MACRONUTRIENTS , MICRONUTRIENTS , WATER, CALORIE INTAKE , RECOMMENDED DIETARY INTAKE , DIET MYTHS , HEALTHY DIET , MALNUTRITION

1. NUTRITION
-KARISHMA SACHDEV
1st year MPT(Neurological and
Psychosomatic Disorders)

2.  Macronutrients –Carbohydrate ,Protein , Fat
 Micronutrients- Vitamins , Minerals
 Water
 Energy content of a meal from its macronutrient composition.
 MyPyramid recommendations
 Busting Diet Myths
 Malnutrition
 Recommended Dietary Allowances And Guidelines

3. Macronutrients are those nutrients that the body needs in large
amounts. These provide the body with energy (calories).
Micronutrients are those nutrients that the body needs in smaller
amounts.
NUTRIENTS
MACRONUTRIENTS MICRONUTRIENTS

5. CARBOHYDRATES
MONOSACCHARIDE
GLUCOSE
FRUCTOSE
GALACTOSE
DISACCHARIDE
SUCROSE
LACTOSE
MALTOSE
POLYSACCHARIDE
PLANT POLYSACCHARIDE
STARCH
(complex
carbohydrates)
FIBER
ANIMAL POLYSACCHARIDE
GLYCOGEN

6. • Muscle glycogen serves as the major source of
carbohydrate energy for active muscles during
exercise.
• In contrast to muscle glycogen, liver glycogen
reconverts to glucose for transport in the blood to the
working muscles.
• Glycogenolysis describes this reconversion process
• Glycogen glucose
• it provides a rapid extra-muscular glucose supply.
• Depleting liver and muscle glycogen through dietary
restriction or intense exercise stimulates glucose
synthesis from structural components of the other
macronutrients
• (principally protein’s amino acids) through the process
of gluconeogenesis.

7. • Elevated blood sugar cause the pancreas’ beta cells to secrete additional insulin that facilitates
the muscles’ uptake of the glucose excess, inhibiting further insulin secretion.
• If blood sugar decreases below normal (hypoglycemia), the pancreas’ alpha cells immediately
secrete glucagon to increase glucose availability and normalize the blood sugar level.

8. • Fibres hold considerable water and give “bulk” to the food residues in the intestines, often
increasing stool weight and volume by 40% to 100%.
• This bulking-up action may aid gastrointestinal functioning and reduce the chances of
contracting colon cancer and other gastrointestinal diseases.
• Increased fiber intake, particularly water soluble fibers may modestly reduce serum
cholesterol.
• Dietary fiber intake of between about 20 to 40 g per day depending on age and gender (ratio
of 3:1 for water-insoluble to soluble fiber) plays an important part of a well-structured diet.
 Persons with marginal levels of nutrition should not consume excessive fiber because
increased fiber intake decreases the absorption of calcium, iron, magnesium, phosphorus,
and trace minerals.

10. Carbohydrates serve three primary functions related to energy metabolism and
exercise performance:
1. Energy source.
Powers muscle action (particularly high-intensity exercise) and other more “silent” forms of biologic work
For physically active people , maintains the body’s limited glycogen stores.
If dietary carbohydrate intake exceeds the cells’ capacity to store glycogen, the carbohydrate excess readily converts
to fat, thus triggering an increase in the body’s total fat content.
2. Protein sparer
Adequate carbohydrate intake preserves tissue proteins.
Normally, protein contributes to tissue maintenance, repair, and growth and as a minor nutrient energy source.
With reduced glycogen reserves, gluconeogenesis synthesizes glucose from protein (amino acids) and the glycerol
portion of the fat molecule (triacylglycerol).
This metabolic process increases carbohydrate availability and maintains plasma glucose levels under three
conditions:
a. Dietary restriction
b. Prolonged exercise
c. Repeated bouts of intense training

11. • 3. Metabolic primer.
• By products of carbohydrate breakdown serve as a “primer” to facilitate the body’s use of fat for
energy, particularly in the liver.
• Insufficient carbohydrate metabolism increases dependence on fat utilization for energy.
• The lack of adequate byproducts of glycogen catabolism produces incomplete fat breakdown
with accumulation of ketone bodies (acetoacetate and -hydroxybutyrate, acetone-like
byproducts of incomplete fat breakdown).
• In excess, ketone bodies increase body fluid acidity to produce a potentially harmful condition
called acidosis or, specifically with regard to fat breakdown, ketosis.
• When this happens, the body cannot generate a sustained high level of aerobic energy transfer
from fat-only metabolism.
• This consequence reduces an individual’s maximum exercise intensity.

12. 4. Fuel for the Central Nervous System
• The central nervous system requires carbohydrate for proper functioning.
• Under normal conditions, the brain uses blood glucose almost exclusively for fuel without
maintaining a backup supply of this nutrient.
• In poorly regulated diabetes, during starvation, or with a low carbohydrate intake, the brain
adapts metabolically after about 8 days to use relatively large amounts of fat (in the form of
ketones) as an alternative to glucose as the primary fuel source.
• At rest and during exercise, the liver serves as the main source to maintain normal blood glucose
levels. In prolonged intense exercise, blood glucose eventually decreases below
• normal levels because of liver glycogen depletion and active muscles’ continual use of available
blood glucose.
• Symptoms of a modest hypoglycemia include feelings of weakness, hunger, and dizziness.
• This ultimately impacts exercise performance and may partially explain “central” or neurologic
fatigue associated with prolonged exercise or starvation.
• Sustained and profound hypoglycemia can trigger unconsciousness and produces
irreversible brain damage.

13.  The glycaemic index serves as a relative (qualitative) indicator of carbohydrates’ ability
to increase blood glucose levels.
 Digestion and absorption rates of different carbohydrate-containing foods might explain
the carbohydrate intake–diabetes link.

15. In contrast, diets with fiber-rich, low-glycemic carbohydrates tend to
lower blood glucose and the insulin response after eating, improve
blood lipid profiles, and increase insulin sensitivity.
Type 2 diabetes results when the pancreas cannot produce sufficient
insulin to regulate
blood glucose or becomes insensitive to the effects of insulin, causing
it to rise.
Thus requiring progressively greater insulin output to control blood
sugar levels.
Consistently eating such foods can reduce the body’s sensitivity to
insulin (i.e., the body resists insulin’s effects).

16. LIPIDS
SIMPLE
LIPIDS
Saturated
Fatty Acids
Unsaturated
Fatty Acids
COMPOUND
LIPIDS
Phospholipids Glucolipids Lipoproteins
HDL LDL
VLDL Chylomicrons
DERIVED
LIPIDS
Cholesterol

18. • Lipoproteins serve important functions because they constitute the main form for lipid
transport in the blood.

20. Cholesterol participates in many complex bodily processes, including the
following five functions:
1. Builds plasma membranes
2. Precursor in synthesizing vitamin D
3. Synthesizes adrenal gland hormones, including estrogen, androgen, and progesterone.
4. Serves as a component for bile (emulsifies lipids during digestion)
5. Helps tissues, organs, and body structures form during fetal development.
Five rich sources of cholesterol include:
1. Egg yolk
2. Red meats
3. Organ meats (liver, kidney, and brains)
4. Shellfish (shrimp, lobster, crab, scallops, clams, oysters, mussels
5. Dairy products (ice cream, cream cheese, butter, and whole milk)
Foods of plant origin contain no cholesterol.

21. Trans-fatty acids derive from the hydrogenation of unsaturated corn, soybean, or sunflower oil.

22. Why they are increasingly being used?
• to keep processed foods fresher longer
• so fats can be reused more often in deep-frying
• to improve the flavour and texture of some foods such as
baked goods
Permissible limit:
WHO recommendation: Limited to less than 1% of total
energy intake. It has called for the total elimination of TFAs
in global food supply by 2023.
FSSAI has proposed to limit TFA limit in foods to 2% and
eliminate trans fats from foods by 2022.

25. Four important functions of lipids in the body include:
1. Energy reserve
2. Protection of vital organs and thermal insulation
3. Transport medium for fat-soluble vitamins
4. Hunger suppressor (reduces over eating)- satiety after meals

26. Proteins are large biomolecules, or macromolecules, consisting of one or more long chains of
amino acid residues.

29. • For adults, the recommended protein intake equals
0.83 g per kg of body mass.
• Protein breakdown above the resting level occurs
during endurance and resistance training exercise to
a degree greater than previously thought.
• Athletes in intense training should consume between
1.2 and 1.8 g of protein per kg of body mass daily.
• Reduced carbohydrate reserves from either diet or
exercise increase protein catabolism, making it
imperative to maintain optimal levels of glycogen
during strenuous training.
Recommended Protein Intake

32. Intestinal bacteria
K1
K2

33. Wernicke's Encephalopathy
rice
Diarrhoea,Dementia, Dermatitis

35.  Vitamins C and E and BETA carotene(VIT A) serve key protective antioxidant
functions. A diet with appropriate levels of these micronutrients reduces the potential for
free radical damage (oxidative stress) and may protect against heart disease and
cancer.
 Excess vitamin supplementation does not improve exercise performance or the potential
for sustaining hard, physical training. Serious illness can occur from regularly consuming
excess fat-soluble and, in some cases, water-soluble vitamins.

39. 1.Water constitutes 40% to 70% of an individual’s total body mass. Muscle contains 72%
water by weight, and water represents only about 50% of the weight of body fat.
2. Approximately 62% of total body water occurs intracellularly (inside the cells), and 38%
occurs extracellularly in the plasma, lymph, and other fluid outside the cell.
3.The normal average daily water intake of 2.5 L comes from liquid intake (1.2 L), food
(1.0 L), and metabolic water produced during energy-yielding reactions (0.3 L).
4. Daily water loss occurs through urine (1.0–1.5 L), through the skin as
insensible perspiration (0.35 L) and sweat (500–700 mL), as water vapor in
expired air (0.25–0.35 L), and in feces (0.10 L).

40. Water serves six important functions:
1. Provides the body’s transport and reactive medium.
2. Diffusion of gases occurs across moist body surfaces.
3. Waste products leave the body through the water in
urine and feces.
4. Absorbs considerable heat with only minimal
changes in temperature from its heat-stabilizing
qualities.
5. Watery fluids lubricate joints, keeping bon
surfaces from grinding against each other.
6. Being noncompressible, water provides structure
and form through the turgor it imparts to the body’s
tissues.

41. HOW TO DISTINGUISH AMONG HEAT CRAMPS, HEAT EXHAUSTION, AND
HEAT STROKE

45. • Key principles of good eating include variety, balance, and moderation.
• The pyramid is based on the 2005 Dietary Guidelines for Americans
published by the Department of Health and Human Services and the
Department of Agriculture.
• A personalized pyramid is obtained by logging on to the website.
• www.mypyramid.gov

48. • Protein is bad for you
The Truth: Protein, even in large amounts, isn’t harmful to your bones or
kidneys (unless you suffer from a pre-existing condition).
• Carbohydrates are bad for you.
The Truth: As long as you do not overindulge, there is nothing inherently
about carbohydrates.
• Eating fat will make you fat.
The Truth: If you stay in a caloric surplus, a low-fat diet won’t make you
lose weight. You need some omega-3 and omega-6 fatty acids, and
necessarily give you a heart attack (but too much trans fat may).
• Egg yolks are bad for you
The Truth: Compared to egg whites, the yolk contains most of an egg's
good stuff, including the bulk of its iron, folate and vitamins. The yolks also
contain two nutrients—lutein and zeaxanthin—that support eye and brain health.

49. • Foods labeled “natural” are healthier
The Truth: Overall, the “natural” label isn’t tightly regulated. Importantly, neither
the USDA nor the FDA defines “natural” in relation to the healthfulness of the
words, a “natural” label doesn’t guarantee the product is healthful (though it
• You should “detox” regularly
You’re supposed to be cleansed of…?
The Truth:
Well, detox-diet companies don’t really know. A 2009 investigation of ten
they couldn’t name a single “toxin” eliminated by any of their fifteen products.
When a substance really is noxious, a “detox diet” won’t help.
Your liver, kidneys, lungs, and other organs work around the clock to remove
substances and excrete the waste products of metabolism.
What explains their current popularity? One answer is: quick weight loss.
from carbs and you can exhaust its glycogen stores in as little as 24 hours.
• Eating often will boost your metabolism
The Truth: Digestion does slightly increase your metabolic rate, but your meals’
frequency will have less effect on your weight than their total caloric content at
day.

50. • To lose fat, don’t eat before bed
The Truth: Eating late won’t make you gain weight, unless it drives you to
eat more. Resisting tasty, high-calorie snacks can also be harder after a
• To lose fat, do cardio on an empty stomach
The Truth: There’s very little difference between cardio in the fed or fasted
state with regard to fat loss, muscle preservation, daily caloric intake, or
What really matters, then, is you. Fed or fasted state: pick whichever
better.
• You need protein right after your workout
The Truth: Unless you’ve been exercising on an empty stomach, you don’t
need protein immediately after your workout, but you might benefit from
grams per kilogram of body weight (0.11–0.27 g/lb) within the next
What matters most, however, is how much protein you get over the course
• Salt is bad for you
The Truth: Salt reduction is important for people with salt-sensitive
hypertension, and excessive salt intake is associated with harm. But a
drastic decrease in salt intake has not shown uniform benefit in clinical
trials. Most people will benefit more from a diet of mostly unprocessed
foods than from micromanaging their salt intake.

51. • When it comes to figuring out what to eat for
weight loss, the most important factor is
eating less.
• When you consume less calories than you
spend you will lose weight and the diet that
helps you lose weight best will be the one that
allows you to consume less calories without
causing much distress or lethargy.
The key is to pick a diet that you can adhere to.

52. • But what about the magic of fad diets?
• Many diets, fad or not, do work.This is mainly because they reduce calories.
• Several diets restrict your carbohydrate intake:
• The Ketogenic Diet is very high in fats, low in proteins, and very low in carbohydrates.
• The Atkins Diet is high in fats, high in proteins, and very low in carbohydrates.
• The “Paleo Diet” (hunter-gatherer diet) is high in fats, high in proteins, and low in carbohydrates.
• Fats and proteins digest more slowly than carbohydrates, so are more satiating.
• In addition, most diets (including the three already mentioned) recommend the consumption of
foods that are less calorie-dense (more fibers and a higher water content: a pound of broccoli packs
less calories than a pound of grains).
• Finally, carbohydrates participate in the synthesis of serotonin, which can cause cravings in some
obese individuals.

53. • Therefore, people on a low-carb diets lose weight because they naturally eat less and avoid
the large binges caused by carbohydrate cravings.
• People on very-low-carb diets can also lose weight very quickly on the short term because the
depletion of their glycogen stores leads to the excretion of bound water.
• That explains why two trials found that people on a low-carb diet had lost more weight than
people on a low-fat diet after 6 months but not 12.
• Consuming your macronutrients together (balanced diet) or separately (dissociated diet, also
known as “food combining”) makes no difference with regard to weight or fat loss.
• Since prolonged fasting might increase heat expenditure, diets that manipulate fasting
(Intermittent Fasting, Alternate Day Fasting) may have some benefits on the “calories out”
side of things.
• Yet, even here, weight lost is mostly due to the fact that you control eating: It is much harder
to overeat in 8 hours than in 16.

54. ..DownloadsHPDP-Diabetes_dash eating plan.pdf

55. The World Health Organization (WHO) defines malnutrition as "the cellular
imbalance between the supply of nutrients and energy and the body's demand for
them to ensure growth, maintenance, and specific functions."
Malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of
energy and/or nutrients.
The term malnutrition addresses 3 broad groups of conditions:
1. undernutrition, which includes wasting (low weight-for-height), stunting (low
height-for-age) and underweight (low weight-for-age);
2. micronutrient-related malnutrition, which includes micronutrient deficiencies (a
lack of important vitamins and minerals) or micronutrient excess; and
3. overweight, obesity and diet-related noncommunicable diseases (such as heart
disease, stroke, diabetes and some cancers)

60. Marasmus – Represents simple starvation . The body adapts to a chronic state of
insufficient caloric intake
(severe weight loss or wasting )
Kwashiorkor – It is the body’s response to insufficient protein intake but usually
sufficient calories for energy
bloated appearance due to water retention (bi-lateral oedema).
Marasmic -kwashiorkor – a combination of both wasting and bi-lateral oedema.
It is a group of body depletion disorders which include kwashiorkor, marasmus
and the intermediate stages.

69. • Inadequacies in intake of vitamins and minerals often referred to as micronutrients, can
also be grouped together.
• Micronutrients enable the body to produce enzymes, hormones, and other substances that
are essential for proper growth and development.
• Iodine, vitamin A, and iron are the most important in global public health terms; their
deficiency represents a major threat to the health and development of populations
worldwide, particularly children and pregnant women in low-income countries.

70. • Overweight and obesity
• Overweight and obesity is when a person is too heavy for his or her height. Abnormal or
excessive fat accumulation can impair health.
• In adults, overweight is defined as a BMI of 25 or more, whereas obesity is a BMI of 30 or
more.
• Overweight and obesity result from an imbalance between energy consumed (too much) and
energy expended (too little). Globally, people are consuming foods and drinks that are more
energy-dense (high in sugars and fats), and engaging in less physical activity.
• Diet-related noncommunicable diseases
• Diet-related noncommunicable diseases (NCDs) include cardiovascular diseases (such as
heart attacks and stroke, and often linked with high blood pressure), certain cancers, and
diabetes. Unhealthy diets and poor nutrition are among the top risk factors for these diseases
globally.

71. ..DownloadsRDA_short_report.pdf
..DownloadsMy_Plate_08-2020.pdf
..DownloadsDietaryGuidelinesforNINwebsite
.pdf

76. • Essentials of Exercise Physiology Fourth Edition -McArdle , Katch & Katch
• Examine.com
1.^ Strasser B, Spreitzer A, Haber P. Fat loss depends on energy deficit only,
independently of the method for weight loss. Ann Nutr Metab. (2007)
2.^ Astrup A, Meinert Larsen T, Harper A. Atkins and other low-carbohydrate diets:
hoax or an effective tool for weight loss. Lancet. (2004)
3.^ Golay A, et al. Similar weight loss with low-energy food combining or balanced
diets. Int J Obes Relat Metab Disord. (2000)
• K PARK – Textbook of Preventive And Social Medicine
• O.P GHAI Essential Paediatrics - 8th Edition
• WHO
• ICMR- National Institute of Nutrition India

77. THANK YOU