Nutrition is the study of foods and their relationship to health. Nutrients are substances that provide energy, build cells and tissues, and regulate bodily functions. The essential nutrients humans must obtain from food include water, protein, fat, carbohydrates, vitamins, and minerals. Carbohydrates provide energy and assist immune function, while fats supply energy, fill cells, and aid nutrient absorption. Proper nutrition maintains health and prevents deficiency diseases.

1. Nutrition

2. Nutrition
Nutrition
 “Nutrition is the science of foods and their components (nutrients
and other substances)including the relationship to health and
disease; processes within the body; and the
social.economic,cultural and psychological implications to
eating".
 "Nutrition is the relationship of foods to the health of the human
body and this concerns the actions, interactions and balances
of nutrients. The process within the body include
ingestion,absorption,metabolism of nutrients and excretion of
end-products."
 Nutrition is the study of foods in relation to health. One author
(Rinzler,2004)has a three-word definition. "nutrition equals life.
 "All living cells need food and water to live. If human beings
don't eat and drink, they will die. The primary components in
food are the energy givers and the nutrients; both need water as
the medium of their activities. It is the kind and quantity of the
food and water that one consumes that determines the quality of
life one desires

3. Essential Nutrients
 A nutrient is any substance, organic or inorganic ,that
can supply energy, build and repair cells and tissues,
and regulate life processes. Some nutrients are needed
by animals. Other than human being.
 An essential nutrient cannot manufactured in the body
in adequate amounts needed for specific functions.it
has to be supplied from food or from a nutritional
supplement. The more appropriate term to use is
"dietary supplement" versus "nonessential nutrients" that
are manufactured in the body or have precursors from
dietary intake that can become essential nutrients.

4. Essential Nutrients
 An essential nutrient is linked to a specific deficiency disease.
For example, a child who lacks protein for extended periods of
time develops the protein-deficiency disease known as
kwasiorkor.persons who do not get enough vitamin C develop
the vitamin C deficiency disease,scurvy.The main treatment of
the deficiency disease is to supply the specific nutrient that
was inadequate. However, other nutrients are also needed
because of interrelationships among nutrients.
 Not all nutrients are essential for all species of animals. For
example, vitamin C is an essential nutrient for human beings,
but not for dogs. A dog's body makes Vitamin C it needs.
 The study of essentiality for a nutrient is a continuous process.
The science of nutrition involves dynamic changes. To date,
there are at least 45 individual nutrients essential fro human
beings. Choline was the most recently added to the list only in
2002.It is possible that he future researchers may reveal
additional nutrients. Changes in the list of essential nutrients are
evident when one compares the Tables of Recommend Dietary
Allowances (RDAs) for nutrients and readings from textbook
since 1940.

5. Nutriture or Nutritional Status
Nutriture, which means refers to the condition of how well-
nourished the human body, depends on several criteria, such
as physical signs and symptoms of good nutrition, medical
history, blood and urine tests, anatomical changes seen in
imaging or x-rays and other medical instruments, and history
of dietary intake up to current food habits.
Malnutrition
Mal-means "bad", thus malnutrition is an undesirable state of
one's health, which could either be an undernourished
individual or someone who is overnourished.The former may
be caused by starvation, inadequate supply of one or more
nutrients or/and energy, or it could be a secondary effect of a
metabolic disorder or a medical condition that interfere with
nutritional processes in the body. Examples of over-nutrition
are cases of obesity or toxic effects from excessive intake of
specific nutrients.

6. Essential nutrients for human
beings
Water
Fat/Lipids
Vitamins
FAT/LIPID CARBOHYDRATE
WATER PROTEIN
S S MINERALS
VITAMINS
Protein

7. Essential nutrients for human
WATER beings

8. Water is essential to life and nutritional health.
Humans can live for several weeks without food,
but we can survive only a few days without
water. Approximately 60% of the adult human body
is composed of water
Function:
Transports nutrients and oxygen into cells
Moisturizes the air in lungs
Helps with metabolism
cushions our vital organ
Helps our organs to absorb nutrients better
Regulates body temperature
Detoxifies
Protects and lubricates our joints
Prevents dehydration

9. Deficiencies:
 dehydration Toxicity;
 kidney stones  dilution of important
 sodium imbalance electrolytes (mineral
 orthostatic hypotension salts) that may lead
hyponatremia to erratic heart
 hypertension rhythm and death
 indigestion, constipation
and heartburn
Main Source:
 contributes to memory loss Water
 dry skin
If you're not sure about your
hydration level, look at your recommended eight
urine. If it's clear, you're in 8-ounce glasses of
good shape. If it's dark, you're water a day
probably dehydrated

12. Fat
Essential nutrients for human
Essential nutrients for human
beings
beings
Fats- are organic compounds
that are made up of carbon,
hydrogen, and oxygen. They are
a source of energy in foods. Fats
belong to a group of substances
called lipids, and come in liquid
or solid form. All fats are
combinations of saturated and
unsaturated fatty acids.

13. Fat Essential nutrients for human
Essential nutrients for
beings
human beings
Function:
 Fat is one of the 3 nutrients (along with protein and
carbohydrates) that supply calories to the body.
 provides 9 calories per gram,
 essential for the proper functioning of the body. Fats
 provide essential fatty acids
 serves as the storage substance for the body's extra
calories
 fills the fat cells (adipose tissue) that help insulate the
body
 an important energy source.
 helps for maintaining healthy skin and hair
 helps the body absorb and move the vitamins A, D,
E, and K through the bloodstream.

15. Food Sources
These are the biggest dietary cause of high LDL levels ("bad cholesterol").
When looking at a food label, pay very close attention to the
percentage of saturated fat and avoid or limit any foods that are high.
Saturated fat should be limited to 10% of calories.
Saturated fats are found in animal products such as
 butter, cheese, whole milk, ice cream, cream, and fatty meats. They
are also found in
 some vegetable oils -- coconut, palm, and palm kernel oils.
(Note: Most other vegetable oils contain unsaturated fat and are
healthy.)

16. UNSATURATED FATS
help to lower blood cholesterol if
used in place of saturated fats.
However, unsaturated fats have a
lot of calories, so you still need to
limit them. Most (but not all) liquid
vegetable oils are unsaturated.
 (The exceptions include coconut,
palm, and palm kernel oils.)

17. (A) Monounsaturated Fats.
These fats are also called MUFA – Monounsaturated fatty
acids. As explained above they have only one double
bond between the carbon atoms.
Examples of Monounsaturated fatty acids:
Palmitoleic acid and Oleic acid.
Natural Sources of Monounsaturated Fats.
1) Whole milk products.
2) Red meat.
3) Fruits like olives and avocado.
4) Nuts.
5) Oils such as Tea seed oil, Olive oil, Canola Oil,
Grape seed oil, Macadamia oil, Groundnut or peanut
oil, Sesame oil, Corn oil, Safflower oil, Sunflower oil,
Camellia.
6) Whole Grain wheat cereal.
7) Oatmeal.

18. A.Monounsaturated fats:
When there is only one
carbon atom with a
double bond, it becomes
monounsaturated fat as
shown above.
B.Polyunsaturated fats:
When there are more than
one carbon atoms with a
double bond, it is called
polyunsaturated fat as
shown above.

19. Benefits and Advantages of
Monounsaturated Fats.
help in lowering the low density
lipoprotein (LDL) or the bad cholesterol
in the blood.
Help to maintain a healthy lipid profile.
Disadvantages of Monounsaturated
Fats.
These fats are more vulnerable to
rancidity than saturated fats.
They are known to increase insulin
resistance – that is makes insulin less
effective

20. About (B) Polyunsaturated Fats
Or polyunsaturated fatty acids have more than one double bond
between the carbon atoms in their molecular structure as explained
and shown above. That is there are more than one carbon atoms
which do not have a hydrogen atom attached to them.
Omega-3 fatty acids and Omega-6 fatty acids are two
polyunsaturated essential fatty acids which are not manufactured
by the body and have to be obtained from dietary sources.
Food Sources of Polyunsaturated Fats.
1) Whole Grain Wheat.
2) Bananas.
3) Sunflower seeds.
4) Hemp seeds. Essential
5) Peanut butter. nutrients
6) Margarine. for
7) Fish especially wild human
salmon and fish oil.
beings
8) Nuts.
9) Leafy green vegetables.
10) Algae
11) Krill

21. Essential Fatty Acids (EFAs)
• Essential Fatty Acids (EFAs) are necessary fats that
humans cannot synthesize, and must be obtained
through diet. EFAs are long-chain polyunsaturated fatty
acids derived from linolenic, linoleic, and oleic acids.
There are two families of EFAs: Omega-3 and Omega-6.
Omega-9 is necessary yet "non-essential" because the
body can manufacture a modest amount on its own,
provided essential EFAs are present. The number
following "Omega-" represents the position of the first
double bond, counting from the terminal methyl group on
the molecule. Omega-3 fatty acids are derived from
Linolenic Acid, Omega-6 from Linoleic Acid, and
Omega-9 from Oleic Acid.

22. Omega-3 derived from Linolenic Acid
FUNCTION
 formation of cell walls, making them supple and
flexible,
 improving circulation and oxygen uptake with proper
red blood cell flexibility and function.
 reduce the risk of heart attack
 inhibit the growth of prostrate cancer
 reduced risk of breast cancer
 prevents hypertriglyceridemia
 prevents angina
 prevents atherosclerosis
 prevents bipolar disorder
 prevents cardiac arrhythmias
 prevents hypercholesterolemia
 prevents dementia
 prevents depression

23. Omega-3 deficiencies:
 to decreased memory and mental abilities,
 tingling sensation of the nerves,
 poor vision,
 diminished immune function,
 increased triglycerides and "bad" cholesterol (LDL) levels,
 impaired membrane function,
 hypertension,
 irregular heart beat,
 learning disorders,
 menopausal discomfort,
 itchiness on the front of the lower legs,
 and growth retardation in infants, children, and pregnant women.
 Depression
 Cardiovascular Disease
 Type 2 Diabetes
 Fatigue
 Dry, itchy skin
 Brittle hair and nails
 Joint pain

24. Sources of Omega 3: Flaxseed oil (flaxseed oil has the
highest linoleic content of any food), flaxseeds, flaxseed
meal, hempseed oil, hempseeds, walnuts, pumpkin
seeds, Brazil nuts, sesame seeds, avocados, some dark
leafy green vegetables (kale, spinach, purslane, mustard
greens, collards, etc.), canola oil (cold-pressed and
unrefined), soybean oil, wheat germ oil, salmon,
mackerel, sardines, anchovies, albacore tuna, and
others.

25. TRANS FATTY ACIDS
These fats form when vegetable oil hardens (a process
called hydrogenation)
 can raise LDL levels.
 lower HDL levels ("good cholesterol").
Sources
 commercial baked goods (donuts, cookies, crackers),
 processed foods, and margarines.
HYDROGENATED AND PARTIALLY HYDROGENATED FATS
This refers to oils that have become hardened (such as
hard butter and margarine). Partially hydrogenated
means the oils are only partly hardened. Foods made
with hydrogenated oils should be avoided because they
contain high levels of trans fatty acids, which are linked
to heart disease. (Look at the ingredients in the food
label.)

28. Omega-9 (Oleic Acid)
Essential but technically not an EFA, because the
human body can manufacture a limited amount,
provided essential EFA's are present.
Monounsaturated oleic acid lowers heart attack risk
and arteriosclerosis, and aids in cancer prevention.
Found in foods: Olive oil (extra virgin or virgin),
olives, avocados, almonds, peanuts, sesame oil,
pecans, pistachio nuts, cashews, hazelnuts,
macadamia nuts, etc

29. TRANS FATTY ACIDS
These fats form when vegetable oil hardens (a process
called hydrogenation)
 can raise LDL levels.
 lower HDL levels ("good cholesterol").
Sources
 commercial baked goods (donuts, cookies, crackers),
 processed foods, and margarines.
HYDROGENATED AND PARTIALLY HYDROGENATED
FATS
This refers to oils that have become hardened (such as
hard butter and margarine). Partially hydrogenated
means the oils are only partly hardened. Foods made with
hydrogenated oils should be avoided because they
contain high levels of trans fatty acids, which are linked to
heart disease. (Look at the ingredients in the food label.)

31. What are
Carbohydrates?
 They provide storage and transport of energy
 assist in proper functioning of the immune system
 play major roles in fertilization, pathogenesis,
 blood clotting
 development
Function of Carbohydrates:
 The primary function of carbohydrates is to provide energy for
the body, especially for the brain and nervous system.
 Glucose is the main component of carbohydrates and is used
for energy.
 Carbohydrates are not essential nutrients for humans. The
body can obtain all of its energy from protein and fats.
However, the brain and neurons generally cannot burn fat and
need glucose for energy. The body can make some glucose
from a few of the amino acids in protein and also from
triglycerides (fats).

32. There are two types of
carbohydrate: Carbohydrates are one of the
three macronutrients, a group
complex and simple that also includes protein and fat.

35. Importance of Carbohydrates
Energy Yielding Compounds
 D-Ribose, are the structural elements of nucleic acid and
coenzymes.
 Act as intermediates in hexose monophosphate stant.
 D- Lyxose, a constituent of a lyxoflavin isolated from human
muscle.
 D-glucose carried out by the blood and used in tissues.
 D-fructose can be changed to glucose in the liver and
intestine and used in the body.
 Glycosides are important in medicine.
 Hexosamines is used as antibiotic.
 Monosaccharide are important constitute of nucleotides and
nucleic acids.
 Disaccharides act as an intermediate in the digestion,
important as a dietary constituent and major source of
energy in the diet.
 Starch and glycogen serve as temporary stores of glucose in
plants and animals respectively.

36. Carbohydrates
Functions of Carbohydrates
 Glucose act as energy yielding compounds, the
major fuel of the tissue, constitutes the structural
material of the organism, converted to other
carbohydrates having highly specific functions.
 Glycogen acts as important storage of food material
of the organism.
 Play a key role in the metabolism of amino acids
and fatty acids.
 Act as protective function- mucosubstance.
 Act as intermediates in respiration and
carbohydrates metabolism e.g., (trioses).
 Participate in lipid synthesis.
 Pentoses - Synthesis of nucleic acid; Some co-
enzymes (e.g., NAD, FAD, FMN, etc.); ATP, ADP, AMP,
and also synthesis of polysaccharides.

37. Carbohydrates Deficiency
Hyperglycaemia
Glycosuria
Galactosemia
Pentosuria
Diarrhoea and flatulence
Ketosis
Under weight.
Toxicity :
Getting too many carbohydrates can cause
excessive weight gain, which can lead to
obesity and other health problems

38. Nutrient Distribution in the
Body
Nutrient Distribution in the
Body
 An easy way to remember the relative
distribution of the six groups of nutrients is the
"60-20-20 Rule". The figures below are rounded
and are averages for an adult of normal weight.
 Water is about 60% of total body weight.
 Lipids are about 20% of total body weight.
 About 20% of total body weight is a combination of
mostly protein (Mainly muscle tissues or lean body
mass) plus carbohydrates, minerals and vitamins.
 An infant has more water than the above
average.
 An obese person has more fat relative to the
others.
 Women of the same age and height tend to
have more body fat than males of the same
age and height.

39. Nutrient Distribution in the Body
The Scope of Nutrition and Its Relationship with Other
Disciplines
Nutritional science comprises the body of scientific knowledge
governing the nutritional requirements of humans for
maintenance,growth,activity and reproduction.
Nutrition builds on three fundamental
areas of science:
1.The physical sciences, particularly the anatomy of the body, how
growth and development of cells and organs, physical fitness and well-
being are affected by nutrition.
2.The biological sciences of biochemistry and physiology help us to see how
nutrition relates with how the body works to promote health and wellness
throughout the life cycle. Genetics explains the inherited traits of a person. The
study of genetic nutrition is in its infancy and may explain the familial
tendencies of some diseases that may run in a family tree.
3.The behavioural sciences help us to better understand how nutrition is interwoven with our
unique nature as human beings. Anthropology ,psychology and other social sciences
provide the background of the cultural diversity of people how food habits are formed.
Attitudes toward food and eating patterns develop throughout our life span from the
aculturing influences of faily group. Ethnic/regional group,community,nation,even our
world.

40. Nutrient Distribution in the
Body
How we perceive ourselves and our
food, what we choose to eat, why
we eat what we do and in what
manner, all become integral part of
human nutrition.
As one saying goes," Tell me what
you eat and I can tell you who you
are".

41. A.Water is the most important nutrient. Following
water, the nutrients of highest priority are those that
prove energy, which most be supplied from foods or
can be supplied from quantities stored in the body.
B. Essential nutrients are needed throughout life; only
the amounts of nutrients needed change. The client's
utilization of foods,eaten,stage of growth and
development,sex,body size,weight,physical activity,
and state of health influence nutrient requirements.
C. No single food contains all the essential nutrients
in amounts needed for optimum health.

42. Basic concepts of nutrients
Good nutrition is essential for the following:
 Growth
 Normal organ development and
functioning
 Normal reproduction
 Maintenance and replacement of worn-
out cells and tissues
 Optimum activity level and working
efficiency
 Resistance to infection and disease
 The ability to repair bodily damage or
injury

43. Basic concepts of nutrients
 Proper nutrition means that all the essential nutrients
are supplied and utilized in adequate balance to
maintain optimal health and well -being.
 Most people are interested in how to be assured that
they get proper nutrients in the amounts needed from
daily meals and snacks. They probably recognized
the six classes of nutrients- protein,
carbohydrate,fat,vitamins,minerals and water
although it may surprise some to learn that water
considered a nutrient.
 All the nutrients most of us need can be obtained by
eating variety of different type of foods. It is the
nutrients in food, which are needed.However,in
practice, nutrition educators speak in terms of foods
that they can buy, prepare and serve and not in
terms of the name of the nutrients.

44. Basic concepts of nutrients
Nutrients are important chemical to perform one or
more of the following functions:
1.Furnish fuel needed for energy
2.Provide materials to build,repair,and maintain
body tissues
3.Supply substances that function in the regulation of
body processes.
The fundamental principles of nutrient interaction
state that:
1.Individual nutrients have many specific metabolic
functions, including primary and supporting roles,
and
2.No nutrient ever works alone.

45. Basic concepts of nutrients
Each nutrient has certain special jobs to do
in the building maintenance, and operation
of the body. These jobs cannot be done by
other nutrients-an extra supply of one
cannot make up for a shortage of another.
There are other jobs to be done in the body
that require nutrients to work together as
teams. To build bones, the nutrients vitamin
D, calcium, and phosphorous interact. One
member of the team cannot perform its job
unless all the others are present in the right
amounts.

46. Cumulative Effects Of Nutrition
Cumulative Effects Of Nutrition
Cumulative effects are the results of something that is done repeatedly
over many years.
Example:
 Eating excessive amounts of saturated fats for many years contribute
to atherosclerosis which leads to heart attacks.
 Years of overeating without increasing energy expenditure cause
obesity and may predispose the individual to metabolic diseases like
hypertension, Type 2(non-insulin-dependent) diabetes mellitus,
gallbladder disease,gout,foot problems, certain cancer and even
personality disorder.
Individual at Risk from Poor Nutritional Intake
 Infants and preschool children- depend on their mother's selection of
food.
 Adolescents- like to snack and eat at unusual hours, subject to
"peerpressure,easily influenced by opinions of their friends who eat
"junk" foods.
 Pregnant women-an expectant mother requires a diet that provide
sufficient nutrients for the developing fetus,her own body.
 Elderly-psychological changes like aging affect nutrient intake and
metabolism, lack of dentition, decreases taste senses and
appetite,and lowered resistance o infections.

47. Chapter 2
Common Nutrition
Problems in the
Philippines and
Assessment Of
Nutritional Status

48. The Role of the Food and Nutrition Research Institute in Nutrition
Surveys
The Philippine Plan of Action for Nutrition (PPAN) includes agencies
at national and local levels for carrying out programs and projects
for nutrition improvement in the Philippines. Its research arm is the
Food and Nutrition Research Institute Department of Science and
technology (FNRI-DOST).
Among its Tasks are to:
 Conduct nutrition researches on emerging nutritional problems
and non-communicable nutrition-related diseases.
 Spearhead food and nutrition research and development
activities.
 Develop information technology resources for efficient and
effective use of food and nutrition researches.
 Report changes in the prevalence of under nutrition.
 Update the official statistics on the Philippine nutrition situation
by conducting National Nutrition Surveys (NNS).It provides data
on the per capita food consumption and energy and nutrient
intakes among Filipino households

49. Two Main Nutrition Problems
besetting the country:
 Protein Energy
Malnutrition(PEM)-affecting
young children.
 Micro-Nutrient Deficiencies-
specifically iron -deficiency
anemia, iodine deficiency
disorders and Vit A deficiency.

50. Protein-Energy Malnutrition (PEM).
According to the 2003 results of the 6th National survey, protein-
energy malnutrition continues to persist in the country.
 Among preschool -age children (0-5 years old). 72 out of every
100 are normal.
 Out of 1000,276 are underweight;304 are short and 14 are
overweight. Moreover 55 out of 1000 are thin.
 Among school-age children(6-10years old),72 out of every 100
are normal. Out of 1000,276 are underweight;365 are short and
13 are overweight.
 Among 11-19years old preadolescents and adolescents,155
out of 1000 are underweight while 35 are overweight.
 Among pregnant and lactating owmen,26.6% and
11.7%,respectively,are underweight.
 Among adults,12.3% are Chronic Energy Deficient (CED) and
23.9% are overweight to obese.

51. Protein-Energy Malnutrition
(PEM).

52. Micro-nutrients Deficiencies
 Iron-Deficiency Anemia (IDA)
IDA- condition in which the concentration of
haemoglobin is below the level that is normal for a
given individual. Detected by measuring the blood
haemoglobin level.
 Out of 10 Filipinos,3 are anaemic.
 About 2 out of 3 infants 6 months to and 11 months old
while among<1 year and 1 year old chicldren,53 out
of 100 are anaemic.
 Out of every 1000 pregnant women,439 are anaemic
and 422 out od 1000lactating women are afflicted
with IDA.
 Anemic pregnant women are prone to deliver low
birth-weight babies and are likely to experience labor
complications.
 Children with IDA have short attention span, reduced
ability to learn and are usually irritable.

53. Iron Deficiency Anemia (IDA)
Iron Deficiency Anemia (IDA) that affect the
brain development especially among
children that also causes weak resistance.

54. Iodine Deficiency Disorders (IDD)
IDD refers to spectrum of physical and mental
abnormalities, caused by a simple lack of iodine
in the body.
 Include goiter, mental retardation, deaf-mute
condition,squint,difficulty with standing or walking
normally and stunting the limbs.
 Iodine-deficient women frequently suffer abortion and
stillbirths.
 About 1/3 of the Filipino population is at risk to IDD.
 About 11 out of 100 children have moderate to severe
IDD.
 Incidence of moderate to severe IDD is 18% among
pregnant and 23.7% among lactating women.

55. Iodine Deficiency Disorders
(IDD)
goiter

56. mental retardation

57. Iodine Deficiency Disorders
(IDD)
deaf-mute condition

58. squint, difficulty with standing or
walking normally and stunting the limbs

59. Vitamin A Deficiency (VAD)
VAD results in Xerophthalmia(dryness of the
eye),night blindness(inability to see in the dim
light),eyes sensitive to bright light, rough dry
skin and membranes nose and throat, low
body resistance to disease, poor growth and
blindness in severe cases.
About 4 out of every 10 pre-schoolers are
vitamin A-deficient.
About 175 out of every 1000 pregnant
women are vitamin A-deficient.
About 1 out of every lactating women is
vitamin A-deficient.

60. 1. Night Blindness. Difficulty low body resistance to
seeing in the dark.
2. Xerophthalmia (Dry Eyes).The
disease, poor growth
white of the eye loses its shine
and begins to wrinkle.
3. Bitot's Spots Patches of little Vitamin A
gray bubbles on the whites of
the eye. Deficiency
4. Corneal Ulceration Dullness or
damage to the cornea. (VAD)
5. Keratomalcia Soft or
bulging cornea.

61. Overweight and Obesity
 Almost 24 out of 100 adults are overweight and obese in the 2003
FNRI survey.
 225 out of 1000 adults aged 20 years and over are hypertensive.
About 37% of hypertensive persons have high cholesterol levels.
 Hypercholesterolemia and dyslipidemia are risk factors to
atherosclerosis.
 85 out of 1000 adults aged 20 years and over have elevated total
cholesterol>_240g/ dL.
 Females tend to be more at risk to overweight and obesity than
males. In 2003 FNRI survey prevalence of male adult obesity is 3%
compared to 5.7% to females.
Overweight prevalence in adult males is 17.9% which is lower than the
prevalence in females at 21.5%.
 Older lactating women are more at risk to overweight and obesity
than lactating women.
 The 2003 FNRI survey reports a 3.4% prevalence of diabetes mellitus.
 The death rate from diabetes mellitus increased, from 4.3 per 100,000
population in 1984,to 7.1% per 100,000 population in 1993 (PHS
report,1999)
 Cataract ,neuropathy and cerebral stroke were the most frequently
reported complications of diabetes (1998 study).

63. Causes of Under nutrition in the Philippines
Signs of under nutrition appear when nutritional
reserves are depleted and nutrient energy intake are
insufficient to meet day-to-day needs or added
metabolic stress.

64. Concluding Remarks
Based non the results of the 2003 National
nutrition Survey of the FNRI,the prevalence
of VAD and IDA among children and
women reproductive age continue to be
high, and for children, they're even higher
than that of 1998.Iodine Deficiency
Disorder (IDD) has substantially declined
among children and pregnant women
although remains high among lactating
women. To address on this problem of
micronutrient supplementation, dietary
diversification and food fortification.

65. The main causes of
malnutrition in the Philippines
are:
Poverty
Poor food choices
Large family size
Low level of nutrition education
Poor distribution of food supply
Faulty infant feeding and weaning practices
Poor sanitation with widespread incidence of
parasitism and infectious diseases
Urbanization and other environmental factors.

66. Quick check list on the signs of
good nutrition:
 Alert responsive general appearance
 Shiny, lustrous hair, healthy scalp
 Smooth, slightly moist, good color skin, face and
neck; reddish pink mucous membranes
 Bright clear eyes, no fatigue circles
 Moist lips with good color (not pale)no crack at the
corners
 Good pink color tongue, no swelling or bleeding
,firm
 Straight teeth, no crowding, clean, no
discoloration;wellshaped jaw
 General smooth, slightly moist skin, good color
 Flat abdomen, no swelling, no bloating
 No tenderness of legs and feet, no weakness and
swelling

67. No tenderness of legs and feet, no weakness
and swelling
No skeletal malformations
Normal weight for height, age and body fluid
Erect posture, arms and legs straight, abdomen
I n, chest out
Well developed firm muscles
Nervous control: good attention span for age
Cheerful disposition: does not cry easily, not
irritable nor restless
Good appetite and digestion; normal regular
urination and bowel movement
Has general vitality; energetic; vigorous and
does not easily get tired
Sleeps well at night

68. The ABCD
of Nutritional
Assessment

69. A nthropometric Assessment-method of
measuring the variation of physical dimensions and the
gross composition of the body.
Procedures can assist in the identification of mild;
moderate as well as severe states of malnutrition.
2 Types of Measurement
Growth and Body Composition-subdivided into
measurements of fat-free mass and body fat, the two
major components of total body mass.
 Procedures are simple and safe techniques.
 Equipment required is inexpensive and portable.
 Little training needed for personnel to perform the
measurement.

70. B iochemical Assessment
 Based on laboratory analysis of blood and urine
 Common biochemical indices; serum, albumin,
serum albumin/globulin ratio, total iron binding
capacity, total lymphocyte count, complete blood
cell profile, lipid profile, nitrogen balance,creatinine,
creatinine-height index, urinary ketones, urinary
nitrogen, and other constituents in the urine.
 Procedures need skilled personnel and analytical
equipment that are expensive.
 Results are objective and useful for diagnoses and
therapy.

71. C linical Assessment
 Includes Medical History -nutrition. Drastic recent
major surgery, chewing and swallowing difficulty,
habitual intake of oral contraceptives, antibiotics,
and other drugs with nutrient-drug interaction; and
socioeconomic factors such as poverty, lack of
education and inadequate or poor food habits.
 Vital Signs( height, weight, blood pressure readings
and pulse rate) by nurse or physician assistant.
 Physical examination
 Physician completes head to toe PE.

72. D ietary Assessment
 A 24-hour food recall-asking client to recall actual intake for
the past 24 hours. To determine an overall usual eating pattern
of the individual followed by a food frequency questionnaire to
verify and clarify data.
 Food frequency questionnaire- uses a list of specific food items
to record intakes over a given period(day, week, month
year).Questionnaire can be semi-quantitative when subjects
are asked to quantify usual portion sizes of food items without
the use of food models.
 Three ,five or seven day records -are prepared by the client or
patient for the next day's intakes. One advantage of several
days is to cover lost days when the informant may have
different meal patterns over the weekend or when not in school
or work.
 Weighed food record-is a more involved method that needs
care and accuracy. All food consumed over defined period is
weighed.
 this method is used more for metabolic balance studies or for
controlled laboratory experiments.

73. Concluding Remarks
Based non the results of the 2003 National
nutrition Survey of the FNRI,the prevalence
of VAD and IDA among children and
women reproductive age continue to be
high, and for children, they're even higher
than that of 1998.Iodine Deficiency
Disorder (IDD) has substantially declined
among children and pregnant women
although remains high among lactating
women. To address on this problem of
micronutrient supplementation, dietary
diversification and food fortification.

74. The human body is a
intricate structure
composed of cells,
tissues, and organs.

75. Human body composed of :various tissues
( muscle, bone and adipose)
BONES
ADIPOSE

76. Various Organs
INTESTINES,KIDNEY
BRAIN,LUNGS,HEART

77. various glands(pancreas, thyroid
gland, pituitary gland)

78. cell

80. Function

81. Protein
Food Sources
When proteins are digested, amino acids are
left. The human body needs a number of
amino acids to break down food. Amino
acids need to be eaten in large enough
amounts for optimal health.
Amino acids are found
in animal sources such as
 meats, milk, fish, and eggs
Plant sources such as
 soy, beans, legumes,
 nut butters
 some grains (such as wheat germ).

82. Protein Deficiency
 Abdominal enlargement,
excessive loss in urine and disease
to lower urinary tracts-
 Vomiting
 Diarrhea
 Nephrosis
 Lassitude
 Oedema
 Kwashiorkor (Protein malnutrition)
 Marasmic - Kwashiorkor
 Negative nitrogen balance.

83. Amino acids are classified into two groups:
Essential amino acids cannot be made by the
body. As a result, they must come from food.
The nine essential amino acids are: histidine,
isoleucine, leucine, lysine, methionine,
phenylalanine, threonine, tryptophan, and
valine.
Nonessential amino acids
"Nonessential" means that our bodies produce
an amino acid, even if we don't get it from the
food we eat.
They include: alanine, asparagine, aspartic
acid, glutamic acid,
arginine, cysteine, glutamine, tyrosine, glycine,
ornithine, proline, and serine.

84. 8 Essential amino acids
Tryptophan - a precursor for serotonin and melatonin.
 It is plentiful in chocolate, oats, bananas, dried dates, milk, cottage
cheese, meat, fish, turkey and peanuts.
Lysine - Lysine deficiency can result in a deficiency in niacin (Vitamin B)
and this can cause the disease pellagra.
 beneficial in treating and preventing herpes.
 Lysine sources include green beans, lentils, soybean, spinach and
amaranth.
Methionine - supplies sulphur and other compounds required by the
body for normal metabolism and growth.
 belongs to a group of compounds called lipotropics that help the liver
process fats.
 It is found in fish, whole grains, and dairy.
Valine: needed for muscle metabolism, tissue repair, and for the
maintenance of proper nitrogen balance in the body.
 found in high concentration in the muscle tissue.
 one of the three branched chain amino acids, which means that it
can be used as an energy source by muscle tissue.
 helpful in treating liver and gallbladder disorders, and it is
 good for correcting the type of severe amino acid deficiencies that
can be caused by drug addiction.
 Dietary sources of valine include dairy products, grain, meat,
mushrooms, peanuts, and soy proteins.

85. Leucine: Leucine is a branched chain essential amino acid
 stimulates muscle protein synthesis
 major fuel involved in anabolic (tissue building) reactions
 During times of starvation, stress, infection, or recovery from
trauma, the body mobilizes leucine as a source for
gluconeogenesis (the synthesis of blood sugar in the liver) to aid
in the healing process. It has recently been suggested that
leucine may have beneficial therapeutic effects on the
prevention of protein wasting, as it occurs during starvation, semi-
starvation, trauma, or recovery after surgery.
Leucine is found in
 cottage cheese, sesame seeds, peanuts, dry lentils, chicken, and
fish.
Isoleucine: Isoleucine is a branched chain amino acid
 important for blood sugar regulation,
 muscle development and repair,
 haemoglobin development, and energy regulation. Deficiencies
of isoleucine result in possible dizziness, headaches, fatigue,
depression, confusion and irritability.
Isoleucine is found in eggs, fish, lentils, poultry, beef, seeds, soy,
wheat, almonds and dairy.

86. Threonine:
 important for antibody production.
 It can be converted into glycine and serine.
Deficiencies are rare but can result in skin disorders
and weakness.
 Dietary sources of threonine include dairy, beef,
poultry, eggs, beans, nuts, and seeds.
Phenylalanine: Phenylalanine
 serves in the body as a precursor to the
catecholamine family of hormones. These hormones
include adrenaline and noradrenaline, which are
activating substances in the central and peripheral
nervous systems. Deficiencies are rare but can
include slowed growth, lethargy, liver damage,
weakness, oedema, and skin lesions.
 Food sources or phenylalanine are dairy, almonds,
avocados, lima beans, peanuts, and seeds.

87. Protein

88. Protein
Essential amino acids have been defined as those
amino acids that our body cannot synthesize on its
own. Essential amino acids must therefore be
obtained from our diet.

89. Protein
Two amino acids, histidine and cysteine, are essential to the
new born infants, and histidine may even be essential for adults.
Nonessential amino acids
those that the body can manufacture on its
own.

90. Non-essential amino acids
Alanine
 During exercise, muscle tissue breaks down and toxins
are released. Alanine works to
 remove these toxins so the liver is able to metabolize
them and eliminate them from the body.
 help to keep cholesterol levels in check.
Asparagine
 A requirement in amino acid transformation
 helps the nervous system maintain its equilibrium.
 acts as a detoxifier in the system and regulates
metabolism.
Aspartic Acid
Similar to asparagine, aspartic acid helps
 to elevate metabolic levels.
 Due to its effect on cellular energy, it is sometimes
used to combat fatigue and depression.
 acts as a synthesizer for other amino acids.

91. Cysteine
Non-essential amino acids
Like alanine, cysteine
works as a detoxifier in the body, but also
performs as an antioxidant, combating free-radicals.
strengthens stomach lining and is essential to healthy hair, skin
and nails.
Cystine
Created from the formation of two cysteine molecules,
regarded as a more stable amino acid,
works as a powerful antioxidant and
helps to form strong connective tissues.
responsible for the creation of glutathione,
a vital liver detoxifier
used in topical treatments to maintain youthful-looking skin.
Glutamine
 also aiding in the production of glutathione,
 the most abundant amino acid in the bloodstream.
 proper brain function and digestion
 may possibly help to suppress hunger.

92. Glycine
Non-essential amino acids
 A glucogenic amino acid supplies beneficial glucose the
body needs for energy.
 proper cell growth and function
 crucial to digestive health.
 makes up a large portion of collagen which helps skin retain
its elasticity and healing properties.
Histidine
 Important in the production of red and white blood cells
 helps to repair body tissue.
 Histamine is produced by histidine during an allergic reaction
 responsible for sexual arousal.
 detoxifier.
Proline
 In order for the body to create new, healthy cells, it produces
proline.
 regeneration of skin and helps to reduce sagging and
wrinkles.
 proponent of collagen and cartilage helps keep muscles
and joints pliable.

93. Non-essential amino acids
Serine
 Also derived from glycine, serine is essential to brain
function particularly the chemicals that determine
mood and mental stability.
 found in all cell membranes,
 also aids in muscle formation and immune health.
Taurine
Like glutamine, Taurine is
 a free amino acid that travels through the bloodstream
 detoxifier and digestion aid.
 improve brain function and athletic performance.
Threonine
 A protein balancer in the body,
 helps to form tooth enamel,
 stabilize blood sugar levels and
 assists in healthy liver function.
 acts as a stress reducer and skin rebuilder.

94. Non-essential amino acids
Sources of Non-Essential Amino Acids
Although these nonessential amino acids are
readily available in a healthy human body,
they can also be found in
 whole foods like nuts, grains, meats, fruits and
vegetables, or can be added to the body
through supplements should there be a
deficiency.
Careful monitoring of supplements is advised to
avoid altering the normal balance of citric acid
in the system causing the liver and kidneys to
function improperly.

96. Vitamins
Vitamins are essential organic
substances that are needed in small
amounts in the diet for the normal
function, growth, and maintenance of
body tissues.
Vitamins are
divided into two
groups: Water
Soluble and Fat
Soluble
Essential nutrients for human beings

97. Water-soluble vitamins
consist of the B
vitamins and vitamin
C.
dissolve easily in water and,
in general, are readily excreted from the
body, to the degree that urinary output is a
strong predictor of vitamin consumption
 Because they are not as readily stored, more
consistent intake is important.
Many types of water-soluble vitamins are
synthesized by bacteria
Water-soluble vitamins are easily lost with
overcooking.

98. Vitamin B1 thiamine Food sources
functions as the coenzyme Pork/pork products,
thiamine pyrophosphate (TPP) beef, liver,
yeast/baked
in the metabolism of
products, enriched
carbohydrate and in and whole grain
conduction of nerve cereals, nuts, and
impulses. seeds

99. Toxicity :
none reported

100. Riboflavin (vitamin B2)
 works with the other B
vitamins
 important for body growth
and red blood cell
production
 helps in releasing energy
from carbohydrates.

101. Milk, eggs, mushrooms, Infants: 0.3 – 0.4 mg
Children: 0.5 – 0.6 mg
whole grains, enriched Adolescents: 0.9 – 1.3 mg
grains, Men: 1.3 mg Women: 1.1 mg
Pregnant Women: 1.4 mg
green leafy vegetables, Lactating Women: 1.6 mg
yeast,
liver, and oily fish

102. Niacin Vitamin B3
Works with other
 Pellagra:
vitamins,  diarrhea,
help release energy  dematitis,
from carbohydrates, dementia,
essential for growth  death
and involved in
hormone synthesis

103. Meat, poultry, fish, Infants: 2 – 4 mg NE
Children: 6 – 8 mg NE
yeast, enriched and Adolescents: 12 – 16 mg NE
whole grain breads Men: 16 mg NE
Women: 14 mg NE
and cereals, Pregnant Women: 18 mg NE
peanuts, Lactating Women: 17 mg NE
mushrooms, milk,
and eggs Toxicity
(tryptophan)

104. Pantothenic acid (Vitamin B5 )
Deficiency
Function Infants: 1.7 – 1.8
 headache,
 help to fight mg Children: 2 – 3
 fatigue ,
allergies mg Adolescents:
 impaired
 beneficial in 4 – 5 mg Men &
 muscle
the Women: 5 mg
 coordination,
maintenance Pregnant Women:
 abdominal
of healthy 6 mg
cramps
skin, muscles Lactating
 vomiting. Toxicity
and nerves Women: 7 mg
Sources  Paresthesia
 diarrhea
 Meat ,  digestive
 Broccoli Toxicity  disturbances and
 ,avocados water retention

113. important role in the secretion of hormones,
such as cortisone because of the role it plays
in supporting the adrenal gland.
used in the creation of lipids,
neurotransmitters, steroid hormones
and hemoglobin.
help to fight allergies and are
beneficial in the maintenance of
healthy skin, muscles and nerves.
helpful to fight wrinkles as well as
graying of the hair.

114. Biotin (Vitamin B 8)
Biotin containing coenzymes
participate in key reactions that
produce energy from carbohydrate
and synthesize fatty acids and protein.
Infants: Dermatitis,
Raw egg yolk, liver,
convulsions, hair
peanuts, certain Infants: 5 – 6 μg
loss (alopecia),
vegetables Children: 8 – 12 μg
neurological
Adolescents: 20 –
disorders,
Whole grains, 25 μg Men &
impaired growth
eggs, nuts and Women: 30 μg
seeds, widely Pregnant Women:
distributed in 30 μg Lactating
small amounts Women: 35 μg

115. FUNCTION DEFICIENCY
 Make antibodies. Antibodies are
needed to fight many diseases.  Dermatitis,
 Maintain normal nerve function  anemia,
 Make hemoglobin. Hemoglobin  convulsion,
carries oxygen in the red blood  depression,
cells to the tissues.  confusion,
 Break down proteins. Keep  Decline in
blood sugar (glucose) in normal immune
ranges function

116. Sources
 Avocado
 Banana
 Legumes (dried beans)
 Meat
 Nuts
 Poultry
 Whole grains
 Sunflower seeds,
 Spinach
Toxicity Infants: 0.1 – 0.3 mg
Children: 0.5 – 0.6 mg
None from foods, excess Adolescents: 1.0 -1.3 mg Men &
intake above 100 mg/day Women (19 – 50 years): 1.3 mg
from supplements causes Men over 50 years: 1.4 mg Women
neuropathy (nerve over 50 years: 1.3 mg Pregnant
Women: 1.9 mg Lactating
destruction) and skin lesions Women: 1.2 mg

117. Vit. B9 Folic acid /folate
 helps tissues grow and cells  Megaoblastic
work. (macrocytic)
 before and during anemia,
pregnancy helps  abdominal pain,
 prevent certain birth
diarrhea,
defects, including spina
bifida.  birth defects such as
 helps prevent anemia. tube defects.

118. Sources
Ready-to-eat breakfast
cereals, enriched grain
products, green vegetables,
liver, legumes, oranges. The
use of fortified foods are
encouraged for all women
of child bearing age (15-45
years).
None (up to 5 mg/day); intake
from fortified food and
supplements over 1000 μg/day,
Infants: 65 – 80 μg not including food; folate masks
Children: 150 – 200μg vitamin B 12 deficiency
Adolescents: 300 – 400 μg allowing progression of
neurological damage.
Men & Women: 400 μg/day Supplements containing >400
Pregnant Women: 600 μg μg available by prescription
Lactating Women: 500 μg only.

119. Cyanocobalamin,
hydroxycobalamin,methylcobalamin
 Pernicious Anemia:
FUNCTION  macrocytic anemia,
 Vitamin B12, like the other B  nervous system
vitamins, is important for disturbances;
 paresthesia (tingling and
metabolism. numbness in limbs),
 helps in the formation of red  difficulty walking,
blood cells and in the  loss of bowel and
maintenance of the central bladder control,
nervous system.  dementia

120. Meat, fish, poultry, ready-
to-eat fortified breakfast
cereals, eggs, fermented
dairy products (cheese,
yogurt, etc). The use of
fortified foods and
supplements are
recommended for adults
51 and over
Acne-like rash [causality is not
conclusively established].