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Major Food/Nutrition
Carbohidrate as main energy source Protein Fat
Nutritional significance
Is most concentrated dietary energy source 9 kcal/g (37Kj/g) Man has a wide range of sources Animal / plant sources Animal : Monogastric : Kind of fat depends on fat ingested Ruminant : fat is re-synthesized to form saturated
Function
1. 2. Increase palability of food Act as a vehicle for Fat-soluble vitamins Membrane cell structure To transport energy: As VLDL TG FA As FFA bound to albumin Store of Energy as TG Control metabolism Transport cholesterol
Source of Protein
Human requiredment
Depends on the Obligatory Nitrogen lost Childhood, where growth and Development is in progress After injury, surgery and recovery from illness In Chirrotic patient, Protein absorption and metabolism is disturbed.
2 Height (m)
Variation
1.
2. Sex Race Oriental Blacks LBM Whites Heredity weight and height is Under genetic influence
3.
Pregnancy
Total weight gain 12-14kg 4.2 Kg Fetus Placenta Amniotic fluid 8.2 Kg Maternal tissues Plasma Edema EC/IC 4 Kg Fat
LBM
Men > Women (2/3) Thus requirement for (Women) Protein Energy is
Increase FM
Hypertension Hypercholesterolemia, Hypertriglyceride Risk increases when FM is distributed abdominally
Assessment : W/H ratio
Under Nutrition
TBP decrease TBW distortion DRY Risk of Infection increases Poor wound healing Mortality increases
Physical Activity
Active physical activity - LBM develop - FM undeveloped/less body fat - Thicker bone Immobilization (blood Vol ), Space travel - Decrease in LBM, Bone density (N, Ca, P decrease) and Paralyzed limbs,
Osteoporosis
Occur more often in Women More common in: Physical inactivity Age over 40 yo (Women)
Digestion
All carbohydrates have to be hydrolyzed into monosaccharide. - Can be absorbed - Crossed intestinal wall After absorption - Portal Circulation - Liver
Intolerance
1. Inability to hydrolyzed carbohydrate and absorb especially Laktose 2. Oral Tolerance Test Is used in the diagnosis of Carbohydrate intolerance 3. Symptoms
Abdominal discomfort Borborygmi Flatulence Diarrhea
3. Diabetes Mellitus The relationship between DM and Carbohydrate consumption is conflicting. Sucrose consumption = Blood glucose (Am Diabetes mellitus Assoc Report : Diabetes 20:633-634. 1971) draw consensus regarding Carbohydrate diet and DM. Fructose & Sorbitol produce minimal insulin level response
4. Cardiovascular disease. Dietary carbohydrate may have role in ischemic HD Type IV hyperlipidemia is associated with coronary artery disease due to the level of TG is dependent on level of carbohydrate consumed Effect of sucrose is greater over starch However, if P.U.F is added, the effect on TG level is reduced.
5 Cataracts Galactose and glucose play significant role in the development of cataract. This mono sacharide is further metabolized in the lens. (Osmotic effects!) Glucose cataract is seen in DM patient Galactose cataract is seen in galactosemia
Clinical signs
1. Tissue wasting 2. Oedema (fall in plasma protein & decrease in connective tissue). 3. Changes in appearance of hair and nails 4. Metabolic impairment 5. Impaired immunity
Poor muscle tone Dermatitis, Facial butterfly Nonspecific vaginitis Rachitis Anemia not responding to Iron Fatigue of visual accomodation Purpura etc
Vegetarian diets
1. Most vegetarians are healthy, thus this type of diet must be adequate ? 2. Two types : Strict Vegetarian (Vegan); no milk, milk products, egg Lacto-ovo-vegetarians (Vegetarian)
1. Some people are vegetarian by choice (based on religious custom or habit, Hindu) 2. Animal lover 3. Protein products are expensive
Vegan diet
May be deficient in protein The diet must be well varied Legumes should contribute 15% dietary energy. Cereal : Legume = 70:30 Low plasma iron (Pregnancy and lactation required more iron !