Nutrilite Health Institute


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The Nutrilite Health Institute (NHI), headquartered in Buena Park, California, USA, is a global leader in plant-based nutrition science. NHI brings together international leaders in nutrition science from academia and industry to study and discuss scientific research, education and practical, personalized solutions to help consumers reach their own optimal health.

Published in: Health & Medicine, Technology
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Nutrilite Health Institute

  1. 1. Principles of Nutrition Nutrilite Health Institute certification course By Amway India
  2. 2. Introduction AGENDA
  3. 3. The Complete Course Agenda <ul><li> 15 Min Introduction </li></ul><ul><ul><li>15 Min Food Guide Pyramid </li></ul></ul><ul><ul><li>60 Min Nutrition “What is it ?&quot; - Water & Protein </li></ul></ul><ul><ul><li>30 Min Nutrition “What is it ?” - Carbohydrates & Fats </li></ul></ul><ul><ul><li>10 Min Review/Activities/Group </li></ul></ul><ul><ul><li>20 Min Break </li></ul></ul><ul><ul><li>10 Min Human Physiology – Introduction </li></ul></ul><ul><ul><li>60 Min C ells and Cell Physiology </li></ul></ul><ul><ul><ul><ul><ul><li>Cell Structure </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Cell and energy </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Fat Metabolism </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Protein Metabolism </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Glucose Metabolism </li></ul></ul></ul></ul></ul><ul><ul><li>20 Min Revision </li></ul></ul><ul><li>Total: 240 mins </li></ul>
  4. 4. The Complete Course Agenda <ul><li>10 MIN Summarize previous day learning </li></ul><ul><li>20 MIN Opener/Activity </li></ul><ul><li>50 MIN Digestive System </li></ul><ul><ul><ul><ul><ul><li> Stomach </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li> Liver </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li> Pancreas </li></ul></ul></ul></ul></ul><ul><li>40 MIN Urinary System – Kidney </li></ul><ul><li>20 MIN Tea / snacks BREAK </li></ul><ul><li>10 MIN Review/Activity/Group </li></ul><ul><li>50 MIN Respiratory System - Nose & Nasal Passages; Pharynx ; Trachea; Bronchioles; Lungs </li></ul><ul><li>50 MIN Cardiovascular System – Heart; Blood Flow (Heart) ; </li></ul><ul><li>Blood Vessels; Blood Pressure; Blood as Delivery System </li></ul><ul><li>10 MIN Review/Activity/Group </li></ul>
  5. 5. The Complete Course Agenda <ul><li> </li></ul><ul><li>10 MIN Summarize previous day learning on Nutrition </li></ul><ul><li>15 MIN Central Nervous System - Brain </li></ul><ul><li>15 MIN Peripheral Nervous System - Autonomic Nervous System ; Sensory Somatic Nervous System </li></ul><ul><li>15 MIN Musculature System – Skeletal; Cardiac; Smooth </li></ul><ul><li>15 MIN Integumentary System – Skin; Hair; Nails </li></ul><ul><li>10 MIN Human Physiology Review </li></ul><ul><li>20 MIN Tea / snacks BREAK </li></ul><ul><li>10 MIN Activity: Short quiz on Physiology </li></ul><ul><li>120 MIN Water Soluble Vitamins – Vitamin C; Vitamin B; B1- Thiamin; B2- Riboflavin; B3- Niacin; B5- Pantothenic </li></ul><ul><li>Acid;B6- Pyridoxine B12- Cobalamin; Biotin; Folic Acid </li></ul><ul><li>10 MIN Review/Activity/Group </li></ul>
  6. 6. The Complete Course Agenda <ul><li>10 MIN Summarize previous day learning </li></ul><ul><li> 60 MIN Fat-Soluble Vitamins – Vitamin A ; Vitamin D </li></ul><ul><li>60 MIN Fat-Soluble Vitamins – Vitamin E ; Vitamin K </li></ul><ul><li> 15 MIN Review/Activity/Group </li></ul><ul><li>20 MIN Tea / snacks BREAK </li></ul><ul><li> 10 MIN Opener / Activity </li></ul><ul><li>60 MIN Minerals - Calcium, Chromium; Copper; Iron; Selenium </li></ul><ul><li>60 MIN Mineral – Zinc; Potassium; Sodium; Magnesium; Phosphorus </li></ul><ul><li>10 MIN Short class test/ Review/Activity/Group </li></ul>
  7. 7. The Complete Course Agenda <ul><li> </li></ul><ul><li>10 MIN Total Nutrition Review </li></ul><ul><li>10 MIN Diet and Disease Introduction </li></ul><ul><li>90 MIN Cardiovascular Disease - Pathophysiology; Diet Therapy </li></ul><ul><li>20 MIN Tea / snacks BREAK </li></ul><ul><li> 60 MIN Diabetes - Pathophysiology; Diet Therapy </li></ul><ul><li>50 MIN Cancer - Pathophysiology; Diet Therapy </li></ul><ul><li>10 MIN Review/Activity/Group </li></ul>
  8. 8. The Complete Course Agenda <ul><li> </li></ul><ul><li>10 MIN Review/Activity/Group </li></ul><ul><li>60 MIN AIDS/HIV - Pathophysiology; Diet Therapy </li></ul><ul><li>20 MIN Tea / snacks BREAK </li></ul><ul><li>60 MIN Food Science & Technology - Agriculture and food products; Alternative agriculture methods; Integrated pest management; Organic farming; Pesticides; Food safety </li></ul><ul><li>and food borne illness; Food irradiation; food additives; </li></ul><ul><li>Biotechnology </li></ul><ul><li>60 MIN Organic farming – Cd; Supplementation </li></ul><ul><li>30 MIN Short class test/Review/Activity/Group </li></ul><ul><li>Date will be announced: FINAL TEST </li></ul><ul><li>1 1/2 Hours </li></ul>
  9. 9. Nutrition “What is it” Nutrition “What is it”
  10. 10. Nutrition
  11. 11. Food Guide Pyramid F O O D P Y R A M I D
  12. 12. What is Nutrition? <ul><li>Metabolism of Foods </li></ul><ul><li>Nutritive Value of Foods </li></ul><ul><li>Qualitative and Quantitative Requirements </li></ul><ul><li>Changes in Nutrient Requirements </li></ul><ul><li>Cultural Factors </li></ul>
  13. 13. Six Classes of Nutrients <ul><li>Carbohydrate </li></ul><ul><li>Fat </li></ul><ul><li>Protein </li></ul><ul><li>Vitamins </li></ul><ul><li>Minerals </li></ul><ul><li>Water </li></ul>*The Human Body Like Food is Composed Largely of Nutrients
  14. 14. Nutrition <ul><li>60% Water </li></ul><ul><li>20% Fat </li></ul><ul><li>20% Protein, Carbohydrate, Vitamins, and Minerals </li></ul>Composition of Foods Composition of Body <ul><li>70% Water </li></ul><ul><li>1% Fat </li></ul><ul><li>4% Protein </li></ul><ul><li>24% Carbohydrates </li></ul><ul><li>1% Vitamins & Minerals </li></ul>
  15. 15. <ul><li>These nutrients are required in a large amount by the body. </li></ul><ul><li>Carbohydrates </li></ul><ul><li>Fat </li></ul><ul><ul><ul><ul><li>Proteins </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Dietary Fiber </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Water </li></ul></ul></ul></ul>Energy Rich Foods Macro Nutrients Body Building foods
  16. 16. <ul><li>These nutrients are required in a very small quantity, However are extremely critical for the normal functioning of the body. </li></ul><ul><li>Vitamins </li></ul><ul><li>Minerals </li></ul>Protective foods Micro Nutrients
  17. 17. Video 1- Micro Nutrients Video on Phytonutrients Click to Start
  18. 18. Elements of Nutrients Inorganic Nutrients Minerals Water Organic Nutrients Carbohydrates Fats Proteins Vitamins a b <ul><li>Proteins also contain the mineral sulfur </li></ul><ul><li>Some vitamins contain nitrogen, some contain minerals </li></ul>Carbon Hydrogen Oxygen Nitrogen Minerals
  19. 19. Energy <ul><li>Capacity to do Work </li></ul><ul><li>Energy in Food is Chemical Energy </li></ul><ul><li>Body Converts Chemical Energy mechanical energy </li></ul>
  20. 20. Energy -yielding Nutrients <ul><li>Carbohydrate </li></ul><ul><li>Fat </li></ul><ul><li>Protein </li></ul>
  21. 21. Measurement of Energy <ul><li>Energy is measured in Calories </li></ul><ul><li>Calorie: A Unit by Which Energy is Measured </li></ul><ul><li>Food Energy is measured in Kilocalories </li></ul><ul><ul><li>1000 Calories = 1 Kilocalorie </li></ul></ul><ul><li>1 Kilocalarie of Heat is needed to raise the Temperature – </li></ul><ul><ul><li>1 Kilogram of Water 1 Degree Celsius </li></ul></ul>
  22. 22. Energy in Foods <ul><li>Carbohydrates </li></ul><ul><li>Protein </li></ul><ul><li>Fat </li></ul><ul><li>Alcohol* </li></ul>4 kcal/gram 4 kcal/gram 9 kcal/gram 7 kcal/gram* = = = =
  23. 23. Energy in the Body <ul><li>Heart -Beating </li></ul><ul><li>Brain- Thinking </li></ul><ul><li>Legs -Walking </li></ul><ul><li>Breathing </li></ul><ul><li>Eliminating Wastes </li></ul>Nutrients to Fuel Metabolic and Physical Activities
  24. 24. Excess Nutrient Consumption <ul><li>Excess Consumption of </li></ul><ul><li>Energy-Yielding Nutrients </li></ul><ul><ul><ul><li>Converted to Fat and Stored in the Body </li></ul></ul></ul>
  25. 25. Classification of Nutrients <ul><li>Macronutrients (Macro = BIG) Protein, Carbohydrate, Fat, and Water </li></ul><ul><li>Micronutrients (Micro = small) Vitamins and Minerals </li></ul>
  26. 26. Water <ul><li>Indispensable Nutrient </li></ul><ul><li>Fundamental to All Life on Earth </li></ul>
  27. 28. Water in Body Fluids <ul><li>Intracellular Fluid: Fluid Within Cells </li></ul><ul><ul><li>Approximately 2/3 of Body Water </li></ul></ul><ul><ul><li>High in Potassium and Phosphate </li></ul></ul><ul><li>Interstitial Fluid: Fluid Between Cells </li></ul><ul><ul><li>Approximately 1/3 of Body Water </li></ul></ul><ul><ul><li>Large Component of Extra Cellular Fluid </li></ul></ul><ul><ul><li>Usually High in Sodium and Chloride </li></ul></ul>
  28. 29. Water's Role <ul><li>Shock Absorber </li></ul><ul><li>Body Temperature Regulation </li></ul><ul><li>Maintains Blood Volume </li></ul><ul><li>Lubricant and Cushions Joints </li></ul>
  29. 30. Water's Role <ul><li>Carries Nutrients and Waste </li></ul><ul><li>Helps form Structure of Molecules </li></ul><ul><li>Participates in Chemical Reactions </li></ul><ul><li>Solvent for Small Molecules </li></ul>
  30. 31. Water Sources <ul><li>Beverage and Water </li></ul><ul><li>Foods Contain Water </li></ul><ul><ul><li>Fruit and Vegetables = Up to 95% Water </li></ul></ul><ul><ul><li>Meats and Cheese = Up to 50% Water </li></ul></ul>
  31. 32. Water content in foods Almonds 7% Apples 85% Apricots 85% Bananas 76% Bean Sprouts 92% Bread Whole Wheat 35% Broccoli 91% Butter 20% Cabbage Raw 92% Carrots Raw 88% Olives 80% Onions 89% Oranges 86% Papayas Raw 89% Parsley Raw 86% Peaches Raw 90% Peanuts Shelled Trace Peanut Butter Trace Pears Raw 82% Peas Raw 81% Pecans 7% Peppers Green 94% Cauliflower Raw 91% Celery 94% Cherries Raw 80% Chicken Broiled Coconut Dried 7% Collards Boiled 91% Corn Sweet Fresh 74% Cucumbers Raw 96% Eggs Raw Whole 74% Egg Plant Raw 92% Fruit Cocktail 80% Pickles Dill 93% Pineapple Raw 85% Plums Raw 87% Potatoes Raw 85% Pumpkin Canned 90% Radish Raw 95% Spinach Raw 92% Squash Boiled 96% Grape Fruit Raw 88% Grapes 82% Honey 15% Jams / Preserves 30% Lettuce Head 91% Macaroni/Spaghetti Cooked 72% Margarine 20% Okra Boiled 91% Straw Berries 90% Sweet Potatoes Boiled in Skin 71% Tomatoes Raw 93% Turkey Roasted 62% Dry seeds, such as the grains and legumes were intentionally left of the following list as they should have a common moisture content of 10% or less. All pure fats and oils contain no water. The water content of each of the foods below is shown by the number following the food. After these foods have been dehydrated, their weight will be reduced by close to the following percentage :
  32. 33. Water Balance Water Sources Liquids Foods Metabolic Water Amount (ml) 550 to 1500 700 to 1000 200 to 300 1450 to 2800 Water Excretion Kidneys Skin Lungs Feces Amount (ml) 500 to 1400 450 to 900 350 150 2450 to 2800
  33. 34. Water Recommendations <ul><li>Recommendations : </li></ul><ul><ul><li>Diet </li></ul></ul><ul><ul><li>Activity </li></ul></ul><ul><ul><li>Environmental Temperature </li></ul></ul><ul><ul><li>Humidity </li></ul></ul><ul><li>Adult Recommendations </li></ul>*Amount of Water = Amount of Energy Expended
  34. 35. Water Recommendations <ul><li>Person Expending 2,000 Kcal per Day </li></ul><ul><ul><li>2 to 3 Liters of Water </li></ul></ul><ul><ul><li>7 To 11 Cups </li></ul></ul><ul><li>Best Sources: Water, Milk, and Juice </li></ul><ul><li>Not Substitutes: Alcohol, Caffeine-Beverages </li></ul>*Act as Diuretics
  35. 36. What are Proteins? <ul><li>The name Protein was suggested by Mulder in 1838 to the complex, organic, nitrogeneous substances found in animal and plant tissues. </li></ul>
  36. 37. What are Proteins? <ul><li>Proteins are the foremost & forefront nutrients </li></ul><ul><ul><li>Important constituents of tissues and cells of the body </li></ul></ul><ul><ul><li>These are present inside the cell as well as in the plasma </li></ul></ul><ul><ul><li>They form 16% wet weight of the cell </li></ul></ul><ul><ul><li>As enzymes and hormones they are concerned with vital metabolic processes </li></ul></ul><ul><ul><li>As antibodies they help defend against infections </li></ul></ul>
  37. 38. Classification of Proteins <ul><li>Structural proteins </li></ul><ul><li> Proteins which form part of the body structure </li></ul><ul><ul><ul><li>Collagen - gives tensile strength to the body </li></ul></ul></ul><ul><ul><ul><li>Elastin - provides elasticity to the skin </li></ul></ul></ul><ul><ul><ul><li>Keratin – helps formation of nails & hair </li></ul></ul></ul><ul><li>They have a slow turnover and therefore a long half life </li></ul>
  38. 39. Classification of Proteins <ul><li>Functional proteins </li></ul><ul><li>Proteins which regulate the various functions in the body. </li></ul><ul><ul><li>- Enzymes acts as catalyst for various metabolic functions </li></ul></ul><ul><ul><li>- Hormones trigger some specific reactions e.g. Insulin which regulates the glucose metabolism in the body, has half life of 0.5 second and if not so will result in hypoglycemia </li></ul></ul><ul><li>They have a faster turnover and shorter life span </li></ul>
  39. 40. Classification of Proteins <ul><li>Depending upon the combination in which they exist in the body, Proteins can also be classified as : </li></ul><ul><ul><ul><li>Muco protein: Protein when combined with carbohydrates .eg saliva mucos. </li></ul></ul></ul><ul><ul><ul><li>Lipo protein: Protein when combined with lipids eg. cholestrol, triglyceride in emulsion form. </li></ul></ul></ul><ul><ul><ul><li>Transport protein: Protein when used as carrier eg . Iron is transported in the form of haemoglobin in the body </li></ul></ul></ul>
  40. 41. <ul><li>Proteins are made up of Amino acids </li></ul><ul><ul><li>Dietary proteins provide amino acids for the synthesis of body proteins </li></ul></ul><ul><ul><li>Amino acids are composed of carbon, hydrogen, oxygen, nitrogen, sulphur and sometimes phosphorus </li></ul></ul>Structure of Protein
  41. 42. <ul><li>There are 22 naturally occurring amino acids. </li></ul><ul><li>Of these 22 amino acids , </li></ul><ul><ul><li>9 amino acids are known as essential since they cannot be synthesized in the body </li></ul></ul><ul><ul><li>Rest are non essential as they can be synthesized in the body by inter conversion of compounds already present in the body </li></ul></ul>Amino Acids
  42. 43. Types of Amino Acids <ul><li>Depending upon the chemical structure Amino Acids can also be classified as under : </li></ul><ul><ul><ul><li>Aliphatic : Glycine, Alamine, Threonine, Serine </li></ul></ul></ul><ul><ul><ul><li>Acidic : Aspartic, Glutamic </li></ul></ul></ul><ul><ul><ul><li>Branched Chain : Valine, Leucine, isoleucine </li></ul></ul></ul><ul><ul><ul><li>Aromatic : Phenylalanine , Tyrosine, Tryptophan </li></ul></ul></ul><ul><ul><ul><li>Basic : Lysine , Arginine, Histidine </li></ul></ul></ul><ul><ul><ul><li>Sulphur containing amino acids : Cystine, Cystaine, Methionine </li></ul></ul></ul><ul><ul><ul><li>Iminoacid : Proline </li></ul></ul></ul>
  43. 44. Limiting Amino Acids <ul><li>Essential Amino Acid </li></ul><ul><li>Protein from Plants ( Usually Limiting) </li></ul><ul><ul><li>Corn: Deficient in Tryptophane and Lysine </li></ul></ul><ul><ul><li>Legumes (Beans): Deficient in Methionine </li></ul></ul><ul><ul><li>Grains (Wheat): Deficient in Lysine </li></ul></ul>
  44. 45. Complete Proteins <ul><li>Essential Amino Acids </li></ul><ul><li>Nonessential Amino Acids </li></ul><ul><li>Animal Sources = Essential Amino Acids </li></ul><ul><ul><li>Meat </li></ul></ul><ul><ul><li>Fish </li></ul></ul><ul><ul><li>Poultry </li></ul></ul><ul><ul><li>Cheese </li></ul></ul><ul><ul><li>Eggs </li></ul></ul><ul><ul><li>Milk </li></ul></ul>
  45. 46. Digestion and Absorption of Protein <ul><li>Protein in Food Do Not Become </li></ul><ul><li>Body Proteins </li></ul><ul><li>Protein in Food Supply Amino </li></ul><ul><li>Acids </li></ul>
  46. 47. Digestion and Absorption of Protein <ul><li>Hydrolysis of Protein Begins in the Stomach </li></ul>HCL ( in the Stomach) Amino Acids Blood Stream Acted upon by Gastric juices
  47. 48. Various Sources of proteins <ul><li>Cereals and Millets </li></ul><ul><li>Pulses, legumes </li></ul><ul><li>Milk and milk products </li></ul><ul><li>Egg and Flesh Foods </li></ul><ul><li>Soya </li></ul>
  48. 49. Functions Of Dietary Proteins <ul><li>Provide AA for the formation of tissues during growth. </li></ul><ul><li>To provide AA for the growth of fetus in pregnancy and for the production of milk proteins during lactation. </li></ul>
  49. 50. Functions Of Dietary Proteins <ul><li>To replace the daily loss of body protein. </li></ul><ul><li>To provide AA for the formation of enzymes, blood protein and certain hormones of protein nature. </li></ul>
  50. 51. RDA of Protein ….. contd
  51. 52. Experimental assessment of Protein sources.
  52. 53. Experimental assessment of Protein sources. <ul><li>Protein Digestibility Corrected Amino Acid Score </li></ul><ul><ul><li>Measures the nitrogen content of undigested protein to indicate the digestibility of protein present in a particular source. </li></ul></ul><ul><ul><li>Measured on a scale of 0 - 1 </li></ul></ul><ul><ul><ul><li>- where 0 represents least digestibility and 1 represents maximum digestibility. </li></ul></ul></ul>
  53. 54. Count What You Eat
  54. 55. Count What You Eat
  55. 56. Carbohydrates <ul><li>Compounds composed of carbon, oxygen and hydrogen molecules </li></ul><ul><li>Carbo = Carbon </li></ul><ul><li>Hydrate = With Water (H2O) </li></ul>
  56. 57. Carbohydrate Family <ul><li>Monosaccharides </li></ul><ul><ul><li>Glucose (Blood Sugar) </li></ul></ul><ul><ul><li>Fructose (Fruit Sugar) </li></ul></ul><ul><ul><li>Galactose (Milk Sugar) </li></ul></ul><ul><li>Disaccharides </li></ul><ul><ul><li>Sucrose (Table Sugar) </li></ul></ul><ul><ul><li>Lactose </li></ul></ul><ul><ul><li>Maltose </li></ul></ul>Simple Carbohydrates (Sugars) Complex Carbohydrates <ul><li>Starch (Polysaccharides)* </li></ul><ul><li>Fibers (Nonstarch Polysaccharides) </li></ul><ul><ul><li>Soluble </li></ul></ul><ul><ul><li>Insoluble </li></ul></ul>*Glycogen is a Complex Carbohydrate (a Polysaccharide), but not a Dietary Source of Carbohydrate
  57. 58. Starch <ul><li>Glucose Molecules Linked </li></ul><ul><li>Plants Store Glucose as Starch </li></ul><ul><li>Humans Eat Plants </li></ul><ul><li>Body Hydrolysis </li></ul><ul><ul><li>Starch to Glucose Energy </li></ul></ul>
  58. 59. Glycogen <ul><li>Animal Polysaccharide </li></ul><ul><li>Manufactured and Stored in Liver </li></ul><ul><li>Not Significant Source of Carbohydrate </li></ul><ul><li>Not Complex Carbohydrate in Foods </li></ul><ul><li>Food Sources </li></ul>
  59. 60. Fiber <ul><li>Structural Part of Plants </li></ul><ul><ul><li>Vegetables, Fruits, Grains, Legumes </li></ul></ul><ul><li>Non-Starch Polysaccharides : </li></ul><ul><ul><li>Cellulose, Hemicellulose, Pectins, Gums, Mucilages </li></ul></ul><ul><li>Non Polysaccharides : </li></ul><ul><ul><li>Lignins, Cutins, Tannins </li></ul></ul>
  60. 61. Fiber: Sources, Actions, Structures <ul><li>Food Sources </li></ul><ul><li>Action in the Body </li></ul><ul><li>Type of Fiber </li></ul>Soluble Fibers Fruits (Apples, Citrus), Oats, Barley, Legumes Delay GI Transit Delay Glucose Absorption Lower Blood Cholesterol Gums, Pectins, Some Hemicelluloses, Mucilages Insoluble Fibers Wheat Bran, Whole-Grain Breads and Cereals, Vegetables Accelerate GI Transit Increase Fecal Weight Slow Starch Hydrolysis Delay Glucose Absorption Cellulose, Many Hemicelluloses, Lignins
  61. 62. Video 2: Good Fats Video on good fats Click to Start
  62. 63. Fat <ul><li>Definition </li></ul>
  63. 64. Lipid Family <ul><li>Triglycerides (Fats and Oils) </li></ul><ul><li>Glycerol (1 per Triglyceride) </li></ul><ul><li>Fatty Acids (3 per Triglyceride) </li></ul><ul><ul><li>Saturated </li></ul></ul><ul><ul><li>Monounsaturated </li></ul></ul><ul><ul><li>Polyunsaturated </li></ul></ul><ul><ul><ul><li>Omega-6 </li></ul></ul></ul><ul><ul><ul><li>Omega-3 </li></ul></ul></ul><ul><li>Phospholipids (Such as Lecithin) </li></ul><ul><li>Sterols (Such as Cholesterol) </li></ul>
  64. 65. Saturated Fats <ul><li>Hydrogenated Fatty Acids </li></ul><ul><ul><li>Chemical Process: </li></ul></ul><ul><ul><ul><li>Hydrogen Atoms + Mono or Polyunsaturated Fats </li></ul></ul></ul><ul><ul><li>Fats More Stable </li></ul></ul><ul><ul><li>Prolongs Shelf Life </li></ul></ul><ul><ul><li>Protects Against Oxidation </li></ul></ul><ul><ul><li>Sources: Margarine, Shortening, Baked Goods </li></ul></ul>
  65. 66. Effects on Health <ul><li>Saturated Fats Elevate Blood Cholesterol Heart Disease </li></ul><ul><li>Hydrogenated Fats Trans Fatty Acid Heart Disease </li></ul><ul><li>Unsaturated Fats Lower Blood Cholesterol Heart Disease </li></ul>
  66. 67. Role of Triglycerides and Fatty Acids <ul><li>Provide Energy </li></ul><ul><li>Enhance Palatability </li></ul><ul><li>Influence Texture of Foods </li></ul><ul><li>Enable Absorption of Fat Soluble Vitamins </li></ul><ul><li>Insulate the Body </li></ul><ul><li>Protect Organs Against Shock </li></ul><ul><li>Help Body Use Carbohydrates and Proteins </li></ul>
  67. 68. Essential Fatty Acids <ul><li>Body Can Make All But &quot;2&quot; Fatty Acids </li></ul><ul><ul><li>Linoleic Acid </li></ul></ul><ul><ul><li>Linolenic Acid </li></ul></ul><ul><li>Indispensable to Body Function </li></ul><ul><li>Supplied by Diet </li></ul>
  68. 69. Comparison of Dietary Fats
  69. 70. Linoleic Acid: Omega 6 <ul><li>Arachidonic Acid </li></ul><ul><li>Structure and Function of Cell Membranes and Inflammation Reactions </li></ul>
  70. 71. Linolenic Acid: Omega 3 <ul><li>Body Can Produce </li></ul><ul><ul><li>EPA - Eicosapentaenoic Acid </li></ul></ul><ul><ul><li>DHA - Docosahexanenoic Acid </li></ul></ul><ul><li>Development and Maintenance : </li></ul><ul><ul><li>Brain and Retina of Eye </li></ul></ul><ul><ul><li>Integrity of Skin, Kidney, Liver, Reproductive Organs </li></ul></ul>
  71. 72. Linolenic Acid: Omega 3 <ul><li>Essential for Normal Growth and Development </li></ul><ul><li>Regulates: </li></ul><ul><ul><li>Blood Clotting </li></ul></ul><ul><ul><li>Blood Pressure </li></ul></ul><ul><ul><li>Lipid Concentrations </li></ul></ul><ul><ul><li>Inflammation Responses </li></ul></ul>
  72. 73. Linolenic Acid: Omega 3 <ul><li>Important Role in Prevention and Treatment of: </li></ul><ul><ul><li>Heart Disease </li></ul></ul><ul><ul><li>Hypertension </li></ul></ul><ul><ul><li>Arthritis </li></ul></ul><ul><ul><li>Cancer </li></ul></ul>
  73. 74. Sources of Omega Fatty Acids <ul><li>Omega-6 </li></ul><ul><li>Linoleic Acid </li></ul><ul><li>Arachidonic Acid </li></ul><ul><li>Omega-3 </li></ul><ul><li>Linolenic Acid </li></ul><ul><li>EPA and DHA </li></ul>Leafy Vegetables, Seeds, Nuts, Grains, Vegetable Oils (Corn, Safflower, Soybean, Cottonseed, Sesame, Sunflower) Meats (or can be Made from Linoleic Acid) Fats and Oils (Canola, Soybean, Walnut, Wheat Germ, Margarine, and Shortening Made from Canola and Soybean oil) Nuts and Seeds (Butternuts, Walnuts, Soybean Kernels) Vegetables (Soybeans) Human Milk Shellfish and Fish* (Mackerel, Tuna, Salmon, Bluefish, Mullet, Sturgeon, Menhaden, Anchovy, Herring, Trout, Sardines) (or can be Made from Linolenic Acid)
  74. 75. Phospholipids <ul><li>Similar to Triglyceride </li></ul><ul><li>Choline and Phosphate Group </li></ul><ul><li>Lecithin - Used as an Emulsifier </li></ul><ul><ul><li>Emulsifier: Promotes the Mixture of Two Substances such as Oil and Water, that are not Mutually Soluble </li></ul></ul>
  75. 76. Role of Phospholipids <ul><li>Constituents of Cell Membranes </li></ul><ul><li>Lipid Transportation </li></ul><ul><li>Fat Soluble Substances: Vitamins and Hormones </li></ul><ul><li>Emulsifiers </li></ul>
  76. 77. Sterols <ul><li>Liquid Compounds </li></ul><ul><li>Multiple Ring Structure </li></ul><ul><li>Cholesterol </li></ul>
  77. 78. Cholesterol <ul><li>Animal Foods </li></ul><ul><ul><li>Meats </li></ul></ul><ul><ul><li>Eggs </li></ul></ul><ul><ul><li>Fish </li></ul></ul><ul><ul><li>Shellfish </li></ul></ul><ul><ul><li>Poultry </li></ul></ul><ul><ul><li>Dairy Products </li></ul></ul><ul><ul><li>Organ Meats (Liver, Kidneys) </li></ul></ul>
  79. 80. Physiology <ul><li>Organism </li></ul><ul><li>Cellular </li></ul><ul><li>Molecular </li></ul>
  80. 81. Structural Organization <ul><li>Atoms </li></ul><ul><li>Molecules </li></ul><ul><li>Cells </li></ul><ul><li>Tissues </li></ul><ul><li>Organ </li></ul><ul><li>Systems </li></ul><ul><li>Organism </li></ul>
  81. 82. Cells <ul><li>Membrane </li></ul><ul><ul><li>Fat </li></ul></ul><ul><ul><li>Holds Cell Together </li></ul></ul><ul><ul><li>Separates Cells </li></ul></ul>Cells: Building Blocks of Our Body
  82. 83. Cells <ul><li>Passive Diffusion </li></ul><ul><li>Active Transport </li></ul>Cells: Building Blocks of Our Body
  83. 84. Cytoplasm <ul><li>Liquid Inside &quot;Cell Membrane&quot; </li></ul><ul><li>Organelles &quot;Tiny Organs&quot; </li></ul><ul><ul><li>Mitochondria </li></ul></ul><ul><ul><li>Endoplasm </li></ul></ul><ul><ul><li>Lysosomes </li></ul></ul>
  84. 85. Nucleus <ul><li>Brain of Cell </li></ul><ul><li>DNA </li></ul><ul><li>Ribosomes &quot;RNA&quot; </li></ul><ul><li>Protein Synthesis </li></ul>
  85. 86. Energy <ul><li>Food = Energy </li></ul><ul><li>ATP = Energy </li></ul><ul><li>Mitochondria </li></ul>
  86. 87. Metabolism <ul><li>Anabolic - small large </li></ul><ul><ul><li>Amino Acids Proteins </li></ul></ul><ul><ul><li>Uses ATP </li></ul></ul><ul><li>Catabolic Fat Acetyl CoA ATP </li></ul><ul><ul><li>Proteins Amino Acids </li></ul></ul><ul><ul><li>Make ATP </li></ul></ul>
  87. 88. Fat <ul><li>Anabolic - Triglycerides Fat </li></ul><ul><li>Catabolic - Fat Acetyl CoA ATP </li></ul>
  88. 89. Protein <ul><li>Anabolic - Amino Acids Protein </li></ul><ul><li>Catabolic - Protein Amino Acids </li></ul><ul><ul><li>Essential Amino Acids </li></ul></ul><ul><ul><li>Non-Essential Amino Acids </li></ul></ul>
  89. 90. Sugar <ul><li>Anabolic - Sugar Glycogen </li></ul><ul><li>Catabolic - Glycogen Sugar ATP </li></ul>
  90. 91. PHYSIOLOGY <ul><li>Digestive System </li></ul>
  91. 92. Digestive System Esophagus Large intestine – 5 Ft long Stomach Small intestine 21 ft long Appendix
  92. 93. Digestive System <ul><li>Mouth </li></ul><ul><li>Teeth </li></ul><ul><ul><li>Breakdown Food </li></ul></ul>Digestion: Breaking Complex Food Into Smaller Particles
  93. 94. Digestive System Teeth Tongue Salivary gland Epiglottis Esophagus
  94. 95. Digestive System <ul><li>Tongue </li></ul><ul><ul><li>Propels Food </li></ul></ul><ul><ul><li>Taste Buds (Sweet, Sour Salt) </li></ul></ul><ul><li>Salivary Glands (Saliva) </li></ul><ul><ul><li>Moisten Food </li></ul></ul><ul><ul><li>Begin Digestion - Starch </li></ul></ul><ul><li>Tonsils </li></ul><ul><ul><li>Part of Immune System </li></ul></ul>
  95. 96. Digestive System <ul><li>Epiglottis </li></ul><ul><ul><li>Muscles to Prevent Food Entering Lungs </li></ul></ul><ul><ul><li>Directs Food to Esophagus and Blocks Trachea </li></ul></ul><ul><ul><li>Coughing </li></ul></ul><ul><li>Esophagus </li></ul><ul><ul><li>Muscular Tube to Stomach </li></ul></ul>
  96. 97. Digestive System <ul><li>Stomach </li></ul><ul><ul><li>Sphincter-Muscle Closes Stomach </li></ul></ul><ul><ul><ul><li>Reflux </li></ul></ul></ul><ul><ul><li>Churns Food-Chyme </li></ul></ul><ul><ul><ul><li>Mixes With Acid and Pepsin </li></ul></ul></ul><ul><ul><li>Mucus Protects Stomach </li></ul></ul><ul><ul><li>Intrinsic Factor </li></ul></ul>
  97. 98. Digestive System <ul><li>Stomach </li></ul><ul><ul><li>Vomiting </li></ul></ul><ul><ul><ul><li>Reflex </li></ul></ul></ul><ul><ul><ul><li>Bulimia - Esophagus, Teeth </li></ul></ul></ul><ul><ul><li>Ulcers </li></ul></ul><ul><ul><li>Gastrectomy </li></ul></ul>
  98. 101. Digestive System <ul><li>Liver - Largest Organ </li></ul><ul><ul><li>Metabolism </li></ul></ul><ul><ul><li>Bile Production </li></ul></ul><ul><ul><li>Vitamin Storage </li></ul></ul><ul><ul><li>Remove Chemicals </li></ul></ul><ul><ul><li>Cholesterol Production </li></ul></ul><ul><ul><li>Essential for Life </li></ul></ul>Accessory Organs Liver Stomach
  99. 102. Digestive System <ul><li>Pancreas – 5 inches long </li></ul><ul><ul><li>Digestion </li></ul></ul><ul><ul><li>Blood Sugar Levels </li></ul></ul><ul><ul><li>Diabetes - Type I and Type II </li></ul></ul>Accessory Organs Pancreas Duodenum
  100. 103. Urinary System <ul><li>Kidney Urinary Ducts Urinary Bladder </li></ul><ul><li>Filtration System </li></ul><ul><li>Urine </li></ul><ul><ul><li>Chemical Waste </li></ul></ul><ul><ul><li>Salts </li></ul></ul><ul><ul><li>Water </li></ul></ul>Kidney Urinary duct Bladder
  101. 104. Urinary System <ul><li>More Sweat = Less Urine </li></ul><ul><li>Kidney Plays Role in Blood Pressure </li></ul><ul><ul><li>Urine Production Blood Pressure </li></ul></ul><ul><ul><li>Salt Balance </li></ul></ul><ul><li>Chemicals Metabolized in Liver Excreted in Kidney </li></ul>
  102. 105. Respiration <ul><li>Nose </li></ul><ul><ul><li>Filter </li></ul></ul><ul><ul><li>Warm </li></ul></ul><ul><ul><li>Moisten </li></ul></ul>Nose Trachea Bronchioles Lungs nasal area trachea lungs
  103. 106. Respiration <ul><li>Trachea </li></ul><ul><ul><li>Stiff Tubes </li></ul></ul><ul><ul><li>Larynx </li></ul></ul><ul><li>Bronchioles </li></ul><ul><ul><li>Tubes to Lungs </li></ul></ul><ul><ul><li>Cilia </li></ul></ul><ul><ul><li>Mucus </li></ul></ul>Nose Trachea Bronchioles Lungs pharynx larynx trachea
  104. 107. Respiration <ul><li>Alveoli </li></ul><ul><ul><li>Gas Exchange </li></ul></ul><ul><ul><li>Surface Area </li></ul></ul><ul><li>Inhalation/Exhalation </li></ul><ul><ul><li>Brain </li></ul></ul><ul><ul><li>Gas Exchange </li></ul></ul><ul><ul><li>Surface Area </li></ul></ul>Nose Trachea Bronchioles Lungs
  105. 108. Respiration <ul><li>Hemoglobin </li></ul><ul><ul><li>Protein </li></ul></ul><ul><ul><li>Oxygen/Carbon Dioxide </li></ul></ul>Nose Trachea Bronchioles Lungs
  106. 110. Cardiovascular System <ul><li>Artria Contract Ventricles Contract </li></ul><ul><li>Heart Rhythm Pacemaker </li></ul><ul><ul><li>60-80 Beats/Minute </li></ul></ul>Body Left Heart Lungs Right Heart Body
  107. 111. Cardiovascular System <ul><li>Arteries </li></ul><ul><ul><li>Blood from Heart </li></ul></ul><ul><ul><li>Muscular </li></ul></ul><ul><ul><li>Systole/Diastole </li></ul></ul><ul><ul><li>Blood pressure (Pulse) </li></ul></ul><ul><ul><ul><li>Feel Your Wrist </li></ul></ul></ul><ul><ul><li>Capillaries </li></ul></ul><ul><ul><ul><li>Tiny (Feed Body) </li></ul></ul></ul>Blood Vessels
  108. 112. Cardiovascular System <ul><li>Venuoles </li></ul><ul><ul><li>Tiny (Take Blood to Veins) </li></ul></ul><ul><li>Veins </li></ul><ul><ul><li>Blood to Heart </li></ul></ul><ul><ul><li>Little Muscle </li></ul></ul><ul><ul><li>Smooth Blood Flow </li></ul></ul>Blood Vessels
  109. 113. Cardiovascular System <ul><li>Blood Pressure 120/80 mmHg </li></ul><ul><ul><li>Heart Pump </li></ul></ul><ul><ul><li>Blood Vessels </li></ul></ul><ul><ul><li>Amount of Blood </li></ul></ul><ul><li>Need to Move Blood </li></ul><ul><ul><li>Too Much Bad Hypertension </li></ul></ul><ul><ul><li>Too Little Bad Hypotension </li></ul></ul>
  110. 114. Cardiovascular System <ul><li>Red Cells - Hemoglobin/Oxygen </li></ul><ul><ul><li>Lungs </li></ul></ul><ul><ul><li>Metabolism + Oxygen </li></ul></ul><ul><ul><li>Metabolism and Carbon Dioxide </li></ul></ul><ul><ul><li>Anemia </li></ul></ul>Blood Red Cells/White Cells/Plasma
  111. 115. Cardiovascular System <ul><li>White Cells </li></ul><ul><ul><li>Immunity </li></ul></ul><ul><ul><li>Infection </li></ul></ul><ul><li>Platelets </li></ul><ul><ul><li>Blood Clot </li></ul></ul>Blood Red Cells/White Cells/Plasma
  112. 116. Cardiovascular System <ul><li>Plasma - Liquid </li></ul><ul><ul><li>Proteins </li></ul></ul>Blood Red Cells/White Cells/Plasma
  113. 117. Nervous System Nervous System
  114. 118. Nervous System <ul><li>Central Nervous System (CNS) </li></ul><ul><li>Peripheral Nervous System (PNS) </li></ul>
  115. 119. Nervous System <ul><li>Coordinates Body Actions + Functions </li></ul><ul><li>Processes Information </li></ul><ul><ul><li>External </li></ul></ul><ul><ul><li>Internal </li></ul></ul>Brain Spinal Cord Nerves Nerves Spinal Cord Brain
  116. 120. Nervous System <ul><li>Spinal Cord </li></ul><ul><ul><li>Gray Matter </li></ul></ul><ul><ul><li>White Matter </li></ul></ul><ul><ul><li>Meninges </li></ul></ul><ul><ul><li>Backbone </li></ul></ul>CNS
  117. 121. Nervous System <ul><li>Connects PNS with Brain </li></ul><ul><li>Coordinates Reflexes </li></ul><ul><li>Spinal Nerves </li></ul><ul><ul><li>Senses </li></ul></ul><ul><ul><li>Movement </li></ul></ul>CNS
  118. 122. Nervous System <ul><li>Computer </li></ul><ul><li>Coordinates + Processes All Information </li></ul><ul><li>Prepares + Coordinates Responses </li></ul><ul><li>Gray Matter/White Matter </li></ul>Brain
  119. 123. Nervous System <ul><li>Cerebrum (Memory, Reasoning, Intelligence, Personality, Senses, Logic) </li></ul><ul><li>Cerebellum (Physical Activity) </li></ul><ul><li>Brain Stem </li></ul><ul><ul><li>Brain Cord </li></ul></ul><ul><ul><li>Cord Brain </li></ul></ul>Brain
  120. 124. Nervous System <ul><li>Autonomic Nervous System </li></ul><ul><ul><li>We Do Not Control This System </li></ul></ul><ul><ul><li>Sympathetic/Parasympathetic </li></ul></ul><ul><ul><ul><li>Blood Pressure </li></ul></ul></ul><ul><ul><ul><li>Digestion </li></ul></ul></ul><ul><ul><ul><li>Intestines </li></ul></ul></ul><ul><ul><ul><li>Lungs </li></ul></ul></ul><ul><ul><ul><li>&quot;Fight or Flight&quot; </li></ul></ul></ul>Peripheral Nervous System (PNS)
  121. 125. Nervous System <ul><li>Sensory Nerves </li></ul><ul><ul><li>(Taste, Smell, Sight, Touch, Hearing) </li></ul></ul><ul><li>Somatic Muscle Nerves (Movement) </li></ul>PNS
  122. 126. Musculature <ul><li>Skeletal Muscles </li></ul><ul><ul><li>Movement Connected to Bones </li></ul></ul><ul><ul><li>Voluntary </li></ul></ul><ul><ul><li>Red Fibers Slow </li></ul></ul><ul><ul><li>White Fibers Fast </li></ul></ul><ul><ul><li>Everywhere </li></ul></ul><ul><ul><li>Somatic Nerves </li></ul></ul>
  123. 127. Musculature <ul><li>Smooth Muscles </li></ul><ul><ul><li>Involuntary </li></ul></ul><ul><ul><li>Blood Vessels, Visceral organs </li></ul></ul><ul><ul><li>Autonomic Nerves </li></ul></ul><ul><li>Cardiac Muscles </li></ul><ul><ul><li>Heart </li></ul></ul><ul><ul><li>Involuntary </li></ul></ul><ul><ul><li>Autonomic nerves </li></ul></ul>
  124. 128. Musculature <ul><li>Consume ATP to do Work </li></ul><ul><li>Need Calcium, Sodium, Potassium </li></ul>
  125. 129. Integumentary System <ul><li>Skin </li></ul><ul><ul><li>Epidermis (Barrier) </li></ul></ul><ul><ul><li>Dermis (Blood, Muscles, Connection) </li></ul></ul><ul><li>Barrier </li></ul><ul><ul><li>Infection </li></ul></ul><ul><ul><li>Waterproof </li></ul></ul><ul><ul><li>Mechanical </li></ul></ul>
  126. 130. Integumentary System <ul><li>Pigment </li></ul><ul><ul><li>Protect Against Sunlight </li></ul></ul><ul><li>Heat Regulation </li></ul><ul><ul><li>Sweating </li></ul></ul><ul><ul><li>Blood Flow </li></ul></ul>
  127. 131. Integumentary System <ul><li>Vitamin D from Sunlight </li></ul><ul><li>Touch </li></ul><ul><li>Pain </li></ul><ul><li>Pressure </li></ul><ul><li>Heat </li></ul><ul><li>Nerve Fibers </li></ul>
  128. 132. Vitamins
  129. 133. Vitamins <ul><li>Vita = Life </li></ul><ul><li>Amine = Containing Nitrogen </li></ul><ul><ul><li>The First Vitamin Discovered Contained Nitrogen </li></ul></ul>
  130. 134. Vitamins <ul><li>Organic </li></ul><ul><li>Essential Nutrients </li></ul><ul><li>Requirements Minute (Small) </li></ul><ul><li>Perform Specific Functions </li></ul><ul><ul><li>Growth </li></ul></ul><ul><ul><li>Reproduction </li></ul></ul><ul><ul><li>Maintenance of Health and Life </li></ul></ul>
  131. 135. Vitamins <ul><li>Vitamins Differ from Energy-Yielding Nutrients such as Carbohydrate, Proteins and Fat </li></ul><ul><li>Structure </li></ul><ul><li>Function </li></ul><ul><li>Food Contents </li></ul>
  132. 136. <ul><li>Vitamins Similar to Energy-Yielding Nutrients : Carbohydrate, Protein and Fat </li></ul><ul><li>Vital to Life </li></ul><ul><li>Organic </li></ul>Vitamins
  133. 137. Vitamins <ul><li>Available in Foods </li></ul><ul><li>Organic </li></ul><ul><ul><li>Destructible : </li></ul></ul><ul><ul><ul><li>Light: Riboflavin (B2) </li></ul></ul></ul><ul><ul><ul><li>Oxygen: Vitamin C </li></ul></ul></ul><ul><ul><ul><li>Heat : Thiamin (B1) and Vitamin C </li></ul></ul></ul>
  134. 138. Vitamins <ul><li>Solubility : </li></ul><ul><ul><li>Hydrophilic: (Water-Soluble) </li></ul></ul><ul><ul><ul><li>Carbohydrate, Protein </li></ul></ul></ul><ul><ul><ul><li>Vitamins B and C </li></ul></ul></ul><ul><ul><li>Hydrophobic: (Fat-Soluble) </li></ul></ul><ul><ul><ul><li>Fat </li></ul></ul></ul><ul><ul><ul><li>Vitamins A, D, E, K </li></ul></ul></ul>
  135. 139. Precursors <ul><li>Provitamins Inactive Vitamin Form </li></ul><ul><li>Chemically Changed to Active Form of Vitamins </li></ul>
  136. 149. Riboflavin-Vitamin B2 <ul><li>Functions </li></ul><ul><ul><li>Coenzymes FMN and FAD </li></ul></ul><ul><ul><li>Energy Metabolism </li></ul></ul><ul><ul><li>Supports Normal Vision </li></ul></ul><ul><ul><li>Supports Skin Health </li></ul></ul><ul><li>Food Sources </li></ul>
  137. 150. Riboflavin-Vitamin B2 <ul><li>Deficiency Disease </li></ul><ul><ul><li>Ariboflavinosis </li></ul></ul><ul><li>Deficiency Symptoms </li></ul><ul><ul><li>Skin Rash </li></ul></ul><ul><ul><li>Cracks and Redness of Mouth </li></ul></ul><ul><ul><li>Sensitivity to Light </li></ul></ul>
  138. 151. Niacin-Vitamin B3 <ul><li>Functions </li></ul><ul><ul><li>Coenzymes NAD and NADP </li></ul></ul><ul><ul><li>Energy Metabolism </li></ul></ul><ul><ul><li>Nervous System </li></ul></ul><ul><ul><li>Digestive System </li></ul></ul><ul><li>Food Sources </li></ul>
  139. 152. Niacin-Vitamin B3 <ul><li>Deficiency Disease </li></ul><ul><ul><li>Pellegra </li></ul></ul><ul><li>Deficiency Symptoms </li></ul>
  140. 153. Biotin <ul><li>Food Sources </li></ul>
  141. 154. Biotin <ul><li>Functions </li></ul><ul><ul><li>Coenzyme </li></ul></ul><ul><ul><li>Energy Metabolism </li></ul></ul><ul><ul><li>Fat Synthesis </li></ul></ul><ul><ul><li>Amino Acid Metabolism </li></ul></ul><ul><ul><li>Glycogen Synthesis </li></ul></ul>
  142. 155. Biotin <ul><li>Deficiency Symptoms </li></ul><ul><ul><li>Loss of Appetite and Nausea </li></ul></ul><ul><ul><li>Abnormal Heart Action </li></ul></ul><ul><ul><li>Depression </li></ul></ul><ul><ul><li>Muscle Pain and Weakness </li></ul></ul>
  143. 156. Pantothenic Acid-Vitamin B5 <ul><li>Food Sources </li></ul>
  144. 157. Pantothenic Acid-Vitamin B5 <ul><li>Functions </li></ul><ul><ul><li>Coenzyme A </li></ul></ul><ul><ul><li>Energy Metabolism </li></ul></ul>
  145. 158. Pantothenic Acid-Vitamin B5 <ul><li>Deficiency Symptoms </li></ul><ul><ul><li>Insomnia </li></ul></ul><ul><ul><li>Fatigue </li></ul></ul>
  146. 159. Pyridoxine-Vitamin B6 <ul><li>Functions </li></ul><ul><ul><li>Coenzymes PLP and PMP </li></ul></ul><ul><ul><li>Amino Acid Metabolism </li></ul></ul><ul><ul><li>Fatty Acid Metabolism </li></ul></ul><ul><ul><li>Converts Tryptophan to Niacin </li></ul></ul><ul><li>Food Sources </li></ul>
  147. 160. Pyridoxine-Vitamin B6 <ul><li>Deficiency Disease </li></ul><ul><ul><li>Anemia (small-cell type) </li></ul></ul>
  148. 161. Folate-Folic Acid-Folacin <ul><li>Functions </li></ul><ul><ul><li>DNA Synthesis </li></ul></ul><ul><ul><li>New Cell Formation </li></ul></ul><ul><li>Food Sources </li></ul>
  149. 162. Folate-Folic Acid-Folacin <ul><li>Deficiency Disease </li></ul><ul><ul><li>Anemia (large-cell type) </li></ul></ul><ul><li>Deficiency Symptoms </li></ul><ul><ul><li>Diarrhea </li></ul></ul><ul><ul><li>Depression/Mental Confusion </li></ul></ul>
  150. 163. Cobalamin-Vitamin B12 <ul><li>Functions </li></ul><ul><ul><li>Coenzymes </li></ul></ul><ul><ul><li>New Cell Synthesis </li></ul></ul><ul><ul><li>Fatty Acids </li></ul></ul><ul><ul><li>Amino Acids </li></ul></ul><ul><ul><li>Maintain Nerve Cells </li></ul></ul>
  151. 164. Cobalamin-Vitamin B12 <ul><li>Food Sources </li></ul>
  152. 165. Cobalamin-Vitamin B12 <ul><li>Deficiency Disease </li></ul><ul><ul><li>Pernicious Anemia </li></ul></ul><ul><li>Deficiency Symptoms </li></ul><ul><ul><li>Fatigue </li></ul></ul><ul><ul><li>Degeneration of Peripheral Nerves </li></ul></ul><ul><ul><li>Hypersensitivity </li></ul></ul>
  153. 166. Ascorbic Acid-Vitamin C <ul><li>Functions </li></ul><ul><ul><li>Collagen Synthesis </li></ul></ul><ul><ul><li>Antioxidant </li></ul></ul><ul><ul><li>Amino Acid Metabolism </li></ul></ul><ul><ul><li>Absorption of Iron </li></ul></ul><ul><ul><li>Resistance to Infection </li></ul></ul>
  154. 167. Ascorbic Acid-Vitamin C <ul><li>Food Sources </li></ul>
  155. 168. Ascorbic Acid-Vitamin C <ul><li>Deficiency Disease </li></ul><ul><ul><li>Scurvy </li></ul></ul><ul><li>Deficiency Symptoms </li></ul>
  156. 169. Fat Soluble Vitamins <ul><li>Fat-Soluble Vitamins </li></ul>
  157. 170. Fat Soluble Vitamins: A, D, E, K <ul><li>* Differ From Water-Soluble Vitamins </li></ul><ul><li>Found in Fat and Oily Parts of Foods </li></ul><ul><li>Insoluble in Water </li></ul><ul><li>Lymphatic System </li></ul>
  158. 171. Fat Soluble Vitamins: A, D, E, K <ul><li>* Differ From Water-Soluble Vitamins </li></ul><ul><li>Greater Risks for Toxicity </li></ul><ul><li>Stored in Liver and Adipose Tissue </li></ul><ul><li>Not Readily Excreted </li></ul>
  159. 172. Vitamin A and Beta-carotene <ul><li>First Fat-Soluble Vitamin Recognized </li></ul><ul><li>Beta-Carotene, Precursor to Vitamin A </li></ul><ul><li>Three Forms of Vitamin A (Retinoids) </li></ul><ul><ul><li>Retinol (an Alcohol) </li></ul></ul><ul><ul><li>Retinal (an Aldehyde) </li></ul></ul><ul><ul><li>Retinoic Acid (an Acid) </li></ul></ul>
  160. 173. Beta Carotene as an Antioxidant <ul><li>Protects the Body Against Disease </li></ul><ul><ul><li>Free Radicals </li></ul></ul><ul><ul><ul><li>Heart Disease </li></ul></ul></ul><ul><ul><ul><li>Cancer </li></ul></ul></ul><ul><ul><ul><li>Arthritis </li></ul></ul></ul><ul><ul><ul><li>Cataracts </li></ul></ul></ul>
  161. 174. Retinol-Vitamin A <ul><li>Functions </li></ul><ul><ul><li>Vision </li></ul></ul><ul><ul><li>Maintenance of Cornea </li></ul></ul><ul><ul><li>Mucous Membranes </li></ul></ul><ul><ul><li>Skin, Bone, and Tooth Growth </li></ul></ul><ul><li>Food Sources </li></ul>
  162. 175. Retinol-Vitamin A in Vision <ul><li>Cornea </li></ul><ul><li>Transportation of Light Energy Nerve Impulses at Retina </li></ul><ul><li>Supports Growth of Bones </li></ul><ul><ul><li>Remodeling of Bone </li></ul></ul>
  163. 176. Retinol-Vitamin A <ul><li>Deficiency Disease </li></ul><ul><ul><li>Hypovitaminosis A </li></ul></ul><ul><li>Deficiency Symptoms </li></ul>
  164. 177. Retinol-Vitamin A Deficiency <ul><li>Vitamin A Stores: 90% in Liver </li></ul><ul><li>Adequate Protein </li></ul><ul><li>Vitamin A Food Sources </li></ul><ul><li>Global Nutrition Problem </li></ul><ul><li>Night Blindness </li></ul><ul><li>100 Million Children with Deficiency </li></ul>
  165. 178. Calciferol-Vitamin D <ul><li>Significant Sources </li></ul><ul><ul><li>Food </li></ul></ul><ul><ul><li>Sunlight </li></ul></ul>
  166. 179. Calciferol-Vitamin D from the Sun <ul><li>Natural Exposure to Sunlight </li></ul><ul><ul><li>Sun Imposes No Risk of Toxicity </li></ul></ul><ul><ul><ul><li>Prolonged Exposure Degrades the Vitamin D Precursor </li></ul></ul></ul>
  167. 180. Calciferol-Vitamin D from the Sun <ul><li>Ultraviolet Rays of the Sun </li></ul><ul><ul><li>Dark Skinned People Prone to Rickets </li></ul></ul><ul><ul><li>Deficiency More Likely in Elderly </li></ul></ul><ul><ul><ul><li>Vitamin D Fortified Foods or Supplements </li></ul></ul></ul>
  168. 181. Calciferol-Vitamin D <ul><li>Functions </li></ul><ul><ul><li>Raises Blood Calcium and Phosphorus </li></ul></ul><ul><ul><li>Hormone </li></ul></ul><ul><ul><li>Organs: Intestines, Kidneys, Bones </li></ul></ul><ul><ul><li>Stimulates Absorption from GI Tract </li></ul></ul><ul><ul><li>Bone Growth </li></ul></ul>
  169. 182. Calciferol-Vitamin D <ul><li>Deficiency Disease </li></ul><ul><ul><li>Rickets </li></ul></ul><ul><ul><li>Osteomalacia </li></ul></ul><ul><li>Deficiency Symptoms </li></ul>
  170. 183. Tocopherol-Vitamin E <ul><li>1922, Discovery in Vegetable Oils </li></ul><ul><li>Anti sterility Factor = Tocopherol </li></ul><ul><li>Compound Named Vitamin E </li></ul><ul><ul><li>Alpha Beta </li></ul></ul><ul><ul><li>Gamma Delta </li></ul></ul>
  171. 184. Tocopherol-Vitamin E <ul><li>Food Sources </li></ul><ul><ul><li>20% = Vegetable Oils </li></ul></ul><ul><ul><li>20% = Fruits and Vegetables </li></ul></ul><ul><ul><li>15% = Grain Products </li></ul></ul><ul><li>Animal Fats: Meat and Milk Fat Contain Little or No Vitamin E </li></ul>
  172. 185. Tocopherol-Vitamin E <ul><li>Functions </li></ul><ul><ul><li>Antioxidant </li></ul></ul><ul><ul><li>Stabilization of Cell Membranes </li></ul></ul><ul><ul><li>Regulation of Oxidation Reactions </li></ul></ul><ul><ul><li>Protection of PUFA </li></ul></ul><ul><ul><li>Protection of Vitamin A </li></ul></ul>
  173. 186. Vitamin E as an Antioxidant <ul><li>Oxidation </li></ul><ul><ul><li>Transformation of Energy Fuels to ATP </li></ul></ul><ul><ul><li>Oxidation of Polyunsaturated Fatty Acids </li></ul></ul><ul><ul><li>Protection of Lungs </li></ul></ul><ul><ul><ul><li>Air Pollutants (Nitrogen or Ozone) </li></ul></ul></ul><ul><ul><li>Protects Red Blood Cells </li></ul></ul>
  174. 187. Tocopherol-Vitamin E Deficiency <ul><li>Rare in Humans </li></ul><ul><ul><li>Fat Malapsorption </li></ul></ul><ul><ul><li>Cystic Fibrosis </li></ul></ul><ul><li>Causes of Vitamin E Deficiency </li></ul><ul><ul><li>Erythrocyte Hemolysis </li></ul></ul>
  175. 188. Vitamin K <ul><li>Blood Clotting </li></ul><ul><li>“ K” = Danish Word Koagulation (Coagulation or Clotting) </li></ul><ul><li>13 Different Proteins and Calcium </li></ul><ul><ul><li>Vitamin K Essential Synthesis of Protein </li></ul></ul>Calcium and thromboplastin (a phospholipid) from blood platelets Vitamin K Precursor Prothrombin (an inactive protein) Thrombin (an active enzyme) Fibrinogen (a soluble protein) Fibrin (a solid clot) Blood-Clotting Process
  176. 189. Vitamin K <ul><li>Significant Sources </li></ul><ul><ul><li>Food </li></ul></ul><ul><ul><li>Non-Food </li></ul></ul><ul><ul><ul><li>Bacteria in GI </li></ul></ul></ul><ul><ul><ul><li>Bacterial Synthesis </li></ul></ul></ul>
  177. 190. Vitamin K <ul><li>Functions </li></ul><ul><ul><li>Blood-Clotting Synthesis </li></ul></ul><ul><ul><li>Bone Growth </li></ul></ul>
  178. 191. Vitamin K Deficiency <ul><li>Deficiency is Rare </li></ul><ul><ul><li>Bile Production </li></ul></ul><ul><ul><li>Diarrhea </li></ul></ul><ul><ul><li>Malabsorption Diseases (Crohn’s) </li></ul></ul><ul><ul><li>Sulfa Drugs </li></ul></ul><ul><ul><li>Antibiotics </li></ul></ul>
  179. 192. Vitamin K Deficiency <ul><li>Surgery: Blood Clotting Time Checked </li></ul><ul><li>Newborn Babies: Sterile Digestive Tract </li></ul><ul><ul><li>Vitamin K-Producing Bacteria </li></ul></ul><ul><ul><li>Plasma Prothrombin Concentrations </li></ul></ul><ul><ul><li>Hemorrhagic Disease </li></ul></ul>
  180. 194. Minerals <ul><li>Major Minerals : Macrominerals </li></ul><ul><ul><li>Essential nutrients in larger amounts </li></ul></ul><ul><ul><li>Amounts larger than 5 grams </li></ul></ul><ul><li>Trace Minerals : Microminerals </li></ul><ul><ul><li>Essential nutrients in smaller amounts </li></ul></ul><ul><ul><li>Amounts smaller than 5 grams </li></ul></ul>
  181. 195. Minerals in 60kg Human Body
  182. 196. Inorganic Elements <ul><li>Minerals are inorganic elements </li></ul><ul><li>Retain chemical identity </li></ul><ul><li>Cannot be destroyed by: </li></ul><ul><ul><li>Heat </li></ul></ul><ul><ul><li>Acid </li></ul></ul><ul><ul><li>Air </li></ul></ul><ul><ul><li>Mixing </li></ul></ul>
  183. 197. Inorganic Elements <ul><li>Preservation of minerals </li></ul><ul><li>Ash from food remains </li></ul><ul><li>Minerals lost through leaching in water </li></ul>
  184. 198. Body’s Handling of Minerals <ul><li>Amount of minerals absorbed </li></ul><ul><li>Ease of absorption, transportation and excretion </li></ul><ul><li>Carriers to be absorbed and transported </li></ul><ul><li>Increased risk of toxicity </li></ul>
  185. 199. Variable Bioavailability <ul><li>Binders </li></ul><ul><ul><li>Phytic Acid : calcium, iron, zinc </li></ul></ul><ul><ul><ul><li>Legumes and grains </li></ul></ul></ul><ul><ul><li>Oxalic Acid : calcium and iron </li></ul></ul><ul><ul><ul><li>spinach and chocolate </li></ul></ul></ul>
  186. 200. Sodium <ul><li>Principal cation (+) of extracellular fluid </li></ul><ul><ul><li>Cation : positively charge ions </li></ul></ul><ul><ul><li>Extracellular fluid : fluid outside cell </li></ul></ul><ul><li>Maintain acid-base balance </li></ul><ul><li>Essential to nerve transmission </li></ul><ul><li>Essential to muscle contraction </li></ul>
  187. 201. Sodium Roles in the Body <ul><li>Foods provide more sodium than the body needs </li></ul><ul><ul><li>Intestinal tract absorbs sodium readily </li></ul></ul><ul><ul><li>Sodium travels freely in the blood </li></ul></ul><ul><ul><li>Kidneys filter all sodium out of the blood </li></ul></ul><ul><ul><li>Kidneys return to bloodstream exact needs </li></ul></ul><ul><ul><ul><li>Excretion = Consumption </li></ul></ul></ul>
  188. 202. Sodium Recommendations <ul><li>Diets rarely lack sodium </li></ul><ul><li>Committee on dietary allowances </li></ul><ul><ul><li>Minimum : adults = 500 mg per day </li></ul></ul><ul><ul><li>Maximum : (NaCl) less than 6 g per day </li></ul></ul>
  189. 203. Sodium Recommendations <ul><li>Salt (sodium chloride) is about 40% sodium </li></ul><ul><ul><li>1 g salt = 400 mg sodium </li></ul></ul><ul><ul><li>5 g salt = 1 tsp </li></ul></ul><ul><ul><li>1 tsp salt = 2,000 mg sodium </li></ul></ul>
  190. 204. Sodium and Hypertension <ul><li>Majority of people with HTN, salt restriction does not lower blood pressure </li></ul><ul><ul><li>Most effective dietary treatment </li></ul></ul><ul><ul><ul><li>for HTN is weight loss </li></ul></ul></ul>
  191. 205. Sodium in Foods <ul><li>Processed foods high amounts of sodium </li></ul><ul><li>Fresh fruits and vegetables low sodium </li></ul><ul><ul><li>75% sodium added to foods at table or during preparation </li></ul></ul><ul><ul><li>15% sodium added during cooking </li></ul></ul><ul><ul><li>10% natural sodium in foods </li></ul></ul>
  192. 206. Chloride Roles in the Body <ul><li>Major anion (-) in extracellular fluids </li></ul><ul><li>Association with sodium (NaCl) </li></ul><ul><li>Moves freely across membranes </li></ul><ul><li>Critical for fluid and electrolyte balance </li></ul>
  193. 207. Chloride Roles in the Body <ul><li>Chloride ion is part of hydrochloric acid (HCL) </li></ul><ul><ul><li>Strong acidity of gastric juice </li></ul></ul><ul><ul><li>Proper digestion </li></ul></ul><ul><ul><ul><li>Protein digestion and iron absorption </li></ul></ul></ul><ul><ul><ul><li>Vomiting loss of HCL </li></ul></ul></ul>
  194. 208. Chloride Recommendations and Intakes <ul><li>Abundant in foods (especially processed) </li></ul><ul><li>No RDA set </li></ul><ul><ul><li>Estimated minimum requirement 750 mg per day </li></ul></ul>
  195. 209. Potassium <ul><li>Positively charged ion (+) </li></ul><ul><li>Body’s principal Cat-Ion inside the cells </li></ul>
  196. 210. Potassium Roles in the Body <ul><li>Maintaining fluid and electrolyte balance </li></ul><ul><li>Maintaining cell integrity </li></ul><ul><li>Homeostasis (steady heartbeat) </li></ul>*If cells were to give up to the blood only 6% of the K(+) they contain, it would stop the heart
  197. 211. Potassium Recommendations and Intakes <ul><li>Abundant inside all living cells </li></ul><ul><li>Richest sources are fresh foods </li></ul><ul><ul><li>Fruits </li></ul></ul><ul><ul><li>Processed foods: more sodium less potassium </li></ul></ul><ul><li>Canned vegetables </li></ul><ul><li>Luncheon meats </li></ul><ul><li>Ready to eat cereals </li></ul>
  198. 212. Potassium and Hypertension <ul><li>Potassium </li></ul><ul><ul><li>Prevent or help to correct HTN </li></ul></ul><ul><li>Low potassium diets raise blood pressure: </li></ul><ul><ul><li>Hypertensive </li></ul></ul><ul><li>High potassium intake protects against stroke </li></ul>
  199. 213. Potassium Deficiency <ul><li>Dietary deficiency rare </li></ul><ul><li>Excessive losses versus deficient intake: </li></ul><ul><ul><li>- Diabetic acidosis - Dehydration </li></ul></ul><ul><ul><li>- Prolonged vomiting - Diarrhea </li></ul></ul><ul><ul><li>- Diuretics - Steroids </li></ul></ul><ul><ul><li>- Laxatives </li></ul></ul>
  200. 214. Calcium <ul><li>Most abundant mineral in the body </li></ul><ul><li>Found primarily in: </li></ul><ul><ul><li>Bones </li></ul></ul><ul><ul><li>Teeth </li></ul></ul>
  201. 215. Calcium Roles in the Body <ul><li>99% of body’s calcium in bones </li></ul><ul><ul><li>Bone structure </li></ul></ul><ul><ul><ul><li>Rigid frame </li></ul></ul></ul><ul><ul><ul><li>Attachment point for muscles </li></ul></ul></ul><ul><ul><li>Calcium bank </li></ul></ul><ul><ul><ul><li>Readily available source </li></ul></ul></ul><ul><ul><ul><li>Readily to body fluids </li></ul></ul></ul>
  202. 216. Calcium in Bones <ul><li>Formation/dissolution simultaneously </li></ul><ul><li>State of constant flux </li></ul><ul><ul><li>Osteoblast cells build bone </li></ul></ul><ul><ul><li>Osteoclast cells break down bone </li></ul></ul>
  203. 217. Calcium in Bones <ul><li>Birth to 20 years: </li></ul><ul><ul><li>Actively growing in length, width, shape </li></ul></ul><ul><li>12 to 29 years: </li></ul><ul><ul><li>Peak bone mass </li></ul></ul><ul><ul><li>Bones growing thicker and denser </li></ul></ul><ul><li>30 to 40 years: </li></ul><ul><ul><li>Bone loss exceeds new bone formation </li></ul></ul>
  204. 218. Calcium in Body Fluids <ul><li>1% circulates as ionized calcium </li></ul><ul><li>Ionized calcium is vital to life </li></ul><ul><ul><li>Regulation in muscle contraction </li></ul></ul><ul><ul><li>Clotting of blood </li></ul></ul><ul><ul><li>Transmission of nerve impulses </li></ul></ul>
  205. 219. Calcium in Body Fluids <ul><li>Ionized calcium is vital to life: </li></ul><ul><ul><li>Secretion of hormones </li></ul></ul><ul><ul><li>Activation of some enzyme reactions </li></ul></ul><ul><ul><li>Cofactor in a protein (calmodulin) </li></ul></ul><ul><ul><ul><li>Conveys signals to the inside cells </li></ul></ul></ul><ul><ul><ul><li>Helps maintain normal blood pressure </li></ul></ul></ul>
  206. 220. Calcium and Disease Prevention <ul><li>Preventing and treating hypertension </li></ul><ul><ul><li>Epidemiological studies show low dietary calcium correlates with high prevalence of hypertension </li></ul></ul><ul><li>Relationship between dietary calcium </li></ul><ul><li>and blood cholesterol, diabetes, and cancer </li></ul>
  207. 221. Calcium Balance <ul><li>Blood calcium falls too low, </li></ul><ul><li>3 organ systems may raise it: </li></ul><ul><ul><li>Intestines : absorb more calcium </li></ul></ul><ul><ul><li>Bones : release more calcium </li></ul></ul><ul><ul><li>Kidneys : excrete less calcium </li></ul></ul>
  208. 222. Factors Influencing Calcium Absorption <ul><li>Factors that Promote </li></ul><ul><li>Calcium Absorption </li></ul><ul><li>Hormones that promote growth </li></ul><ul><li>Ingestion with a meal; stomach acid </li></ul><ul><li>Vitamin D </li></ul><ul><li>Lactose </li></ul><ul><li>Phosphorus in an optimal ratio </li></ul><ul><li>Factors That Interfere </li></ul><ul><li>with Calcium Absorption </li></ul><ul><li>Diminished absorption with aging </li></ul><ul><li>Lack of stomach acid </li></ul><ul><li>Vitamin D deficiency </li></ul><ul><li>High phosphorus intake </li></ul><ul><li>High-fiber diet </li></ul><ul><li>Phytates and oxalates </li></ul><ul><li>High protein intake </li></ul>
  209. 223. Calcium-Binding Protein <ul><li>Body regulates calcium absorption </li></ul><ul><ul><li>Average calcium absorption </li></ul></ul><ul><ul><ul><li>Adult = 30% </li></ul></ul></ul><ul><ul><ul><li>Pregnant women = 50% </li></ul></ul></ul><ul><ul><ul><li>Growing child = 50-60% </li></ul></ul></ul>
  210. 224. Calcium Recommendations and Intakes <ul><li>Internationally, recommendations vary </li></ul><ul><li>Calcium intakes are low in most of world </li></ul><ul><li>WHO recommends: </li></ul><ul><ul><li>400-500 mg per day (adults) </li></ul></ul><ul><li>Protein intakes are also low in most of world </li></ul>
  211. 225. Calcium Sources <ul><li>Most abundant in milk and milk products </li></ul><ul><li>Recommended daily milk servings: </li></ul><ul><ul><li>Children 2 cups </li></ul></ul><ul><ul><li>Teenagers 3 cups </li></ul></ul><ul><ul><li>Adults 2 cups </li></ul></ul><ul><ul><li>Pregnancy (women) 3 cups </li></ul></ul><ul><ul><li>Pregnancy (teens) 4 cups </li></ul></ul>
  212. 226. Absorbability of Calcium Excellent Good Fair Poor Cauliflower, watercress, brussels sprouts, mustard greens, broccoli, turnip greens, carrot, dates Milk, soy milk, tofu* Almonds, sesame seeds, pinto beans Spinach Foods Ranked According to Absorbability of Calcium *Calcium-set tofu
  213. 227. Osteoporosis <ul><li>Osteoporosis: bone loss reaches point when bones fracture under common everyday stress </li></ul>
  214. 228. Calcium Deficiency <ul><li>Bone mass peaks = skeletal maturity (30) </li></ul><ul><ul><li>Dense bone mass is best protection against age-related bone loss and fracture </li></ul></ul><ul><ul><li>Low calcium intake during growing years impairs acquisition of optimal bone mass </li></ul></ul><ul><ul><li>Adults lose bone as they age (40) </li></ul></ul>
  215. 229. Phases of Bone Development Bone Density Age in Years Time of Peak Bone Mass Active Growth Bone Loss 10 20 30 40 50 60 70 80
  216. 230. Phosphorus Roles in the Body <ul><li>Found in blood plasma as phosphorus salts (Phosphates) </li></ul><ul><li>In all body cells as part of buffer system </li></ul><ul><ul><li>Phosphoric acid </li></ul></ul><ul><ul><li>Salts </li></ul></ul><ul><ul><li>Maintains acid-base balance </li></ul></ul>
  217. 231. Phosphorus Roles in the Body <ul><li>Phopholipids help transport other lipids in the blood </li></ul><ul><ul><li>Phospholipids are major structural components of cell membranes </li></ul></ul><ul><ul><li>Effect transport of nutrients into and out of cells </li></ul></ul><ul><li>Proteins, casein, contain phosphorus in </li></ul><ul><li>their structure (phosphoproteins) </li></ul>Cell Membranes
  218. 232. Phosphorus Roles in the Body <ul><li>Part of DNA and RNA </li></ul><ul><ul><li>Genetic code material in every cell </li></ul></ul><ul><ul><li>necessary for all growth </li></ul></ul><ul><li>Assists in energy transfer during cellular metabolism </li></ul><ul><ul><li>Enzyme and B vitamins activity </li></ul></ul><ul><ul><li>ATP, uses three phosphates </li></ul></ul>
  219. 233. Phosphorus Recommendations <ul><li>Same as calcium, except during infancy </li></ul><ul><li>Diets that provide adequate energy and protein also supply adequate phosphorus </li></ul>
  220. 234. Phosphorus Recommendations <ul><li>Age </li></ul><ul><li>0 – 6 months </li></ul><ul><li>6 months – 1year </li></ul>Nutrient 400 mg Calcium 300 mg Phosphorus 600 mg Calcium 500 mg Phosphorus
  221. 235. Magnesium <ul><li>Cat-Ion (Mg++) within body's cells </li></ul><ul><li>Active in many enzyme systems </li></ul><ul><li>Over half of body's magnesium is in bones </li></ul>
  222. 236. Magnesium <ul><li>1% in the extracellular fluid </li></ul><ul><li>Bone magnesium is reservoir to ensure availability </li></ul><ul><li>Remaining magnesium found in muscle and tissue </li></ul>
  223. 237. Magnesium Roles in the Body <ul><li>Important to 300+ enzyme systems </li></ul><ul><li>Energy metabolism </li></ul><ul><ul><li>Catalyst reaction - the reaction of ATP </li></ul></ul><ul><ul><li>Essential to the body's use of glucose </li></ul></ul><ul><li>Synthesis of protein, carbohydrates and nucleic acids </li></ul><ul><li>Cell's membrane transport system </li></ul>
  224. 238. Magnesium Roles in the Body <ul><li>Muscle contraction and blood clotting </li></ul><ul><ul><li>Calcium promotes processes </li></ul></ul><ul><ul><li>Magnesium inhibits processes </li></ul></ul><ul><li>Regulates the functioning of the lungs </li></ul><ul><li>Prevent dental caries </li></ul><ul><li>Supports normal functioning of immune system </li></ul>
  225. 239. Magnesium Deficiency <ul><li>Protein malnutrition </li></ul><ul><li>Renal or endocrine disorders </li></ul><ul><li>Prolonged vomiting or diarrhea </li></ul><ul><li>Extensive use of diuretics </li></ul>*Even when average magnesium intakes are below RDA, symptoms are not apparent except with disease
  226. 240. Magnesium and Hypertension <ul><li>Magnesium ion is critical to heart function </li></ul><ul><ul><li>Protects against hypertension </li></ul></ul><ul><ul><li>protects against heart disease </li></ul></ul><ul><ul><li>deficiency causes walls of arteries and capillaries to constrict- possibly contributing to hypertension </li></ul></ul><ul><li>Studies on magnesium show intakes are lower in men who have heart attacks </li></ul>
  227. 241. Sulfur <ul><li>Part of some amino acids </li></ul><ul><li>Body does not use sulfur by itself </li></ul><ul><li>Methionine, and cysteine </li></ul><ul><li>Skin, hair, and nails </li></ul><ul><li>Severe protein deficiency will lack sulfur containing amino acids </li></ul><ul><li>Thiamin and Biotin also contain sulfur </li></ul>
  228. 242. Trace Minerals: Overview <ul><li>Body requires them in small, minuscule quantities </li></ul><ul><li>Function similarly to minerals </li></ul><ul><ul><li>Assists enzymes in diverse tasks all over body </li></ul></ul><ul><li>Each has special duties that only it can perform </li></ul>
  229. 243. Trace Mineral Food Sources <ul><li>Content in foods unpredictable: </li></ul><ul><ul><li>Soil </li></ul></ul><ul><ul><li>Water quality </li></ul></ul><ul><ul><li>Processed foods </li></ul></ul><ul><li>Factors in diet and body affect absorption and bioavailibility </li></ul><ul><li>Abundant in a variety of foods, whole foods </li></ul>
  230. 244. Trace Mineral Deficiencies <ul><li>Severe deficiencies of common minerals more easily recognized </li></ul><ul><li>Mild deficiencies are easy to overlook </li></ul><ul><li>Common result of deficiency </li></ul><ul><ul><li>Children failure to grow and thrive (GI tract, heart, bones, blood muscles, CNS) </li></ul></ul>
  231. 245. Trace Mineral Interactions <ul><li>Excess of one trace mineral may cause deficiency of another, e.g., Manganese overload iron deficiency </li></ul><ul><li>Iron deficiency makes the body much more susceptible to lead poisoning </li></ul>
  232. 246. Trace Mineral Interactions <ul><li>Deficiency of one may exacerbate problems associated with deficiency of another </li></ul><ul><ul><li>Combined iodine and selenium deficiency thyroid hormone production </li></ul></ul><ul><li>Factors that enhance absorption of one may decrease absorption of another </li></ul><ul><ul><li>Vitamin C enhances absorption of iron but depresses that of copper </li></ul></ul>
  233. 247. Iron <ul><li>Essential nutrient that is vital for energy </li></ul><ul><li>Accumulation in body causes harm </li></ul><ul><ul><li>Iron is found in two ionic states: </li></ul></ul><ul><ul><ul><li>Ferrous ion (reduced): Fe++ </li></ul></ul></ul><ul><ul><ul><li>Ferric ion (oxidized): Fe+++ </li></ul></ul></ul>
  234. 248. Iron Roles in the Body <ul><li>Most of body’s iron found in two proteins </li></ul><ul><ul><li>Hemoglobin in the red blood cells </li></ul></ul><ul><ul><li>Myoglobin in the muscle cells </li></ul></ul><ul><li>Iron helps accept, carry and release oxygen </li></ul>
  235. 249. Iron Roles in the Body <ul><li>Found in many enzymes that oxidize compounds </li></ul><ul><li>Required by enzymes involved in making part of all cells' metabolism </li></ul><ul><li>Amino acids, hormones, neurotransmitters </li></ul>
  236. 250. Heme and Nonheme Iron <ul><li>Heme iron found flesh of animals </li></ul><ul><ul><li>Meats, poultry, fish (40% heme, 60% nonheme) </li></ul></ul><ul><ul><li>10% of the average person’s intake </li></ul></ul><ul><ul><li>Well absorbed by the body at a constant rate of 23% </li></ul></ul><ul><ul><li>Iron deficiency absorption </li></ul></ul>
  237. 251. Heme and Nonheme Iron <ul><li>Nonheme iron found in plant and animal foods </li></ul><ul><ul><li>Vegetables, fruits, milk </li></ul></ul><ul><ul><li>90% of the average person’s intake </li></ul></ul><ul><ul><li>Absorption rates 2% - 20% and influenced by: </li></ul></ul><ul><ul><ul><li>Dietary factors </li></ul></ul></ul><ul><ul><ul><li>Body iron stores </li></ul></ul></ul>
  238. 252. Heme and Nonheme Iron in Foods Nonheme Heme Nonheme Nonheme Heme From meats only From all foods Only foods derived from animal flesh provide heme, but they also contain nonheme iron All the iron in foods derived from plants is nonheme iron Dietary iron intake, daily average
  239. 253. Absorption Inhibitors <ul><li>Phytates and fibers in whole grain cereals and nuts </li></ul><ul><li>Calcium and phosphorus in milk </li></ul><ul><li>EDTA in food additives </li></ul><ul><li>Tannic acid (tea, coffee, nuts, fruits, vege) </li></ul>
  240. 254. Adaptability of Absorption <ul><li>10% -15% dietary iron is absorbed </li></ul><ul><li>Absorption varies from person to person </li></ul><ul><ul><li>2% in person with GI disease </li></ul></ul><ul><ul><li>35% in a rapidly growing, healthy child </li></ul></ul>
  241. 255. Adaptability of Absorption <ul><li>Absorption adjusts to supply and to need </li></ul><ul><ul><li>Iron absorption is increased: </li></ul></ul><ul><ul><ul><li>If the need increases (pregnancy) </li></ul></ul></ul><ul><ul><ul><li>If a person’s iron intake diminishes </li></ul></ul></ul>
  242. 256. Iron Recycling <ul><li>Average red blood cell live 3 months </li></ul><ul><ul><li>Liver and spleen </li></ul></ul><ul><ul><ul><li>Remove iron from blood, take it apart, prepare for excretion or recycling </li></ul></ul></ul><ul><ul><ul><li>Iron is salvaged liver attaches it to blood transferrin transports back to bone marrow for new RBC </li></ul></ul></ul>Liver Spleen
  243. 257. Iron Recycling <ul><li>Body loses some iron daily </li></ul><ul><ul><li>Via the GI tract </li></ul></ul><ul><ul><li>If bleeding occurs </li></ul></ul><ul><ul><li>Tiny amounts in urine, sweat, shedded skin </li></ul></ul>
  244. 258. Prevalence of Iron Deficiency <ul><li>Worldwide, most common deficiency </li></ul><ul><li>Affects an estimate 15% of world’s population with highest prevalence in developing countries </li></ul><ul><li>Young children and pregnant </li></ul><ul><li>women </li></ul><ul><li>Iron deficiency Anemia. </li></ul>
  245. 259. Zinc <ul><li>Cofactor by more than 100 enzymes in every organ of the body </li></ul><ul><ul><li>DNA and RNA </li></ul></ul><ul><ul><li>Manufactures heme for hemoglobin </li></ul></ul><ul><ul><li>Essential fatty acid metabolism </li></ul></ul><ul><ul><li>Releases Vitamin A from liver stores </li></ul></ul>
  246. 260. Zinc <ul><li>Cofactor by more than 100 enzymes in every organ of the body </li></ul><ul><ul><li>Metabolizes carbohydrates </li></ul></ul><ul><ul><li>Synthesizes proteins </li></ul></ul><ul><ul><li>Metabolizes alcohol in the liver </li></ul></ul><ul><ul><li>Disposes of damaging free radicals </li></ul></ul>
  247. 261. Iodine <ul><li>Iodine is indispensable to life </li></ul><ul><li>Needed in trace amounts </li></ul><ul><li>Iodine in foods is converted to iodide ion in the GI tract </li></ul>
  248. 262. Selenium <ul><li>Essential mineral that is an antioxidant. </li></ul><ul><li>Antioxidant effect may also benefit the CVS and give protection against Cancer. </li></ul><ul><li>Enzyme that converts thyroid hormone to its active form </li></ul><ul><li>Not commonly found in food. </li></ul>
  249. 263. Copper <ul><li>Body contains about 100 mg of copper </li></ul><ul><ul><li>1/3 is in the muscles </li></ul></ul><ul><ul><li>1/3 is in the liver and brain </li></ul></ul><ul><ul><li>1/3 is in the bones, kidneys, blood, and other tissues </li></ul></ul>
  250. 264. Copper Roles in the Body <ul><li>Copper serves as a constituent of enzymes </li></ul><ul><ul><li>Enzymes catalyze oxidation of ferrous to ferric ions </li></ul></ul><ul><ul><li>Iron metabolism makes it a key factor in hemoglobin synthesis </li></ul></ul><ul><ul><li>Functions as an antioxidant </li></ul></ul><ul><ul><li>Formation of Myelin </li></ul></ul>
  251. 265. Copper Roles in the Body <ul><li>Copper serves as a constituent of enzymes </li></ul><ul><ul><li>Helps manufacture collagen and heal wounds </li></ul></ul><ul><ul><li>Helps in the formation of Myelin sheath. </li></ul></ul><ul><ul><li>Mild Anti- Inflammatory effect </li></ul></ul><ul><ul><li>Oxygen Free Radical Metabolism </li></ul></ul>
  252. 266. Chromium <ul><li>Essential mineral </li></ul><ul><li>Participates in carbohydrate and lipid metabolism </li></ul>
  253. 267. Chromium Roles in the Body <ul><li>Helps maintain glucose homeostasis </li></ul><ul><li>Works with hormone insulin to facilitate glucose uptake into cells and energy release </li></ul><ul><li>Diets low in chromium may impair glucose tolerance, insulin response, and glucagon response </li></ul><ul><li>Glucose tolerance factor (GTF) enhances insulin's action </li></ul>
  254. 268. INTER RELATIONSHIP BETWEEN VARIOUS NUTRIENTS NUTRIENTS ASSOCIATED WITH VITAMIN A Requires ZINC for its release from the Liver; needs FAT for its proper absorption VITAMIN D Works along with CALCIUM & PHOSPHORUS ; together they ensure proper Bone development needs FAT for its proper Absorption VITAMIN E Works synergistically with SELENIUM as potent antioxidants . Needs FAT for its proper absorption. VITAMIN K Works in association with CALCIUM thereby helping in Blood clotting. Needs FAT for its proper Absorption
  255. 269. INTER RELATIONSHIP BETWEEN VARIOUS NUTRIENTS NUTRIENTS ASSOCIATED WITH VITAMIN C Crucial for IRON Absorption FOLIC ACID Aids in IRON Absorption; Also ↓ Homocystein levels COPPER Aids in IRON Absorption MAGNESIUM Works with CALCIUM to Promote Bone Growth & Muscle Contraction PHOSPHORUS Associated with VITAMIN B1, B2 B3, B6 for their Co-enzyme Activity
  256. 270. 1 in 8 people living in Indian metros suffer from diabetes! By 2020, scientists expect 40 million Americans will suffer from Osteoarthritis. Diet & Disease SOME FACTS
  257. 271. Causes of Death <ul><li>Infectious diseases </li></ul><ul><ul><li>TB, diarrhea, malaria, AIDS </li></ul></ul><ul><li>Cardiovascular </li></ul><ul><ul><li>Heart, coronary, cerebrovascular </li></ul></ul><ul><li>Cancer </li></ul><ul><li>Respiratory </li></ul>
  258. 272. Leading Causes of Death in 2004 Infections diseases ( tuberculosis, diarrhea, HIV/AIDS, malaria ) Circulatory diseases ( coronary heart, cerebrovascular ) Cancer disease/conditions (lung, stomach, colon and rectum, liver, breast) Respiratory Perinatal conditions Diabetes Nutritional deficiencies
  259. 273. Diet and disease <ul><li>Obesity </li></ul><ul><ul><li>1.2 billion people in the world are overweight </li></ul></ul><ul><ul><li>300 million of them are Obese </li></ul></ul>
  260. 274. Diet and disease <ul><li>How to calculate BMI </li></ul><ul><ul><li>BMI = weight in kg /height (mts x mts) </li></ul></ul><ul><ul><ul><li>BMI > 18.5 is underweight </li></ul></ul></ul><ul><ul><ul><li>18.5- 24.9 is normal weight </li></ul></ul></ul><ul><ul><ul><li>25.0 – 29.9 is overweight </li></ul></ul></ul><ul><ul><ul><li>30.0 – 39.9 is Obese </li></ul></ul></ul><ul><ul><ul><li>40.0- and higher is severely obese </li></ul></ul></ul>
  261. 275. Hazards of Obesity <ul><li>Adult </li></ul><ul><li>Pre mature deaths </li></ul><ul><li>Maturity onset diabetes </li></ul><ul><li>Pain in the hip joint </li></ul><ul><li>Heart disease </li></ul><ul><li>Hypertension </li></ul><ul><li>Cancer </li></ul><ul><li>Fatty Liver disease </li></ul><ul><li>Vascular disorders </li></ul><ul><li>Thrombosis </li></ul><ul><li>Obstructive Sleep Apnea </li></ul><ul><li>Musculoskeletal problems </li></ul><ul><li>Gastro esophageal reflux </li></ul><ul><li>Children </li></ul><ul><li>Bowing of legs because of weight </li></ul><ul><li>Sever headache can lead to vision loss </li></ul><ul><li>Suffer daytime sleepiness </li></ul><ul><li>Breathing difficulty during sleep </li></ul><ul><li>Obese female may develop polycystic ovary disease </li></ul><ul><li>chances of diabetes </li></ul><ul><li>Hypertension </li></ul><ul><li>Gall bladder disease </li></ul><ul><li>Raised blood cholesterol </li></ul>
  262. 276. Obesity may lead to…….. Hypertension Heart diseases Diabetes Increased blood cholesterol levels Breathing difficulty Stroke High rate of certain type of cancer Fatty liver Vascular diseases. Reproductive problems in females
  263. 277. Childhood Obesity …….. <ul><li>Obesity among Children is on the rise from 1998 to 2006 </li></ul><ul><li>2-5 yrs prevalence increased 5%- 13.9% </li></ul><ul><li>6-11yrs prevalence increased 6.5%- 8.8 % </li></ul><ul><li>12-19yrs prevalence increased by 5%-17.4% </li></ul>
  264. 278. Childhood Obesity ……..
  265. 279. Childhood Obesity …….. <ul><li>Factors that lead to childhood obesity. </li></ul><ul><li>Genetic factors or some genetic Disorders </li></ul><ul><li>Underlying illness (Hypothyroidism) </li></ul><ul><li>Eating Disorders </li></ul><ul><li>Certain Medication </li></ul><ul><li>Sedentary lifestyle </li></ul><ul><li>Psychological/Emotional Disturbances </li></ul>
  266. 280. Video 4: Childhood Obesity….. Video on Child Nutrition Click to Start
  267. 281. Preventing Obesity …….. <ul><li>Tips to parents </li></ul><ul><li>Children do not need to finish every bottle or meal. </li></ul><ul><li>Avoid prepared and sugared foods when possible </li></ul><ul><li>Limit the amount of High calorie foods kept in the home </li></ul><ul><li>Provide a healthy diet with 30% or fewer calories derived from Fat </li></ul>
  268. 282. Preventing Obesity …….. <ul><li>Tips to parents </li></ul><ul><li>Provide ample fiber in the child’s diet </li></ul><ul><li>Skimmed milk may safely replace whole milk at 2 yrs of Age </li></ul><ul><li>Do not provide food for comfort or as a reward. </li></ul><ul><li>Limit the amount of T.V. viewing </li></ul><ul><li>Encourage active Play such as walks, ball games etc </li></ul>
  269. 283. Diet and Heart Disease
  270. 284. Why Does the Heart Quit? <ul><li>Not enough oxygen and nutrition </li></ul><ul><li>Poisons build up in the heart </li></ul><ul><li>Muscle dies </li></ul>
  271. 285. What happens Then? <ul><li>Heart gets bigger </li></ul><ul><li>Heart works harder </li></ul><ul><li>Heart tires out </li></ul><ul><li>Heart fails </li></ul>
  272. 286. When Heart Muscles Die What Happens? <ul><li>Muscle replaced with scar tissue </li></ul><ul><li>Scar tissue does not work </li></ul><ul><li>More scar tissue less muscle </li></ul><ul><li>Heart quits </li></ul>
  273. 287. What Causes Heart Failure? <ul><li>High blood pressure (Hypertension) </li></ul><ul><li>Coronary blood vessel disease </li></ul><ul><li>Atherosclerosis </li></ul>
  274. 288. How Does High Blood Pressure Affect the Heart? <ul><li>Heart must work harder </li></ul><ul><li>Uses more energy </li></ul><ul><li>Muscle starves </li></ul>
  275. 289. What Does Coronary Vessel Do? <ul><li>Blocks blood through heart muscle </li></ul><ul><li>Less food and oxygen to heart </li></ul><ul><li>Muscle starves </li></ul>
  276. 290. What Does Atherosclerosis Do? <ul><li>Blocks blood flow to brain </li></ul><ul><li>Brain does not get food and oxygen </li></ul><ul><li>Brain cells die </li></ul>
  277. 291. What Causes High Blood Pressure? <ul><li>Sometimes water balance problems </li></ul><ul><li>Obesity </li></ul><ul><li>Other diseases </li></ul><ul><li>Undetermined causes </li></ul>
  278. 292. High Blood Pressure Leads To <ul><li>Stroke </li></ul><ul><li>Congestive heart failure </li></ul><ul><li>Heart attack </li></ul><ul><li>Kidney disease </li></ul><ul><li>Blood vessel damage </li></ul>
  279. 293. How Can We Treat High Blood Pressure? <ul><li>Exercise, diet, stress reduction </li></ul><ul><li>Increase urine flow </li></ul><ul><li>Make the heart work less hard </li></ul><ul><li>Relax blood vessels </li></ul>
  280. 294. Cholesterol <ul><li>Is a fat-like waxy substance essential to body chemistry </li></ul><ul><li>Is manufactured by our bodies </li></ul><ul><li>Contained in foods we eat </li></ul>
  281. 295. Cholesterol <ul><li>LDL </li></ul><ul><ul><li>“ Bad” cholesterol </li></ul></ul><ul><ul><li>Lower is better </li></ul></ul><ul><li>HDL </li></ul><ul><ul><li>“ Good” cholesterol </li></ul></ul><ul><ul><li>Higher is better </li></ul></ul>
  282. 296. Saturated Fats <ul><li>D ECREASE </li></ul><ul><li> Y OUR </li></ul><ul><li> S ATURATED </li></ul><ul><li> F ATS ! </li></ul>
  283. 297. Athersclerosis Leads To <ul><li>Heart attack </li></ul><ul><li>Stroke </li></ul><ul><li>Sudden death </li></ul>
  284. 298. Major Risk Factors for CVD <ul><li>Cigarette smoking </li></ul><ul><li>High blood pressure </li></ul><ul><li>High levels of cholesterol and fat in blood </li></ul><ul><li>Family history of heart disease </li></ul><ul><li>Male gender </li></ul><ul><li>Increasing age </li></ul>
  285. 299. Major Risk Factors for CVD <ul><li>Diabetes </li></ul><ul><li>Overweight </li></ul><ul><li>Lack of exercise </li></ul>
  286. 300. Compounding Risk Factors None Cigarettes Cigarettes and Cholesterol Cigarettes and Cholesterol and High Blood Pressure
  287. 301. Coronary Risk Factors <ul><li>Modifiable </li></ul><ul><ul><li>Hypercholesterolemia </li></ul></ul><ul><ul><li>Hypertension </li></ul></ul><ul><ul><li>Smoking </li></ul></ul><ul><ul><li>Physical inactivity </li></ul></ul><ul><ul><li>Diabetes mellitus </li></ul></ul><ul><ul><li>Low LDL </li></ul></ul><ul><ul><li>Obesity </li></ul></ul><ul><li>Fixed </li></ul><ul><ul><li>Family history </li></ul></ul><ul><ul><li>Age </li></ul></ul><ul><ul><li>Menopausal females without hormone replacement </li></ul></ul>
  288. 302. To Reduce Your Risk <ul><li>Control High Blood Pressure </li></ul><ul><li>Do NOT smoke </li></ul><ul><li>Follow proper diet </li></ul>
  289. 303. ALSO: To Reduce Your Risk <ul><li>Exercise regularly </li></ul><ul><li>Have regular medical check-ups </li></ul><ul><li>Identify and treat diabetes </li></ul>
  290. 304. Triglycerides <ul><li>Triglycerides are the fat in food we eat </li></ul><ul><li>Our bodies manufacture and store triglycerides when we eat more calories than we need </li></ul>
  291. 305. Saturated Fatty Acids <ul><li>Saturated fatty acids are the main culprit in raising blood cholesterol levels </li></ul>
  292. 306. Dietary Recommendation <ul><li>Total fat intake should be less than 30% of calories </li></ul><ul><li>Saturated fatty acid intake should be less than 10% of calories </li></ul>
  293. 307. Dietary Recommendation <ul><li>Monounsaturated fatty acids should make up 10% - 15% of total calories </li></ul><ul><li>Monounsaturated fatty acids seem to lower blood cholesterol if the diet is low in saturated fats but still provide fat-dense calories </li></ul>
  294. 308. Proper Mix of Fat in Diet <ul><li>Up to 10% polyunsaturated </li></ul><ul><li>Less than 10% saturated </li></ul><ul><li>Balance from monounsaturated </li></ul>
  295. 309. Trans Fatty Acids <ul><li>Tend to raise LDL cholesterol levels </li></ul><ul><li>Major sources: </li></ul><ul><ul><li>Margarine </li></ul></ul><ul><ul><li>Vegetable shortening </li></ul></ul><ul><ul><li>Fast foods </li></ul></ul><ul><ul><li>Baked products </li></ul></ul>
  296. 310. Coronary Heart Disease 1% drop cholesterol = 2% drop coronary heart disease risk
  297. 311. Dietary Treatment for Coronary Heart Disease <ul><li>Less than 7% of calories as saturated fat </li></ul><ul><li>Less than 200 mg per day cholesterol </li></ul><ul><li>30% or less of calories as total fat </li></ul><ul><li>55% or more of calories as carbohydrate </li></ul><ul><li>15% of calories as protein </li></ul>
  298. 312. Dietary Treatment <ul><li>3 to 4 teaspoons servings of fat and oils per day </li></ul><ul><li>Use cooking methods with little </li></ul><ul><li>or no fat (bake, broil, roast, steam, poach, sauté, or microwave) </li></ul><ul><li>Trim visible fat before cooking meat and poultry, drain off fat after cooking </li></ul>
  299. 313. Dietary Treatment <ul><li>Limit use of organ meats </li></ul><ul><li>Choose skim or 1% fat milk, nonfat or low-fat yogurt or cheese </li></ul><ul><li>Limit intake of saturated fatty acids </li></ul><ul><li>Read labels for amount and type of fat </li></ul>
  300. 314. Sodium <ul><li>Epidemiological evidence </li></ul><ul><li>Individual response </li></ul><ul><li>Patients likely to have the greatest response to sodium: </li></ul><ul><ul><li>Older persons </li></ul></ul><ul><ul><li>Those with high initial blood pressure </li></ul></ul><ul><ul><li>Those with a family history of hypertension </li></ul></ul>
  301. 315. Salt/Sodium <ul><li>Use less salt at the table and in cooking </li></ul><ul><li>Use herbs, spices instead of salt </li></ul><ul><li>Limit intake of foods high in added sodium </li></ul><ul><li>Look for unsalted varieties of foods </li></ul>
  302. 316. Lifestyle Modification For Control of Hypertension <ul><li>Reduce weight if necessary </li></ul><ul><li>Limit daily intake of alcohol </li></ul><ul><li>Reduce daily sodium intake to <6 grams NaCl (salt) or <2.4 grams sodium </li></ul><ul><li>Exercise regularly </li></ul>
  303. 317. Fiber <ul><li>Fiber </li></ul>Eat More Fiber
  304. 318. Obesity <ul><li>Blood pressure </li></ul><ul><li>Atherosclerosis </li></ul><ul><li>Heart </li></ul><ul><li>Gall bladder </li></ul><ul><li>Diabetes </li></ul><ul><li>Pregnancy and surgery </li></ul><ul><li>Joint disease </li></ul>
  305. 319. Diet and Diabetes
  306. 320. Diabetes Mellitus <ul><li>A clinically and genetically heterogeneous group of disorders that is characterized by elevated blood glucose. </li></ul>
  307. 321. What Causes Diabetes? <ul><li>Causes and cures remain unknown </li></ul><ul><li>Researchers believe tendency is present at birth </li></ul><ul><li>Who is most likely to get diabetes? </li></ul><ul><li>People over 40 </li></ul><ul><li>Women with a high birth weight baby </li></ul><ul><li>Overweight </li></ul><ul><li>Family History </li></ul>
  308. 322. Types of Diabetes <ul><li>Diabetes Mellitus </li></ul><ul><ul><li>Type I (IDDM: Insulin dependent) </li></ul></ul><ul><ul><li>Type II (NIDDM: Non-insulin dependent) </li></ul></ul><ul><li>Diabetes Insipidus </li></ul><ul><li>Gestational Diabetes </li></ul>
  309. 323. Type I (IDDM) Diabetes <ul><li>Juvenile diabetes </li></ul><ul><li>Pancreas makes little or no insulin </li></ul><ul><li>Insulin dependent diabetes </li></ul><ul><li>Appears suddenly and worsens rapidly </li></ul>
  310. 324. Type I Diabetes
  311. 325. Type II (NIDDM) Diabetes <ul><li>Makes enough insulin but the body does not use it effectively </li></ul><ul><li>Usually occurs in adults after age 40 </li></ul><ul><li>Non-insulin dependent diabetes </li></ul><ul><li>Develops slowly and can go undetected for years </li></ul>
  312. 326. Type II Diabetes
  313. 327. Diabetes Insipidus <ul><li>Kidney’s inability to conserve water </li></ul><ul><li>Failure of the hypothalamus to release ADH </li></ul><ul><li>Large amounts of urine </li></ul><ul><ul><li>Change in appetite </li></ul></ul><ul><ul><li>Loss of strength </li></ul></ul><ul><ul><li>Emaciation </li></ul></ul>
  314. 328. Classification of Diabetes <ul><li>Type I </li></ul><ul><li>Type II </li></ul><ul><li>GDM </li></ul><ul><li>IGT </li></ul>~5% ~95% ~2% - 4% pregnant women ~11% of population ~6% of population
  315. 329. Screening for Diabetes <ul><li>Fpg* (MG/DL) </li></ul><ul><li><115 </li></ul><ul><li>116 - 140 </li></ul><ul><li>>140 </li></ul>Significance Normal IGT Diabetes likely Action Retest in 3 years 1. Additional testing 2. Check risk factors 3. Medical nutrition therapy 1. Confirm by second FPG 2. Treat diabetes *Fasting plasma glucose
  316. 330. What Problems Face a Diabetic? <ul><li>Maintaining blood sugar levels </li></ul><ul><li>Organ failures: </li></ul><ul><li>- Measuring blood </li></ul><ul><li>Insulin injections </li></ul><ul><li>Exercise </li></ul><ul><li>- Diet </li></ul><ul><li>Medications </li></ul><ul><li>Weight </li></ul><ul><li>- Eyes </li></ul><ul><li>Nervous system </li></ul><ul><li>Heart disease </li></ul><ul><li>- Kidneys </li></ul><ul><li>Blood vessels </li></ul><ul><li>Stroke </li></ul>
  317. 331. How Do We Treat Diabetes? <ul><li>Type I </li></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Diet </li></ul></ul><ul><ul><li>Injected insulin </li></ul></ul><ul><ul><ul><li>Fast acting </li></ul></ul></ul><ul><ul><ul><li>Moderate </li></ul></ul></ul><ul><ul><ul><li>Long acting </li></ul></ul></ul>
  318. 332. How Do We Treat Diabetes? <ul><li>Diabetes insipidus </li></ul><ul><ul><li>Usually patient is comfortable except with annoyance of frequent: </li></ul></ul><ul><ul><ul><li>Need to drink </li></ul></ul></ul><ul><ul><ul><li>Need to urinate </li></ul></ul></ul>
  319. 333. Type II Diabetes <ul><li>Non-insulin dependent </li></ul><ul><ul><li>Insulin secretion insufficient or excessive </li></ul></ul><ul><ul><li>Tends to occur after age of 40 </li></ul></ul><ul><ul><li>80% are above ideal body </li></ul></ul><ul><ul><li>weight </li></ul></ul>
  320. 334. Benefits of Weight Loss <ul><li>Reduces blood pressure </li></ul><ul><li>Reduces serum triglycerides, total cholesterol </li></ul><ul><li>Increases HDL-cholesterol </li></ul><ul><li>Reduces blood glucose levels </li></ul>
  321. 335. Obesity <ul><li>Obesity is the most important, modifiable risk factor for type 2 diabetes </li></ul><ul><li>BMI greater than 35 risk for type 2 diabetes by 93-fold in females </li></ul><ul><li>BMI greater than 35 risk for type 2 diabetes by 42-fold in males </li></ul>
  322. 336. Indications for Insulin in Type II <ul><li>Ineffectiveness of: </li></ul><ul><ul><li>Meal plan </li></ul></ul><ul><ul><li>Physical activity </li></ul></ul><ul><ul><li>OHAs </li></ul></ul><ul><ul><li>Endogenous insulin </li></ul></ul><ul><li>As therapy for an acute medical condition </li></ul>
  323. 337. Treatment Obese, Non-Insulin Dependent <ul><li>Meals coordinated with insulin </li></ul><ul><li>Weight reduction* </li></ul><ul><li>Regular exercise </li></ul><ul><li>* May eliminate or reduce need for insulin </li></ul>
  324. 338. Regulation of Blood Glucose Levels Blood Glucose Insulin Counterregulatory Hormones Fed Fasting
  325. 339. Benefits of Exercise <ul><li>Improved fitness </li></ul><ul><li>Flexibility, endurance, strength </li></ul><ul><li>R educes cardiovascular risk factors </li></ul><ul><li>Dyslipidemia, hypertension, obesity </li></ul><ul><li>Lowers blood pressure </li></ul><ul><li>type II and IGT </li></ul><ul><li>psychological well-being </li></ul>
  326. 340. Goals of Medical Nutrition Therapy <ul><li>Achieve blood glucose goals </li></ul><ul><li>Achieve optimal lipid levels </li></ul><ul><li>Provide appropriate calories for: </li></ul><ul><ul><li>Reasonable weight </li></ul></ul><ul><ul><li>Normal growth and development </li></ul></ul><ul><ul><li>Pregnancy and lactation </li></ul></ul><ul><li>Prevent, delay, or treat nutrition-related complications </li></ul><ul><li>Improve health through optimal nutrition </li></ul>
  327. 341. Nutrition Recommendations For Persons With Diabetes <ul><li>Protein </li></ul><ul><li>Carbohydrate </li></ul><ul><li>Fat </li></ul><ul><li>Fiber </li></ul>
  328. 342. Diabetes Food Pyramid ~6% of population
  329. 343. High-Fiber Foods <ul><li>Legumes </li></ul><ul><li>Fresh fruit </li></ul><ul><li>Raw vegetables </li></ul><ul><li>Whole grains: </li></ul><ul><ul><li>Oats, wheat, brown rice </li></ul></ul>Contains guar and pectin Contains cellulose
  330. 344. Consuming High-Fiber Foods <ul><li>Consuming high-fiber foods may: </li></ul><ul><ul><li>Lower post-meal blood glucose </li></ul></ul><ul><ul><li>Lower fasting blood glucose </li></ul></ul><ul><ul><li>Lower insulin requirements </li></ul></ul>
  331. 345. Nonnutritive Sweeteners <ul><li>Aspartame, acesulfame-K, saccharin </li></ul><ul><li>Safety based on Acceptable Daily Intake </li></ul><ul><ul><li>ADI: amount of a food additive that can be safely consumed on a daily basis over a person’s lifetime without any adverse effects </li></ul></ul><ul><ul><li>Includes a 100-fold safety factor </li></ul></ul><ul><ul><li>Average intake of aspartame ~4% ADI </li></ul></ul><ul><li>Safe for use, including pregnancy </li></ul>
  332. 346. Sodium <ul><li>To choose low sodium in food : </li></ul>
  333. 347. Oral Hypoglycemic Medication <ul><li>Increases sensitivity of receptor to insulin </li></ul><ul><li>Stimulates pancreas to increase production of insulin </li></ul>
  334. 348. Effects of Adequate Insulin on Protein Metabolism <ul><li>Anticatabolic </li></ul><ul><ul><li>Proteolysis </li></ul></ul><ul><ul><li>Gluconeogensis </li></ul></ul><ul><li>Anabolic </li></ul><ul><ul><li>Protein synthesis </li></ul></ul><ul><li>Amino acid transport </li></ul>
  335. 349. Diabetes-Related Conditions Requiring Medical Nutrition Therapy <ul><li>Hypertension </li></ul><ul><li>Nephropathy </li></ul><ul><li>Gastroparesis </li></ul><ul><li>Diabetes complicated by surgery </li></ul><ul><li>Macrovascular complications </li></ul><ul><li>Obesity </li></ul>
  336. 350. Nephropathy <ul><li>Type I diabetes ~35% </li></ul><ul><li>Type II diabetes ~ 20% </li></ul><ul><li>Accounts for ~35% of new cases of end-stage renal disease (ESRD) </li></ul>
  337. 351. Syndrome X Obesity (Upper Body) Genetics Insulin Resistance Hyperinsulinemia Dyslipidemia Hypertension Glucose Intolerance (IGT and Type II)
  338. 352. Lipoprotein Abnormalities Related to Diabetes <ul><li>TG and VLDL (type II) </li></ul><ul><li>HDL-C </li></ul><ul><li>Cholesterol and LDL-C similar to general public </li></ul><ul><li>Chylomicron clearance </li></ul>
  339. 353. Select Meal Planning Approaches <ul><li>General guidelines </li></ul><ul><li>Menu planning systems </li></ul><ul><li>Exchange systems </li></ul><ul><li>Counting systems </li></ul>
  340. 354. General Guidelines <ul><li>Benefits : </li></ul><ul><ul><li>Easy to understand </li></ul></ul><ul><ul><li>Good “first step” tool </li></ul></ul><ul><ul><li>Inexpensive </li></ul></ul><ul><ul><li>Allows patient to make choices </li></ul></ul>
  341. 355. Menu Planning Systems <ul><li>Benefits : </li></ul><ul><ul><li>Gives specific instructions </li></ul></ul><ul><ul><li>Simple to use </li></ul></ul><ul><ul><li>Variety of choices </li></ul></ul><ul><ul><li>May include recipes </li></ul></ul>
  342. 356. Exchange Lists <ul><li>Benefits : </li></ul><ul><ul><li>Groups foods with similar nutrition content </li></ul></ul><ul><ul><li>Teaches portion control </li></ul></ul><ul><ul><li>Can adjust calories </li></ul></ul><ul><ul><li>Teaches about CHO, fat, and protein </li></ul></ul><ul><ul><li>Cookbooks based on exchanges </li></ul></ul>
  343. 357. Acute Complications of Diabetes <ul><li>Hypoglycemia </li></ul><ul><li>Hyperglycemia </li></ul><ul><li>Diabetic ketoacidosis (DKA) </li></ul>
  344. 358. <ul><li>Insulin deficiency or resistance </li></ul><ul><li>Food </li></ul><ul><li>Glucagon or other CRH </li></ul><ul><li>Stress </li></ul><ul><li>Illness </li></ul><ul><li>Infection </li></ul><ul><li>Too much insulin or OHA </li></ul><ul><li>Not enough food </li></ul><ul><li>Unusual amount of exercise </li></ul><ul><li>Skipped or delayed meals </li></ul>Factors Affecting Blood Glucose Levels
  345. 359. Hypoglycemia <ul><li>Causes </li></ul><ul><li>Symptoms </li></ul><ul><ul><li>Shakiness </li></ul></ul><ul><ul><li>Sweating </li></ul></ul><ul><ul><li>Confusion </li></ul></ul><ul><ul><li>Irritability </li></ul></ul>
  346. 360. Hypoglycemia <ul><li>Treat blood glucose < 70 mg/dl </li></ul><ul><ul><li>15 g CHO </li></ul></ul><ul><ul><li>Wait 15 minutes </li></ul></ul><ul><ul><li>Retest and monitor symptoms </li></ul></ul><ul><li>Hypoglycemic unawareness </li></ul>
  347. 361. Hyperglycemia <ul><li>Symptoms </li></ul><ul><ul><li>Polyuria </li></ul></ul><ul><ul><li>Polydipsia </li></ul></ul><ul><ul><li>Dry mouth </li></ul></ul><ul><ul><li>Weight loss </li></ul></ul><ul><ul><li>Fatigue </li></ul></ul>
  348. 362. Hyperglycemia <ul><li>Can lead to DKA, coma, and death </li></ul><ul><li>DKA </li></ul><ul><ul><li>Blood glucose > 250 mg/dl </li></ul></ul><ul><ul><li>Urine ketones </li></ul></ul>
  349. 363. Treatment Plan for Hyperglycemia <ul><li>Test urine or blood </li></ul><ul><li>Call physician or health care team </li></ul><ul><li>Report results and symptoms </li></ul><ul><li>Follow doctor’s advice </li></ul>
  350. 364. Diet and Cancer
  351. 365. Burden of Cancer in India Estimated number of new cancers diagnosed in India every year: 700 - 900,000.
  352. 366. Causes of Cancer <ul><li>Tobacco*** </li></ul><ul><li>Sunlight*** </li></ul><ul><li>Genetic* </li></ul><ul><li>Environment* </li></ul><ul><li>Diet </li></ul>
  353. 367. Tobacco <ul><li>Lung, mouth, liver, kidney </li></ul><ul><li>Chemicals in smoke cause cancer </li></ul><ul><li>Daily, continuous exposure </li></ul>
  354. 368. How Do We Decrease Tobacco-Related Causes? <ul><li>STOP smoking </li></ul><ul><li>Decrease amount of cigarette smoked </li></ul><ul><li>Do not inhale </li></ul><ul><li>Filters </li></ul>
  355. 369. How Does Sunlight Cause Cancer <ul><li>U.V. light </li></ul><ul><li>Damages DNA </li></ul><ul><li>Mutation cancer </li></ul><ul><li>Skin cancer </li></ul>
  356. 370. How Do Genes Play a Role in Cancer? <ul><li>Prevent cell death </li></ul><ul><li>Increased mutations </li></ul><ul><li>Breast, prostate, intestine </li></ul><ul><li>Cancer families </li></ul>
  357. 371. What Can We Do to Decrease Gene-Related Cancers? <ul><li>Not much yet </li></ul><ul><li>Future (?) </li></ul>
  358. 372. What Environmental Causes are There? <ul><li>Radon </li></ul><ul><li>Some chemicals </li></ul><ul><ul><li>Mostly are work place </li></ul></ul><ul><li>Asbestos </li></ul>
  359. 373. What Can We Do to Decrease Environmental Risks? <ul><li>Remove radon and asbestos </li></ul><ul><li>Better chemical control </li></ul>
  360. 374. What Roles Does Diet Play in Cancer? <ul><li>Difficult to determine </li></ul><ul><li>Causation versus correlation </li></ul><ul><li>Salt </li></ul><ul><li>Fats* </li></ul><ul><li>Food preparation and storage </li></ul><ul><ul><li>Microbes and cancer </li></ul></ul>
  361. 375. How Can We Use Diet to Decrease Cancer Risk? <ul><li>Fiber* </li></ul><ul><li>Good nutrition </li></ul><ul><li>Preservatives </li></ul><ul><li>Antioxidants </li></ul>
  362. 376. Why is Cancer So Deadly? <ul><li>Detection </li></ul><ul><li>Invasion </li></ul><ul><li>Metastasis </li></ul>
  363. 377. What Makes Detection So Important? <ul><li>Currently a cancer may be in the body for up to 20 years </li></ul><ul><li>Kills normal cells </li></ul><ul><li>Goes elsewhere in the body </li></ul>
  364. 378. What is Invasion? <ul><li>Benign tumors </li></ul><ul><ul><li>Cysts: displace normal tissue </li></ul></ul><ul><li>Malignant tumors </li></ul><ul><ul><li>Invade normal tissue </li></ul></ul><ul><ul><li>Disrupt organ function </li></ul></ul><ul><ul><li>Invades blood vessels and lymph </li></ul></ul>
  365. 379. What is Metastasis <ul><li>Spread of cancer throughout the body </li></ul><ul><li>Blood vessels </li></ul><ul><li>Lymph system </li></ul><ul><li>The real killer </li></ul>
  366. 380. Treatment of Cancer <ul><li>Surgery </li></ul><ul><li>Radiation </li></ul><ul><li>Drugs </li></ul><ul><li>Immune system </li></ul>
  367. 381. Prevention of Cancer: Best But Poorly Understood <ul><li>Stop smoking*** </li></ul><ul><li>Decrease sun exposure*** </li></ul><ul><li>Diet </li></ul><ul><li>Antioxidants </li></ul><ul><li>Alcohol </li></ul>
  368. 382. Cancer Incidence <ul><li>Oesophagus </li></ul><ul><li>Lung </li></ul><ul><li>Stomach </li></ul><ul><li>Colon/rectum </li></ul><ul><li>Breast </li></ul><ul><li>Prostate </li></ul>
  369. 383. Cancer Prevention <ul><li>60-70% of all cancer cases could be prevented through: </li></ul><ul><ul><li>Sensible dietary choices </li></ul></ul><ul><ul><li>Maintaining a healthy body weight </li></ul></ul><ul><ul><li>Keeping physically active </li></ul></ul><ul><ul><li>Not smoking </li></ul></ul>
  370. 384. Good News! <ul><li>Protective factors </li></ul><ul><li>Risk factors </li></ul>
  371. 385. Protective Factor: 1 <ul><li>Cabbage family vegetables </li></ul><ul><li>Mustard family vegetables </li></ul><ul><ul><li>Cabbages </li></ul></ul><ul><ul><li>Mustards </li></ul></ul><ul><ul><li>Broccoli </li></ul></ul><ul><ul><li>Brussels sprouts </li></ul></ul><ul><ul><li>Cauliflower </li></ul></ul>
  372. 386. Protective Factor: 2 <ul><li>Fiber </li></ul><ul><ul><li>Whole grain breads </li></ul></ul><ul><ul><li>Whole grain flours </li></ul></ul><ul><ul><li>Wholes grain cereals </li></ul></ul><ul><ul><li>Peas </li></ul></ul><ul><ul><li>Beans </li></ul></ul><ul><ul><li>Fruits </li></ul></ul><ul><ul><li>Vegetables </li></ul></ul>
  373. 387. Antioxidants <ul><li>Population studies show that high intake of Plant foods (fruit and vegetables) is associated with reduced risk of cancer and heart disease </li></ul><ul><li>Plant Foods are rich in antioxidants as flavonoids, Vitamins E and C, and Carotenoids </li></ul>
  374. 388. Protective Factor: 3 <ul><ul><li>Lettuce </li></ul></ul><ul><ul><li>Carrots </li></ul></ul><ul><ul><li>Peaches </li></ul></ul><ul><ul><li>Apricots </li></ul></ul><ul><li>Vitamin A </li></ul><ul><li>Beta Carotene </li></ul><ul><ul><li>Spinach </li></ul></ul><ul><ul><li>Squash </li></ul></ul><ul><ul><li>Broccoli </li></ul></ul><ul><ul><li>Sweet potatoes </li></ul></ul>
  375. 389. Protective Factor: 4 <ul><ul><li>Cauliflower </li></ul></ul><ul><ul><li>Broccoli </li></ul></ul><ul><ul><li>Mustard greens </li></ul></ul><ul><li>Vitamin C </li></ul><ul><ul><li>Tomatoes </li></ul></ul><ul><ul><li>Peppers </li></ul></ul><ul><ul><li>Celery </li></ul></ul><ul><ul><li>Brussels sprouts </li></ul></ul>
  376. 390. Protective Factor: 4 <ul><li>Vitamin C </li></ul><ul><ul><li>Mangoes </li></ul></ul><ul><ul><li>Kiwi fruit </li></ul></ul><ul><ul><li>Currants </li></ul></ul><ul><ul><li>Lemon </li></ul></ul><ul><ul><li>Amla </li></ul></ul>
  377. 391. Phytochemicals <ul><li>Chemicals in plants that have nutrient or other functions. </li></ul><ul><ul><li>Dietary Sources </li></ul></ul><ul><ul><ul><li>soy, oats, tea, grapes, garlic, tomato </li></ul></ul></ul><ul><ul><li>Supplements Sources </li></ul></ul><ul><ul><ul><li>ginseng, echinacea </li></ul></ul></ul>
  378. 392. Activities of Phytochemicals <ul><li>Antioxidants </li></ul><ul><li>Enzyme Modulation </li></ul><ul><li>Cell Proliferation </li></ul><ul><li>Angiogenesis </li></ul><ul><li>Genetic </li></ul><ul><li>Anti-Inflammatory </li></ul><ul><li>Endocrine function </li></ul><ul><li>Platelet aggregation </li></ul><ul><li>Vascular Reactivity </li></ul>
  379. 393. Protective Factor: 5 Weight Control
  380. 394. Walk Away the Calories Brisk Walking For: Equals: 20 minutes 100 calories 30 minutes 150 calories 45 minutes 225 calories 60 minutes 300 calories 70 minutes 350 calories
  381. 395. Cancer <ul><li>Cancer risk reduction </li></ul><ul><li>Eliminate risk factors </li></ul>
  382. 396. Risk Factor: 1 <ul><li>Dietary fat </li></ul><ul><li>Fat calories </li></ul>
  383. 397. Risk Factor: 2 <ul><li>Salt cured </li></ul><ul><li>Nitrite cured </li></ul><ul><li>Smoked foods </li></ul>
  384. 398. Risk Factor: 3 <ul><li>Cigarettes are 87% of lung cancer </li></ul><ul><li>30% of all cancer is smoking related </li></ul>
  385. 399. Risk Factor: 4 <ul><li>Alcohol </li></ul><ul><li>Compound risk: Alcohol + Cigarettes </li></ul>
  386. 400. Risk Factor: 5 <ul><li>Excessive sun </li></ul><ul><ul><li>Avoid midday sun </li></ul></ul><ul><ul><li>Sunscreen SPF 15 </li></ul></ul><ul><ul><li>Protective clothing </li></ul></ul><ul><ul><li>Avoid sunlamps, tanning pills and tanning parlors </li></ul></ul>
  387. 401. AIDS/HIV <ul><li>AIDS/HIV </li></ul>
  388. 402. What is Aids? <ul><li>Acquired Immune Deficiency syndrome </li></ul>
  389. 403. How Does Virus Affect Us? <ul><li>Targets immune cells </li></ul><ul><ul><li>Kills lymphocytes </li></ul></ul><ul><ul><li>Stored in macrophages </li></ul></ul><ul><li>Lose immune system </li></ul>
  390. 404. How Do We Lose Our Immune System? <ul><li>Virus invades lymphocyte (helper) </li></ul><ul><li>Moves to cell nucleus </li></ul><ul><li>Takes over cell DNA </li></ul><ul><li>Cell makes too much virus </li></ul><ul><li>Cell dies </li></ul><ul><li>Virus spreads to more lymphocytes </li></ul>
  391. 405. What Kills an AIDS Patient? <ul><li>Infections: &quot;opportunistic infections&quot; </li></ul><ul><li>Diet problems </li></ul><ul><li>Organ failure </li></ul>
  392. 406. How Can We Prevent AIDS? <ul><li>&quot;Safe sex&quot; </li></ul><ul><li>Clean needles </li></ul><ul><li>Common sense </li></ul>
  393. 407. How Do We Treat AIDS? <ul><li>Diet </li></ul><ul><li>Exercise </li></ul><ul><li>Drugs </li></ul>
  394. 408. What Do Drugs Do <ul><li>Prevent virus from replicating </li></ul><ul><li>Prevent virus from reforming </li></ul>
  395. 409. What Are the Problems With Drugs? <ul><li>Very expensive </li></ul><ul><li>Complex schedules of drug taking </li></ul><ul><li>Resistance </li></ul>
  396. 410. Immune System <ul><li>Prevents against invading organisms </li></ul><ul><li>Kills tumor cells </li></ul>
  397. 411. What If Immune System Malfunctions <ul><li>Autoimmune disease: immune system attacks itself </li></ul><ul><li>Cancer develops </li></ul><ul><li>Opportunistic infections </li></ul>
  398. 412. Nutrition and HIV/AIDS <ul><li>Optimize your health </li></ul><ul><ul><li>Prevention and treatment of HIV/AIDS associated malnutrition </li></ul></ul>
  399. 413. Weight Loss Means <ul><li>11Kg </li></ul>17,500 calories =
  400. 414. Why Nutrition? <ul><li>Optimize immune function to minimize disease progression </li></ul><ul><li>Manage symptoms to reduce risk weight loss and wasting </li></ul><ul><li>Component team-based approach to managing HIV/AIDS disease </li></ul>
  401. 415. Wasting; A Definition <ul><li>Involuntary weight loss greater than 10% baseline body weight + either chronic diarrhea or chronic weakness and documented fever in the absence of concurrent illness or condition other than HIV infection </li></ul>
  402. 416. Link b
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