Food? Anything eaten or drunk which can be ingested, digested and absorbed by the body. Used as: Energy Source Building, repair or protective material Nutrition? “Food at work” Process by which all body parts receive and utilize nutrients Nutrients? Components or Chemicals in food needed to grow, reproduce and lead healthy life Macro Nutrients Carbohydrates Proteins Fats Water Micro Nutrients Vitamins Minerals

1. -Anu Chopra
12 Dec. 2014

2. Food and Nutrition
Food?
Anything eaten or drunk which can be ingested, digested and
absorbed by the body.
Used as:
Energy Source
Building, repair or protective material
Nutrition?
“Food at work”
Process by which all body parts receive and utilize nutrients
Nutrients?
Components or Chemicals in food needed to grow, reproduce
and lead healthy life

3. Food and Nutrition (cont …)
Optimum Nutrition
Nutritional status
Malnutrition
 Under nutrition
 Over nutrition
Signs of Good Nutrition
 Shiny hair
 Smooth skin
 Clear eyes
 Alert expression
 Well developed bone structure
 Resistance to diseases
 Regular sleep and elimination habits
 Increased life span

4. Food Components
Macro Nutrients
Carbohydrates
Proteins
Fats
Water
Micro Nutrients
Vitamins
Minerals

5. Food Pyramid

6. Food Groups
Vegetable and Fruit
Green and Yellow vegetables and fruits
Amla-guava-citrus fruits
Whole grains
Plant oils
Pulses
Egg, Fish and poultry
Low fat dairy and soy products
Nuts and oilseeds
Sugar and Jaggery

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Proteins - Introduction
Greek word meaning Prime Importance
Building blocks of human body
75% of body solids is Proteins
Organic Substances made of Amino Acids
Nitrogenous compounds
Must for growth and repair of all cells and tissues

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Proteins - Sources
Lean meat
Lean poultry
Fish
Milk, cheese and yogurt
Beans
Eggs
Nuts, seeds and peanut butter
Fish
Milk
Soya
Bean

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Complementary Proteins

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Proteins – Digestions and absorption
Mouth
No digestion
Stomach
Pepsin Enzyme acts in an acidic medium
Small Intestine
Trypsin, Chymotrypsin and Carboxypeptidase
Enzymes break proteins into amino acids
Absorption of amino acids takes place in GIT

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Proteins – Functions
Growth and maintenance
Source of energy (4KCal/gm)
Regulation of body processes
Immunoglobins or antibodies
Hormones (Insulin, TSH)
Enzymes
Contractile Proteins (Actin and Myosyin in muscles)
Structural Proteins (Collagen, Keratin)
Transport Proteins (Hemoglobin)

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Proteins – Deficiency and Excess
Deficiency leads to PEM
Excess (more than 2gm/Kg body wt. for prolonged
period)
Kidney failure
Increased Calcium excretion
Allergies

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Protein Requirement
Males – 0.9 to 1.0 gm/Kg body weight
Females – 0.8 to 0.9 gm/Kg body weight
10-35% of calories should come from protein sources.
Excess protein beyond what is recommended provides no additional
benefits toward athletic performance or muscle building.
Only athletic training builds muscle.
Requirement may vary under certain conditions
 Physiological state
 Calorie adequacy
 Protein quality
 Physical exercise
 Heat and environment
 Metabolic stress
 Infection

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Lipids - Introduction
Lipids – Heterogeneous compounds including fats,
oils, waxes
Insoluble in water
Soluble in organic solvents like ether and chloroform
Concentrated form of energy (9KCal/gm)
Complex molecule made of fatty acids and glycerol
Liquid at 200
C?
Yes – Fat
No – Oil
Less Oxygen compared to Carbohydrate

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Fatty Acids

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Fatty Acids - Classification
Essential
Cannot be synthesized by body
E.g. Linoleic (omega-6) and Linolenic (omega-3) acid
Help in brain development, retinal function and preventing
dermatitis
Act as precursors of hormone like substance called
EICOSANOIDS (prostaglandin, thromboxane, leukotrines)
which help in regulation of BP, heart rate, blood clotting
and immune response
Non-Essential
Can be synthesized by body
E.g. Palmitic acid, Oleic acid.

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Fats – Digestion and
absorption
Mouth
No digestion
Stomach
No digestion
Only fat size is reduced
Small Intestine
Hormone cholecystokinin is secreted which control secretion
of bile (produced by liver, and stored in gall bladder)
Pancreatic and intestinal lipase act on fat in alkaline medium
and break into fatty acids and glycerol
Absorption takes place in Small Intestine
Excess is stored in adipose tissue

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Fats – Functions
Source of energy (9kcal/gm)
Supplies heat and insulation
Provides padding around vital organs
Carrier of fat soluble vitamins (A, D, E, K)
Provides satiety value
Add flavor and texture to food
Protein sparing action
Cholesterol helps in synthesis of sex hormones
EFA needed for maintenance of body functions

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Fats – Deficiency and Excess
Deficiency
Leads to failure in growth and reproduction
In infants eczema of skin
Excess
Obesity
Digestion and absorption of food is slowed
Calcium absorption decreases
Ketosis occurs

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Fats - Sources
Plant sources
Nuts and oil seeds (Peanuts, soybean, palm)
Hydrogenated vanaspati, margarine
Cereal, pulses and fruits are poor sources
Animal Source
Pork, poultry, eggs, dairy products

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Fat – Requirement
20-30% of total calories should come from fat
 Majority coming from unsaturated fats and less than
10% from saturated fats
SFA:MUFA:PUFA should be 1:1.5:1
Omega-6:Omega-3 should be 4:1

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Cholesterol
White soft waxy compound found in
blood stream and body cells
Use to form cell membranes,
hormones, brain and nerve cells
2gm synthesized daily
Stored in liver
Found only in animal food
Normal level – 150-200 mg/100 ml
blood
Rich sources
Egg yolk, organ meats, dairy fat
Lipoprotiens help to transport

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Vitamins - Introduction
Organic compounds required in minute
amounts
Required to maintain growth and normal
metabolism
Do not provide any energy
Most vitamins cannot be synthesized by body

24. Vitamin A (retinol, carotene)
Vitamin A is fat-soluble vitamin needed for the normal
structure and functioning of the cells in the skin and body
linings, e.g. in the lungs.
This vitamin also helps with vision in dim light, as well a
keeping the immune system healthy.
It is found in two forms; retinol in foods from animal
sources and carotenoids (the most abundant of which
is the beta-carotene) from plant sources.
Vitamin A – retinol is found in liver and whole milk,
Vitamin A – carotenoids are found in dark green leafy
vegetables, carrots and orange coloured fruits.

25. Too much or too little?
Deficiency leads to poor vision in dim light or night blindness.
Severe deficiency can lead to total blindness.
Vitamin A is stored in the liver and too much vitamin A can
be toxic.
Consuming too much vitamin A whilst being pregnant has
been linked to birth defects.

26. Vitamin D (Cholecalciferol)
Vitamin D is needed for the absorption of calcium and
phosphorous from foods, to keep bones healthy.
Recent research also suggests that vitamin D enhances immune
function and improves muscle strength.
Vitamin D is found in the diet, but most of our vitamin D is
made in the body the action of ultra violet rays on the skin.
Vitamin D occurs naturally in some animal
products, including fish liver oils, oily fish,
egg yolk, and butter.
Cereals, margarine and low fat spreads are
also fortified with vitamin D.

27. Too much or too little?
Deficiency of vitamin D leads to rickets and the formation of
soft bones. This causes the bones in the legs to bend. Deficiency
in adults causes Osteomalacia resulting in pain and muscular
weakness.
Vitamin D can be stored by the body. Too much vitamin D can
lead to excess levels of calcium in the blood.
Young children, housebound older adults, and people who
practice religions where their skin must be covered, may be at
risk of deficiency through lack of exposure of their skin to
sunlight.

28. Vitamin E (Tocopherol)
Vitamin E is a group of similar molecules with common
properties and functions.
Vitamin E acts as an antioxidant and protects cells in the body
against damage.
Vitamin E is mainly found in vegetable oils, nuts,
seeds and wheat germ.

29. Deficiency and excess of
vitamin E
A deficiency in this vitamin is rare because it is so widely
available in the diet.
In very rare cases neurological disabilities such as lost reflexes
have developed.
Vitamin E has a low toxicity, but in very large doses may
interfere with absorption of vitamin A.

30. Vitamin K
Vitamin K is needed for normal clotting of blood and is
also required for normal bone structure.
Infants are given vitamin K at birth.
Vitamin K is also produced by the bacteria in the gut.
Vitamin K is found in green leafy vegetables e.g.
broccoli, lettuce, cabbage, spinach and meat and
dairy products.

31. Too much or too little?
Deficiency of vitamin K is rare in
adults, but is sometimes seen in
new born babies.

32. Thiamin (B1)
Thiamin is needed for the release of energy from
carbohydrate. It is also involved in the normal functioning of
the nervous system and the heart.
Thiamin is mainly found in whole grains, nuts, meat
(especially pork), fruit and vegetables and fortified
cereals.

33. Too much or too little?
Thiamin deficiency can lead to the development of the disease
beri-beri. Symptoms include fatigue, weakness of the legs and
anorexia.
As the body excretes any excess thiamin, there is no evidence
of any toxic effects of high doses.

34. Riboflavin (B2)
Riboflavin is needed for the release of energy from
carbohydrate, protein and fat.
It is also involved in the transport and metabolism of iron in
the body and is needed for the normal structure and function
of skin and body linings.
Riboflavin is found in milk, eggs, rice, fortified
breakfast cereals, liver, legumes, mushrooms and green
vegetables.

35. Too much or too little?
There is no deficiency related disease, however, the tongue,
lips and skin become affected when the body is low in
riboflavin.
As the body excretes any excess thiamin, there is no evidence
of any toxic effects of high doses.

36. Niacin (B3)
Niacin is important for releasing energy from food, and is
important for the normal structure of the skin and body
linings.
Niacin is also needed for the normal functioning of the
nervous system.
Niacin can be found in meat, wheat and maize flour,
eggs, dairy products and yeast.

37. Too much or too little?
Deficiency of niacin can result in the disease pellagra.
Symptoms can include:
• dermatitis;
• dementia;
• diarrhoea.
Problems associated with excessive intakes are rare.

38. Vitamin B12
Vitamin B12 is needed for the formation of red blood
cells and the normal functioning of the nervous system.
Vitamin B12 also helps to release energy from food.
Vitamin B12 is found exclusively in animal products,
plant products do not provide any vitamin B12.
It is found in meat, fish, cheese, eggs, yeasts
extract and fortified breakfast cereals.

39. Deficiency of vitamin B12
Deficiency of vitamin B12 can lead to pernicious anaemia.
It can also lead to some neurological problems.
Deficiency is rare, but may be a problem for people following
strict vegan or vegetarian diets.

40. Folate (Folic acid)
Folate is important for the formation of healthy red blood cells.
It is also needed for the nervous system and specifically for the
development of the nervous system in unborn babies.
It can reduce the risk of neural tube defects in a fetus, e.g.
spina bifida.
Good sources of folate include green leafy
vegetables brown rice, peas, oranges, bananas and
fortified cereals.

41. Deficiency of folate
Deficiency of folate can lead to megaloblastic anaemia.
Symptoms can include insomnia, depression and
forgetfulness.
It is recommended that all women who are planning a
pregnancy take a daily supplement of folic acid. Once
pregnant, supplementation should continue for the first 12
weeks to reduce the risk of neural tube defects.

42. Vitamin C (Ascorbic acid)
Ascorbic acid is needed to make collagen which is required
for the normal structure and function of body tissues, such as
skin, cartilage and bones.
It also acts as an antioxidant that protects the body from
damage by free radicals.
Sources of ascorbic acid include fresh fruits, especially
citrus fruits and berries, green vegetables, peppers
and tomatoes. Ascorbic acid is also found in potatoes
(especially in new potatoes).

43. Too much or too little?
Scurvy can result from lack of ascorbic acid. It tends to occur
in infants and the older adults.
Scurvy leads to spots on the skin, bleeding gums and loose or
loss of teeth.
Over nutrition of ascorbic acid is rare.

44. Minerals
Minerals are inorganic substances needed by the body for
many different functions.
Some minerals are needed in very tiny amounts, these are
known as trace elements, such as fluoride.

45. Calcium (Ca)
Calcium is important for the formation and maintenance of
strong bones and teeth, as well as the normal functioning of
nervous system and muscles.
It is also involved in blood clotting.
Milk and dairy products are the most important sources
of calcium. Other sources include bread, calcium
enriched soya products, green leafy vegetables and fish
with soft edible bones.

46. Too much or too little?
Poor intakes of calcium can result in poor bone health which
can increase the risk of diseases such as osteoporosis later in
life.
Taking high doses of calcium supplements can cause stomach
pains and diarrhoea.

47. Iron (Fe)
Iron is needed for needed for the formation of haemoglobin
in red blood cells which transport oxygen around the body.
It is also required for energy metabolism and has an
important role in the immune system.
Haem iron is present in animal sources in the form
of haemoglobin.
Non haem iron is present in plant sources such as
beans, nuts, dried fruits, wholegrains, soya bean
flour and dark green leafy vegetables.

48. Too much or too little?
A lack of iron will lead to anaemia. Symptoms include:
feeling of tiredness;
lacking in energy;
general weakness;
poor concentration.
Too much iron in the diet can result in constipation,
nausea and vomiting.

49. Phosphorus (P)
Phosphorus is essential for the structure bones and teeth, for
the structure of cell membranes and for energy metabolism.
Phosphorus is found in red meat, dairy products, fish,
poultry, bread, rice and oats.

50. Potassium (K)
Potassium is essential for water and electrolyte balance and
normal functioning of cells, including nerves.
Potassium is present in all foods, but found richly in fruit
(dried fruits, bananas, berry fruits), leafy green
vegetables (e.g. broccoli and spinach) meat, nuts,
seeds and pulses.

51. Sodium (Na)
Sodium is needed to regulate body water content and
electrolyte balance.
Sodium is also needed for the absorption of some nutrients
and water from the gut.
Sodium is present in very small amounts in raw
foods. It is often added as salt during processing,
preparation, preservation and serving.
High salt processed foods include bacon, cheese,
yeast extract and smoked fish.

52. Too much or too little?
Consuming too much sodium increases the risk of high blood
pressure. High blood pressure is linked with an increased risk
of heart disease and stroke.
Sodium deficiency is unlikely, but can be caused by excessive
sweating or vomiting and diarrhoea.
It is recommended that adults and children over the age of 11
years cut down on salt and consume no more than 6g per day.

53. Fluoride (F)
Fluoride is needed for the formation of strong teeth and
protects against dental decay (caries).
Fluoride is a trace element, therefore only a small amount is
required for good health.
Fluoride can be found in drinking water and in small
amounts in tea and saltwater fish.
Some areas add fluoride to the drinking water.
Fluoride toothpastes are another important source.

54. Too much or too little?
An excessive intake of fluoride can lead to mottling or
discolouration of teeth.

55. Nutrient interactions
Some nutrients work together in the body completing
different functions.
For example:
• the vitamins A,C and E;
• calcium phosphorus and fluoride;
• calcium and vitamin D;
• iron and vitamin C;
• carbohydrates and B vitamins.

56. Anti-oxidants
Vitamins A, C and E are anti-oxidants and work together in
the body to protect cells against oxidative damage from free
radicals.
This damage to cells can increase the risk of developing
diseases such as heart disease and cancer.

57. Calcium, phosphorus and
fluoride
These nutrients are involved in the mineralisation of teeth
and bones which keep them hard and strong.
Vitamin D and calcium
Vitamin D controls the amount of calcium available.
A lack of vitamin D in the body results in reduced
absorption of calcium.

58. Iron and ascorbic acid
Ascorbic acid aids the absorption of non haem iron (non meat
sources of iron) when eaten at the same time.
This is particularly important for people following strict vegan
or vegetarian diets.

59. Carbohydrates and Vitamins B
Riboflavin and thiamin are involved
in the release of energy from
carbohydrate.

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Water
Body’s transport medium – nutrients, gases and
waste products
Lubrication of our joints
Proper muscle contraction
Temperature regulation
% Body
Weight Loss
Symptoms
0.5 Thirst
2 Loss of appetite, discomfort
3 Dry mouth, impaired physical performance
5 Difficulty in concentrating
8 Dizziness, mental confusion, weakness
10 Muscles spasm

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Diet Planning Principles
Consume enough to meet needs for energy
and for essential nutrients – Adequacy
Proportion of foods in diet – Balance
Energy balance – Calorie Control
Nutrient vs. Energy content – Nutrient
Density
All foods can fit in a good diet – Moderation
Wide selection from all food groups – Variety

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Diet Planning – other considerations
Family needs – different age groups
Save time and energy
Economic consideration and easy availability
Likes and dislikes
Religious and social considerations

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Exchange List
Grouping of foods in which the carbohydrates, fats,
proteins, and calories are similar for the serving sizes
listed
Why? Convenience, variety, adequacy
For example, one can substitute one chapati with other
cereals such as rice, bajra, bread or noodles, etc. – in
the amount that gives approximately the same
carbohydrates as one chapati.
The various groups for which exchange can be done
are cereals, meat, milk and milk products, legumes and
grams, fats and oils, fruits and vegetables.

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Cereal Exchange
No Name Raw Amount (g) Household
Measures
1 Idli 30 2
2 Dosa 30 1
3 Poha 30 ¾ Katori
4 Porridge 30 1 Katori
5 Chapati 30 1 (6-inch)
6 Bread 40 2 (small)
7 Rice 30 1 Katori
8 Glucose Biscuits 15 2-3
9 Marrie 25 4-5
CALS: 100kcal, CHO: 21 g, PRO: 3 g, FAT: 0.5g

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Pulse Exchange
No Name Raw Amount (g) Household
Measures
1 Dal (Moong, Masur, Tur) 30 1 Katori
2 Whole Pulses (Rajma,
Channa)
30 1 Katori
3 Rasam 30 2 Katoris
CALS: 100kcal, CHO: 17 g, PRO: 7 g, FAT: 0.5g
No Name Raw Amount (g) Household
Measures
1 Soya bean 23 1 Katori
CALS: 100kcal, CHO: 4.7 g, PRO: 10 g, FAT: 4.5 g

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Meat and Egg Exchange
No Name Raw Amount (g) Household
Measures
1 Chicken 90 5 medium pieces
2 Goat meat (lean) 80 4 medium pieces
3 Fish 115 3 pieces
CALS: 100kcal, CHO: 0 g, PRO: 20 g, FAT: 2 g
No Name Raw Amount (g) Household
Measures
1 Egg, whole 50 1
CALS: 85kcal, CHO: 0 g, PRO: 6.7 g, FAT: 6.7 g
No Name Raw Amount (g) Household
Measures
1 Egg white 30 1
CALS: 15kcal, CHO: 0 g, PRO: 3.6 g, FAT: 0 g

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Vegetable Exchange
No Name Raw Amount (g) Household
Measures
1 Palak 100
2 Lettuce, Cabbage 100
3 Cauliflower 100
4 Tomato 100
5 Bhindi 100
6 Cucumber 100
CALS: 20kcal, CHO: 5 g, PRO: 0 g, FAT: 0 g
No Name Raw Amount (g) Household
Measures
1 Carrots 100
2 Onions 100
3 Mushrooms 115
4 Potato 50
CALS: 50kcal, CHO: 10 g, PRO: 2 g, FAT: 0 g

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Fruit Exchange
No Name Raw Amount (g) Household
Measures
1 Bananas 45 2 small
2 Pear 100 1 small
3 Apple 85 1 medium
4 Orange 110 1 medium
5 Mango 40 2 slices
6 Watermelon 300 2-3 slices
7 Grapes 75 18-20
CALS: 50kcal, CHO: 12.5 g, PRO: 0 g, FAT: 0 g

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Milk Exchange
No Name Raw Amount Household
Measures
1 Cow’s Milk 150 ml 1 cup
2 Paneer (Cow’s Milk) 30 g 4 cubes
3 Curd 150 g ¾ Katori
CALS: 100 kcal, CHO: 4 g, PRO: 5 g, FAT: 7 g
No Name Raw Amount Household
Measures
1 Buffalo Milk 85 ml ½ cup
CALS: 100 kcal, CHO: 5 g, PRO: 4.3 g, FAT: 6.5 g
No Name Raw Amount Household
Measures
1 Skimmed Milk 350 ml 2 cups
CALS: 100 kcal, CHO: 16 g, PRO: 8.8 g, FAT: 0.4 g

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Fat Exchange
No Name Raw Amount Household
Measures
1 Oil/Ghee 11 g 2 tsp
2 Butter 14 g 3 tsp
CALS: 100 kcal, CHO: 0 g, PRO: 0 g, FAT: 11 g

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Food Guide Pyramid
• Dairy = calcium,
carbohydrate, protein,
riboflavin, vitamin D,
magnesium, zinc
• Meat = protein, thiamin,
riboflavin, zinc niacin, B6,
folate, B12, magnesium, iron
• Fruits or Vegetables =
carbohydrate, vitamin C,
vitamin A, magnesium,
potassium, dietary fiber,
folate
• Grains = carbohydrate,
thiamin, riboflavin, niacin,
folate, magnesium, iron,
zinc, dietary fiber

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Nutrition Assessment of Individuals
Historical information
Health status
Medications
Family history
Marital status, ethnic background,
Education level, drug and alcohol

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Anthropometric Data
Height
Weight
Triceps Skinfold
Head Circumference in infants and children
Compared to standards for age group used over time

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Steps in Meal Planning
1. Calculate Ideal Body Wt (IBW)
 Height (cm) – 100, for Males
 Height (cm) – 105, for Females
1. Energy Needs
 Depending on wt. and physical activity
Activity Calories per Kg IBW
Obese Normal Underweight
Sedentary 20-25 30 35
Moderate 30 35 40
Heavy 35 40 45

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Steps in Meal Planning (cont …)
3. Distribution of Calories
 15-18% From Proteins
 60-70% from CHO
 20-25% from Fats
4. Prepare Master Exchange List
 To arrive at required calories, CHO and Fats
5. Prepare a sample menu
6. Counseling Tips
• Express empathy
• Reflective listening
• Positive re-enforcement
• Visual aids
• Eye contact