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Nutrients

By: SumayyaNaseemOptometrist (PICO), COT & COA (JCAHPO USA), MMSPH Student Abasyn University

Contents1. Types of Nutrients

2. Good and Fair Sources

3. Daily Requirements

4. Functions of various Nutrients

5. Nutrients and Diseases

NutrientsChemical substances that constitute food and are responsible for the functions of food and protects body from disorder.

No substance can be called food unless it contains at least one nutrient.

Valuable food like milk contains a variety of nutrients and performs about all food functions.

I. Macro Nutrients1. Proteins2. Carbohydrates3. Fats4. Water

II. Micro Nutrients5. Vitamins6. Minerals

Types of Nutrients (Based on the amount required by the body)

Found in membranes, enzymes, collagen, hair, nails and skins

1. Proteins

Contain Carbon, Hydrogen, Oxygen and Nitrogen – Most contain Sulphur – Some contain Phosphorus, iron, Copper and Zinc etc

About 20% of total weight is proteins

• Proteins make the Hair, Nails & muscles etc

• Growth and maintenance of body tissues

• Provide energy when low calorie intake

• Control Growth and Metabolic activities

• Speed up Biochemical Reactions and Digestion.

• Hemoglobin: A Protein with Iron… Oxygen carrying function

• Fibrinogen: Helps in Blood Clotting & Healing

Hormones & Enzymes

Protection

Functions of ProteinsStructural Support &Growth and Energy • Antibodies:

• Antibodies are proteins that bind to the pathogens and inhibit their activities.

In Blood

Sources

• Cereals, Pulses, Oil seeds • Egg, Meat, Milk

• Egg Proteins (the best among food proteins)

Animal Origin

Fair SourcesPlant Origin

Good Sources

Daily Requirements• One gm/kg body weight per day for adults

• Additional 15 gm per day during pregnancy

• Additional 25 gm during first six months of lactation and 18 gm during 6-12 months of lactation

• Protein Requirements of Infants (g/Kg)

Age (months) Requirements per day

0 – 3 2.30 gm3 – 6 1.85 gm6 – 9 1.65 gm

9 – 12 1.50 gm

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1. MARASMUS

2. KWASHIORKOR

3. CACHEXIA

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4. ANAEMIA

Proteins Deficiency Diseases

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5. PROTEIN-ENERGY MALNUTRITION (PEM)

6. SKIN RASHES, HAIR LOSS, BRITTLE NAILS, SKIN ULCERS

7. WEIGHT LOSS

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8. EDEMA IN SEVERE CASES

Proteins Deficiency Diseases

KETOSIS DIGESTIVE & KIDNEY

DISORDERS

AFFECTS MENTAL HEALTH

DISORDERS CAUSED BY A HIGH-PROTEIN DIET

Mono Saccharides (Glucose, Fructose, Galactose), Di Saccharides (Sucrose, Lactose, Maltose) and Poly Saccharides (Starches, Fiber , Cellulose, Glycogen)

50 – 70 % of energy must be provided by carbohydrates.

Carbohydrates and Proteins provide 4 Kcal per gm

2. CARBOHAYDRATES ( Hydrates of Carbon)

• Carbohydrates are a major and instant source of energy - one gram provides 4 kcal of energy.

• RBCs and Brain cells use carbohydrates as energy

• Essential for the development of brain in children

• Carbohydrates are essential for the synthesis of certain non-essential amino acids and oxidation of fats

For BrainRibose

Functions of Carbohydrates

Growth and Energy

• Ribose – A Pentose Carbohydrate ,is part of RNA and DNA

For NEAA & Fats

Sources

• Cereals• Pulses• Fruits

• Vegetables• Nuts

• Milk (largely)

• Meat (to some extent)

Plant Origin

Animal Origin

Daily Requirements 250 – 325 grams per day

50 – 70 % of energy must be provided by carbohydrates

Pakistani foods in general contain 90% carbohydrates

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1. USAGE OF FAT AS FUEL SOURCE:  Low carbohydrate in our diet causes the  fat reserves to be used as fuel source.

2. KETOSIS:  In the absence of carbohydrates, the body starts using the proteins and convert it to sugars . This causes ketosis which is nothing but the accumulation of ketones in the body

3. HYPOGLYCEMIA

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4. UNDERWEIGHT

Carbohydrates Deficiency Diseases

• 10 – 15 % of body weight is adipose tissue

• Very rich source of energy• Energy of 9 Kcal per gram of fat

3. FATS

• Simple Lipids - Triglycerides• Compound Lipids – Phospholipids• Derived Lipids – Cholesterol

Provision of energy and spares proteins from being used for energy

Serve as vehicles for fat soluble vitamins like A, D, E, K

Support of viscera like heart, kidneys and intestines

Provide insulation beneath the skin

Make foods palatable/ eatable

EFAs decrease serum cholesterol and LDL

Cholesterol is a precursor of steroid hormones

Functions of Fats

Sources

Oil seeds like:• Ground nut• Sunflower• Mustard• Coconut

Cereals &Pulses

• Ghee• Butter• Milk and Eggs• Cheese• Fats on meat • Fats on Fish

Animal Origin

Fair SourcesPlant Origin

Good Sources

Daily Requirements• 20-30% of energy must be provided by fats of

which 50% should be vegetable origin.• The FDA's RDI for fats is 65 g or 30 percent of

your daily calorie intake.• One Kg of adipose tissue yields 7700 kcal of

energy

11. Hair loss,  cold intolerance,

bruising, poor growth, poor wound healing and low body weight.

2. PHRENODERMA: Rough and dry skin due to lack of essential fatty acids

3. As many vitamins and antioxidants are fat soluble, therefore deficiency of fat affects the level and activity of vitamins and can impact whole body.

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Fats Deficiency Diseases

Obesity Coronary Heart

Disease

Cancer Colon & Breast Cancer

DISORDERS CAUSED BY A HIGH- FAT DIET

• Water is a chemical compound with the chemical formula H2O. • A water molecule contains one oxygen and two hydrogen atoms

4. WATER

Safe drinking water is essential to humans even though it provides no calories

• The human body contains from 55% to 78% water.

•  The body requires between 1 & 7 liters of H2O per day 

to avoid dehydration• The precise amount depends on the level of

activity, temperature, humidity, and other factors.

Functions of Water• Water is at the center of life. This is why nobody can live more

than 3 to 5 days without any water intake.

• Water is your body's principal chemical component and makes up about 60 percent of your body weight.

• Every system in your body depends on water. For example, water flushes toxins out of vital organs, carries nutrients to your cells and provides a moist environment for ear, nose and throat tissues.

5 Basic Functions of Water • Cell life• Chemical and metabolic reactions• Transport of nutrients• Body temperature regulation• Elimination of waste

Sources• Drinking Water• Drinks• Beverages• Fruits

Daily Requirements

• One man consumes 3.0 liters and women 2.2 liters

• Pregnant women should increase intake to 2.4 liters (10 glass) and breastfeeding women should get 3 liters (12 glass), since an especially large amount of fluid is lost during nursing

Water Deficiency Disorders Dehydration:

Lack of water can lead to dehydration, a condition that occurs when you don't have enough water in your body to carry out normal functions. Even mild dehydration can drain your energy and make you tired. It can be fatal too.

Dry mouth, sunken eyes, dry skin, cold hands and feet, weak and rapid pulse, rapid and shallow breathing, confusion, exhaustion, and coma.

Seen in children with diarrhea, gastroenteritis and vomiting.

5. Minerals About 50 minerals are found in human body

Minerals are inorganic substances that serve a variety of functions such as cofactors in :

• Enzyme-catalyzed reactions• Regulation of acid-base balance• Nerve conduction • Muscle irritability and• Structural elements in the body.

Each mineral is required in specific amounts ranging from various gm per day. Some of the more important of these are calcium, phosphorus, sodium, potassium and iron.

Macro minerals: The minerals, which are required in amounts greater than 100 mg/ day.Micro minerals: The minerals, which are required in amounts less than 100 mg/ day.

(i) Calcium (1.5 – 2% of body weight) A major mineral element of the body (1.5 – 2% of body weight)• Functions: Formation of bones, milk and teeth, coagulation of blood, contraction

of muscles and metabolism.

• Sources: Milk and milk products, eggs, fish, green leafy vegetables and cereals.

Absorption is increased by Vitamin D and decreased by phytates and oxalates.

• Deficiency: Not clear cut even in the case of low intake. Rickets and Osteomalacia

may not occur if vitamin D intake is sufficient

• Requirements: Infants 500 mg per day

Adolescents 600 mg per dayAdults 500 mg per dayPregnancy and Lactation 1000 mg per day

(ii) Iron• Functions: Iron is essential for the production of haemoglobin, which helps

deliver oxygen from the lungs to the body tissues, synthesize iron enzymes that are required to utilize oxygen for the production of cellular energy .

• Sources:• Haem Iron – (bioavailability good) found in meat, poultry, liver.• Non-haem Iron – (bioavailability poor) found in chick peas,

beans, cereals, green leafy vegetables and apricot etc• Cooking in iron vessels is another source.• Iron Supplements and Fortified foods.

Daily Requirements: AGE GROUP DAILY IRON NEEDED• Infants 5-12 months 0.7 mg• Children 1-12 years 1.0 mg• Males 13-16 years 1.8 mg• Females 13-16 years 2.4 mg• Adult Males 0.9 mg

Adult Females• Menstruating 2.8 mg• Pregnancy 1st half 0.8 mg• Pregnancy 2nd half 3.5 mg• Lactation 2.4 mg• Post menopause 0.7 mg

• Iron Deficiency Disorders:• Anemia:

Effects on Children:• Impaired motor development and coordination• Impaired IQ• Decreased physical activity• Fatigue

Effects on Adults: • Decreased physical work and earning and Decreased immunity

Effects on pregnant women:

• Increased maternal morbidity and mortality• Increased foetal morbidity and mortality• Increased incidence of Low Birth Weight

(iii) Iodine• Functions: It is known to be essential in maintaining the function of the thyroid

and parathyroid glands in the human body and the production of thyroxine, a hormone associated with proper thyroid functioning. Iodine also promotes general growth and development within the body as well as aiding in metabolism.

• Sources: Cod fish, Shrimps, Fish and Fortified salt.

• Daily Requirements: In your entire lifetime you will need less than a teaspoon of iodine

to ensure good health, we need 150 micrograms (or 20,000th of a teaspoon) to meet your daily requirement.

• Deficiency Disorders: Goiter ,Cretinism and Mental Retardation.

6. Vitamins....The Vital Amines

Vitamins are classified as:• Fat Soluble Vitamins: A, D, E and K• Water Soluble Vitamins: C and B complex

Vitamin B Complex:– Vitamin B1 (thiamine)– Vitamin B2 (riboflavin)– Vitamin B3 (niacin or niacinamide)– Vitamin B5 (pantothenic acid)– Vitamin B6 (pyridoxine)– Vitamin B9 (folic acid)– Vitamin B12 (various cobalamins)

Vitamin AFunctions:• Contributes towards the production of retinal pigments needed

for vision in dim light• Maintain normal function of glandular and epithelial tissue lining;

of intestinal, respiratory tract, urinary tract, skin and eyes• Supports skeletal growth• Increases immunity – anti-infective• Protects against epithelial cancers

Sources:• Animal: Liver, eggs, butter, cheese, whole milk, fish and meat –

cod liver oil• Plants: Green vegetables, yellow fruits, Carrot• Fortified Foods: Banaspati Ghee, Margarine, Milk, Bread

VITAMIN A DEFICIENCY - a public health problem

OCULAR: (XEROPTHALMIA)• Night Blindness• Conjunctival Xerosis• Bitot’s Spots• Corneal Xerosis• Keratomalacia

EXTRA-OCCULAR: • Growth Retardation• Infections• Degeneration of myelin sheath of nerve cells• Alteration of mucosa of renal pelvis and urinary bladder predisposing to

calculi• Atrophy of germinal epithelium – reproduction defective

TOXICITY:• Excess of Vitamin A in the body may cause Nausea, Vomiting, Anorexia,

Sleep Disorder, Desquamation of Skin, Papiloedema, Enlarged Liver, Teratogenesis

TREATMENT:• Massive doses of Vitamin A – All children with corneal ulcer must receive

Vitamin A

RDA (RECOMMENDED DAILY ALLOWANCE )

Retinol OR Beta Carotene

(mcg) (mcg)

• Adults 600 2400

• Lactating Mothers 950 3800

• Infants 350 1200• Children 1-6 400 2400

• Age 7 – 19 600 2400

Vitamin KFUNCTIONS• Helps coagulation of blood

SOURCES• Green leafy vegetables like spinach, cabbage, lettuce, Milk, Eggs

(Vit.K1)• Some amounts are formed by the bacterial action of intestinal

flora(Vit.K2)• Deficiency usually does not occur even if not supplied in diet

DEFICIENCY• May occur in liver disease • There is delay in normal coagulation time with more bleeding on

slight injury

RDA• 1000 IU per day• Infants at risk must receive a single IM injection of Vitamin K

after birth

Vitamin EFat Soluble compound -----Tocopherols

FUNCTIONS:• Helps in reproduction

SOURCES:• Vegetable oils, Cotton seed, Sunflower seed, Egg yolk,

Butter, Fortified Cooking Oils and Butter.

DEFICIENCY:• Sterility in animals – Threatened abortion

RDA:• Adults 10 mg• Infants3 mg

Vitamin DNutritionally important forms in man are:1. Calceferol (Vitamin D2)2. Cholecalciferol (Vitamin D3)

Functions:• Intestine & Kidneys: Promotes intestinal absorption of Ca and

Phosphorus• Bone: Stimulates normal mineralization• Others: Permits normal growth

Sources:• Animal fats, Fish liver oils, Liver, Egg yolk, Butter, Cheese, Milk• Fortified foods like Ghee, Margarine, Bread, Whole Milk, Infant

Foods• Exposure to UV rays of Sunlight convert cholesterol in skin to Vit. D

VITAMIN D DEFICIENCY DISORDERS

• Rickets in children: A disease characterized by deformed bones• Osteomalacia in adults especially pregnant and lactating mothers

TOXICITY• Excessive intake is harmful and may manifest itself as: anorexia,

nausea, vomiting, thirst, drowsiness, coma and cardiac arrhythmias

RDA• Adults 2.5 mcg (100 IU)• Infants and Children 5.0 mcg (200 IU)• Pregnancy & Lactation 10.0 mcg(400 IU)

Vitamin C (Ascorbic Acid)Functions:• Plays an important role in tissue oxidation• Needed for the formation of collagen• Facilitates iron absorption from gut

Sources:• Fresh fruits like citrus, guava, green leafy vegetables,

germinating pulses and amla.

Deficiency Disorders:• Rare – Scurvy characterized by swollen and bleeding gums,

subcutaneous bleeding, bleeding in to joints, delayed wound healing and anemia.

RDA• 40 to 60 mg per day

Vitamin B1 (Thiamine)Functions:

Maintain good appetite, normal digestion, muscle tone and healthy mental attitude

Sources:

• Good sources are: Soya bean, Peanuts, Whole grains, Cereals, Nuts & ground nuts.

• Fairly good sources are Liver, Organ meat, Poultry, Egg yolk, Beans and Peas

• Mother milk is a good source also.• Thiamine is lost during cooking due to leaching of the vitamin in to

cooking water or when washed and also lost in foods having baking soda

RDA Ranges between 0.5 mg – 2 mg per day

Vitamin B1 Deficiency Disorders• Wernicke’s Encephalopathy• Beri Beri

– Dry Beri Beri (when nervous system is affected)– Wet Beri Beri (when there are cardiac symptoms and signs)– Infantile Beri Beri (when mothers are thiamine deficient)

Prevention• Encourage people to eat thiamine rich diet• Stop Alcohol• Supplements for lactating mothers

Vitamin B2 (RiboFlavin)Functions:

• Plays an important role in cellular growth• It is a cofactor involved in a number of enzymes involved in

energy metabolism

Sources:

• Rich sources are eggs, liver, green leafy vegetables, milk & Products

• Fair sources are wheat and pulses – Meat and fish contain small amounts

• Losses are due to leaching of this vitamin in to cooking water

RDA• 0.7 to 2.2 mg per day

Vitamin B2 Deficiency Disorders• Ariboflavinosis (severe form)

• Hyporiboflavinosis (milder form)

• Skin and mucosa are affected – angular stomatitis, glossitis, circumcorneal vascularisation, keratitis, susceptibility to cataract

• Impaired neuromotor function, impaired wound healing, peripheral neuropathy

Vitamin B3 (niacin or niacinamide)Functions:• Essential for Carbohydrates, fats and proteins metabolism• Essential for the normal functioning of skin, intestines and

nervous system• An essential amino acid tryptophane serves as its precursor

Sources:• Coffee, Peanuts, Liver, Kidney, meat, poultry, fish, legumes and

ground nuts• Milk is a poor source but a rich source of tryptophane• In maize niacin is in bound form and not available to body

Vitamin B3 Deficiency Disorders• Pellagra: characterized by Diarrhea, Dermatitis and

Dementia (occurs in maize eating communities)

• Glossitis and Stomatitis(Stomatitis is an inflammation of the mucous lining of any of the structures in the mouth,

which may involve the cheeks, gums, tongue, lips, throat, and roof or floor and Glossitis: Tongue Inflammation)

RDA• 0.7 to 2.2 mg per day

Vitamin B5 (Pantothenic acid) Functions:

Metabolism Sources: • Major source is meat. The most significant sources of

pantothenic acid in nature are coldwater fish ovaries and royal jelly.

• It is found in nearly every food, with high amounts in whole grain cereals, legumes, eggs, meat, royal jelly, avocado, and yogurt.

• Whole grains are another good source of the vitamin, but milling removes much of the pantothenic acid, as it is found in the outer layers of whole grains

• Pantothenic acid is an ingredient in some hair and skin care products

Vitamin B5 Deficiency Disorders• Impaired energy production, due to low CoA levels, which could

cause: irritability, fatigue, and apathy. Neurological symptoms can also

appear in deficiency. They include numbness, paresthesia, and muscle cramps and Hypoglycemia.

• Additional symptoms could include restlessness, malaise, sleep disturbances, nausea, vomiting, and abdominal cramps.

• In a few rare circumstances, more serious (but reversible) conditions have been seen, such as adrenal insufficiency and hepatic encephalopathy.

• One study noted painful burning sensations of the feet were reported in tests conducted on volunteers. Deficiency of pantothenic acid may explain similar sensations reported in malnourished prisoners of war.

RDA

RDA: 6 mg/day

Vitamin B6 (PYRIDOXINE)Functions:Plays an important role in the metabolism of carbohydrates, fats and proteins

Sources:Widely distributed in food e.g. milk, liver, meat, egg yolk, fish, whole grain cereals, legumes, and vegetables.

Deficiency: • Rare but occurs with niacin deficiency• Peripheral neuritis• INH (Isoniazid for TB) is a known antagonist and patients on

INH must get 10 mg pyridoxine per day

RDA• 2 mg per day – In pregnancy and lactation 2.5 mg per day

Vitamin B9 (Folic Acid)Functions: Plays an important role in the synthesis of nucleic acidsNeeded for the normal development of blood cells in the bone marrow

Sources:Leafy vegetables, dairy products, Milk, eggs, cereals

Deficiency Disorders:Megaloblastic anemia, glossitis, chielosis , GI disturbances like

diarrhea.Severe deficiency may cause infertility and sterility.Folic acid antagonists like alcohol, pyramethamine and cotrimoxazole

may cause abortion, congenital malformationsRequirements are greatest when rapid cell multiplication like growth

& pregnancy

RDA• Healthy adults and children 100 mcg per day• Pregnancy 400 mcg per day• Lactation 150 mcg per day

Vitamin B12 CobalaminsFunctions:Cooperates with folates in the synthesis of DNA and helps in

Synthesis of fatty acids in myelin

Sources:• Liver, kidney, meat, fish, milk cheese• Not found in vegetables• Synthesized by bacteria in colon

Deficiency Disorders:• Rare and usually in vegetarians• Megaloblastic anemia (Pernicious Anemia)• Demyelinating neurological lesions in the spinal cord

RDA• Infants and children 0.2 mcg per day• Adults 1 mcg per day • Pregnancy and Lactation 1.5 mcg per day

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