CHP300 :Community Health Program-l

1. NUTRITION AND HEALTH CHP300:Community Health Program-l Mohamed M. B. Alnoor

2. Objectives: • To define nutrition and related words. • To identify nutritional requirements. • To understand Food pyramid. • To list types of nutrients and their relation to health. • To define malnutrition and its classification. • To list main malnutrition problems. • To understand Obesity.

3. NUTRITION AND HEALTH Definitions • Nutrients • Nutrition • Macronutrients • Micronutrients • Dietetics: • Community Nutrition: • Nutritional Epidemiology:

4. CLASSIFICATION OF FOODS by origin - Foods of animal origin - Foods of vegetable origin

5. CLASSIFICATION OF FOODS by chemical composition -Proteins -Fats Vitamins -Carbohydrates -Vitamins Water Minerals -Minerals -Water Carbo- hydrates Fat Protein

6. CLASSIFICATION OF FOODS by predominant function • Body building foods: • Energy giving foods: • Protective foods:

7. Nutritional Requirements The adequate diet & Food Pyramids Food Group System: • Classifies foods according to similarity in nutrient content.

9. Nutritional Requirements Food Pyramids Lessons from Food Pyramid 1- Maintain a healthy weight. BMI: 18.5 to 24.9 2- Eat good fats (avoid bad fats): Oils found in nuts, seeds, grains and fish. • Rich in unsaturated fats necessary for good health. • Should constitute > 30 to 45% of the total fat. 19 to 25 

10. Nutritional Requirements Food Pyramids Lessons from Food Pyramid 3. Eat whole-grain carbohydrates. • More nutritious than refined carbohydrates • More slowly digested • Less stress on pancreas. (whole meal bread, whole wheat, brown rice) Why?

11. Nutritional Requirements Food Pyramids Lessons from Food Pyramid 4-Avoid red meat as a protein source and emphasize plant proteins. 5- Take a multivitamin daily. • Insurance against any deficiency. 6- Eat plenty of dark green leafy vegetables and fruits. • Lowers blood pressure and cholesterol and reduces the risk of cancer.

12. Main types of Nutrients Energy Supplying Nutrients: • Carbohydrates • Lipids • Protein • Vitamins • Minerals • Water Non-Energy Supplying Nutrients:

13. PROTEINS Main types of Nutrients Energy Supplying Nutrients • Complex organic nitrogenous compounds. • Contain sulfur, phosphorous and iron. • About 20 different amino acids(aa) in human body. • 8-9“essential” aa Why are they called “essential” ? Essential for what ?

14. Protein Needs: Main types of Nutrients Energy Supplying Nutrients PROTEINS • Adults: 0.8 gm/kg body weight per day • Excess protein is not used to build more muscle -extra aa are used for energy -or converted to fat and stored.

15. Sources of Proteins : Main types of Nutrients Energy Supplying Nutrients PROTEINS • Animal sources : Complete proteins; have all essential aa. • Plant sources : Incomplete proteins; lack one or more essential aa.

16. PROTEINS Main types of Nutrients Energy Supplying Nutrients Functions of Proteins: • Body building • Repair and maintenance of body tissues • Maintenance of osmotic pressure • Synthesis of bioactive substances and vital molecules e.g. immunoglobulins

17. Main types of Nutrients Energy Supplying Nutrients LIPIDS • Lipids include cholesterol and triglycerides • Fats are necessary for health Functions 1 – Highest source of energy (9Kcal/g). 2 - Spare protein. 3 - Adipose tissue holds the body organs and nerves in place. 4 - Maintain body temperature. 5 - Transportation of fat soluble vitamins.

18. Classification of Fats Main types of Nutrients Energy Supplying Nutrients LIPIDS Saturated fat: • Animal foods • Palm oil • coconut oil (Richest source)

19. Classification of Fats Main types of Nutrients Energy Supplying Nutrients LIPIDS Monounsaturated fat: • Olives oil • Peanuts oil • canola oil

20. Classification of Fats Main types of Nutrients Energy Supplying Nutrients LIPIDS Polyunsaturated fat: Richest source • Sunflower oil • Corn oil • cotton seed oil • nut oil

21. Classification of Fats Main types of Nutrients Energy Supplying Nutrients LIPIDS Trans Fatty Acids • Hydrogenated & • Partially hydrogenated fats more solid margarine liquid oils hydrogenation

22. Classification of Fats Main types of Nutrients Energy Supplying Nutrients LIPIDS • Saturated fat and trans fatty acids could be harmful to health • Baked products and fried foods are often made with hydrogenated fats Hydrogenated fat:

23. Main types of Nutrients Energy Supplying Nutrients LIPIDS Classification of Fats • Necessary for: Cholesterol: • cell membranes • production of: • vitamin D • Bile • some hormones

24. Main types of Nutrients Energy Supplying Nutrients LIPIDS Classification of Fats • Only in animal foods Cholesterol: • blood levels risk of heart disease

25. Main types of Nutrients Energy Supplying Nutrients LIPIDS Fat requirements • The WHO Expert committee on Prevention of Coronary Heart Disease has recommended that only 20 to 30% of total dietary energy is to be provided by fats. (<30%) • At least 50 % of fat intake should consist of vegetable oils rich in essential fatty acids.

26. Main types of Nutrients Energy Supplying Nutrients CARBOHYDRATES Functions: 1 - Main source of energy: 4 Kcals/gram. 2 - Essential for the synthesis of certain non-essential aa. 3 - Necessary for normal fat metabolism. 4 - Necessary for integrity of nerve cells.

27. Main types of Nutrients Energy Supplying Nutrients CARBOHYDRATES Functions: 5 - Lactose allows growth of beneficial bacteria in the intestine. 6 - Important for normal elimination (excretion); fibers Recommended intake is 55% to 65% of calories, primarily from starchy foods. The inability of the body to metabolize carbohydrates properly = DM

28. Main types of Nutrients Energy Supplying Nutrients CARBOHYDRATES Classification of CHOS 1- Monosaccharides: glucose or fructose 2- Disaccharides: Sucrose (G + F) 3- Oligosaccharides (3-10). 4- Polysaccharides (11-1000) a-Digestible e.g. starch b-partially digestible e.g. dextrin c-Indigestible e.g. cellulose

29. Fiber Main types of Nutrients Energy Supplying Nutrients CARBOHYDRATES • Indigestible plant material e.g. cellulose • Dietary fiber is mainly non-starch polysaccharide • It is found in vegetables, fruits and grains. • Solublefiber swells or dissolves in water. Rich sources include apples, bananas, citrus fruits, carrots

30. Fiber Main types of Nutrients Energy Supplying Nutrients CARBOHYDRATES Importance: • Reduces cholesterol absorption • Slows absorption of glucose Solublefiber

31. Fiber Main types of Nutrients Energy Supplying Nutrients CARBOHYDRATES Insolublefiber remains unchanged in water. Insolublefiber Rich food sources include brown rice, wheat bran, and whole grain products.

32. Fiber Main types of Nutrients Energy Supplying Nutrients CARBOHYDRATES • Reduces the risk of: Insolublefiber Importance: • Heart disease • Diabetes type II • Diverticulosis • Hemorrhoids • Constipation • Colorectal cancer

33. Refined CHOS Versus Whole Grains Main types of Nutrients Energy Supplying Nutrients CARBOHYDRATES • Whole grains are higher than refined carbohydrates in fiber, vitamins, minerals, and other beneficial compounds • Whole grains: • Take longer to digest • Make people feel full sooner • Cause a slower rise in glucose levels

34. Main types of Nutrients Energy Supplying Nutrients CARBOHYDRATES Refined CHOS Versus Whole Grains • Choose foods that have a whole grain as the first item on the ingredient list on the food label ADVICE • Whole wheat, whole rye, whole oats, oatmeal, whole-grain corn, brown rice, popcorn, barley, etc.

35. Main types of Nutrients Non-Energy Supplying Nutrients • Vitamins • Minerals • Water

36. Main types of Nutrients Non-Energy Supplying Nutrients VITAMINS • Provide no calories (no energy) • Needed in very small amounts • Regulate growth. • Maintain tissues. • Help carbohydrates, proteins, and fats release energy. Functions:

37. Main types of Nutrients Non-Energy Supplying Nutrients VITAMINS Classification of Vitamins • Water Soluble: • Fat Soluble:

38. Main types of Nutrients Non-Energy Supplying Nutrients VITAMINS Classification of Vitamins • Water Soluble: 8 different B Vits and vitamin C • Fat Soluble: Vits A, D, E, and K - Healthy people do not need supplements; - Supplementation toxic high levels

39. Main types of Nutrients Non-Energy Supplying Nutrients Fat Soluble Vitamins Vitamin A • «Vitamin A» covers both: • a pre-formed vitamin: retinol (animal sources) • a pro-vitamin: beta carotene(plant sources) which is converted to retinol in the intestinal mucosa.

40. Main types of Nutrients Non-Energy Supplying Nutrients Fat Soluble Vitamins Vitamin A • Essential for normal vision. • Necessary for maintaining the integrity and the functioning of glandular and epithelial tissue which lines intestinal, respiratory and urinary tracts as well as the skin and eyes. Functions of Vitamin A:

41. Main types of Nutrients Non-Energy Supplying Nutrients Fat Soluble Vitamins Vitamin A • It supports growth, especially skeletal growth • It may protect against some epithelial cancers such as bronchial cancers. Functions of Vitamin A:

42. Main types of Nutrients Non-Energy Supplying Nutrients Fat Soluble Vitamins Vitamin D The nutritionally important forms of Vitamin D in man are: -Calciferol (Vitamin D2) and -Cholecalciferol (Vitamin D3)

43. Main types of Nutrients Non-Energy Supplying Nutrients Fat Soluble Vitamins Vitamin D Functions of Vitamin D: • Intestine: Promotes intestinal absorption of calcium and phosphorus • Bone: Stimulates normal mineralization, enhances bone reabsorption( resorption), affects collagen maturation • Kidney: Increases tubular reabsorption of phosphate

44. Main types of Nutrients Non-Energy Supplying Nutrients Fat Soluble Vitamins Vitamin D • Leads to: Deficiency of Vitamin D: - Rickets in children - Osteomalacia in adults

45. Main types of Nutrients Non-Energy Supplying Nutrients Fat Soluble Vitamins Vitamin E • Antioxidant, Protects RBCs from haemolysis. • Vitamin E deficiency : • Neurological problems: • spinocerebellar ataxia • myopathies • Aaemia

46. Main types of Nutrients Non-Energy Supplying Nutrients Fat Soluble Vitamins Vitamin K • Important for blood coagulation • Deficiency causes hemorrhagic manifestations.

47. Main types of Nutrients Non-Energy Supplying Nutrients Water Soluble Vitamins Vitamin B1 (Thiamine) • Function: essential for the utilization of carbohydrates, (found on the membranes of neurons).

48. Deficiency of (Thiamine) Main types of Nutrients Non-Energy Supplying Nutrients Water Soluble Vitamins Vitamin B1 (Thiamine) • Beriberi may occur in three main forms: • Dry beriberi • Wet beriberi • Infantile beriberi

49. Main types of Nutrients Non-Energy Supplying Nutrients Water Soluble Vitamins Vitamin B2 (Riboflavin) • Important for cellular metabolism, oxidation and reduction. • Deficiency: angular stomatitis & glossitis (magenta tongue).

50. Main types of Nutrients Non-Energy Supplying Nutrients Water Soluble Vitamins Vitamin B6 (Pyridoxine) • Pyridoxine (vitamin B6) plays an important role in the metabolism of amino acids, fats and carbohydrate. • The requirement of adults vary directly with protein intake.