Human Nutrition

Carbohydrate Fat Protein Vitamins Minerals Water

The Two Classes of Nutrients

1. Energy Yielding: Carbohydrate, Fat, Protein 1. Non-energy Yielding: Vitamins, Minerals, Water

Energy Yielding Nutrients:

Nutrient Carbohydrate Protein Fat Energy 4kcal/g 4kcal/g 9kcal/g

Alcohol (Non-nutrient) 7kcal/g

Energy, defined:
Calorie- a unit of energy that food provides the body. 1 calorie is the amount of energy required to raise the temperature of 1g water by 1oC. 1 kilocalorie (kcal) = 1000 calories

Energy Density of Two Breakfasts

LOWER ENERGY DENSITY HIGHER ENERGY DENSITY

450-gram breakfast = 500 kcal, an energy density of 1.1 (500 kcal 450 g 1.1 = kcal/g).

144-gram breakfast = 500 kcal, an energy density of 3.5 (500 kcal 144 g = 3.5 kcal/g).

Energy Recommendations
Carbohydrate: 45% - 65% Fat: 20% - 35% Protein: 10% - 35%

Metabolism

Metabolism:
Metabolism: refers to the entire network of chemical processes involved in maintaining life. Energy metabolism: the ways that the body obtains and spends energy from food.

More Terms:
Anabolism: The building of compounds from small molecules into larger ones. Energy is used for this process to take place. Catabolism: The breakdown of molecules into smaller units. Energy is released in this process.
Ex: Glucose catabolism results in the release of CO2 and H2O

Breakdown of nutrients for energy:

1. Glucose breakdown 2. Glycerol and Fatty Acid breakdown 3. Amino Acid breakdown
Fats

Carbohydrates

Common Pathway

Energy

n tei Pro

Weight Maintenance:
Dietary fat can be easily transformed into body fat. Surplus protein leads to:
1. Replacing daily losses. 2. Increased protein oxidation (energy). 3. Storage as fat.

Surplus carbohydrate leads to:

1. Storage as glycogen. 2. Increased CHO oxidation (variable w/ diet). 3. Storage as fat.

Carbohydrates Function: ENERGY!

1. Immediate energy in the form of GLUCOSE 2. Reserve or stored energy in the form of GLYCOGEN

Types of Carbohydrates:
1. Simple Carbohydrates: (Sugars)
1. Monosaccharides 2. Disaccharides

2. Complex Carbohydrates: (Starches and Fibers)

1. Polysaccharides

The Monosaccharides:
Definition: Mono = One Saccharide= Sugar 1. Glucose 2. Fructose 3. Galactose

GFG

The suffix ose refers to sugar. Monosaccharides are chemically bound to form the disaccharides. (di=two)

Simple Carbohydrates:

The Monosaccharides Glucose C6H12O6

The essential energy source for all body functions. Other names: Dextrose and Blood Sugar. A component of each disaccharide.

Simple Carbohydrates:

The Monosaccharides Fructose:

The sweetest of all sugars (1.5 X sweeter than sucrose) Occurs naturally in fruits and honey the fruit sugar

Simple Carbohydrates:

The Monosaccharides Galactose

Seldom occurs freely in nature Binds with glucose to form sugar in milk: lactose. Once absorbed by the body, galactose is converted to glucose to provide energy.

Simple Carbohydrates:

The Disaccharides
Combination of 2 monosaccharides.

The Disaccharides:
1. Maltose 2. Sucrose 3. Lactose

Simple Carbohydrates:

The Disaccharides
Maltose
Maltose = Glucose + Glucose Produced when starch breaks down. Used naturally in fermentation reactions of alcohol and beer manufacturing.

Simple Carbohydrates:

The Disaccharides
Sucrose
Sucrose = Glucose + Fructose * Table sugar
* Found naturally in plants: sugar cane, sugar beets, honey, maple syrup * Sucrose may be purified from plant sources into Brown, White and Powdered Sugars.

Simple Carbohydrates:

The Disaccharides
Lactose
Lactose = Glucose + Galactose The primary sugar in milk and milk products. Many people have problems digesting large amounts of lactose (lactose intolerance)

The Complex Carbohydrates:

Polysaccharides: containing 2 or more monosaccharides attached together Three types are important in nutrition:
1. Glycogen- digestible 2. Starch- digestible 3. Fiber- indigestible

The Complex Carbohydrates:

Glycogen
The storage form of glucose in the body. Stored in the liver and muscles. Found in tiny amounts in meat sources. Not found in plants. Not a significant food source of carbohydrate.

The Complex Carbohydrates: Starch

The major digestible polysaccharide in our diet. The storage form of carbohydrate in plants. Sources: Wheat, rice, corn, rye, barley, potatoes, tubers, yams, etc.

The Complex Carbohydrates: Fiber

Indigestible polysaccharides Types of fiber: 1. Soluble- gums, pectins, mucilages, some hemicellulose 2. Insoluble- cellulose, lignin, many hemicelluloses

Health Benefits of Fiber:

Fiber adds mass to the feces. Prevents diverticulosis. Reduces obesity. May reduce cholesterol. May control blood sugar. May prevent cancer of the large intestine.

Lactose intolerance:
Inability to digest lactose. Lactose becomes food for intestinal bacteria, resulting in painful gas and abdominal cramping. Treated by consuming lactase in pill form. Lactase breaks down lactose. Is NOT due to a milk allergy.

Insulin Resistance:
Condition characterized by decreased tissue sensitivity to action of insulin. May lead to: cardiovascular disease and/or type 2 diabetes. At risk: Overweight individuals, those with a parent or sibling with Type II diabetes, women who have had gestational diabetes. Treatment: Modified diet: Diabetic diets (monitor fat and simple carbohydrate

What is the Glycemic Index?

A measurement of the effect a food has on your blood sugar level. The purpose of the glycemic index is for diabetics who need to be concerned about their blood sugar levels and athletes who need to restore their blood sugar levels after an athletic performance. High glycemic foods will raise your blood sugar more rapidly ex: honey, juices, potatoes, etc.

Diets high in carbohydrate:

Excess glucose is stored as glycogen. When glycogen stores are full, glucose is converted to fat. Fat cells can store unlimited quantities. Excess of ANY nutrient results in weight gain or increased fat stores.

Dietary Recommendations:
50-100g/ day CHO to prevent ketosis. Increased complex carbohydrates: whole grains, fruits and vegetables. Limited simple carbohydrates: sugary foods, potatoes, white bread, white rice. Fiber intake 20-35g/ day.

The Lipids

Fats in Food

Provide essential fatty acids (EFA) Provide concentrated food energy Carry fat soluble vitamins Provide raw materials for synthesis Stimulate appetite, provide satiety

The Lipids:
There are three classes of lipids
1. Triglyceride 2. Phospholipid 3. Sterol

1. Triglycerides
3 Fatty acids + 1 glycerol Combined together via a condensation reaction.

Fatty Acids
A component part of the triglyceride. A chain of Carbon atoms with Hydrogen attached:
Has an Acid Group (COOH) at one end Has a Methyl Group (CH3) at the other end

Found in most lipids in the body and in food.

Saturated Fatty Acids

Bonds between the Carbon atoms are single bonds. In other words: All of the Carbon atoms are Saturated with Hydrogen atoms. Sources: Animal fats. Usually solid at room temperature: butter, lard, etc.

Unsaturated Fatty Acids

Has at least one double bond between carbons. Are usually liquid at room temperature. Polyunsaturated: (many saturated)
TWO or MORE carbon-carbon double bonds. Ex: Corn, soybean, safflower oils

Monounsaturated: has ONE carboncarbon double bond

Ex: Canola oil, olive oil

Essential Fatty Acids

Must be supplied by the diet. Examples:
(alpha-linolenic) Omega-3 fatty acid (linolenic) Omega-6 fatty acids

Important for immune response, vision, cell structure, etc.

Saturation
Adds firmness Saturated fats are more firm; solid at room temperature.

Influences stability polyunsaturated FAs will go rancid (oxidation) more readily.

Saturation: Hydrogenation
Hydrogenation- Saturating a compound by adding Hydrogen atoms. Conversion of a polyunsaturated oil into solid margarine or shortening. Prolongs shelf-life, alters texture. Produces trans-fatty acids.
Example: Margarine

Saturation: Trans-fatty acids

Trans-fatty acids A result of hydrogenation. A change in shape from the cis form to the trans form. Behave more like saturated fats in the body A diet high in trans-fats has been linked to heart disease.

Cis fatty acids:

Most commonly found in nature. The hydrogens next to the double bonds are on the same side of the carbon chain.

Trans fatty acids:

The hydrogens are on opposite sides of the double bonds. This is a result of hydrogenation

Functions of Triglyceride
1. Energy: 9kcal/gram 2. Main stored from of energy; stored in adipose cells. 3. Protects the organs and insulates the body.

2. Phospholipids:
Definition: A glycerol backbone with one or two fatty acids, a phosphate group and a hydroxyl group. Uniqueness: Soluble in fat and dissolves in water.
Ex. Lecithin

Used as an emulsifier in food. What allows the phospholipid to be soluble in water?

3. The Sterols
Contain a multi-ring structure and a hydroxyl group (-OH). Are derived from both plants and animals. Cholesterol comes from animal sources. The group of sterols includes: bile acids, testosterone, vitamin D, cortisol, etc.

Digestion of Fat:
Lingual Lipase- released by the salivary glands; begins fat digestion in the mouth. Gastric lipase- hydrolyzes fat in the stomach. Bile- released into the small intestine; emulsifies fat. Pancreatic lipase- digests fat in the small intestine.

Absorption of Fat:
Glycerol and short chain fatty acids go directly into the circulatory system. Larger lipids need help: Once in the intestinal cell, large lipids are converted to chylomicrons. Chylomicrons- lipid packages with protein escorts are released into the lymphatic system. From the lymphatic system chylomicrons are taken all over the body.

Lipoproteins:
Transport vehicles for fat in the lymph and blood systems.
1. 2. 3. 4. Chylomicrons Very Low Density Lipoprotein (VLDL) Low Density Lipoprotein (LDL) High Density Lipoprotein (HDL)

Fat: Recommended intakes

30% or less of your daily calories from total fat. Diets low in saturated (less than 10% of calories) and trans-fats. Reduce cholesterol intake (<300mg/day) Consume foods rich in Omega-3 and Omega-6 fatty-acids 2 times per week. Read the food label.

Fat Replacers:
1. Simplesse- A texturizing agent made from egg protein 2. Olestra- sucrose polyester

OLESTRA

Proteins- Vital to Life

Proteins:
Contains carbon, hydrogen, oxygen and nitrogen atoms. Provide energy: 4 kcal/g Structural component of cells Contributes to blood clotting, fluid balance, vision, cell growth and repair, etc. Composed of amino acids (AAs)

Functions of Proteins:
Enzymes in the body Structural units Transport systems Immune constituents Regulatory factors

** In order to use proteins for synthesis in our body, we

must consume adequate energy. If we do not consume enough energy, our body will break down dietary protein for an energy source. Thus, if we dont consume adequate energy, protein cannot do its job.

Amino Acids
The building blocks of protein. There are 20 different amino acids.
9 of them are essential amino acids

Amino Acids (cont.),

Nonessential AAs: The body can synthesize these AAs. Essential AAs: (9) The body cannot make these AAs; must be consumed in the diet. Conditionally Essential AAs: ex: Phenylalanine (essential) and Tyrosine (nonessential).

Protein Denaturation:
Denaturation: Altering shape or stability Caused by: 1. Heat (cooking) 2. Acids (stomach acid) 3. Force (whipping egg-whites) Becomes irreversible after a certain point.

Denatured protein:

Egg-white meringue; Cooked egg omelet; Denatured by force. Denatured by heat.

Protein Quality:
Limiting Amino Acid: When essential AAs are not provided in sufficient quantities to support protein synthesis. Complete protein: Provides all of the essential amino acids. High quality proteins: Ex. Animal proteins Low quality proteins: Ex. Plant proteins Complementary proteins: combination of foods to provide the essential AAs.

Protein-energy Malnutrition:
Prevalent in immuno-compromised patients, the elderly, homeless, etc. Most often occurs in developing countries. Can occur in people with eating disorders

Protein-energy Malnutrition:
Marasmus: A severe deprivation of food over a long time.
Inadequate energy and protein intake. Occurs most commonly in children. Muscles and organs weaken due to lack of protein. Impairs brain development and learning ability. Inability to keep warm; lack of insulation. Growth ceases.

Protein-energy Malnutrition:

Protein-energy Malnutrition:
Kwashiorkor: A sudden, recent deprivation in food intake. - Results from protein deficiency. - Muscle wasting. - Inadequate fluid-balance: leaking occurs into the interstitial fluid; edema - Fatty liver, causes bulging belly.

Protein-energy Malnutrition:

Kwashiorkor:
Severe deprivation of protein.

Recommended Intake:
12% of total calories from protein. 0.8g protein per kilogram body weight.
(pounds/2.2 = weight in kilograms)

Consume adequate calories from all macronutrients (carbs, fat and protein).

Protein supplementation:
Excess dietary protein will not become protein in the body. Excess protein will be turned to fat. Working your muscles is the way to build more muscle. Excess of amino acids can harm the body. The bottom line: Be careful. Eat a well-balanced diet.

Energy Balance and Body Composition

Energy Balance
1. Positive energy balance: Energy IN > Energy OUT result: stored in adipose tissue * necessary during pregnancy, growth. 2. Negative energy balance: Energy IN < Energy OUT result: weight loss

What is hunger?
The feeling that prompts thoughts of food and motivates food consumption. A physiological response: a feeling. Influenced by nutrients in the bloodstream, eating patterns, climate, etc.

What is hunger?
Appetite Signals that guide dietary selection. Comes from a psychological state. Can have physiological dimensions (desire for a certain food).

Satiety
1. The brain signals the body to stop eating (hunger is suppressed). 2. Sensory stimulation: meal was eaten. 3. Effects of nutrient digestion, absorption and metabolism are felt. 4. Over time, lack of food leads to lack of satiety. 5. The cycle begins again.

Internal Forces that regulate satiety:

Cholecystokinin (CCK) and GI distention register satiety. The hypothalamus: As the sympathetic nervous system declines, food intake increases: the opposite is true. Increased nutrients in the blood. Hormonal and drug affects.

Energy use by the body:

1. Basal thermogenesis (basal metabolism) 2. Exercise-induced thermogenesis (physical activity) 3. Diet-induced thermogenesis (thermic effect of food) 4. Adaptive thermogenesis (energy of adaptation) Thermogenesis: The bodys generation of heat.

Energy use by the body:

1. Basal metabolism Defined: Basic functions in the human body that support life. BMR (Basal metabolic rate): The rate at which the body spends energy for maintenance activities. Rates vary with age, height, activity, etc.

Energy use by the body:

2. Physical Activity Defined: Voluntary movement of the skeletal muscles and support systems. The muscles need energy to move Influenced by: duration, frequency and intensity. Energy expended depends on: muscle mass, body weight and activity.

Energy use by the body:

3. Thermic effect of food: Defined: The energy required to aid in digestion, absorption, transport and metabolism of food.

Energy use by the body:

4. Adaptive thermogenesis Defined: Adjustments in energy expenditure related to changes in environment, physiological events, trauma or hormone status.

Body Composition:
Muscle, bone, fat and tissue that make up a persons body weight. Body weight = fat + lean tissue (including H2O) A persons weight does not accurately represent their body composition.

What is a healthy body weight?

Identify weights associated with good health and longevity.
1. Weight within the suggested range for height. 2. Fat distribution at low risk of illness and premature death. 3. Medical history without risk factors of obesity: blood pressure, blood cholesterol, etc.

Body Mass Index (BMI):

Describes relative weight for height. Healthy weight Underweight: Overweight: BMI 18.5-24.9 BMI below 18.5 BMI above 25

Average BMI in the U.S. = 26.5

Overweight v. Overfat
Health risks of being obese apply to people who are overfat:
Men >25% body fat Women > 30-35% body fat

Measuring body fat:

Underwater weighing (most accurate) Skinfold thickness Bioelectrical impedance

How much body fat?

It depends on the individual person. Women naturally have more body fat: 18-32%. Men may have 10-25% body fat. Athletes need less body fat. Pregnant women, people living in colder climates need more body fat. A person should have enough body fat to meet basic needs but not too much to incur health risks.

Distribution of body fat:

Critical to health. Intra-abdominal fat: stored around the organs of the abdomen. (Apple shape)
Increased risk of heart disease, stroke, diabetes, hypertension and some cancers.

Lower-body fat: stored around the hips and thighs. (Pear shape)
Less susceptible to health problems. Most common in women during reproductive years.

Body Types:
Apple shape:
Intra-abdominal fat.

Pear shape:
Lower-body fat

Common in men.

Common in women.

Health Risks and Body Weight:

Underweight:
Malnutrition, Illness, Smoking habits, Extreme physical activity. Inadequate immune response and decreased ability to fight disease. Infertility. Osteoporosis and bone fractures. Increased weight increases health.

Health Risks and Body Weight:

Overweight:
Increased risk of diabetes, hypertension, heart disease, respiratory disease, etc. Increased mortality. Weight gain >20 lbs in adulthood correlates with increased mortality. Normal weight and unfit people have increased mortality. Decreased weight increases health.

Health Risks and Body Weight:

Heart disease (CHD):
Obesity and heart disease are related. Central obesity is especially harmful. Inactivity is harmful. Obesity increases risk factors for CHD. Weight loss can lower risk factors for CHD.

Health Risks and Body Weight:

Diabetes:
2x more likely to develop in an obese person. Central obesity is related to diabetes. Increased insulin resistance in obese people. Weight gain (11-24 lbs) since age 18 doubles the risk of developing diabetes. Weight loss improves glucose tolerance and insulin resistance.

Diet and Health

Table 1-5 Page 24

Table 1-6 Page 25

Diseases of the past:

Black death (Bubonic plague) Tuberculosis Small pox

Number of deaths (2001):

Heart Disease: 700,142 Cancer: 553,768 Stroke: 163,538 Chronic lower respiratory diseases: 123,013 Accidents (unintentional injuries): 101,537 Diabetes: 71,372 Influenza/Pneumonia: 62,034 Alzheimer's disease: 53,852
Source: CDC, NCHS

Heart Disease and Stroke:

CVD- Cardiovascular disease; diseases of the heart and blood vessels. CHD- coronary heart disease; a type of CVD that involves atherosclerosis and hypertension. The leading cause of death.

Atherosclerosis:
1.Begins with the accumulation of plaques along arterial walls; especially at branch points. - Nutrition: High saturated
fat intake contributes to plaque development.

Atherosclerosis (cont.):
2. Platelets cause clots to form in response to plaque formation.
Thrombosis- a clot that may restrict blood flow, causing gradual tissue death. Embolism- a clot that causes sudden tissue death. Nutrition prevention: Omega-3 fatty acids promote heart-healthy eicosanoids.

Atherosclerosis (cont.):
3. Blood flow diminishes: Plaque and blood clots restrict blood flow; tissues die.
- Heart attack results. - Transient ischemic attack (TIA) or stroke results.

4. Blood pressure rises: Plaques narrow blood vessels, causing pressure to rise.
- Causes further damage.

CVD Risk Factors:

1. Abnormal blood lipids
-high cholesterol, high LDL and low HDL

Metabolic Syndrome

Not modifiable

2. 3. 4. 5. 6. 7. 8. 9.

Hypertension Insulin resistance and diabetes Obesity Smoking Physical inactivity Gender Age Family History

Reducing your risk of CVD:

1. Live a healthy lifestyle. 2. Control your body weight. 3. Maintain recommended blood lipid levels. 4. Reduce saturated fat intake. 5. Include omega-3 fatty acids in the diet.
fish are good sources)

What about alcohol and CVD?

Red wine may increase HDL levels and benefit heart health. This is due to flavonoids and antioxidants in the red wine. Grapes and grape juice can have the same effect. Too much alcohol can increase triglycerides, blood pressure and weight.
Source: The American Heart Association

Hypertension: (Htn)
Chronic elevated blood pressure. 2x more common in type-2 diabetics. Development: Obesity Insulin resistance

Hypertension risk factors:

Smoking High blood lipids Diabetes Gender (higher in men) Age (> age 60 at greater risk) Heredity Obesity Race (Highest in African Americans) Diet and physical activity

Cancer:
Diseases from growth of malignant tumors. Dietary factors
Cancer initiators
Diet may be linked to 1/3 of all cancer cases. Things we consume may be carcinogens.

Cancer promoters
Accelerate tumor development.

Anti-promoters
May reduce the risk of developing cancer.

Cancer: Reducing your risk:

Eat a diet rich in plant-based foods. Maintain a healthy weight. Be physically active. Drink alcohol in moderation, if at all. Choose low-fat and low-salt foods. Prepare and store foods safely. Dont use tobacco.

Diabetes mellitus:
Type-2 Diabetes
90-95% of all cases. Seen in adults and obese children. Cells become insulin resistant. At first, higher than normal insulin is produced, but the cells become resistant. Genetics influence development.

Nutrition intervention and Diabetes:

Strict carbohydrate counting meal plans. Consume small meals throughout the day. Loss of 10% body weight may reduce insulin resistance. The AMOUNT of carbohydrate affects blood glucose more that its source.