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SlideShare utilise les cookies pour améliorer les fonctionnalités et les performances, et également pour vous montrer des publicités pertinentes. Si vous continuez à naviguer sur ce site, vous acceptez l’utilisation de cookies. Consultez notre Politique de confidentialité et nos Conditions d’utilisation pour en savoir plus.
Dr. Dalia El-Shafei
Assoc. prof., Community Medicine Department, Zagazig
Identify sources, functions, effect of deficiency of nutrients.
Understand the characteristics of adequate, balanced diet.
Develop a diet plan by using the dietary guides and nutritional pyramid.
Describe diets for vulnerable groups.
Understand the causes, manifestations and control of malnutrition problems.
Explain methods of assessment of nutritional status.
Describe diet plans for selected chronic diseases (therapeutic diet).
• The dynamic processes by which the body can utilize the consumed food for energy
production, growth, tissue maintenance and regulation of body functions.
• A chemical substance that is present in food & needed by the body in amounts of g. as
macronutrients (carbohydrates, proteins, fats) or mg. or µg. as micronutrients
(vitamins, minerals) for energy production, growth and regulation of body functions.
• Anything liquid or solid formed of different nutrients & utilized by the body for
energy production, growth, tissue maintenance, and regulation of body functions.
• The whole daily consumed food.
• The unit of measure used to express the fuel value produced from food. It equals
the amount of heat needed to raise the temperature of 1 liter of water 1°C.
• The food which is free of artificial or natural harmful
compounds, not contaminated with infectious agents or
toxins or heavy metals and not polluted by radiation.
• The availability of food in adequate quantity & quality
with reasonable price at any time for all groups of
• Providing of food of a high nutritive value to vulnerable
groups at low prices or free of charge e.g., milk powder
for infants, flour, cheese & cereals for pregnant &
• Addition of a certain nutrient to a particular food in which
it is deficient to improve its nutritive value, e.g, addition
of I2 to table salt, iron to flour, vitamins A & D & E to
vegetable oils & powdered milk.
• Addition of certain nutrients to food which lost during
food baking or processing as addition of vit.B to flour &
vit.C to milk.
are needed in
proteins and fats.
which are needed
in milligrams or
Water: it forms
about 70% of
Formed for C-H-
Carbon atom is
the source of
They are mainly
found in plant
foods (made by
Only animal food
is milk “source of
for babies before
they be able to
eat solid food”
About 50-55% of
by the guidelines
for healthy diet”.
FUNCTIONS OF CARBOHYDRATES:
gram → 4
Aid in more
Functions of soluble fibers (as
white apple, pectins, beans….etc)
• ↓ total serum cholesterol level because
they absorb bile salts in intestine, so
liver consumes more amount of
cholesterol to form more bile salts.
• Help promote normal blood glucose
level (delay digestion).
• Enhance body use of insulin in insulin
resistance syndrome as all types of fibers
contribute to low glycaemic index meals.
Functions of insoluble fibers (as
apple skin, cellulose….etc)
• Absorb water 10-15 times their
volume, so add bulk to food.
• Satiating action.
• Stimulate intestinal motility, so
prevent constipation→ ↓colonic
pressure & ↓ absorption of toxins and
carcinogens from colon.
DISORDERS OF EXCESS CARBOHYDRATE INTAKE:
(EXCESS SUGAR INTAKE)
↑ Insulin output
• ↑ tendency for blood
• More rapid return to
hunger pains after a big
All fats are lipids but not all lipids are fats
Formed of C-H-O atoms with greater
concentration of carbon → more energy
values “1gm →9 kcals”.
Fats in our bodies (in adipose tissue) 95%
are triglycerides which are formed of 3 fatty
acids + 1 molecule glycerol (water-soluble
carbohydrate) which allows the transport of
fats through the water-based blood stream.
FATTY ACIDS: ARE CLASSIFIED INTO
Saturated F.A. (SFA): hard in
room temp., mainly animal fats,
coconut oil, palm oil.
Unsaturated F.A. (USFA):
liquid in room temp., mainly
vegetable oils (olive oil, corn
oil, sunflower oil & cotton seed
Essential F.A.: cannot be
synthesized in the body as:
Linoleic, Linolenic &
Non-essential F.A.: can be
synthesized by the body.
FATS: • The most concentrated source of energy: 1gm →9 kcals.
• Sparing burning of protein if carbohydrate deficient.
• Sources of essential fatty acids.
• Give satiety & add flavor and palatability to food.
• Promote absorption of fat-soluble vitamins.
• Insulate & control body temperature.
• Protect body organ by cushioning.
• Provide some structural components as cell membranes, axon sheath of nerve
cells and some digestive hormones and enzymes.
• Omeg-3 fatty acids: unsaturated F.A. (EPA-DHA) found in fish oils (sardines,
salmon and mackerel) and have the following functions:
• ↓arterial stiffness. -↓clotting time of blood.
• ↓ risk of cancer. - ↓inflammation process. -↑level of H.D.L.
• Functions of olive oil: (monounsaturated F.A.):
• Improve insulin resistance syndrome status. -Elevate HDL level.
Fats in cold water fish are mainly Omega-3 F.A. which do not
solidify in the very cold arctic water. Imagine that would happen to
these fish if their body fat consisted of saturated fat, they would
solidify and sink. Therefore, fish from cold arctic waters have to be
high in Omega-3 F.A. to survive
TYPES OF CHOLESTEROL:
HDL cholesterol has more protein
than LDL or VLDL which allows
more cholesterol to be taken from
the body cells resulting in removal
of cholesterol through the liver.
Very low density
FUNCTIONS OF CHOLESTEROL:
It is a fat-related substance as it does not produce energy, formed in
animal liver only, so not found in plant food (vegetable oils).
adrenal & sex
Precursor of bile
salts which are
essential for fat
NORMAL BLOOD LEVEL
Total < 200 mg/dl
LDL-C <130 mg/dl
>40 mg/dl for
>50 mg/dl for
EFFECT OF EXCESS FAT INTAKE
Overweight & obesity.
↑LDL-C & triglycerides in blood → atherosclerosis & CHD.
Diabetes mellitus type II & gall bladder stones.
Repeated heating of vegetable oils (USFA) →transformation into SFA
“junk foods with repeated frying of oils”.
Margarine which is trans-FA (hydrogenated saturated vegetable oils) & promotes
CVD as it ↑ LDL-C & ↓ HDL-C despite it does not contain cholesterol. Butter
contains cholesterol & SFA but it ↑ both LDL-C & HDL-C.
Proteins are formed
of amino acids
SOURCES OF PROTEIN (TYPES OF PROTEINS):
Contain the essential amino
Animal foods as meat, fish,
Not contain all the essential
amino acids & contain the
other non-essential amino
Vegetable foods as cereals,
It is an ideal
Contains all the
essential A.A. in
& utilizable by
human milk &
FUNCTIONS OF PROTEINS
Body building & growth (formation, maintenance and
repair of cells).
Formation of essential components: hormones,
enzymes, immune cells, immunoglobulins &
Regulation of fluid movement of blood by control of
Regulation of acid-base balance (control movement
of chemical ions in & out of the cells).
Production of energy: 1 gram → 4 kcals.
DEFICIENCY OF PROTEINS:
Functions of Water:
Aids in digestion,
& excretion processes.
Serves as a solvent for
body constituents & as
a medium for all
chemical reactions in
Carries nutrients to &
waste products from
cells as a part of the
lubrication of the
moving parts in the
Water requirements: “Adults : 1ml/K.cal., Infants: 1.5 ml/K.cal”.
• Essential compounds that can’t
be manufactured by the body
in sufficient amount & have to
be supplied by food.
• Classified into:
Vitamins B group & Vitamin
Vitamins A, D, K, E.
“Absorbed from the intestine
with the dietary fat through the
lymphatic system & stored in
liver & not excreted in urine”.
Minerals (essential elements)
• Inorganic elements
• Classified into:
Major minerals: as calcium
phosphorus, sodium, chlorine,
potassium, magnesium and
Trace elements: as iron, zinc,
iodine, selenium, manganese,
chromium and copper.
Fat-sol. Vit. & sources Functions Deficiency
Vit. A (Retinol)
- Precursor: carotene
In: Liver, Butter, egg yolk, Dark green leafy
vegetables, Deep yellow & orange vegetables
- Constituent of visual
- Necessary for growth and
-Rough dry skin.
- [Ergocalciferol (D2)] - [Cholecalciferol (D3)]
-7-dehyrocholesterol (in skin)
- formed by U.V.R in the skin
In:- Cod liver oil -egg yolk -fish with bones
-Promotes absorption of
calcium & phosphorus.
-Favors deposition of
calcium in bones.
-Reduces excretion of
phosphorus in urine.
Vit. E (Tocopherol):
Whole grain cereals, Legumes, nuts, fish, Green
- Hemopoiesis (protects
RBCs from haemolysis)
-Anemia in premature
Vit. K (Mendione):
Dark green leafy vegetables, Egg yolk, cheese,
- Synthesized by intestinal bacteria
- Formation of
prothrombin and other
Vit. B1 (Thiamin):
Whole grains -yeast -Organ meats -
- Helps in carbohydrate metabolism
- Promotes good functioning of nervous
system and other systems.
Vit. B2 (Riboflavin):
Whole grains, yeast -Organ meats,
eggs, milk, milk products, green leafy
Helps in metabolism of carbohydrates,
proteins and fats.
- Cheilosis - Cataract
Vit. B3 (Niacin):
Whole grain cereals -Legumes, yeast -
meat, meat organs
-Carbohydrate metabolism - Pellagra
Vit. B12 (Cobalamin):
Animal source protein only as: meat,
- Hb Synthesis & Formation of RBCs.
-Folic acid metabolism
Folic acid (Folacin):
Dark green leafy vegetables, legumes,
whole grain cereals, meats, eggs
- Formation of RBCs -Megaloblastic anemia
- Neural tube defect.
Vit. C (ascorbic acid):
Citrus fruits, tomatoes, strawberries,
green leafy vegetables, green peppers,
- Antioxidant - Wound healing
-Collagen tissue formation -Iron
-Connective tissues of blood vessels
- Scurvy - Anemia
Major minerals Functions Deficiency
Calcium (Ca++): Milk – milk products
- green leafy vegetables - sardines,
salmon with bones
-Bone and teath formation
- Aids in blood coagulation
-Helps in muscles contractions
-Aids in enzymatic functioning
-Rickets - Osteomalacia
- Osteoporosis -Poor blood
Phosphorus (P3-): Milk – milk
products – egg yolk – meat – nuts –
legumes – whole grains
-Bone and teeth formation
-Aids in acid-base balance
-Fragile bones -Stiff joints
Potassium (K+): Banana, orange,
apricots, carrots, potatoes –meats,
milk, milk products -legumes,
-Key role in acid-base balance
-Aids in enzymatic reactions
- ↓heart rate -bone
Sodium (Na+): (In sodium
chloride)Common salt, naturally in
vegetables and milk
-Maintenance of acid-base balance
-Control of muscle contractions
-disturbed muscle action
Magnesium (Mg++): Dark green leafy
vegetables -whole grains, nuts-bran -
banana – apricots - sea foods -tea –
-Bone and teeth formation
-Protein synthesis & lipid metabolism
-Regulates heart beats
-C.N.S. problem, as: confusion,
apathy, hallucinations -
Minerals “Trace elements” Functions Deficiency
Haeme sources: liver, red meat
Non haeme source: Dark green leafy
vegetables, legumes, whole grains,
molasses, dried fruits
-Essential for formation of
haemoglobin (in RBCs)
-Part of enzymes and proteins.
Selenium (Se): Meat, eggs, liver,
whole grain cereals, sea foods, garlic
-Antioxidant -↓ cancer risk
-Plays a role in prevention of HIV
-Plays a key role in immune system
Iodine (I-): Fish in salt, water,
vegetables grown in iodine-rich soil
-Regulates energy metabolism as a
part of thyroid hormone
Zinc (Zn++): Whole grains, wheat
germ, liver, yeast, sea foods, milk
-Growth & reproduction
-Immunity, neurological functions
& smell acuity.
-Retarded growth &
Copper (Cu++): Shellfish, liver, nuts,
while grains, chocolates
-Information & survival of RBCs
-In lipid metabolism
Chromium (Cr+++): Liver, whole
grains cheese, legumes, yeast
-Activate enzymatic action
-Enhances removal of glucose from