Human Nutrition and Biochemical Parameters

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Questions and Answers

Which condition is characterized by a severe deficiency of protein, primarily affecting children under age 5?

Cachexia

BMI Deficiency

Marasmus

Kwashiorkor (correct)

During which situation would a negative nitrogen balance typically be observed?

Infancy

Developmental growth

Starvation (correct)

Pregnancy

What is the recommended percentage of total caloric intake for fat consumption according to health guidelines?

35% to 40%

20% to 25%

Less than 30% (correct)

50% to 60%

What is the energy provided by one gram of protein?

4 kcal Signup and view all the answers

Which type of malnutrition is primarily caused by insufficient intake of both protein and energy?

Protein-energy malnutrition Signup and view all the answers

What is a significant consequence of a high-fiber diet in relation to mineral absorption?

Decreased bioavailability of minerals Signup and view all the answers

In marasmus, which bodily change is typically observed?

Loss of subcutaneous fat and muscle mass Signup and view all the answers

What is the primary cause of obesity as a type of malnutrition?

Excessive calorie intake Signup and view all the answers

What is the main focus of the science of nutrition?

Utilization of dietary components required to sustain health and the aspects of diet Signup and view all the answers

Which of the following nutrients is not classified as essential for the human diet?

Vitamin D for adults Signup and view all the answers

Which factor affects the variation in the requirement of nutrients?

Age and reproductive status Signup and view all the answers

What percentage of total calories used does the Basal Metabolic Rate (BMR) account for?

60-70% Signup and view all the answers

What does energy balance mean according to the information provided?

Equal metabolizable energy intake to expenditure and changes in stored energy Signup and view all the answers

Which of the following is not considered a major component group required for human nutrition?

Probiotic cultures Signup and view all the answers

According to WHO, what influences the level of energy intake suitable for long-term health?

Energy expenditure and body size Signup and view all the answers

Which group of nutrients includes both essential and non-essential components?

Proteins Signup and view all the answers

What is the primary consequence of undernutrition in children in developing countries?

Approximately 50% of child death Signup and view all the answers

Which of the following is NOT a consequence of micronutrient deficiency?

Increased appetite Signup and view all the answers

How is obesity defined in terms of body mass index (BMI)?

BMI more than or equal to 30 Signup and view all the answers

What formula is used to calculate BMI?

Weight in kilograms divided by height in meters squared Signup and view all the answers

What is the preferred method of nutritional support in cases of undernourishment when possible?

Enteral feeding Signup and view all the answers

Parenteral nutrition is primarily used for patients who:

Are unable to obtain necessary nutrients through normal or enteral feeding Signup and view all the answers

Which of the following statements is true regarding enteral feeding?

It helps to maintain gut functioning Signup and view all the answers

What are the possible impacts of micronutrient deficiencies according to the content?

Blindness and lower intellectual potential Signup and view all the answers

Study Notes

Human Nutrition & Biochemical Parameters of Nutrition

This presentation covers human nutrition and the biochemical parameters associated with it.

Science of Nutrition

The science of nutrition focuses on qualitative and quantitative aspects of diet.
It also looks at the utilization of dietary components for maintaining health.

Major Components

Major components for human nutrition include carbohydrates, proteins, lipids, minerals, trace elements, vitamins, and fiber.
These components are well-defined biochemically.

Essential Nutrients

Essential nutrients, those not synthesized in the body, are provided through diet.
Essential amino acids and fatty acids fall under this category.
Water-soluble and fat-soluble vitamins (A, E, K) are essential. Vitamin D is essential for children but not adults.

Essential Amino Acids

A table of essential, nonessential, and conditionally essential amino acids is included.
The conditionally essential amino acids are needed in young people and/or during illness.

Essential Fatty Acids

Alpha-linolenic acid (ALA) and linoleic acid (LA) are essential fatty acids.

Variation in Nutrient Requirements

Nutrient needs change based on age, sex, reproductive status, and health conditions (disease, injury, or treatment).

Energy Requirement

The recommended energy intake, according to WHO, balances energy expenditure, body size, and body composition for optimal long-term health.
In children and pregnant/lactating women, energy requirements include those associated with tissue development and milk production.
Energy balance occurs when energy intake equals expenditure plus changes in stored energy.

Basal Metabolic Rate (BMR)

BMR is the resting energy expenditure.
It accounts for about 60-70% of daily caloric expenditure.
BMR considers processes like heart function, cell proliferation, respiration, temperature regulation, circulation, and nutrient processing.
BMR is influenced by age, weight, height, gender, environmental temperature, diet, and exercise.
Direct and indirect calorimetry methods are used to determine BMR.

Nitrogen Balance

Nitrogen balance measures the balance between the intake and excretion of nitrogen, and is an indicator of endogenous energy use.
A positive nitrogen balance is essential for growth in children and during pregnancy and lactation.

Excessive Nutrients

Excess nutrients are often stored as fat, potentially leading to obesity.
When nutrients are insufficient, stored fats and muscle proteins provide energy sources.

Starvation and Hypermetabolic States

Starvation is a severe caloric deficiency.
It can cause permanent organ damage and death.
Starvation involves an imbalance between energy intake and expenditure.
Hormones and cytokines trigger hypermetabolic situations following injuries or infections.
In hypermetabolic states, muscle tissue plays a significant role in gluconeogenesis.

Observation of Hypermetabolic States

Signs of hypermetabolic states include fever, increased basal metabolic rate, increased nutritional needs, increased heart rate and cardiac output, negative nitrogen balance, increased hepatic gluconeogenesis, and synthesis of acute-phase proteins.

Carbohydrates

Carbohydrates are the body's primary energy source; contributing 50-60% of total calories.
Excessive carbohydrate intake can lead to weight gain.
Insufficient carbohydrate intake can trigger fat mobilization, resulting in ketosis and electrolyte imbalances.
One gram of carbohydrate provides 4 kcal (1kJ) of energy.

Protein Requirement

Dietary protein provides amino acids for tissue protein.
The quality of protein depends on its essential amino acid content.
Infants, children, and adults have different essential amino acid requirements (43%, 36%, and 10%, respectively).
Good-quality protein is vital to replace losses due to stress, injury, and conditions like fever.
Protein restriction may be required in diseases like acute liver failure and end-stage renal disease.

Nitrogen Balance Studies

Nitrogen balance assesses the use of dietary amino acids and the balance between anabolic and catabolic processes.
Accurate nitrogen output assessment needs accurate dietary records, plus measurement of fecal and urinary nitrogen levels, including correction factors.
Urine urea nitrogen (UUN) measures total urinary nitrogen (TUN).

Positive vs. Negative Nitrogen Balance

Positive nitrogen balance (protein intake > protein loss) is a sign of healthy growth, development, and pregnancy.
Negative nitrogen balance (protein intake < protein loss) during starvation, cachexia or hypermetabolic conditions necessitates medical intervention for nutritional support.

Protein Synthesis

Protein synthesis depends on the protein levels in the blood along with patient conditions.

Levels of Proteins

Short-lived proteins are useful in tracking the responses to nutritional supplementation.
Prealbumin and RBP levels predict improvements in the patient's nutritional state.

Lipids

Lipids are the most energy-dense macronutrients, providing 9 kcal/g.
A typical American diet contains 35-45% calories from fat.
The American Heart Association recommends reducing fat consumption below 30% of total caloric intake.

Minerals and Trace Elements

A table of minerals, and trace elements, needed by the human body, is presented.

Fiber

Fiber, containing plant components, is indigestible.
Insoluble fiber like cellulose and lignin aids colon health.
High fiber diets can hamper the bioavailability of certain minerals (calcium, iron, zinc).

Malnutrition

Malnutrition encompasses deficiencies, excessive intake, and imbalances of nutrients (essential nutrients).
The prevalence includes undernutrition (wasting, stunting, underweight, micronutrient deficiencies), overweight, and obesity.
Malnutrition causes many diseases and complications.

Types of Malnutrition

Protein-energy malnutrition (PEM) derives from insufficient protein and energy.
Micronutrient deficiencies derive from insufficient vitamins or minerals.
Obesity originates from taking in more calories than the body needs and leads to fat accumulation.

Protein Malnutrition (Kwashiorkor)

Kwashiorkor is a severe protein deficiency, typically found in developing countries.
It affects breast-fed infants when switched to carbohydrate-rich diets, impacting children under 5.

Protein-Energy Malnutrition (Marasmus)

Marasmus is a severe overall deficiency in both calories and protein.
It induces signs of starvation (loss of subcutaneous fat and muscle mass), affecting the overall appearance and requiring glucose synthesis from muscle proteins.

Degrees of Protein-Energy Malnutrition

Protein-energy malnutrition (marasmus) is classified based on BMI (kg/m²).

Undernutrition

Undernutrition involves insufficient nutrients impacting health but not considered severe PEM.
It's a leading cause of child mortality in developing countries (50%).

Micronutrient Deficiency

Micronutrient deficiency arises from insufficient vitamins and minerals.
It leads to various health impacts, including increased infection severity, blindness, impaired immunity, and stunted intellectual and physical development.

Obesity

Obesity is defined as a body mass index (BMI) of 30 or higher.
While protein-calorie malnutrition remains a major issue in developing countries, obesity is increasing in affluent societies worldwide.

BMI

BMI (body mass index) is a measure of an adult's nutritional status.
The calculation involves dividing weight in kilograms by the square of height in meters (kg/m²).
BMI categories include underweight, normal weight, pre-obesity, and different obesity classes.

Therapeutic Nutrition Support

Nutritional intervention is crucial in PEM, undernourishment, and specific nutrient deficiencies.
This involves various methods to support malnourished patients, such as enteral feeding and parenteral nutrition.

Enteral Feeding

Enteral feeding involves introducing nutrients directly into the stomach via tubes.
Enteral formulas prepared to meet individual needs are preferred to other options, whenever possible.

Parenteral Nutrition

Parenteral nutrition (PN) is the intravenous delivery of nutrients in cases where oral or enteral routes are not feasible.
It includes lipid emulsions, glucose, amino acids, electrolytes, and micronutrients to meet nutritional needs.

Biochemical Parameters to Monitor Nutritional Status

Biochemical parameters are used to monitor nutritional status and guide therapeutic interventions.

General Detection & Monitoring of PEM

Assessing PEM in hospitalized patients or those who are aging involves using anthropometric measurements, physical evaluations, and laboratory tests to evaluate the nutritional status.

Lab. Tests to Monitor Nutritional Status

A table lists various tests, such as urine urea nitrogen (UUN), for monitoring nutritional status.

Urinary Urea Nitrogen (UUN)

UUN (urinary urea nitrogen) helps estimate nitrogen balance based on intake and 24-hour excretion.
It is used to estimate total urinary nitrogen (TUN) which corresponds to 80-90% of total nitrogen output.

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Description

This quiz explores human nutrition, focusing on the biochemical parameters associated with essential nutrients and dietary components. Key topics include carbohydrates, proteins, vitamins, and minerals that are crucial for maintaining health. Assess your knowledge on the science of nutrition and its impact on human biochemistry.