NUTRITION - UNIT I

INTRODUCTION

NUTRITION - UNIT I

Nutrition

History, Concepts, Role of nutrition in maintaining health

Nutritional problems in India

National nutrition policy

Factors affecting food and nutrition: Socioeconomic, cultural, traditional, production,

system of distribution, life style and food habits etc.

Role of food and its medical value

Classification of foods

Food Standards

Elements of nutrition: Macro and Micro

Calorie, BMR

INTRODUCTION
Nutrition
The

is

provision of materials necessary

in the form of food to cells and

organisms to support life.
Healthy

diet prevents or alleviates -

common health problems.

History
Nutrition

is a new field of study -

about 100 years old.

Hippocrates

had recognised diet

on a component of health as early

as 300 BC.

History
Past

100 years - The importance of

CHOs, Lipids and Proteins for normal

growth

and

development

were

recognised.
The

next nutrition breakthrough was

the discovery of vitamins.

History
Vitamin

Vitamin

A in 1913, Vitamin C in 1919,

D in 1925, Vitamin K in 1935,

Vitamin

E,

B1(Thiamine),B6(Pyridoxine)-1936,
Vitamin

B2

(Riboflavin)

in

Vitamin B9 (Folic acid) in 1948.

1935,

History
Nutrition

recognized

was

officially
as

an

independent field of study

in 1928 with the formation of
American Institute of Nutrition.

History
It

took about half a century more

for nutrition to achieve its current

status as one of the most talked
about scientific disciplines.

History
Nutrition

encompasses not only the

study of vitamins, minerals and

other

foods,

but

also

diverse

subjects as alcohol, caffeine and

pesticides.

History
Besides,

nutrition research tries to

find out the impact of food on

body by examining the progress in
allied

fields,

chemistry,
immunology.

such

as

biochemistry

physics,
and

CONCEPTS
Nutrition,
Dietetics,
Food,
Diet

CONCEPT - NUTRITION
Nutrition

is defined as the science of

food and its relationship to health.

It
It

is food at work in the body.

includes everything that happens

to food.

CONCEPTS - NUTRITION
It

is the study of nutrients and

processes by which they are used by

the body.
It

is concerned with the part played

by nutrients in the body growth,

development and maintenance.

CONCEPTS - DIETETICS
Dietetics

are the practical

application
principles

of
of

the

nutrition,

which includes planning of

meals for the healthy as
well as the sick.

CONCEPTS - DIETETICS
Good

nutrition

means

maintenance of nutritional
status that enables us to
grow well and enjoy good
health.

CONCEPTS - FOOD
Food

is vital for human existence just

as air and water.

Food

may be defined as anything

eaten or drunk, which meets the

needs of tissue building, regulation
and protection of the body and its
energy needs.

CONCEPTS - FOOD
Food:

Raw material from which bodies

are made.
Intake

of right kinds and amounts can

ensure good nutrition and health evident in ones appearance, well-being

and efficiency.

CONCEPTS - DIET
Diet:

Diet

whatever

refers

people

drink each day.

to
eat,

CONCEPTS - DIET
It

includes

the

normal

diet

people consume and the diet

people consume in groups (hotel
diet), but will also be modified
for the sick as part of their
therapy (diet therapy).

ROLE OF NUTRITION IN MAINTAINING

HEALTH
Primary importance as
1. It

is fundamental for own

health.

ROLE OF NUTRITION IN MAINTAINING

HEALTH
2.

It is essential for the health and

well-being of patients and clients
from the time of eating till it is
utilized for various functions.

ROLE OF NUTRITION IN MAINTAINING

HEALTH
Nutrition helps growth and
development
Prevents malnutrition
Resists infection
Prevents diseases

ROLE OF NUTRITION IN MAINTAINING

HEALTH
Proper

nutrition

supports

wellness
Wellness is more than the
absence of disease
Physical, emotional, and
spiritual health
Active process

ROLE OF NUTRITION IN MAINTAINING

HEALTH

NUTRITION PROBLEMS IN
INDIA
WHO IS AT RISK??

PREGNANT WOMEN
LACTATING WOMEN
INFANTS

PRESCHOOL CHILDREN
ADOLESCENT GIRLS
ELDERLY
SOCIALLY DEPRIVED - (SC & ST Communities)
Vijayaraghav

NUTRITION PROBLEMS IN
INDIA

WHAT ARE THE COMMON PROBLEMS?

WOMEN

POOR WT. GAIN

DURING PREGNANCY
Chronic Energy Deficiency
MICRONUTRIENT
DEFICIENCIES

CHILDREN

LOW BIRTH WEIGHT

GROWTH FALTERING
Protein Energy Malnutrition
MICRONUTRIENT
DEFICIENCIES

FLUOROSIS, LATHYRISM

DIET RELATED CHRONIC DISEASES - OBESITY,

CARDIOVASCULAR DISEASES, DIABETES

Vijayaraghav

PREVALENCE OF LBW IN S.E ASIAN COUNTRIES

Vijayaraghav

NUTRITIONAL DISORDERS IN CHILDREN

PROTEIN

ENERGY MALNUTRITION (PEM)

. CLINICAL FORMS
. SUBCLINICAL UNDERNUTRITION
MICRONUTRIENT

DEFICIENCIES

Vijayaraghav

CLINCAL FORMS of PEM

KWASHIORKOR
OEDEMA+
IRRITABILITY+
GROWTH

FAILURE+

DISCOLOURED

HAIR+
Vijayaraghav

CLINCAL FORMS of PEM

EXTREME WASTING
MARASMUS
SKIN AND BONES
MONKEY/OLD MAN
FACIES
Vijayaraghav

SUB-CLINICAL FORMS OF PEM

UNDERNUTRITION

WASTING

STUNTING

WEIGHT FOR AGE

WEIGHT FOR
HEIGHT
HEIGHT FOR AGE
Vijayaraghav

VITAMIN A DEFICIENCY

KERATOMALACIA

BITOT SPOT

V
A
D

BILATERAL BLINDNESS

WHO Criteria for Public Health Significance

- VAD
Minimum Prevalence (%) in children <6 yrs
BITOT

SPOTS

NIGHT

BLINDNESS

CORNEAL

0.5
1.0

LESIONS

CORNEAL SCARS
Serum Retinol <10

0.01

0.05
g/l 5.0

VITAMIN A DEFICIENCY (%) IN

INDIA
AGE GROUP
PRESCHOOL
CHILDREN
PREGNANT
WOMEN
* 24-71 MONTHS

SOURCE

X1B

XN*

ICMR, 2001

0.7

1.03

NNMB

0.7

NIN- SURVEYS

2.1

ICMR, 2001

2.8

ANAEMIA

ANAEMIA IN FEMALES

PREVALENCE OF ANAEMIA
IS VERY HIGH

NO CHANGE NOTICED OVER

TIME IN THE PREVALENCE

Pregnant
Women

Adolescent
girls

IODINE DEFICIENCY DISORDERS

IODINE DEFICIENCY DISORDERS

GOITRE+

167 millions AT RISK ?

NUTRITIONAL PROBLEMS IN
INDIA
A

survey

in

south

India

has

revealed that about

1%

children

aged

1-5

years

showed signs of kwashiorkor, 2%

marasmus and
3%-5%

vitamin A deficiency.

NUTRITIONAL PROBLEMS IN
INDIA
Community
Many

studies have shown that

mothers give only breast

milk to children up to 2years.

Thus,

no additional food is added

to the childs diet.

NUTRITIONAL PROBLEMS IN
INDIA
Papaya,

vitamin

rich,

considered which produces more

heat - cause miscarriage - avoided
by pregnant women.

NUTRITIONAL PROBLEMS IN
INDIA
Belief

- if a pregnant woman eats

more, the baby will be big and

delivery

difficult,

so

expectant

mothers are not fed adequately

both in quality and quantity.

Nutritional Problems in India

Problem
Features
NUTRITIONAL
PROBLEMS
IN
INDIALess than 2.5kg
Low Birth Weight
Still birth

Birth of dead baby

Kwashiorkor

Protein deficiency between 1

and 4 years

Anaemia

20% adolescent girls and 90%

pregnant women

Nutritional Problems in India

Problem

Features

NUTRITIONAL PROBLEMS IN
Stunted growth
Height
and
weight
not
ideal
INDIA
Night blindness
Cataract
Goitre

Vitamin A deficiency after 50

years
Vitamin A and Vitamin D
deficiency
Iodine deficiency in females

Nutritional Problems in India

Problem

Features

NUTRITIONAL PROBLEMS IN
Under weight INDIA
50% adults
Overweight

15% Mumbai school children are

obese

Diabetes

About 10% of the total population and

about 1/5 above age 50 suffer

Nutritional Problems in India

Problem
NUTRITIONAL
PROBLEMSFeatures
IN
INDIA

Hypertension

Male and female suffer more

in urban areas

Cardiac problems

More in males

Cancer

More in females

Nutritional Problems in India

The

hunger and malnutrition survey

report 2011 covered

7,300

households

in

112

districts

across 9 states and more than 1 lakh

children and 74,000 mothers.

Nutritional Problems in India

The key findings of the survey
42%

children under 5 are underweight; 59% are

stunted.
66%

of mothers did not attend school. Rates of

child underweight and stunting are higher among

mothers with low levels of education.

Nutritional Problems in India

By

2 years, 42% children are underweight

and 58% stunted in the 100 focus districts.

Prevalence

of

child

underweight

has

decreased from 53% in 2004 to 42% in

2011.

Nutritional Problems in India

Birth

weight:

Under

2.5kg

at

birth

and

continue

to

underweight 50%
Over

2.5 kg at birth, but underweight now 34%

Under
Over

2.5kg at birth and stunted now 62%

2.5kg at birth, but stunted now 50%

stay

Nutritional Problems in India

Prevalence

among

of malnutrition is significantly higher

children

particularly

from

Muslims,

low-income
Scheduled

families

Castes

and

Scheduled Tribes although rates of malnutrition are

significant
families.

among

middle

and

high

income

Nutritional Problems in India

We

cannot hope for a healthy future for

India

with

such

large

number

of

malnourished children.
The

government cannot solely depend on

Integrated Child Development Services

(ICDS) to solve the issue.

Nutritional Problems in India

The

government

strengthened

is

and

launching

restructured

ICDS, to start a multisectoral program

for

200

high

initiate
communication

burden
a

districts

and

nationwide
campaign

against

Cause of Nutritional Problem

Poor

Nutrition,

Under

(Malnutrition),
Overnutrition.

Nutrition

Cause of Nutritional Problem

The

World Bank estimates that India

is ranked 2nd in the world of the

number of children suffering from
malnutrition.

Cause of Nutritional Problem

Undernutrition

is

found

mostly in rural areas 10% of

villages and districts accounting
for 27-28% of all underweight
children.

Cause of Nutritional Problem

Children

of

scheduled

tribes have the poorest

nutritional status and the
highest wasting.

DETERMINANTS OF MALNUTRITION
Maternal Malnutrition
Start With A Handicap(LBW)
Faulty Child feeding Practices
Dietary Inadequacy
Frequent Infections
Low Purchasing Power, Large Families
High Female Illiteracy
Taboos And Superstitions

Factors Affecting Nutritional Status

High illiteracy

Unemployment/
Underemployment
Large families

Ignorance
Low Procurement
of foods
Low production
of food grains
Poor environment

Low purchasing power

High dependence rate
False food beliefs
Inadequate intakes
Poor PDS
High cost
Low availability of foods
Reduced work
Malnutrition
output
Morbidity

Poor utilization of services

Absorption of nutrients
Low Appetite
poor coverage of immunization
Improper health services
poor infrastructure
Lack of resources

DIRECT

INTERVENTIONS IN
OPERATION

Convergence Of Services (RCH)

Integrated Child Development Services
Iron And Folic Acid Distribution
Massive Dose Vitamin A Programme
Primary Health Care Programme
Health And Nutrition Education

INDIRECT

Poverty Alleviation Programmes

Environmental Sanitation
Protected Water Supply
Literacy Programme

NATIONAL NUTRITION POLICY

(NNP)
Indias

nutritional policy was formulated in the year

1993 by an act of the parliament

With

the following goals:

1. Reduction of incidence of low birth weight (LBW)

2. Elimination of nutrition blindness

NATIONAL NUTRITION POLICY

NNP

goals:

3. Reduction of anaemia to 20% in pregnant

women.
4. Universal iodination of common salt to loweriodine deficiency disorders to less than 1%.
5. Establish special care to geriatric nutrition.

NATIONAL NUTRITION POLICY

NNP

goals:

6. Increase annual food grain production to 250

metric tons.
7. Steps to create household food security through
poverty alleviation.

NATIONAL NUTRITION POLICY

NNP

goals:

8. Decrease incidence of moderate and severe

malnutrition in children.
9. Promotion of appropriate diets and healthy
lifestyle.

NATIONAL NUTRITION POLICY

NNP

goals:

Short

- term intervention

Long

- term interventions.

NATIONAL NUTRITION POLICY - Short term intervention

Expanding

the nutrition intervention net (ICDS)

Empowering

mothers with nutrition and health

education
Teaching

adolescent girls to avoid anaemia

Ensuring

better nutritional coverage for expectant

women.
Controlling

micronutrient deficiencies and fortifying

NATIONAL NUTRITION POLICY - Long

Term Interventions or Development
Policy Instruments
Food

security

Improvement
Increasing

of dietary pattern

purchase power of the population

Streamlining

System (PDS)

and expanding Public Distribution

NATIONAL NUTRITION POLICY - Long

Term Interventions or Development
Policy Instruments
Strengthening
Nutrition

and public education

Education
Nutrition

and literacy

and surveillance

Information
Ensure

health and family welfare programs

and communication

community participation

NATIONAL NUTRITION POLICY

A

nutritional plan of action was formulated in 1995

To

implement the short and long term policy

instruments with sectorial commitment by the

following nutrition related ministries.

NATIONAL NUTRITION POLICY Nutrition Related Ministries

Agriculture
Food
Civil

production
supplies

Public

distribution

Education

and literacy

NATIONAL NUTRITION POLICY Nutrition Related Ministries

Health

and family welfare

Preventive

care

Information

and broad casting

Awareness
Forestry

and environment protection

NATIONAL NUTRITION POLICY Nutrition Related Ministries

Labor
Rural,

urban and tribal development

Transport
Formation

communications
of high-level committees/councils

for identifying factors affecting food and

nutrition.

2. Cultural,
Taboos And
Superstitions

1. Socioeconomic
- Large Families,
Dietary
Inadequacy
11. Maternal
Malnutrition,
Low Birth
Weight

3.
Religious/Tradition
al

Determinan
ts / Factors
of
Malnutritio
n

10. High Female

Illiteracy

4. Child Rearing
Practices - Faulty
Child Feeding
Practices
5. Production,
6. System of
Distribution

7. Life style,
8. Food Habits

9. Frequent
Infections

Factors Affecting Nutritional

Status
High
Risk
Groups
are

Pregnant
women

Preschool
children

Lactating
women

Adolescen
t girls

Infants
Elderly,
and
socially
deprived

Factors Affecting Choosing

Nutrition

1.Individual characteristics
a.
b.
c.
d.
e.

Age
Gender
State of health
Mood
Education

2.Socioeconomic Factors
a.
b.
c.
d.
e.
f.
g.

Advertising
Environment
Income
Transport
Storage/cooking facilities
Social status
Peer group pressure

3.Geographical and
Cultural factors
a.

Geographical location

b.

Culture

c.

Religion

1. Individual Characteristics
a. Age

Infants have no choice over what they eat, BUT as they

become older they exert more and more control over the food
that thy consume. This normal process of development, as
toddler start expressing their individual food preferences,
starts the establishment of food preferences of lifetime.

Although it may not seem like it to the careers, they still exert
overwhelming control over their childrens consumption.

1. Individual Characteristics
Age

Once children start school, peer group pressure

starts to influence food choice.

Old age also influences food choice, as the frailty of

an individual increases so do the limitations that
the frailty imposes on the ability to purchase,
prepare and consume food.

1.b. Gender
Males

have higher

energy requirements

than females and, in those societies where

they are seen as the breadwinners, they are
likely to be given the largest portion of a
meal and the choicest parts of the food.

1.c. State of Health

An individuals health affects choice in a number
of ways:
A

food

that

causes

discomfort

and

nausea

usually

small

portions

will

be

avoided.
Anorexia
people

choose

mean
of

that

familiar

1.c. State of Health

An individuals health affects choice in a number
of ways:
Foods that are believed to be health-giving or
beneficial for a specific condition will be
chosen. The hot and cold beliefs present in
many cultures are very complicated.
Foods that are associated with comfort will
be chosen.

1.d. Mood
Mood

for

affects an individuals choice of food;

example,

confectionery

some

one

because

he

should be indulged.

may
feels

choose
that

he

1.e. Education
Individuals

sources

and

acquire knowledge from a host of

people.

Not

only

do

they

obtain

nutritional knowledge from people. Who influence

them, such as family and teachers, but they also
acquire

attitudes

as

to

whether

or

not

this

information is important and should be acted upon.

2. Socioeconomic Factors
a. Advertising
Huge amounts of money are spent on food
advertising, the main aims of which are to
persuade people to:
Buy new product
Buy more of a particular product change
brand of a particular product
Maintain loyalty to a specific product.

 No

group of population is excluded from the

influences

of

advertising

and

it

has

profound effects on food choices.

A

lot of advertising on television is intended

to change children eating habits.

2.b.Environment
The environment in which a food is to be prepared
affects food choice as does the environment in which it
is to be consumed.
If the cooking and storage facilities are limited, then
the choice of foods is restricted by whether or not it is
actually feasible to prepare and cook a particular item.
The same applies to where the food is to eaten.
Environment is also influenced by socioeconomic
factors.

2.c. Income
Surveys

income

show that those with a low

have

poorer

those with higher income.

diet

than

2.d. Transport
Superstores stock a wide variety of goods
that are generally at lower prices but are
only accessible to those with their own
transport or good public transport.
Local corner shops usually stock a limited
range of foods at higher prices. This may
mean that foods like fruit, vegetables and
whole meal are expensive.

2.e.Storage/cooking facilities
If

storage and cooking facilities are poor then

it is inevitable that people will have to rely
on manufactured and pre-packed foods which
require little more than unwrapping and
reheating, or buy their food at restaurants or
take-away food shops. This is of particular
significance to those living in bed and
breakfast accommodation.

2.f. Social status

In

every culture there are foods that are

perceived as high-status foods and those that

are considered of low status.
For

example, in the UK cabbage is seen as a

low-status food while broccoli is seen as a

high-status food.

2.g. Peer group pressure

Individuals

want to belong to a group and so

conform to the dietary pattern of those

around them. This is particularly so amongst
children.

3. Geographical and Cultural

Factors
a. Geographical location
This influences the availability of foods.
The staple food of population depends on
the climate, and way in which food is cooked
depends on the availability of fuel.

3.b. Culture
Culture

is

defined

as

the

customs

and

civilization of a particular people or group.

The

dietary

habits

of

any

group

people

conform to a culturally standardized set of

behaviors.

3.b. Culture
These

are acquired from the family and surrounding

community and show considerable variation. Children grow

up in a culture and accept to the cultural tradition that
surrounds them.
Culture

will also govern food intake. In some cultures, the

ideal body shape is very thin, whereas, in others, obesity is

striven for as it signifies wealth and success.

3.c.Religion
Food

has differing significance in different

dietary rules depends on the individual.

ROLE OF FOOD AND ITS MEDICAL

VALUE

BASED ON ITS ORIGIN

BASED ON CHEMICAL
COMPOSITION

FOOD STANDARDS
Definition:

Food standards are a set of criteria that

a food must meet and it should be suitable for

human consumption, such as source, composition,
appearance, freshness, permissible additives, and
maximum bacterial content.

FOOD LAWS IN INDIA

Prevention

of Food Adulteration Act, 1954

Fruit

Products Order,1955

Meat

Food Products Order ,1973

Vegetable

1947

Oil

Products

(Control)

Order,

FOOD LAWS IN INDIA

Edible

Oils Packaging (Regulation) Order 1988

Solvent

Extracted Oil, De- Oiled Meal and

Edible Flour (Control) Order, 1967,

Milk
The

and Milk Products Order, 1992.

Food Safety and Standards Authority of

India (FSSAI), 2006.

PREVENTION OF FOOD
ADULTERATION ACT, 1954
PFA

Act

covers

food

standards,

general

procedures for sampling, analysis of food,

powers

of

authorized

officers,

nature

of

penalties and other parameters related to

food.

PREVENTION OF FOOD
ADULTERATION ACT, 1954
It

deals with parameters relating to food

additives,

preservative,

colouring

matters,

packing & labelling of foods, prohibition &

regulations of sales etc.

FRUIT PRODUCTS ORDER,1955

Objective:

To manufacture fruit & vegetable

products maintaining sanitary and hygienic

conditions

in

the

premises

standards laid down in the Order.

and

quality

FRUIT PRODUCTS ORDER,1955

Minimum

requirements

for

hygienic

production and quality standards:

Location
Sanitary

premises

and surroundings of the factory

and

hygienic

conditions

of

FRUIT PRODUCTS ORDER,1955

Machinery

& equipment with installed

capacity
Quality

control facility & technical staff

Product

standards

Limits

for preservatives & other additives

MEAT Food Products Order ,1973

Fastest
Indian

growing animal protein in India.

consumers prefer to buy fresh meat from the

wet market, rather than processed or frozen meats.

Meat

& meat products are highly perishable in

nature and can transmit diseases from animals to

human-beings.

Vegetable Oil Products (Control)

Order, 1947
Regulated

by this order through the directorate of

Vanaspati, vegetable oils & fats, department of

food, public distribution, ministry of consumer
affairs, and food & public distribution.

EDIBLE OILS PACKAGING

(REGULATION) ORDER 1988
Ensure

edible

availability of safe and quality

oils

in

packed

form

at

determined prices to the consumers.

pre-

SOLVENT EXTRACTED OIL, DEOILED MEAL AND EDIBLE FLOUR

(CONTROL) ORDER, 1967,
Quality

control order to ensure that the

quality reached to the consumers for

consumption

MILK AND MILK PRODUCTS

ORDER, 1992.
The
To

objective of the order is

maintain and increase the supply of liquid milk

of desired quality in the interest of the general

public and
Also

for regulating the production, processing

and distribution of milk and milk products.

THE FOOD SAFETY AND

STANDARDS AUTHORITY OF
INDIA (FSSAI), 2006.
Regulating

body related to food safety and

laying down of standards of food in INDIA.

FSSAI

creates science based standards for

articles of food.

THE FOOD SAFETY AND

STANDARDS AUTHORITY OF
INDIA (FSSAI), 2006.
FSSAI

regulates their manufacture, storage,

distribution,

sale

and

import

to

ensure

availability of safe and wholesome food for

human consumption.

DUTIES AND FUNCTIONS OF

FSSAI
Framing

of Rules, Regulations, Standards and

Guidelines in relation to articles of food.

Procedure

and the enforcement of quality

control on any article of imported into India.

DUTIES AND FUNCTIONS OF

FSSAI
Guidelines for accreditation of certification
bodies engaged in certification of Food Safety
Management System for food businesses.
Providing

to

the

scientific advice and technical support

Central

Government

and

Governments on food safety and nutrition

State

DUTIES AND FUNCTIONS OF

FSSAI
Training

programmes for various stakeholders in

food safety and standards.

Contribute

to the development of international

technical standards for food, sanitary and Phytosanitary standards

DUTIES AND FUNCTIONS OF

FSSAI
Guidelines

for accreditation of Laboratories and

their notification.
Promote

general awareness about Food Safety

and Food Standards.

DUTIES AND FUNCTIONS OF

FSSAI
Collect
Food

and collate data regarding

consumption,

Incidence

and prevalence of biological risk,

Contaminants

in food, Residues of various contaminants,

Identification

of emerging risks and Introduction of rapid

alert system
Creating

information dissemination network across the

country about food safety & issues of concern.

ELEMENTS OF NUTRITION:
MACRO AND MICRO
Food

is

composed

of

wide

distribution

of

nutrients,
Have

very specific metabolic effects on the human

body.
Two

categories: macronutrients, micronutrients.

MACRONUTRIENTS
It
It

constitute the majority of an individuals diet.

essential nutrients that are needed for growth

and energy - carbohydrates, proteins, fats, and

water.

MACRONUTRIENTS
Carbohydrates,

proteins,

and

fats

are

interchangeable as sources of energy.

Fats

yielding 9 calories per gram,

Protein

and carbohydrates each yielding 4 calories

per gram.

Carbohydrates
Composed

of carbon, hydrogen, and oxygen, and

constitute the main source of energy for all body

functions, particularly brain functions, and are
necessary for the metabolism of other nutrients
(Mosby 260).

Carbohydrates
It

is the easiest form of food to convert into energy.

Ingested

carbohydrates are turned into glucose,

which circulates in the bloodstream being readily

available, and into glycogen which is stored in the
liver and muscle cells, for later use.

Protein
Large

combinations of amino acids containing the

elements carbon, hydrogen, nitrogen, and oxygen,

It

the major source of building materials for

muscles, blood, skin, hair, nails, and internal

organs.

Protein
It

is used by the body to build, repair, and maintain

muscle tissue.
The

ingested protein is broken down into peptides

and amino acids which are vital for proper growth,

development, and maintenance of health.

Fat
Composed

of carbon, hydrogen, and oxygen (these

elements are connected together differently than

in carbohydrates).

Fat
3

primary functions are:

They

are the major source of stored energy for the

body,
They

serve to cushion and protect the major organs,

They

act as an insulator, preserving body heat, and

protecting against excessive cold.

Water
Water
The
An

is a key essential to a healthy body.

body is roughly 60% water.

average person needs about 8 cups of water

per day depending on their activity levels.

Water
Typically,

the thirst mechanism is not a good sign

to indicate when the body needs water.

This

mechanism is activated when dehydration has

already occurred.

Water
Dehydration

can lead to heat illnesses - heat

exhaustion and heat stroke because of the
inability to sweat.

It

also can cause electrolyte imbalance and

malfunction of the body systems.

This

can lead
performance.

to

decreases

in

energy

and

MICRONUTRIENTS
Micronutrients
Body

are vitamins and trace minerals.

requires them in very small amounts.

Vitamins

are organic substances that we ingest with

our foods, and that help to trigger other reactions in

the body.

MICRONUTRIENTS
Needed

only in small amounts,

Deficiency
Most

leads to critical health problems.

of the diseases and conditions are due to

deficiency of micronutrients.
WHO

- Elimination of micronutrient deficiency,

labour efficiency will increase multifold.

LIST OF MICRONUTRIENTS
MICRONUTRIENTS: VITAMINS
Vitamin

A, Vitamin B,

Vitamin

C, Vitamin D,

Vitamin

E, Vitamin K and

Carotenoids.

LIST OF MICRONUTRIENTS
Minerals

are

Boron,

Calcium,

Chloride,

Chromium, Cobalt, Copper, Fluoride, Iodine,

Iron, Magnesium, Manganese, Molybdenum,
Phosphorous, Potassium, Selenium, Sodium
and Zinc.

LIST OF MICRONUTRIENTS
ORGANIC ACIDS
Acetic

acid, Citric acid,

Lactic

acid, Malic acid,

Choline

and Taurine.

CALORIE
A
In

calorie is a unit of energy.

nutrition and everyday language, calories refer to

energy consumption through eating and drinking

and energy usage through physical activity.
For

example, an apple may have 80 calories, while a

mile walk may use up about 100 calories.

CALORIE
Symbols:kcal,CalorC
The

international unit of energy is Joule (J)

Fat1

gram = 9 kcal/g

Protein1 gram = 4 kcal/g

Carbohydrates1

gram = 4 kcal/g

THE BASAL METABOLIC RATE

The

basal metabolic rate is the

energy expenditure necessary to

maintain
conditions.

basic

physiologic

BASIC PHYSIOLOGIC CONDITIONS

The

activity of the heart

Respiration
Conduction
Ion

of nerve impulses

transport across membranes

Reabsorption
Metabolic

in the kidney

activity.

 About

60% of the energy - supports the ongoing

metabolic

work

of

the

body

cells,

the

basic

metabolism.
This

is the work that goes on all the time, without

conscious awareness.

person whose energy expenditure amounts to

2,000 cal/day spends as much as 1200 1400

calories to support usual metabolism.

 Basal

metabolic energy required to support the

basic processes of life - circulation, respiration,

temperature maintenance, etc. It excludes digestion
and voluntary activities.
BMR

constitutes the largest proportion (2/3) of a

persons daily expenditure.

Definition
The

BMR is defined as the energy expenditure of a

subject at complete physical and mental rest,

awake (and not during sleep) having normal body
temperature and in the post-absorption state (12
hours after the last meal) and 8 12 hours after any
significant physical activity.

Measurement Basal metabolism

1.

Calorimeter directly by measuring the heat

dissipated under the basic conditions.

2.

Indirectly by measuring oxygen consumption.

Factors affecting BMR

The

metabolic

rate

differs

individuals. It depends on:

1.

Variable factors

2.

Invariable factors

among

different

 Lean

Body

Mass

is a component of

body

composition, calculated by subtracting body fat

weight from total body weight: total body weight
is lean plus fat.
In

equations: LBM = BW BF Lean Body Mass

equals Body Weight minus Body Fat

 LBM

+ BF = BW. Lean Body Mass plus Body Fat

equals Body Weight.

Eg

A man with 165 cm height should have 65 kg as

per normal BMI

Suppose

consider he is 85 kg. then the lean body

mass = 85 - 20 = 65 kg

Invariable factors affecting BMR

Normal Value
BMR

values are expressed as kcal or KJ/m2 of body

surface per hour.

In

adults, BMR for healthy males is 40 kcal (168kJ)

per hour and

Healthy

females is 37 kcal (155kJ) per hour.

Clinical Applications
BMR

estimation

is

used

to

diagnose

disorders
BMR

is used in calculating food and drugs.

thyroid