Diet and Nutrition: Proteins and Vitamins PDF

Okay, here is the conversion of the images into a structured markdown format. ### PROTEINS The term *protein* is taken from the Greek word *protos* meaning primary, ranking first or occupying the first position. Similarly, protein is the first substance recognized as a vital part of living tissue....

Okay, here is the conversion of the images into a structured markdown format. ### PROTEINS The term *protein* is taken from the Greek word *protos* meaning primary, ranking first or occupying the first position. Similarly, protein is the first substance recognized as a vital part of living tissue. It contains nitrogen aside from the basic carbon, hydrogen, and oxygen. Proteins are more complex compounds of high molecular weights and structured in specific arrangements and numbers of their simpler building units, *amino acids*. They are organic substances that, upon digestion, yield these amino acids. ### CLASSIFICATION OF PROTEINS **Simple proteins** * Albumins * Globulins * Glutelins * Prolamins * Albuminoids * Histones and protamines **Compound proteins, conjugated proteins or proteids** are combinations of simple proteins and some other non-protein substance called a prosthetic group attached to a molecule. * Nucleoprotein * Mucoproteins * Lipoproteins * Phosphoproteins * Chromoproteins * Metalloproteins ### ESSENTIAL AND NON-ESSENTIAL AMINO ACIDS * **Essential amino acids** cannot be synthesized by the body and are necessary in the diet. * **Non-essential amino acids** can be manufactured by the body and, therefore, are not as necessary for consideration in the diet. ### COMPLETE AND INCOMPLETE PROTEINS * **Complete proteins** are those that contain all the essential amino acids in sufficient quantity and ratio to supply the body's needs. These proteins are of animal origin-meat, milk, cheese, and eggs. * **Incomplete proteins** are those deficient in one or more of the essential amino acids. They are of plant origin-grains, legumes, seeds, and nuts. ### DIGESTION OF PROTEIN * Mouth * Stomach * Pancreas * Small intestine (Alkaline) ### FUNCTIONS OF PROTEINS * Proteins are used in repairing worn-out body tissue proteins (anabolism) caused by the continued wear and tear (catabolism) going on in the body. * Proteins are used to build new tissue by supplying the necessary Amino acid building blocks. * Proteins are a source of heat and energy. One gram of protein Contains 4 calories. * Proteins are important in the maintenance of normal osmotic relations among the various body fluids. * Proteins contribute to numerous essential body secretions and Fluids, enzymes, and proteins. Some hormones have protein or amino acid components. Mucus and milk are largely protein. Sperm cells are likewise largely protein as is the fluid in which the sperm cells are contained. * Proteins play a vital role in the resistance of the body to diseases, Antibodies to specific diseases are found as part of the plasma globulin, especially in what is known as the gamma globulin fraction of plasma. * Dietary proteins furnish the amino acids for a variety of metabolic functions. ### SOURCES OF PROTEIN * Complete protein foods - meat, fish, poultry, egg, milk, cheese * Legumes, nuts * Breads and cereals ### MEASURES OF PROTEIN QUALITY * Biologic value (BV) - It measures the effectiveness of protein Quality in supporting the body's needs. * Net protein utilization (NPU) – It also measures how capably a Protein is used by the body. The difference is that NPU measures Retention of food nitrogen consumed while BV measures food Nitrogen absorbed. * Protein efficiency ratio (PER) - It measures the increase in weight of a growing animal and compares it with the intake. ### HEALTH EFFECTS OF PROTEIN * Heart disease - Foods rich in animal protein tend to be rich in saturated fats. * Cancer Studies suggest a relationship between high intake of animal protein and some types of cancer like cancer of the prostate gland, pancreas, kidneys, breast, and colon, * Osteoporosis - Calcium excretion rises as protein intake increases. * Weight control - Protein-rich foods are also rich in fat which can Lead to obesity with associated health risks. * Kidney diseases - Excretion of end products of protein metabolism depends on a sufficient fluid intake and healthy kidneys. A high-protein diet increases the work of the kidneys. ### PROTEIN-ENERGY MALNUTRITION (PEM) * Protein-energy malnutrition is a condition resulting from insufficiency of protein or energy or both in the diet. * Acute PEM occurs in children who are thin for their height. * Chronic PEM occurs in children who are short for their age. ### TWO FORMS OF PEM * Marasmus - Severe deprivation of food over a long period of time characterized by insufficiency of protein and energy intake. * Kwashiorkor - This condition reflects an abrupt and recent deprivation of food which develops rapidly as a consequence of deficiency or an illness like measles. The image shows the difference between a child suffering from Kwashiorkor and Marasmus. The former shows a protuberant belly, itchy rash, xerosis, and poor wound healing while the latter shows prominent bones, decreased subcutaneous fat, loose skin. | Kwashiorkor | Marasmus | | :------------------------------------------------------------------------------------ | :------------------------------------------------------------------------------------------ | | It develops in children whose diets are deficient of protein. | It is due to deficiency of proteins and calories. | | It occurs in children between 6 months and 3 years of age. | It is common in Infants under 1 year of age. | | Subcutaneous fat is preserved. | Subcutaneous fat is not preserved. | | Oedema is present. | Oedema is absent | | Enlarged fatty liver. | No fatty liver. | | Ribs are not very prominent. | Ribs become very prominent. | | Lethargic | Alert and Irritable. | | Muscle wasting mild or absent. | Severe muscle wasting | | Poor appetite. | Voracious feeder, | | The person suffering from Kwashiorkor needs adequate amounts of proteins. | The person suffering from Marasmus needs adequate amount of protein, fats and carbohydrates. | ### VITAMINS The word *vitamin* comes from the Latin word vita meaning life and the suffix amine, which is a nitrogen compound. It was discovered later that not all vitamins contain nitrogen; nevertheless, "vitamin" has been used pervasively and has become a common word. ### HISTORICAL BACKGROUND The word vitamin was coined by Casimir Funk in 1912 when he was searching for a constituent in rice bran which could cure beriberi the missing substance he called vitamine comes from vita meaning necessary for life and amine denoting that the anti-beriberi factor contained nitrogen. He hypothesized that nutritional deficiencies which were observed in the past such as scurvy, pellagra, and rickets, were due to the lack of "vitamine." Researchers later showed that not all these dietary factors contained nitrogen, so the final letter "e" was dropped, hence the word "vitamin." * Vitamins are a group of unrelated organic compounds found in food which are needed only in minute quantities in the diet but essential for specific metabolic reactions within the cell and necessary for normal growth and maintenance of health. They are also crucial in the growth, repair, and healthy functioning of body tissues. * Vitamins do not give energy to the body. They merely help convert food into energy through many biochemical reactions. Taking extra vitamins cannot increase one's physical capacity. However, shortage of vitamins may lead to fatigue. A long-term vitamin deficiency even results in the deterioration of health. The human body cannot make its own vitamins except vitamin D and niacin which are produced in the body. Shortage of vitamins particularly A, B, and C may result in loss of appetite. Lost appetite can be restored by taking more of these vitamins. * Vitamins do not have caloric value. Vitamin supplements, however, may contain few calories in their sugar coating. Normally, however, the amount is negligible. ### TERMS ASSOCIATED WITH VITAMINS * Precursors or Provitamins. These are compounds that can be changed to active vitamins. For example, carotenes and cryptoxanthin are precursors of vitamin A. Ergosterol when radiated becomes vitamin D. * Preformed Vitamins. These are naturally occurring vitamins that are in Inactive form and ready for biological use. * Avitaminosis. This refers to a condition resulting from lack of a vitamin. In the later stage of this condition when more defined signs and symptoms occur, a nutritional deficiency disease is recognizable. * Hypervitaminesis. This is sometimes referred to as "vitamin toxicity, a result of excessive accumulation of a vitamin in the body. * Vitamin Malnutrition -The prefix "mal" meaning bad denotes that too much or too little vitamin is not good for the health. * Vitamin-like Compounds - Some substances have physiological roles like vitamins but they are present in larger amounts and are partially synthesized in the body. These substances Include Inositol, choline, lipoic acid, and ubiquinone * Antivitamins or Vitamin Antagonists. These are substances that interfere with the normal functioning of a vitamin. They need to be similar in chemical composition as the vitamin they "antagonize." Examples are dicumerol against vitamin K, avidin against biotin, and thiaminase against thiamine or vitamin B1. | Vitamin | Toxicity from Overdose | | :------------- | :-------------------------------------------- | | Vitamin C | Diarrhea | | | Nausea, cramps | | | Formation of excess oxalic acid in the body | | | Acidification of urine | | | Interference with the use of therapeutic drugs | | | Conditioning to a higher requirement both in infants and adults | | | Intestinal obstruction | | Niacin | False positive urine diabetic test | | | Skin burning, flushing, and itching | | | Nausea, vomiting, diarrhea | | Vitamin B12 | Liver and ovo damage | | | Allergic shock, especially when Vitamin is injected | | Vitamin A | Liver damage | | | Hair loss | | | Bone damage | | | Potential birch defects | | Vitamin D | Severe high blood calcium | | | Brain damage | | | Heart damage | | Vitamin E | Potential birth defects | | | Cramps, diarrhea | | | Dizziness, blurred vision, headaches | | | Increased serum triglycerides in women | | | Decreased serum thyroid hormones in men and women | | Vitamin K | Formation of blood clots | | | Jaundice in infants | | Original Name | Current Name | | :----------------------------------- | :--------------------------------------- | | Vitamin A (anti-infective) | Vitamin A (retinol) | | Vitamin B1 (anti-beriberi antineuritic) | Vitamin B1 (thiamine) | | Vitamin C (B2) | Riboflavin | | Pelagra Preventive Factor | Niacin (nicotinic acid, niacinamide | | Vitamin B complex | Vitamin B6 (pyridoxine) | | | Vitamin B12 (cyanocabalamin) | | | Folasin (folinic acid, pteroylglutamic acid) | | | Blotin | | | Ascorbic Acid | | Vitamin C | Vitamin D (calciferol) | | Vitamin D | Vitamin E (tocopherol | | Vitamin E | Vitamin K (menaquinone and phylloquinone) | | Vitamin K | | ### GENERAL PROPERTIES AND STABILITY 1. Fat-soluble vitamins generally have precursors or provitamins. 2. Because they can be stored in the body, deficiencies are slow to develop. 3. They are not absolutely needed daily from food sources. 4. They are generally stable, especially in ordinary cooking methods. On the other hand, water-soluble vitamins have the following general characteristics: * They must be supplied every day in the diet. * They do not have precursors * They are not stored significantly in the body and any excess is excreted in the urine. * Deficiency symptoms develop relatively fast * Being water-soluble, they are most likely to be destroyed in ordinary cooking. ### VITAMIN A (RETINOL) **Chemical and physical nature** * Preformed vitamin A - animal sources * Provitamin A - precursor carotene; pigment found in green and yellow plants; body converts into vitamin A **Absorption and storage** * Absorption aided by bile salts, pancreatic lipase, and dietary fat * Carotene converted Into vitamin A in intestinal wall * Absorbed through lymphatic system and portal blood to liver (same route as fat) * Large storage capacity in liver, hence potential toxicity levels with large intakes **Stability** *Vitamin A is rather stable to light and heat but Prolonged heating in contact with air destroys it. It is easily destroyed by oxidation and ultraviolet light. A cool atmosphere and refrigeration tend to preserve this vitamin. Vitamin E may be used with vitamin A to preserve the latter ### PHYSIOLOGIC FUNCTIONS * Vision cycle -Vitamin A is a necessary component of visual purple (thodopsin), light-sensitive pigment in the retina enabling it to make adjustments to light and darkness. Retinal is a prosthetic group of photosensitive pigments of both rods (thodopsin) and cones (iodopsin). The reaction involves the oxidation-reaction systems of retinol-retinal and stereochemical changes of the vitamin A molecule. When there is a deficiency of vitamin A, the rods and cones cannot adjust to light changes, resulting in night blindness. An injection of vitamin A corrects this condition within a matter of minutes. Color blindness and other defects of vision cannot be cured by vitamin A. * Epithelial tissue. Vitamin A plays a vital role in the proper synthesis and maintenance of epithelial tissue; hence, the integrity of skin and; internal mucosa, and growth and formation of tooth buds. When vitamin A is lacking, keratinization (hardening and sloughing) happens in the mucous membrane lining of the respiratory tract, digestive tract, urinary system, eyes, and the Skin. Keratinization of the eye epithelium is the stigma of xerophthalmia. * Growth and bone development. Vitamin A is also necessary for the growth and development of skeletal and soft tissues through its effect upon protein synthesis and differentiation of bone cells. It appears that the active metabolite in this capacity is retinoic acid and not retinol. A normal intake of vitamin A helps in the normal bone development. It also affects tooth formation in the early life of animals forming epithelial cells. Excessive vitamin A, however, causes complete disintegration of the bone matrix. * Reproduction-Vitamin A intake must be increased to assure normal reproduction and lactation. Although not yet clear, the role of vitamin A in reproduction may be in steroid hormone synthesis or in cellular differentiation. ### DEFICIENCY * Poor adaptation or night blindness * Eye lesion - This condition is the most critical in Avitaminosis A. The cornea of the eye is affected early and the lacrimal gland fails to function, followed by keratinization and rupture of the corneal tissues. Infection sets in; pus develops; and the eye hemorrhages. This set of symptoms is known as Bitot's spot In its mild form and xerophthalmia in severe form. * Retarded growth * Lower resistance to infection * Faulty skeletal and dental development * Keratinization of epithelial linings * Disturbances in the respiratory, GI, and genitourinary tracts * Skin lesion - Characterized as "roof skin" clinically known as phrynoderma, skin lesion appears as dry and rough skin with papular eruptions occurring around the hair follicles. The sites of dermal changes are usually in the thighs, abdomen, upper arm, and back. ### TOXICITY * Violent headache * Nausea and vomiting * Thickening of the skin with peeling off * Swollen, painful long bones * Coarse sparse hair * Enlargement of the spleen and liver * In young girls, there is cessation of menstruation. * Hypercarotenemia - The ingestion of large amounts of foods containing carotene merely results in deposition of carotene in tissues, particularly the skin and eyes, and gives the person a disturbing yet harmless orange appearance. ### FOOD SOURCES * Preformed vitamin A animal sources (liver, egg yolk, milk, cream, butter, and cheese) * Fortified margarine or skim milk fortified with vitamin A are common foods that are ideal carriers of this vitamin. * Fishes - dilis, clams, mussels or tahong, and other shellfish * Precursors or provitamin A - Green and yellow vegetables (dark leaves of malunggay, sweet potatoes or kamote, kangkong, pechay, squash or kalabasa, spinach or spinaka, alugbati, taro or gabi, saluyot, and bitter gourd or ampalaya are among the Philippine favorites. Yellow fruits of foreign origin rich in vitamin A are apricots, peaches, and nectarines | Population Group | Reference Weight (kg) | RNI µg RE/day | | :--------------- | :-------------------- | :------------ | | Infants, mo | | | | Birth-6 | 6 | 375 | | 6-12 | 9 | 400 | | Children, y | | | | 1-3 | 13 | 400 | | 4-6 | 19 | 400 | | 7-9 | 24 | 400 | | Males, y | | | | 10-12 | 34 | 400 | | 13-12 | 50 | 550 | | 10-12 | 58 | 600 | | 10-12 | 59 | NaN | | Population Group | Reference Weight (kg) | RNI µg RE/day | | :--------------- | :-------------------- | :------------ | | Females, y | | | | 10-12 | 35 | 400 | | 13-15 | 49 | 450 | | 16-18 | 50 | 450 | | 19 and over | 51 | 500 | | Pregnant Women | | 800 | | Lactating Women | | 900 | ### VITAMIN D (CALCIFEROL) **Chemical and physical nature** * Sterols, more hormone-like in source and action * Formed in the skin by irradiation of cholesterol by sunlight **Absorption and storage** * Absorption accompanies that of calcium and phosphorus in the small intestine. * It is formed by sunlight in the skin absorbed into systemic circulation as hormones. * Stored in the liver, but not as great as that of vitamin A **Stability** *Vitamin D is remarkably stable and foods containing it can be warmed or kept for long perioda without deteriorating. ### PHYSIOLOGIC FUNCTIONS * Vitamin D absorbs calcium and phosphorus. * It is also essential for normal growth and development and is important in the formation of normal bones and teeth. ### DEFICIENCY * Tetany is a syndrome characterized by abnormal muscle twitching, cramps, and sharp bilateral spasms of joints in the wrist and ankles. * Rickets in children is the severe form manifested in defective bones and retarded growth. Bones become soft, fragile, and deformed, such as pigeon-breasted, knock-kneed, bow-legged, malformed teeth, and rachitic rosary-like chest. In the latter, the ends of ribs are rounded or beaded. * In infants, dentition and closing of the fontanel are delayed. * In adults, the term used for deficiency in Vitamin D is osteomalacia which means softening of the bones. There are also skeletal deformities, fragility of bones, and rheumatic-like pains of joints. Osteomalacia is sometimes called adult rickets. Image exhibiting the bone structure in a child with normal bone structure vs one riddled with rickets. An illustration of a child with rickets is given, showing labels to the characteristics of slowed growth, odd shaped rips and breast bones, large abdomen, wide joints, deformed bones, and wide ankles. The images consist of a normal spine and leg compared to a spine and legs subjected to tetany. In the left image, scoliosis is shown by the curved spine of a girl. The right image show normal extended fingers being touched with fingers curved as with tetany is known as Trousseau sign. ### TOXICITY * Nausea * Diarrhea * Polyuria * Weight loss in the early stages * Demineralization of bones and deposits of minerals in soft tissues (calcification of soft tissues which is abnormal) in the later stages * Renal damage and uremia as observed in severe cases * Hypercalcemla - excessive quantities of vitamin D (1,000-3,000 IU per kg per day for children and adult) and hypersensitivity to vitamin D leading to hypercalcemia (excess calcium in the blood) ### FOOD SOURCES * Animal sources - fortified margarine, butter, milk, cheese; liver and other glandular organs; fish; sardines and salmon; egg yolk * Plant sources- not significant ### VITAMIN E (TOCOPHEROL) **Chemical and physical nature** * Resistant to oxidation (valuable as an antioxidant) * Fat-soluble, stable to heat and acids **Absorption and storage** * Absorbed with other fat-soluble vitamins, aided by bile and fats * Stored especially in adipose tissue | Population Group | Reference Weight (kg) | RNI µg RE/day | | :--------------- | :-------------------- | :------------ | | Infants, mo | | | | Birth<6 | 6 | 5 | | 6-12 | 9 | 5 | | Children, y | | | 13 | 5 | |1-3 | 13 | 5 | |4-6| 19| 5| |7-9| 24| 5| | Adults, y ||| | 10-18| |5| | Males | || | Females ||5 | | Adults Males | 59|5| | Population Group | Reference Weight (kg) | RNI µg RE/day | | :--------------- | :-------------------- | :------------ | | Females| 51|5| | 50-64 | | 10| | 65 and over | |15 | |Pregnant Women | | 5| |Lactating Women | |5| ### Cont. * In the final weeks of Pregnancy, both mother and baby begin to prepare for birth. The onset of labor begins a remarkable change in the relationship between the woman and her baby. In those hours and moments, the birth process may seem to carry all the power in the universe.