1st MBBS Basic Nutrition Live Dr CK Student Version 2023-24.pptx

ISCM UM1010 2023-24 Basic Nutrition Dr Chiranjeevi [email protected] 30th November 2023 Venue: HALT 4:00 to 5:00 PM  Learning Outcomes Identify the interaction between nutrition and health to correlate a balanced and healthy lifestyle Iden...

ISCM UM1010 2023-24 Basic Nutrition Dr Chiranjeevi [email protected] 30th November 2023 Venue: HALT 4:00 to 5:00 PM  Learning Outcomes Identify the interaction between nutrition and health to correlate a balanced and healthy lifestyle Identify the mechanics of metabolism within the body and the various factors influencing hunger, appetite and fuel oxidation; and changes to these with exercise or fasting Outline the role of nutrition in energy balance and the consequences of varying levels of dietary intake 30/11/2023 , including the effect of excess, on Basic Nutrition - Dr CK - 2023-24 2 Introduction - Nutrition Why do we need to eat? ESSENTIAL nutrients: Maintenance of the body Need to be part of the diet Repair Carbohydrates Growth Amino Acids Function Fatty acids It is important to have the right Vitamins proportion of nutrients. Minerals & Water There is a need to supply nutrients Imbalances may result in that CANNOT be made by the body. disease and deficiency disorders 30/11/2023 Basic Nutrition - Dr CK - 2023-24 3 Macro vs. Micro Nutrients Macro-Nutrients – essential for human survival and growth Carbohydrates Proteins Fats Water Micro-Nutrients – essential for growth and enhance https://kaynutrition.com/macronutrients-vs- the function and usability of micronutrients/ macro-nutrients 30/11/2023 Basic Nutrition - Dr CK - 2023-24 Vitamins 4 Nutrition: Macronutrient Requirements Recommended daily energy intake or energy distribution (UK Govt.): 50% from carbohydrates (60s have B12 deficiency. Turner-McGrievy G, Mandes T, Crimarco A. A plant-based diet for overweight and obesity prevention and treatment. J Geriatr Cardiol. 2017 May;14(5):369-374. 30/11/2023 Basic Nutrition - Dr CK - 2023-24 37  Increasing Iron and protein in the diet Any diet takes planning to ensure the full set of essential components are supplied, a diet low on animal products takes a bit more planning. Iron absorption inhibitors: Complete proteins: Meat, fish, eggs, dairy. Spinach, buckwheat, amaranth, chard, Also quinoa, buckwheat, soya and chia and rhubarb, Soy beans, tea, coffee mycoprotein. Iron chelators (Calcium) Incomplete proteins: Other non-animal sources. Need to be Iron absorption enhancers: combined to get complete set of amino Meat/fish/poultry, Vitamin C-rich fruits, acids. broccoli, brussel sprouts, spring onions, lentils and whole grains, apricots, tomatoes, potatoes, green & red Beans and nuts peppers, White wine 30/11/2023 Basic Nutrition - Dr CK - 2023-24 Nuts and seeds 38  Malnutrition Malnutrition refers to getting too little or too much of certain nutrients. Undernutrition: This type of malnutrition results from not getting enough protein, calories or micronutrients. It leads to low weight-for-height (wasting), height-for-age (stunting) and weight-for-age (underweight). Overnutrition: Overconsumption of certain nutrients, such as protein or fat, can also lead to malnutrition. This usually results in overweight or obesity. 30/11/2023 Basic Nutrition - Dr CK - 2023-24 39  Malnutrition Malnutrition is the cause of death for 0.56/100000 in the U.S.A. and 0.1/100000 in the UK. Rises to 121.11/100000 in Central Africa In 20 African countries - under-5 yrs. age showed stunting, women with reproductive age (WRA) showed anaemia and adults showed obesity/overweight. Malnutrition is not just about quantity of food, but quality. Map of Malnutrition: WHO http://www.worldlifeexpectancy.com/cause-of-death/malnutrition/by-country/ 30/11/2023 Basic Nutrition - Dr CK - 2023-24 40 Malnutrition - Causes Famine : Shortage Starvation, lack of food and variety Poverty : Socio-economic status education lack of food limited access to variety War : Shortage (famine) transport links Child/teenage pregnancy : removal of nutrients by the foetus Lack of variety : weight loss diet : social eating disorders / addiction / psychological https://www.actionagainsthunger.in/ 30/11/2023 hunger/cause/ Basic Nutrition - Dr CK - 2023-24 41  Nutritional deficiencies associated with obesity Micronutrient Prevalence of deficiency Obesity Type 2 diabetes diabetes. International Scholarly Research micronutrient deficiencies that promote *Via M. The malnutrition of obesity: Thiamine B1 15–29% 17–79%a Pyridoxine B6 0–11% — Notices. 2012;2012. Cobalamin B12 3–8% 22% Folic Acid 3-4% — Ascorbic acid C 35–45% —b Vitamin A 17% — Vitamin D 80–90%c 85–90%c Vitamin E 0% 0% Zinc 14–30% — Chromium — 20–40% Selenium 58% — 30/11/2023 Basic Nutrition - Dr CK - 2023-24 42  Thiamine Deficiency and obesity Thiamine (B1)- cofactor for glucose and amino acid metabolism. In glycolysis it is essential for the action of pyruvate dehydrogenase. A deficiency decreases glucose metabolism leading to increased advanced glycosylated end-products that can lead to endothelial dysfunction and potentially worsen type 2 diabetes. *Maguire D, Talwar D, Shiels PG, McMillan D. The role of thiamine Severe thiamine deficiency can lead to beri-beri. dependent enzymes in obesity and obesity related chronic disease states: a systematic review. Clinical nutrition ESPEN. 30/11/2023 Basic Nutrition - Dr CK - 2023-242018 Jun 1;25:8-17. 43 Neurological and heart symptoms ie fast HR,  Vit-D Deficiency and obesity 80-90% of obesity patients have vitamin D deficiency. Vitamin D links obesity with glucose metabolism. Presence of vitamin D receptors on Pancreatic B cells *Van Belle TL, Gysemans C, Mathieu C. Vitamin increases insulin gene transcription D and diabetes: the odd couple. Trends in Endocrinology & Metabolism. 2013 Nov exert beneficial effects on glucose 1;24(11):561-8. *Wimalawansa SJ. Associations of vitamin D tolerance with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. The Journal of steroid biochemistry and molecular biology. 2018 Jan 1;175:177-89. Low vitamin D and mutations in Vit-D *Foroughi M, Maghsoudi Z, Askari G. The receptor are associated with B cell effect of vitamin D supplementation on blood sugar and different indices of insulin resistance dysfunction 30/11/2023 Basic Nutrition - Dr CK - 2023-24 in patients with non-alcoholic fatty liver 44 disease (NAFLD). Iran J Nurs Midwifery Res.  Prenatal nutrition influences postnatal health Dutch famine birth cohort study During World War II, part of the Dutch population was exposed to famine during the severe ‘hunger winter’ of 1944–1945. The tragic circumstances of the Dutch famine of 1944– 1945 created a unique opportunity to assess the effects of prenatal undernutrition on human health in later life. According to the Studies on the Dutch famine, Prenatal nutrition influences postnatal health: Increase*Smith CA. Effects of maternal under nutrition upon the newborn infant in Holland (1944-1945). J Pediatr. 1947 Mar;30(3):229-43. in adult cardiovascular 30/11/2023 heart disease and type Basic Nutrition 2- 2023-24 - Dr CK 45  Effects of Nutritional Deficiencies: Protein Kwashiorkor: enough calories but lacking in protein (essential amino acids) 10 amino acids Leads to oedema, liver damage are required from diet (essential aa’s), derived from our protein Marasmus: too little protein and too few calories. intake. Muscle wasting more evident We cannot make these amino acids on our own. Complete protein: meat, fish, eggs, milk contains ALL essential amino acids Incomplete: leafy veg, beans, grains. Contains only some of the essential amino acids. Marasmus and Kwashiorkor: undernutrition 30/11/2023 Basic Nutrition - Dr CK - 2023-24 46  Phenylketonuria The amino acid Phenylalanine is obtained from the diet, which is converted into tyrosine with the help of phenylalanine hydroxylase (PAH). Other breakdown products contribute to musty smell Low Dopa and Catecholamines Low Melanin: Low pigmentation The absence of PAH results in lack of tyrosine, which in turn leads to low levels of Dopa and melanin. 30/11/2023 Basic Nutrition - Dr CK - 2023-24 47  Phenylketonuria – Contd.. Inability to break down phenylalanine to release essential amino acids (tyrosine). Tyrosine is involved in the Dopa and melanin pathway Results in nervous system damage, low melanin production Detection: New-born spot test Treatment: Low protein diet and amino acid supplement Heel prick test in new-borns for inherited disease screening (NO30/11/2023 Phe). Basic Nutrition - Dr CK - 2023-24 48  Vitamin Deficiencies Vitamin K: Affects clotting. Neonatal injection at birth prevents Haemorrhagic Disease of the New-born (HNB): intracranial and retroperitoneal bleeding. Vitamin C: Scurvy: James Lind’s treatment of scurvy with limes. BBC protein synthesis, wound healing Vitamin D: Rickets Affects Calcium absorption and bone development Supplements required Especially for those whoBasic 30/11/2023 cover up, Nutrition don’t - Dr CK - 2023-24 49  Hypervitaminosis: Dangerous? Hypervitaminosis: Fat soluble vitamins (A,D,E,K) are stored as fat. Primarily caused by fat-soluble vitamins (D and A) They can build up and cause problems i.e. Vitamin A metabolism involves storage in the liver. calcification of heart valves Captain Scott and his team 1912 – Antarctic trip dizziness Vit-A poisoning arguably contributed to their deaths. vision problems Polar bear's liver contains between 24,000 and 35,000 IU per gram bone pain Vitamin A is metabolised to Retinoic Acid. Hypervitaminosis A results in liver abnormalities, including fibrosis and 30/11/2023 Basic Nutrition - Dr CK - 2023-24 cirrhosis. 50 Pregnant women must avoid liver products (fish liver or 30/11/2023 Major Minerals Basic Nutrition - Dr CK - 2023-24 51 Anatomy & physiology Kevin T. Patton, Gary A. Thibodeau.—8th ed.  Mineral Deficiencies Iron: Anaemia weak, tired, decreased cognitive ability children Calcium: Osteopenia: Low bone mass. Risk factor for osteoporosis Osteoporosis manifests as reductions in bone mass, volume and density. Associated with an increased risk of fracture. Symptoms: Fatigue, muscle cramp, Cardiac arrhythmia. Why? 30/11/2023 Basic Nutrition - Dr CK - 2023-24 52 THANK YOU Any Questions? Please write to: [email protected]