-amran-Applied Nutrition.pdf

ALaa-Mansour http://www.nurse.ga
Applied Nutrition
Food Choices:
→ Personal Preference, ‫شخصي‬ ‫اختيار‬
→ Habit, ‫العادة‬
→ Ethnic heritage or Tradition, ‫والتقاليد‬ ‫العرقي‬ ‫التراث‬
→ Social Interactions, ‫االجتماعية‬ ‫التفاعالت‬
→ Availability , Convenience, and Economy, ‫واالقتصاد‬ ‫والراحة‬ ‫التوافر‬
→ Positive and Negative Associations,
→ Emotional Comfort, ‫العاطفية‬ ‫الراحة‬
→ Values, ‫القيم‬
→ Body Weight and Image,‫الجسم‬ ‫وصورة‬ ‫وزن‬
→ Nutrition and Health Benefits, ‫والصحة‬ ‫التغذية‬ ‫فوائد‬
Nutrition: The science of food and the nutrients and other substances contain and action
the body, Including (Ingestion, Digestion, Absorption, Transport, Metabolism, excretion).
Foods: Products come from plants or animal that can be taken, to yield energy .
Diet: The food and beverages a person eats and drinks.
Nutrients: Chemical Substances obtained from food and used in the body to provide energy,
and regulating agents to support grown, maintenance, and repair of body tissues .
Energy: The capacity to do work. (Energy in food is Chemical energy).
The body can convert food chemical energy to?
→ 1. Mechanical 2. Electrical 3. Heat
A calorimeter: ‫الطاقة‬ ‫قياس‬ ‫اداة‬
What is organic nutrients to provide energy?

→ 1. Carbohydrate 2. Fat 3. Protein
Note: Vitamins, Minerals, and Water do not yield energy in the human body.
Macronutrients Micronutrients
Carbohydrate, Fat, Protein. Vitamins, Minerals.
Large Amounts. Small Amounts.
Many grams daily. Milligrams or micrograms daily.
One Kcalorie = 1Kg to raise up 1Celcuis temp in the body.
1Kc = 4.2 Kilojoules.
Not < Inorganic: (Not containing carbon or not related to living things)
Organic: (Containing Carbon, Or carbon-hydrogen bonds.)
1 gram of (Carbohydrate, Protein) = 4 Kcalories of energy .
1 gram of Fat = 9 Kcalories
Normal Protein daily amount:
Normal 0.8 X weight – (Support 1.2 X Weight) - (Muscle Building Support 1.8 X Weight)
Values that make up the DRI:
Estimated Average Requirements (EAR) Daily Amount, Age, Gender group (Healthy)
Recommended Dietary Allowances (RDA) )‫الواحد‬ ‫الشخص‬ ‫(حسب‬ ‫بها‬ ‫الموصى‬
Adequate Intakes (AI) Daily amount sufficient (‫)كفاية‬
Tolerable Upper Intake Levels (UL) Maximum daily amounts of nutrients
Many countries use the recommendation developed by two
international groups ?
Is energy a nutrient? No but is required in the body for metabolic processes, physiological
functions.
FAO Food and Agriculture
WHO World Health Organization

Nutrition Assessment
Malnutrition: any condition caused by excess or deficient food energy or nutrient intake.
Mal = Bad
Undernutrition: deficient energy or nutrients
If the deficiency or excess have (Sign and symptoms)
Deficiency of Energy Deficiency of Nutrient Excess of Energy
1. Extremely thin 1. Skin rashes Obese
2. Losing muscle tissue 2. Depression Increase risk to disease such as:
3. Risk to infections 3. Hair loss → Heart disease
4. Risk to disease 4. Bleeding gums → Diabetes
/////////////////////// 5. Muscle Spasm
/////////////////////// 6. Night Blindness
How To prepare a nutrition assessment ?
How to do nutrition assessment? (4 Methods)
1. Historical information. (History)
2. Anthropometric data. (Measures such as Height and Weight)
3. Physical examination. (Hair, eyes, skin, posture, tongue, fingernails)
4. Laboratory test. (Blood, Urine)

Digestion, Absorption and transport
Digestion: is the body way of breaking down foods preparation to absorption.
Digestion: the process to broken down any food into absorbable units.
Digestion = Take apart
Absorption: uptake of nutrients by the cells of the small intestine for
transport to blood or lymph).
Absorb = Suck in
________________________________________________________________
Gastrointestinal (GI) tract: Is a flexible muscular tube that extends from the
mouth → esophagus→ stomach→ small intestine→ large intestine→ rectum → anus.
Mouth: The process of digestion begins in the mouth. (As you chew) → ‫المضغ‬
Peristalsis: )‫(فهم‬ ‫األمعاء‬ ‫حركة‬
→ Muscles in the intestines contract and relax.
→ This movement helps food to travel through the intestines.
→ . ‫ي‬
‫الهضم‬ ‫الجهاز‬ ‫ر‬
‫عب‬ ‫ات‬‫ز‬‫والغا‬ ‫الطعام‬ ‫جزيئات‬ ‫مرور‬ ‫تمنع‬ ‫األمعاء‬ ‫كة‬
‫حر‬ ‫توقفت‬ ‫اذا‬
→ Contractions in (Stomach 3 Times) (Small intestine 10 times) per minutes.
The breakdown of food into nutrients requires secretions from five
different organs :
1. Salivary glands.
2. Stomach.
3. Pancreas.
4. Liver (Via gallbladder).
5. Small intestine.

Carbohydrase: enzyme that hydrolyzes carbohydrates
Protease: enzyme that hydrolyzes proteins.
Lipase: enzyme that hydrolyzes lipids (fats).
Note: Saliva and gastric juices contain lipases, but most fat breakdown occurs in the small intestines.
Absorption happened in small intestine.
Simple carbohydrates (Sugars)
Three are monosaccharide’s:
Glucose → Fructose → Galactose T.
• Glucose: Sometime known as blood sugar dextrose (G5).
• Fructose: Found in fruits, honey, and saps.
• Galactose: derived from the metabolism of lactose (Milk sugar).
• If the body has deficiency of (Lactose enzyme) → Problems in digesting milk.
Three are disaccharides:
1. Maltose = Glucose + Glucose (Glu + Glu).
2. Sucrose = Glucose + Fructose ( Glu + Fru).
3. Lactose = Glucose + Galactose (Glu + Gal).
Organ or Gland Target Organ Secretion Action
Salivary glands → Mouth → Saliva → 1. Eases swallowing
2. Breakdown Carbohydrate
Gastric glands → Stomach → Gastric juice → 1. Breakdown proteins
2. Protect stomach cells
Pancreas Small intestine Pancreatic juice Breakdown Carb, fats, Proteins
Liver Gallbladder Bile Stored until needed
Gallbladder Small intestine Bile
Intestinal glands Small intestine Intestinal juice Breakdown Carb, fats, Proteins

The Complex Carbohydrates
The complex carbohydrates contain many glucose unit (monosaccharides) strung together as
polysaccharides.
Three types of polysaccharides are important in nutrition:
1. Glycogen: Found only limited in meats, and not at all plants. (important role in the body).
2. Starches: plant polysaccharides (glucose), all starchy found in plants (legumes and tubers).
3. Fibers: There three type of fibers: (Fibers source come from naturally in plants).
→ Dietary fibers: in plant foods, (polysaccharides) not digested by human digestive.
→ Soluble fibers: indigestible food that (dissolve in water), come from fruit.
→ Insoluble fibers: indigestible food (no dissolve in water), found in strings of celery and
skins of corn kernels.
→ Fermentable: bacteria in the GI tract can breakdown fibers to fragments that the body can use
Resistant Starches: these starches escape digestion and absorption in the small intestine.
Amylase: an enzyme that hydrolyzes amylose.
Amylase : is a carbohydrase, an enzyme that breaks down carbohydrates.
Lactose intolerance: a condition result inability to digest the milk sugar lactose.
Lactase deficiency: a lack of the enzyme required to digest disaccharide lactose,
into its component monosaccharides (glucose and galactose).
Symptoms when more lactose:
→ Bloating (gases) → abdominal discomfort → diarrhea.
Galactosemia: is a rare, hereditary disorder of carbohydrate metabolism, that
affects the body ability to convert galactose to glucose.
Treatment if Galactisemia:
1. Soya based formula.
2. No breastfeeding

Carbohydrates provide about half (45% to 65%) of the energy requirements.
A person consuming 2000 kcalories a day should therefore have 900 to 1300
kcalories of carbohydrate, or about 225 to 325 grams.
RDA is set at 130 grams per day is minimum average amount of glucose used by
the brain.
How to calculate : 2000Kcalories X 45% = 900 ÷ 4 (1gram carbohydrate = 4 kcalories)
2000 X 45% = 900 ÷ 4 = 225 grams, of carbohydrates.
2000 X 60% = 1200 ÷ 4 = 300 grams, carbohydrates.
FDA set the daily value for fibers at 25grams (recommended 11.5 grams per
1000-Kcalories for 2000-Kcalories.
Too little CH:
→More fat used as fuel source.‫للوقود‬‫كمصدر‬‫الدهون‬ ‫من‬ ‫المزيد‬ ‫استخدام‬
→Glycogen storage become depleted (‫الجليكوجي‬ ‫مخزون‬ ‫استنفاد‬ ‫إىل‬ ‫يؤدي‬ ‫)مما‬
→body can use protein as energy source by convert protein to CHO (Gluconeogensis).
Gluconeogenesis:
→ Too many CHO
→ Increase triglyceride levels. (‫الثالثية‬ ‫)الدهون‬
→ Convert CHO to fat and stored it.

Proteins (amino acids)
Proteins: Compounds composed of carbon, hydrogen, oxygen, nitrogen atoms.
Some amino acids also contain sulfur atoms.
Amino acids: Building block of proteins.
Protein → Found in → Plants and Animals, analyzed to amino acids.
There are 22 naturally occurring amino acids.
Types of amino acids (A.A):
1. Essential Nine a.a: Cannot be produced by our body, Meat contains all
essential (complete protein).
2. Non essential – thirteen a.a: Can by produced by our body, Come from plants
(Incomplete protein): missing or low in one or more essential a.a.
Table 6-1 ‫حفظ‬ essential amino acids ☺☺
Pepsin: gastric enzyme that hydrolyzes protein, (Secreted in inactive form)
Pepsinogen: Activated by hydrochloric acid in the stomach.
Roles of protein
1. Building material for growth and maintenance to repair tissues.
2. As enzymes
3. Regulate fluid balance
4. Antibodies
5. Source of energy and glucose
6. Neuro transmitters

Nitrogen balance: the amount of nitrogen consumed (N in) with amount excreted (N out)
in a given period of time.
Nitrogen equilibrium ( zero nitrogen balance): N in = N out.
Positive nitrogen: N in > N out. ‫الخارج‬ ‫من‬ ‫ر‬
‫اكب‬ ‫الداخل‬
Negative nitrogen: N in < N out. ‫الداخل‬ ‫من‬ ‫ر‬
‫اكب‬ ‫الخارج‬
Nitrogen excretion in the:
→ urine → feces → sweat.
Researcher use nitrogen balance studies to estimate protein requirements.
Deficiency of proteins leads to PEM (Protein energy malnutrition) like Marasmus disease.
Kwashiorkor disease: (Protein malnutrition) the child has low body weight, water, retention,
moon-shaped face.
RDA protein amount is :
1. Health adult = 0.8g/ kg.
2. Infant = 2.2 /kg
3. RDA for Pregnant = 0.8/kg + 30g
4. RDA for lactation(breastfeeding) = 0.8/kg + 20g
Illness , infection and surgery: physical illness increase protein breakdown in the body.
Phenyl ketonuria (PKU): Rare but, serious inherited disorder (serious case).
→ Caused by defect (problem) in gene that helps create the enzyme needed to
breakdown phenylalanine.
Symptoms of PKU
A musty odor in the breath, skin , urine caused by too much phenylalanine
1. Neurological problems include (seizures).
2. Skin rashes (eczema),
3. Fair skin, Blue eyes: because phenylalanine cant transform into melanin.
4. Abnormally small head, hyperactivity, intellectual disability, delayed development.
5. Behavioral, emotional and social problems, Psychiatric disorders.

Lipids
Normal lipids in the body is (15-20%).
Lipids: a family of compounds includes triglycerides, phospholipids, and sterols.
(insolubility in water).‫بالماء‬ ‫تذوب‬ ‫ال‬
Lipids also include fat-soluble vitamins.
Fats: lipids are (Solid) at room temp (77F or 25C).
Oils: lipids are (Liquid) at room temp (77F or 25C).
Omega 3 fatty acid: polyunsaturated fatty acid, (Three carbons).
Omega 6 fatty acid: polyunsaturated fatty acid (Six carbons).
Major storage form of fat in the body: Triglycerides.
(Tri = three.) _ ( Glyceride = of glycerol ) (Acyl = a carbon chain)
Glycerol: Alcohol composed of a three carbon chain. ol = alchoho.
Triglycerides: 3 fatty acids +glycerol
Phospholipids: lipids containing phosphorus.(Next largest lipid after triglycerides).
Lipoprotein: Formed primarily in the liver. (different groups of triglycerides,
phospholipids, cholesterol with protein.
Cholesterol: Found only in animal tissues.( it is a precursor Vit D dietary source of
cholesterol: egg, yolk, liver, kidney, and brains.
VLDL LDL
Very-low-density lipoprotein Low-density lipoprotein
Produced in (Liver) Derived from VLDL as VLDL triglycerides are
removed and broken down.
Transport lipids to tissues in body Composed of Very high Cholesterol
Composed Primarily of triglycerides High blood cholesterol from LDL = Risk of CVD
HDL: Transports cholesterol from tissues and arteries to the liver.
*Reduces the risk of CVD (Cardio vascular disease).

Essential fatty acids roles
Vital for normal growth of blood vessels and verves.
Keep Skin Health And Youthful.
Protect cells from invasion of microorganism and chemicals.
Deficiency Lead to poor growth and dermatitis.
Essential fatty acids:
1) Linoleic Acid and Omega-6 Family.
2) Linolenic And Omega-3 Family.
3) Ecosanoids.
Triglycerides:
1) provide an energy from saved fat.
2) insulator against temperature extremes. ‫القصوى‬ ‫ارة‬‫ر‬‫الح‬ ‫درجات‬ ‫ضد‬ ‫عزل‬
3) Protect against shock.
4) Help body to use carbohydrate and protein efficiently.
The body can easily store unlimited amounts of fat if given excesses.

Vitamins
Vitamins: Organic substances required by our body for proper
metabolism, growth and maintenance.
We all need vitamins for a healthy life.
Classification of vitamins
• Water- soluble vitamins: Include → B Complex And C.
• Fat-soluble vitamins: Include → A, D, E ,K.
Fat soluble vitamins:↓ >ADEK
Vitamin A (Retinol):
Source: Liver, Fish, Green leafy vegetables.
Function: Vision (Eye-sight), Growth, Tissues healing,
anti oxidant, healthy skin and lower cancer risk.
DEFICIENCY: Night-blindness, vision impairment.
Vitamin D (Calciferol):
Source: Cod liver oil, butter.
Function: Regulates calcium metabolism, Rx of asthma
and arthritis.
DEFICIENCY: Osteoporosis, Osteomalacia.
Vitamin E (Tocopherol):
Source: Vegetables, seed or nut oil.
Function: anti-oxidant, reduces CVD.
DEFICIENCY: Infections, Alzheimer’s.
Vitamin K:
Source: Dark green leafy vegetables, liver, milk.
Function: Necessary for blood clotting.
DEFICIENCY: Hemolytic anemia.

Water soluble vitamin
Vitamin (C):↓
Function: anti-oxidant, formation and maintenance collagen, stimulate immune system.
Source: Lemons, grapefruits, oranges, (Fresh Milk).
Deficiency: Scurvy, anemia.
Vitamin B-1:↓
Source: whole-grain, enriched grain.
Function: Energy metabolism.
Deficiency: Beriberi (edema; dry, muscle wasting).
Server Deficiency: (Wemicke-korsakoff syndrome)
Vitamin B-2:↓
Source: Milk products (yogurt, cheese); whole grain.
Function: part of coenzymes, energy metabolism.
Deficiency: Ariboflavinosis.

Vitamin B-3:↓
Source: Milk, eggs, meats, fish, grains, nuts.
Deficiency: Pellagra → (Dermatitis, Dementia, Diarrhea).
Vitamin B-5:↓
Source: Common in food; chicken, potatoes, tomatoes, liver, egg
yolk, broccoli, whole grains.
Deficiency: Numbness & burning of hands & feet, Muscle Cramps.
Vitamin B-6:↓
Source: Meats, Fish, Liver, Potatoes, Starchy vegetables, legumes, soy.
Function: Amino & Fatty acid metabolism, Helps to make RBC’s
Deficiency: Dermatitis, Anemia, Depression, Confusion, Convulsions.
Vitamin B-7 (Biotin):↓
Source: liver, egg yolk, fish, whole grains (produced by GI bacteria.)
Function: Amino acid & energy metabolism, fat & glycogen synthesis.
Deficiency: Depression, lethargy, hallucinations, ENT rash, hair loss.

Vitamin B-9 (Folic acid):↓
Source: Fortified grains, liver, leafy green vegetables, legumes, seeds.
Function: DNA synthesis, Important to new cell formation.
Deficiency: Anemia (large-cell type).
Vitamin B12:↓
Source: Animal origin (Meat, Fish, Milk poultry, shellfish, cheese, eggs, cereals).
Function: New cell synthesis, maintain nerve cells, break down some fatty and
amino acids.
Deficiency: Pernicious Anemiaa
(deficiency of RBC’s).

Minerals(Part of living tissue)
→ Minerals not contain any calories but assist in production energy.
→ Can’t be synthesized, but some vitamins can be.‫الفيتامينات‬ ‫بعض‬ ‫تصنيع‬ ‫يمكن‬ ‫ولكن‬ ، ‫تصنيعها‬ ‫يمكن‬ ‫ال‬
→ Should be obtained from diet. ‫ي‬
‫الغذائ‬ ‫النظام‬ ‫من‬ ‫عليها‬ ‫الحصول‬ ‫يجب‬
→ Deficiency of some macro minerals can lead to serious health problems.
→ Many minerals are found in water.
Note: major minerals: essential mineral nutrients found in human body in
amounts larger than 5g; called macrominerals. ‫المعادن‬
‫ألرئيسية‬
‫الموجودة‬ ‫األساسية‬ ‫المعدنية‬ ‫المغذيات‬
‫من‬ ‫ر‬
‫أكب‬ ‫بكميات‬ ‫اإلنسان‬ ‫جسم‬ ‫ي‬
‫ف‬
5
‫ج‬
‫ة‬‫الكبب‬ ‫المعادن‬ ‫تسم‬ ‫؛‬ ‫ام‬‫ر‬ .
Type of minerals:
1. Macrominerals:
→ Examples: Calcium, Chloride, Magnesium, Phosphorus, Potassium,
Sodium, Sulphur, Silicon.
2. Microminerals:
→ Examples: Chromium, Copper, Fluorine, Iodine, Iron, Zinc.
Sodium: ↓
Function: Maintains normal fluid and electrolyte balance.
Source: Table salt, soy sauce.
Deficiency: Muscle cramps, mental apathy, loss of appetite.
Chloride: ↓ is major anion outside cells, associates closely with sodium.
Function: Maintains normal fluid and electrolyte balance.
Source: Table salt.
Adults: (2300mg/day 19-50yrs), (2000mg 51-70yrs), (1800mg >70yrs).

Potassium:↓ like sodium & chloride, that plays an important role in maintaining fluid balance.
Function: Maintains normal fluid & electrolyte balance. ‫السوائل‬ ‫توازن‬ ‫عىل‬ ‫يحافظ‬
Source: All whole foods → Meats, Milks, Fruits, Vegetables, grains, legumes.
Deficiency: Irregular heartbeat, muscular weakness, glucose intolerance.
Toxicity Symptoms: Muscular weakness.
Calcium:↓
Function: Mineralization bones and teeth.‫واألسنان‬ ‫العظام‬ ‫دعم‬
Source: Milk and milk products, small fish, legumes, broccoli.
Deficiency Symptoms: (Stop growth in children), (Osteoporosis in Adults).
Toxicity Symptoms: Constipation.
Phosphorus:↓
Function: Mineralization of Bones and Teeth, part of every cell ‫خلية‬ ‫كل‬‫من‬ ‫جزء‬ ‫ي‬
‫وه‬ ‫واألسنان‬ ‫العظام‬ ‫دعم‬
Source: All animal tissues (Meats, fish, poultry, eggs, milk)
Deficiency Symptoms: Muscular weakness, bone pain.
Toxicity Symptoms: Calcification kidneys.‫الكىل‬ ‫تكلس‬

Magnesium:↓
Function: Bone mineralization, Building of protein, Functioning
Immune system.
Source: Nuts, legumes, whole grains, dark green vegetables, seafood chocolate, coca
Deficiency: Convulsions, Bizarre muscle movements (eye & face).
Toxicity : From non food only (diarrhea, alkalosis, dehydration).
Sulphur:↓
Sources: Meats, eggs, milk, legumes, onions and garlic.
Function: Cellular respiration, protein synthesis, maintains Skin, hair, nails.
Deficiency: Acne, nerve disorders, migraines muscle pain, inflammation.
Copper:↓
Sources: Meats, drinking water.
Function: Helps formation RBC’s. ‫ء‬‫ا‬‫ر‬‫الحم‬ ‫الدم‬ ‫يات‬‫كر‬‫تكوين‬ ‫ي‬
‫ف‬ ‫يساعد‬
Deficiency: Damages Bone and Nervous tissue, Cause anemia.

Iodine:↓ ‫اليود‬ ‫مصادر‬ ‫سكند‬ ‫سؤال‬
Sources: Dairy products‫األلبان‬ , Vegetables, iodized, Salt.
Function: Main component thyroid hormone.( ‫ي‬
‫الرئيس‬ ‫)المكون‬.
Deficiency: Causes Goiter.(‫الدرقية‬ ‫الغدة‬ ‫)تضخم‬.
Iron: ↓
Hemoglobin is essential for transferring oxygen in your blood from the lungs to the tissues.
Myoglobin, in muscle cells, accepts, stores, transports and releases oxygen.
Sources: Red meats, Legumes, green leafy vegetables, whole grain, eggs.
Function: Helps Formation hemoglobin in blood.
Deficiency: Anemia.
RDA:
▪ (Men: 8mg/ day). (Women 18mg/day 19-50 yrs), (8mg/day 51+).
Zinc: ↓
Sources: Meats, Seafood, Whole grain breads, dried beans‫مجففة‬ ‫فاصولية‬.
Function: Many enzymes such as digestion, Sexual reproduction, Repair cells.
Deficiency: Depresses growth, diarrhea, Delayed sexual maturation, Alopecia, eye & skin lesions.

Diet-planning principles:
1. Adequacy. ‫كفاية‬
2. Balance. ‫التوازن‬
3. kCalorie (energy) control. )‫(الطاقة‬ ‫ارية‬‫ر‬‫الح‬ ‫ات‬‫ر‬‫السع‬ ‫ي‬
‫ف‬ ‫التحكم‬
4. Nutrient Density. ‫المغذيات‬ ‫كثافة‬
5. Moderation. ‫االعتدال‬
6. Variety. ‫التنوع‬
Food should contain:
1. Natural foods. ‫أ‬
‫طعمة‬
‫طبيعية‬
2. Nutritional foods. ‫أ‬
‫طعمة‬
‫غذائية‬
3. Fresh foods. ‫طازجة‬ ‫أطعمة‬
4. Seasonal foods. ‫موسمية‬ ‫أطعمة‬
5. Clean foods. ‫أطعم‬
‫ة‬
‫نظيفة‬
Key Recommendations for healthy diet:
1. limit intakes of saturated, sugars, salt , alcohol.
2. Weight Management.
3. Physical Activity → Walk or exercise every day 25 – 30 Minutes.
4. Consume sufficient amount of fruit, vegetables, milk, whole grains.
5. Consume less than 10% from saturated fats, less 300mg cholesterol/day, Fat
intake between 20% and 35%.
6. Choose fiber rich fruits, Vegetables, beverages.
7. Little salt (Less than 2300mg sodium or approximately 1 teaspoon salt/day.
8. To avoid microbial food borne illness, keep food safe: clean hand, food
contact surfaces, fruits vegetables.
9. Avoid unpasteurized milk, Avoid undercooked eggs, meat, poultry, fish.
Few thing to maintain healthier diet and lifestyle:
1. Avoid additives. ‫المعلب‬ ‫الطعام‬
2. Avoid soft drinks. ‫المنكهات‬
3. Avoid refined sugars (use natural brown sugar).
4. Avoid red meat.
5. Avoid chemicals in food.

-amran-Applied Nutrition.pdf

Recommended

Recommended

More Related Content

Similar to -amran-Applied Nutrition.pdf

Similar to -amran-Applied Nutrition.pdf (20)

More from AmranOdeh

More from AmranOdeh (18)

Recently uploaded

Recently uploaded (20)

-amran-Applied Nutrition.pdf