant oils, and absorbed and reused by the body; the rest is excreted in
the body readily stores them, making the feces.
deficiencies unlikely.
 These two essential nutrients also serve as Cholesterol Excreted. While bile is in the intestine, some
structural components of cell membranes. of it may be trapped by soluble fibers or by some
 Phospholipids medications, which carry it out of the body in feces
 one of the three main classes of lipids;
Health Effects of Fats
compounds that are similar to triglycerides
● High intakes of saturated or trans fats contribute
but have choline (or another compound) and
to heart disease, obesity, and other health
a phosphorus-containing acid in place of one
problems.
of the fatty acids.
● High blood cholesterol, specifically, poses a
 Phospholipids in Foods. In addition to the
risk of heart disease, and high intakes of
phospholipids used by the food industry as
saturated fat and trans-fat contribute the most
emulsifiers, phospholipids are also found
to high blood cholesterol. Cholesterol in foods
naturally in foods. The richest food sources
presents less of a risk.
of lecithin are eggs, liver, soybeans, wheat
● Polyunsaturated fatty acids of the omega-6 and
germ, and peanuts.
omega-3 families protect against heart disease.
 Roles of Phospholipids. Lecithin and other
● When monounsaturated fat such as olive oil
phospholipids are important constituents of
replaces saturated and trans fats in the diet,
cell membranes. They also act as emulsifiers
the risk of heart disease may be lessened.
in the body, helping to keep other fats in
● Though some fat in the diet is necessary, health
solution in the watery blood and body fluids.
authorities recommend a diet moderate in total
 Sterols
fat and low in saturated fat, trans fat, and
 Sterols are large, complex molecules
cholesterol.
consisting of interconnected rings of carbon.
Cholesterol is the most familiar sterol, but

7
SAS 4: PROTEINS B. Roles of Proteins in the Body
PROTEINS ⎯ Structural components.
- are chemical compounds that contain the •Proteins form integral parts of most body
same atoms as carbohydrates and lipids -CARBON, tissues and confer shape and strength on
HYDROGEN, OXYGEN-but proteins are different in that bones, skin, tendons, and other tissues.
they also contain NITROGEN atoms. Structural proteins of muscles allow
The Structures of Proteins movement.
⎯ Enzymes.
 Protein Chains. •Proteins facilitate chemical reactions.
 The 20 amino acids can be linked end to end ⎯ Transporters.
in a virtually infinite variety of sequences to •Proteins transport substances such as lipids,
form proteins. vitamins, minerals, and oxygen around the
body.
 When two amino acids bond together, the ⎯ Fluid and electrolyte balance.
resulting structure is known as a dipeptide. •Proteins help to maintain the distribution and
 Three amino acids bonded together form a composition of various body fluids.
tripeptide. ⎯ Acid-base balance.
•Proteins help maintain the acid-base balance
 As additional amino acids join the chain, the of body fluids by acting as buffers.
structure becomes a polypeptide. Most ⎯ Antibodies.
proteins are a few dozens to several hundred •Proteins inactivate disease-causing agents,
amino acids long. thus protecting the body.
 Protein Shapes. ⎯ Hormones.
 Polypeptide chains twist into complex shapes. •Proteins regulate body processes. Some, but
 Each amino acid has special characteristics not all, hormones are proteins.
that attract it to, or repel it from, the ⎯ Energy and glucose.
surrounding fluids and other amino acids. •Proteins provide some fuel, and glucose if
 Protein Functions. needed, for the body’s energy needs.
 The dramatically different shapes of proteins ⎯ Other.
enable them to perform different tasks in the •The protein fibrin creates blood clots; the
body. protein collagen forms scars; the protein

opsin participates in vision.
A. Nonessential and Essential Amino Acids
Protein Deficiency
- most recognizable consequences of protein
deficiency include slow growth in children, impaired
brain and kidney functions, weakened immune
defenses, & impaired nutrient absorption from
digestive tract.
Malnutrition
- Protein-Energy Malnutrition (PEM) has
traditionally been used to describe the condition that
develops when the diet delivers too little protein, too
little energy, or both.
Severe Acute Malnutrition (SAM)
- malnutrition caused by recent severe food
restriction; characterized in children by underweight for
height (WASTING).
Chronic Malnutrition
- malnutrition caused by long term food
deprivation, characterized in children by short height for
age (STUNTING)

8
Kwashiorkor SAS 5 : DIGESTION AND ABSORPTION
- Ghanaian word meaning “sickness that infects Anatomy of the Digestive Tract
the first child the second child is born.” A. The Digestive Organs
Marasmus 1. The process of digestion begins in the mouth.
- appropriately named after the Greek word a) The tongue allows you not only to taste food
meaning “dying away”, reflects a prolonged, unrelenting but also to move food around the mouth,
deprivation of food observed in children living in facilitating chewing and swallowing. When
compromised nations. you swallow a mouthful of food, it passes
through the pharynx, a short tube that is
C. Protein in Food shared by both the digestive system and the
 - The protein quality of the diet determines, in respiratory system.
large part, how well children grow and how well 2. Mouth to the Esophagus.
adults maintain their health. a) Once a mouthful of food has been chewed
 Put simply, high-quality proteins provide enough and swallowed, it is called a bolus. Each
of all the essential amino acids needed to support bolus first slides across your epiglottis,
the body’s work, and low-quality proteins don’t. bypassing the entrance to your lungs.
 Two factors influence protein quality: the 3. Esophagus to the Stomach.
protein’s digestibility and its amino acid a) The esophagus has a sphincter muscle at each
composition. end. During a swallow, the upper
esophageal sphincter opens.
Complementary Proteins 4. The Small Intestine.
are two or more proteins whose amino acid a) At the beginning of the small intestine, the
assortments complement each other in such a way that chyme passes by an opening from the
the essential amino acids limited in one are supplied by common bile duct, which secretes digestive
the other. fluids into the small intestine from two
organs outside the GI tract—the gallbladder
and the pancreas.
5. The Large Intestine. (Colon)
a) Having traveled the length of the small
intestine, what remains of the intestinal
contents passes through another sphincter,
the ileocecal valve, into the beginning of
the large intestine (colon) in the lower
right-hand side of the abdomen.
6. The Rectum.
a) As the intestinal contents pass to the rectum,
the colon withdraws water, leaving semi
solid waste. The strong muscles of the
rectum hold back this waste until it is time
to defecate.
B. The Involuntary Muscles and the Glands
Gastrointestinal Motility.
 Once you have swallowed, materials are moved
through the rest of the GI tract by involuntary
muscular contractions.
 This motion, known as gastrointestinal motility,
consists of two types of movement:
⎯ Peristalsis - propels, or pushes
⎯ Segmentation - mixes, with more gradual pushing

9
Liquefying Process. E.Absorption of Nutrients and Transport of Nutrients
 Besides forcing the intestinal contents along, the ⎯ Nutrients leaving the digestive system via the
muscles of the GI tract help to liquefy them to blood are routed directly to the liver before
chyme so that the digestive juices will have access being transported to the body’s cells. Those
to all their nutrients. leaving via the lymphatic system eventually
enter the vascular system, but they bypass the
C.The Process of Digestion liver at first.
1. Digestion in the Mouth. ⎯ Within the circulatory system, lipids travel
a) Digestion of carbohydrate begins in the mouth, bundled with proteins as lipoproteins. Different
where the salivary glands secrete saliva, which types of lipoproteins include chylomicrons, very-
contains water, salts, and enzymes (including low-density lipoproteins (VLDL), low-density
salivary amylase) that break the bonds in the lipoproteins (LDL), and high-density lipoproteins
chains of starch. (HDL).
2. Digestion in the Stomach. 1. Very-low-density lipoproteins (VLDL):
a) Gastric juice, secreted by the gastric glands, is • the type of lipoproteins made primarily
composed of water, enzymes, and by liver cells to transport lipids to various
hydrochloric acid. The acid is so strong that it tissues in the body; composed primarily
burns the throat if it happens to reflux into the of triglycerides.
upper esophagus and mouth. 2. Low-density lipoproteins (LDL): the
• type of lipoproteins derived from VLDL
Digestion in the Small and Large Intestines
as cells remove triglycerides from them.
 Digestive Enzymes.
LDL carries cholesterol and triglycerides
 Pancreatic juice contributes enzymes that
from the liver to the cells of the body and
digest fats, proteins, and carbohydrates.
are composed primarily of cholesterol.
Glands in the intestinal wall also secrete
3. High-density lipoproteins (HDL): the
digestive enzymes.
• type of lipoproteins that transport
 Bicarbonate.
cholesterol back to the liver from
 Pancreatic juice also contains sodium
peripheral cells; composed primarily of
bicarbonate, which neutralizes the acidic
protein.
chyme as it enters the small intestine.
⎯ Elevated blood concentrations of LDL are
 Bile
associated with a high risk of heart disease, as are
 is secreted continuously by the liver and is
low levels of HDL.
concentrated and stored in the gallbladder.
The gallbladder squirts bile into the
duodenum whenever fat arrives there.
 The Rate of Digestion of the energy nutrients
depends on the meal contents. If the meal is high
in simple sugars, digestion proceeds fairly rapidly.
On the other hand, if it is rich in fat, digestion is
slower.
 Protective Factors. The intestines contain
bacteria that produce a variety of vitamins,
including biotin and vitamin K (although bacteria
alone cannot meet the need for these vitamins).

D.The Absorptive System
-The many folds and villi of the small
intestine dramatically increase its surface area,
facilitating nutrient absorption.
-Nutrients pass through the cells of the villi
and enter either the blood (if they are water soluble or
small fat fragments) or the lymph (if they are fat
soluble)

10
SAS 6: METABOLISM, ENERGY BALANCE, AND BODY B. The Body’s Metabolic Work
COMPOSITION Heat Energy and Body Temperature.
A. THE ORGANS AND THEIR METABOLIC ROLES  The cells of each organ conduct metabolic activities
- The metabolic reactions of evry organ specific to that organ.
contribute to the body’s ability to function normally and  In addition, all cells must maintain themselves, and
maintain health. many must reproduce. To do this, they must have
 The Digestive Organs, all the essential nutrients available to them:
 the digestive system transports foods through energy nutrients, vitamins, and minerals, as well as
the gastrointestinal (GI) tract, produces water.
digestive juices and enzymes, absorbs Accelerated Metabolism.
nutrients, provides transport proteins to carry  During severe stress to the body, metabolism
lipids and vitamins to other sites in the body, speeds up. Fever sometimes develops.
and reabsorbs salts and fluids  An accelerated metabolism signifies that fuels are
 The Liver. being used at a rate more rapid than normal; this
 Nutrients absorbed into the bloodstream are may lead to wasting of body organs and loss of
taken first to the liver. The liver is one of the weight, including loss of vital lean tissue.
body’s most active metabolic factories. Building Up and Breaking Down Compounds.
 It receives nutrients and metabolizes,  When not needed by the cells for energy, the
packages, stores, or ships them out for use by basic units of the energy-yielding nutrients are
other organs. It manufactures bile, which the used to build body compounds.
body uses to emulsify fat for digestion and ⎯ Anabolism:
absorption. • reactions in which small molecules are
 It metabolizes and detoxifies drugs, prepares put together to build larger ones.
waste products for excretion, and participates Anabolic reactions require energy (ATP).
in iron recycling and blood cell manufacture. ⎯ Catabolism:
 The Pancreas • reactions in which large molecules are
 The pancreas not only contributes digestive broken down to smaller ones. Catabolic
juices to the GI tract, but also has another reactions release energy (ATP).
metabolic function: it produces the hormones
insulin and glucagon that regulate the body’s A. The Body’s Use of Fuels
use of glucose.  Energy metabolism is the sum total of all the
 The Heart and Blood Vessels. chemical reactions that the body uses to obtain or
 The heart and blood vessels conduct blood, expend energy from foods.
with its cargo of nutrients and oxygen, to all  Earlier chapters described how the energy
the other body cells and carry wastes away yielding nutrients—carbohydrate, fat, and
from them. protein—are broken down into basic units that
 Diseases of the heart and arteries therefore are absorbed into the blood:
affect the health of the whole body. ⎯ From carbohydrates: glucose
 The Kidneys. ⎯ From fat (triglycerides): glycerol and fatty acids
 The kidneys are also active metabolic organs. ⎯ From proteins: amino acids
Unceasingly, for 24 hours of every day, they TCA Cycle.
filter waste products from the blood to be  The breakdown of energy nutrients continues in the
excreted in the urine and reabsorb needed TCA cycle (tricarboxylic acid cycle), as enzymes
nutrients, thereby maintaining the blood’s break down acetyl CoA molecules. With each turn
delicate chemical balances. of the TCA cycle, hydrogen atoms are carried by
 The kidneys’ cells also produce compounds coenzymes to the electron transport chain. The
that help to regulate blood pressure and waste product of these reactions is carbon dioxide,
convert a precursor compound to active which is eventually exhaled.
vitamin D, thereby helping to maintain the
bones.

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Electron Transport Chain. the BMR but with less stringent criteria for
 The final step in energy metabolism occurs at the recent food intake and physical activity.
electron transport chain. In this process, enzymes Consequently, the RMR is slightly higher than
attach a phosphate group to ADP, creating ATP. the BMR.
The hydrogen atoms that were collected by Energy for Physical Activities.
coenzymes during glycolysis, fat breakdown, and The number of kcalories spent on voluntary
the TCA cycles provide the chemical energy that activities depends on three factors: muscle mass, body
drives ATP production. Finally, the same hydrogen weight, and activity.
atoms are linked with oxygen to produce water. Energy to Manage Food.
Aerobic and Anaerobic Metabolism. When food is taken into the body, many cells
 The production of ATP via the electron transport that have been dormant become active. The muscles
chain requires oxygen in the final step and is called that move the food through the intestinal tract speed up
aerobic metabolism. Glycolysis produces ATP their rhythmic contractions, and the cells that
without oxygen and is therefore called anaerobic manufacture and secrete digestive juices begin their
metabolism. When exercise intensity requires tasks.
more ATP than can be provided by the electron
transport chain (due to limited oxygen or other D. Body Weight and Body Composition
factors), ATP production from glycolysis is Body Mass Index (BMI)
stepped up, making glucose a critical fuel for the  An index of a person’s weight in relation to height;
exercising muscles. determined by dividing the weight (in KG) by the
square of the height (in M).
⎯ A healthy weight falls between a BMI of 18.5
and 24.9
⎯ Underweight below 18.5
⎯ Overweight above 25
B. Glucose Production ⎯ Obese above 30.
⎯ When glucose levels drop, glucose can be
produced from several other compounds in a
process called gluconeogenesis.
C. Energy Balance
⎯ A day’s energy balance can be stated like this:
change in energy stores equals the food energy
taken in (kcalories) minus the energy spent on
metabolism and physical activities (kcalories).
More simply:
The energy in
food and beverages is the only contributor to Body Composition
the “energy in” side of the energy balance equation.  For many people, being overweight compared with
Energy Out. the standard means that they are overfat.
The body expends energy in two major ways: to
fuel its basal metabolism and to fuel its voluntary  This is not the case, though, for athletes with dense
activities. bones and well-developed muscles; they may be
⎯ The basal metabolic rate (BMR) overweight but carry little body fat. Conversely,
• is the rate of energy use for metabolism inactive people may seem to have acceptable
under specified conditions: after a 12-hour weights but still carry too much body fat.
fast and restful sleep, without any physical Central Obesity.
activity or emotional excitement, and in a  The distribution of fat on the body may influence
comfortable setting. It is usually expressed as health as much as, or more than, the total fat
kcalories per kilogram of body weight per hour. alone.

⎯ Resting metabolic rate (RMR)  Visceral fat that is stored deep within the central
• is a measure of the energy use of a person abdominal area of the body is referred to as
at rest in a comfortable setting—similar to central obesity or upper body fat.

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Waist Circumference.
 A person’s waist circumference is a good indicator
of fat distribution and central obesity.

Skinfold Measures.
 Skinfold measurements provide an accurate
estimate of total body fat and a fair assessment of
the fat’s location. About half of the fat in the body
lies directly beneath the skin, so the thickness of
this subcutaneous fat is assumed to reflect total
body fat.

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