NCM105 PDF - BSN 2nd Year Summer Midterm 2022

Bachelor of Science in Nursing 2YC NCMA215: BSN 2ND YEAR SUMMER MIDTERM 2022 Coverage for Midterm: Modules 1-8 5) Self-Actualization Needs Basic concepts in nutrition and diet therapy...

Bachelor of Science in Nursing 2YC NCMA215: BSN 2ND YEAR SUMMER MIDTERM 2022 Coverage for Midterm: Modules 1-8 5) Self-Actualization Needs Basic concepts in nutrition and diet therapy Virginia Henderson Nutrition tools, standards and guidelines nutrient - identified fourteen (14) components of basic nursing recommendations - postulated that the unique function of the nurse is to assist the Dietary guidelines and food guides clients, sick or well, in the performance of those activities Nutrition care process (ADIME process) contributing to health or its recovery Nutrition Across the Lifespan Faye Glenn Abdellah Nutrition for Health and Fitness - identified twenty one (21) nursing problems - key nursing problems related to health needs of people BASIC CONCEPTS IN NUTRITION AND DIET THERAPY Dorothy Johnson Discussed by Prof. Donato Mirador - identified seven (7) behavioral subsystem Health - the extent to which an individual or group is able to - Ingestive - taking in nourishment in socially and culturally realize aspirations and satisfy needs and change or cope with acceptable ways environment. It is the complete physical, mental and social well-being and not merely the absence of disease or infirmity. Good Nutrition Nursing - a caring profession; practiced with an earnest - The benefits of good nutrition – health, happiness, efficiency concern for the art of care and science of health. and longevity. Major Goals in Nursing - To promote the health of the individual and prevent the 1) Promotive – an action or measures designed to support occurrence of illness, the nurse must assist the client in behavior conducive to health meeting’s his nutritional needs. 2) Preventive – any actions or measures designed to protect - The primary role of nutrients is to provide the building for the individuals, families, groups, communities from harm to their efficient functioning and maintenance of the body. health - The human body cannot exist for a long time without enough 3) Curative – any actions or measures designed to correct or nourishment from food. We eat food to sustain life, to enable remove disease or any illness. us to grow and be healthy so that we can carry out our task at 4) Rehabilitative – any actions or measures designed to restore work and at play. health and promote recovery from any alteration of health - We must first define the following: Digestion – the process by which foods are broken down Roles and Responsibility of a Nurse for the body to use in growth, development, healing and Caregiver – helping clients promote, restore, and maintain prevention of diseases. dignity, health and wellness Absorption – the process by which digested proteins, fats, Communicator/ Helper – central role of nurses in identifying carbohydrates, minerals and water are actively and needs of the client passively transported through the intestinal mucosa into the blood or lymphatic circulation. Educator/ Teacher – involves nursing activities, health promotion, the primary concern Metabolism – the complex chemical process that occurs in the cells to allow for energy use and for cellular growth Counselor – providing emotional, intellectual and and repair. psychological support Manager/ Coordinator – manages the nursing care. Change agent – assists client to modify behavior Leader – influences other to work together towards a mutually envisioned goal. Clinician – use of technical expertise to administer nursing care Advocate – promotes what is best for the client, protects the client rights Researcher – participates in scientific investigation; uses research findings in practice Collaborator – initiates nursing action within the health team Nursing Theories related to Nutrition Abraham Maslow - Hierarchy of Basic Human Needs 1) Physiologic Needs Oxygen, Fluids, Nutrition, Body temperature, Elimination, Rest and sleep, Sex 2) Safety and Security 3) Love and belonging 4) Self-Esteem Needs J.A.K.E 1 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 Role of Nurse in Nutrition The classification of carbohydrates are the following: Assess nutritional health needs 1) Monosaccharide considered as the simplest form of sugar Nutritional surveillance which is small molecules that require little or no digestion Health education before they can be used by the body and the source is the Nutritional supplementation digestive end product of lactose hydrolysis. There are (3) types National nutrition progammes of monosaccharide: In service education, training a) Glucose which is primarily “physiologic sugar” or “blood sugar”, “dextrose”, “grape sugar”, principal form used by Special care for vulnerable groups the body, moderately sweet sugar works for the body’s Community participation brain, nerve cells, RBC and stores last for only hours. Referrals Gluconeogenesis is the process where protein is converted Records and reports to glucose. Ketosis is the process converting lipids to Participate in research glucose for energy use by the body with less available Evaluation carbohydrates that more fats to be broken down to form ketone bodies. Some sources of glucose can be found abundantly in fruits, sweet corn, corn syrup. Some fruits does have Lycopene (red), Carotene orange and yellow, Anthocyanin (blue and brown) and Cruciferae (white and green). b) Fructose is considered as fruit sugar, the sweetest of all sugar, “levulose” and sources are ripe fruits and honey. c) Galactose is not found in nature and not found in free foods, but produced from lactose (milk sugar) by digestion and is converted to glucose. Galactosemia is the term to infants born with an inability to metabolize galactose. 2) Disaccharide which has two sugar molecules and has 3 types: a) Sucrose considered as the ”cane sugar”, “table sugar”, “beet sugar”, example is Sucrose = glucose + fructose. b) Maltose considered as ”malt sugar”, derived from the digestion of starch wit example of maltose = glucose + glucose. Classification of Nutrients c) Lactose known as milk sugar, least sweet among sugars Carbohydrates – sugars/ starches – provides energy for the with link two molecules of glucose + galactose and body to use. Fibre-aids digestion sources as milk and milk products. Protein – builds and repairs muscle tissues 3) The last type is Complex Carbohydrates or Polysaccharide that Fats and oils – stores energy in body contains many monosaccharide linked together with the Vitamins – promote normal growth, provide proper following types: metabolism, protect against certain diseases a) Starch is the storage form of carbohydrates in plants, Minerals – support function of heart, metabolism, bones/ teeth supply energy for a long period of time and the sources formation are cereal grains, rice, wheat. Water – regulates body function: e.g. nutrient absorption, body b) Dextrin - not found in free foods but the intermediate temp. product of starch digestion with food source of toasted bread + application of dry heat. Macro-nutrients c) Glycogen is an animal starch, storage form of CHO in the Carbohydrates body found in the liver and muscle. Muscle glycogen - It is an organic compound containing C, H, O, Derived from supplies energy directly to surrounding tissues during the Greek word saccharide meaning starches and sugars and work and exercise while liver glycogen is converted to chiefly found in plants. glucose to be used in the body through the process called - It is produced by the process of photosynthesis from - H2O, “glycogenolysis”. Food sources of glycogen are animal CO2 and sun. liver, oysters, muscle meat. - The Total Energy Requirement is ranging from 50% to 70% of d) Fibers considered as roughage because they form bulk of body energy needs is from CHO. CHO has one (1) gram of the diet, act as broom in the digestive tract, indigestible CHO which is equivalent to 4 calories upon complete part of food and primary constituent of plant cell wall, not hydrolysis. digested by human due to lack of enzyme that will split or - The building blocks are called monosaccharide. The digestion break it. The body requirement is 20 to 35 g/day. begin in the mouth with salivary amylase released during the - The following function of Carbohydrates are: process of chewing and are absorbed across the membrane of Chief source of energy, protein sparing; the small intestine and transported to the liver distributed to takes part in building body tissues to some limited extent; the rest of the body. The absorption process begins around 3-6 and hours after eating. regulator of intestinal peristalsis and provider of bulk. J.A.K.E 2 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 - Lack of Carbohydrates resulted to: b) monounsaturated – oleic acid; examples are avocado, underweight and/or rapid weight loss; peanut butter, peanut oil, pili nut, olive oil, shortening; general weakness; and poor physical performance; c) polyunsaturated fatty acids – linoleic acid, vegetable oil: fainting or collapse in severe deficiency; and examples are corn, soybean, rapeseed, canola, sunflower, hypoglycemia in acute carbohydrate deficiency. sesame seeds. Glycerol is water soluble component of - Excessive Carbohydrates may result in: triglycerides; available for the formation of glucose in the dental caries; diet. Steroids are fat related substances that contain obesity/overweight; sterols; main member is cholesterol – important constituent of body cells and tissues. diabetes mellitus and gas formation. The health effects of - The functions of Fats are the following: starch and fibers are promote weight loss/ weight control, protect against heart disease and stroke and cancer, fight Supplies food energy in concentrated form for body against diabetes and promote gastrointestinal health. activities; Fats Protects vital body tissue and insulates body; supplies - Also known as Lipids, consider as organic nutrient containing essential fatty acids; C, H, O attached in a glycerol base. One (1) gram fat is Serves as a carrier of the fat-soluble vitamins (ADEK); equivalent to nine (9) calories with Total Energy Requirement and of 20%-30% is from fat. It remains in the stomach for the Adds palatability and satiety value (sense of fullness) to longest period of time. your meals. The lack of fat in the diet rests in: - A good approach when it comes to breaking up fat calories is underweight, sluggishness, skin irritation similar to to eat 40 percent of daily fat grams at breakfast, 40 percent eczema in infants and signs and symptoms of fat-soluble between midday meal, and 20 percent at dinner. Avoid fatty vitamin deficiency. The excess intake of fat results in: foods at night. It can take 2-4 hours for fat to digest, so if an obesity/overweight, and cardiovascular diseases. individual eat it too late in the evening, the body won't have as Protein much time to utilize this energy before storing it. Bile contains - It is an organic compound containing C,H,O,N and derived bile salts, which act as an emulsifier of lipids. This breaks the from the Greek word “proteios” meaning to hold first place or large fat droplets into smaller droplets that are then easier for is the prime importance. The building blocks are called the fat-digesting enzyme pancreatic lipase to digest. Fats are ‘’amino acid’’. mainly digested in the small intestine. Steatorrhea is the - The total energy requirement supplied by CHON is 10%-15% presence of excess fat in feces. with 1 gram CHON is equivalent to 4 calories upon complete The fats are classified as: hydrolysis. Protein digestion occurs in the stomach and 1) Simple Lipids consider as neutral fats with chemical name is duodenum in which 3 main enzymes, pepsin secreted by the triglycerides and glycerol is derived from a water soluble form stomach and trypsin and chymotrypsin secreted by the of CHO; and (B) Compound lipids which is a combination of pancreas, break down food proteins into polypeptides that are fats with other components; important in human nutrition. The then broken down by various exopeptidases and dipeptidases compound lipid has different types; into amino acids, protein is digested and absorbed in the small a) Phospholipids which has fatty acids, phosphoric acids and intestine. nitrogenous base. Examples are lecithin which is most - It has simple proteins which comprises of albumins that is widely distributed, traces placed in liver, egg yolk and soluble in water, coagulated by heat and globulins that is vegetable oil and added to food products such as cheese insoluble in water, soluble in salt solution, coagulated by heat. and margarine to aid emulsification. Cephalin is needed to - The essential amino acid (EAA) or indispensable amino acid is form thromboplastin for blood clotting. Sphigomyelin one that cannot be synthesized by the body. Examples are which is found in brain and other nerve tissue that serves histidine, phenylalanine, ioleucine, threonine, leucine, as insulator around nerve fibers. tryptophan, lysine, valine, and methionine. Semi-essential or b) Glycolipids which is fatty acids combined with CHO and semi-indispensable amino acid reduces a need for a particular nitrogen. essential amino acid and partially spares it like arginine, c) Lipoprotein which is lipids combination of protein with tyrosine, cystine, glycine, serine. The non-essential amino acid different sub-types Chylomicrons that transport diet- (NEAA) is not dietary essential because the body can derived lipids; mostly triglycerides; Pre-beta lipoprotein synthesize it such as glutamic acid, aspartic acid, alanine, consider as VLDL (very low density lipoprotein); fat proline, norleucine, citrulline, hydroxyglycine, and circulating in the blood during fasting state; Beta hydroxyproline. lipoprotein consider LDL (low density lipoprotein); - The functions are the following: transport in the artery wall; and Alpha lipoprotein Builds and repairs body tissue for growth and consider as scavengers; also known good cholesterol. maintenance such as anabolism – repairing worn out body 2) Derived lipids that is fat substances produced from fats and fat tissue and catabolism – continued wear and tear going on compounds with fatty acids as basic structural unit of fat. in the body; Divided into three forms: Builds resistance to infection by helping form antibodies; a) Saturated fatty acids – palmitic and stearic acids; supplies additional energy; examples are bacon, butter, grated coconut, coconut contributes to numerous body secretions and fluids; and cream, coconut oil, margarine, mayonnaise, cream cheese, maintain water balance. The sources of protein coming sandwich spread, whipping cream, chicharon; from animal sources - egg, milk, milk products, meat, fish, J.A.K.E 3 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 poultry and sea foods and plant sources - cereals (wheat, deficiency develops fast; and with example of Vitamin B rice, corn), legumes (munggo beans, peas, peanuts, complex and Vitamin C. soybeans), processed vegetable protein (vegemeat, tofu). - The lack of protein results in: Fat-Soluble Vitamins Retarded growth in children; Vitamin A Low resistance to infection at any age; - It is also known as retinol with precursor of carotene, absorbed Slow recovery from illness; through lymphatic system and portal blood to liver. An Low birth weight; antioxidant and never be given for pregnant mother for the Protein energy malnutrition- Marasmus and Kwashiorkor; first trimester because causes teratogenic to the baby. Loss of weight; and - The following functions are: Edema, skin lesions, mental sluggishness. Helps maintain normal vision; - Kwashiorkor and Marasmus are protein-energy malnutrition. helps keep lining of the mouth, nose, throat and Kwashiorkor is a protein deficiency, disease caused by severe respiratory tract healthy; helps skin and hair glossy, teeth strong; shortage of protein; associated with post weaning diets ↑ promotes growth; cereals and ↓ in quality and quantity protein; usual onset is maintains the stability of the cell membrane; from 1-6 years old with signs and symptoms of edema, assists in immune reaction. enlarged liver due to accumulation of fat, altered skin and hair - Lacking of vitamin A results in: pigmentation and moon’s face. Marasmus is a protein caloric Bitot’ s Spot a mild form and Xeropthalmia a severe form deficiency, disease caused by inadequate protein and calories, of blindness; from semi-starvation resulting from mother’s failure to nurse inability to see in dim light or “night blindness”; her infant. The onset is from 6 months-4 years old with signs eyes sensitive to bright light; and symptoms of loss of subcutaneous fat-very underweight rough dry skin and membranes of nose and throat; and old man’s face. low body resistance to disease; and - The effects of excessive protein intake: kidney function – high affects health of skin, hair, nails and poor growth. CHON diet - increase work of kidneys; mineral losses – - Excess intake of vitamin A results in: increase CHON diet - calcium excretion rises; obesity – high yellow discoloration of the skin or “carotenemia”; CHON diet – increase intake rich fat foods; heart disease – dry, itchy skin and coarse hair; foods rich in animal protein – rich n saturated fats; and cancer – increase in CHON diet – increases rich saturated fats foods nausea and headache; intake irritability; and loss of appetite. Food sources are animal liver, egg yolk, dairy product, green, yellow and orange Micro-nutrients fruits and vegetable. Vitamins Vitamin D - The word vitamin coming from a Latin word meaning vita – - It is also known as calciferol with precursor of ergosterol, It is life and amine means nitrogen compound. They do not give also produced endogenously when ultraviolet rays from energy but merely help convert food into energy. Bile is sunlight strike the skin and trigger vitamin D synthesis. It can needed for the absorption of fat-soluble vitamins. It acts as co- be warmed or kept for long period of time without enzyme for energy metabolism of CHO, CHON and fats. deteriorating. It is needed for calcium and phosphorous Precursors / Provitamins is a compound that can be changed to absorption, bone mineralization. active vitamins. Preformed Vitamins is a occurring vitamins - The functions of vitamin D are; that are inactive form and ready for biological use. Helps build and maintain strong bones and sound teeth; - Avitaminosis is a lack of vitamins, deficiency. Absorbs calcium and phosphorus; and Hypervitaminosis is a vitamin toxicity, excessive Promotes normal growth and development. accumulation of vitamins in the body. Vitamin malnutrition is - Lack of Vitamin D results in: bad (mal); too much or too little is not good for the health. Tetany – muscle twitching; - Vitamin like compounds are substances have physiological Malformed or soft bones (rickets for children and roles like vitamins but in large amounts partially synthesized osteomalmacia for adult); in the body like inositol, choline etc. Poor development of teeth; - Antivitamins or vitamin antagonist is a substance that interfere Stunted growth (osteoporosis); (5) lowered amount of the normal functioning of the vitamin like dicumerol against calcium and phosphorus in blood. Vitamin K, avidin against biotin. - Excess intake of Vitamin D results in: - There are two classifications of Vitamins: Loss of appetite; 1) Fat soluble vitamins that is dissolve in fat before they are nausea and vomiting; absorbed in the blood stream; not absolutely needed daily intense thirst and frequent urination; from food sources; have precursors, stored in the body severe constipation and/or diarrhea; and deficiency develops slow; with examples of Vitamins muscular weakness; and A, D, E, K. headache and drowsiness. Food sources are dairy products, 2) Water soluble vitamins that is dissolve in water and are eggs, yolks and fatty fish. not stored in the body; absolutely needed daily because excess excreted in the urine; do not have precursor and J.A.K.E 4 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 Vitamin E poor appetite; - It is an antioxidant vitamin with precursor of tocopherol, nervousness; stored in adipose tissue, aided by bile and fats and stable to loss of ankle and knee jerk reflexes; heat and acid. painful calf muscles (cramps); - The functions of vitamin E are: constipation; maintains nerves, muscles and a healthy reproductive fatigue, weakness; and system; retarded growth. helps protect tissues and membranes against the damage - The food sources are whole grains, pork, cereals, legumes, of oxidation; and seeds and nuts. There are types of beri-beri such as infantile - helps in the formation of red blood cells and in the occurs in infant 2 to 5 months of age, gets the disease from utilization of Vitamin K. The food sources are vegetable mother’s milk suffering from beri-beri and symptoms like loss oils, nuts, seeds, whole grains. of voice (aphoria) and cyanosis. Wet - edema on both Vitamin K extremities progress upwards to heart and lungs. Dry – - It is also known as menadione, pytomenadione and involves peripheral nerves causing paresthesia leading to phylloquinone. It is synthesized by normal intestinal flora and paralysis. maintenance of prothrombin level in blood plasma. Vitamin B2 - The functions of vitamin K are: - It is also known as riboflavin, co-enzyme for energy Helps in the normal clotting of the blood; metabolism, essential for protein, fat and carbohydrates increases calcium absorption; and metabolism and vitamin readily destroyed in cooking. maintains strong healthy bones. - The functions of vitamin B2 are: - Lacking of vitamin K results in: keeps eyes and skin healthy; slow clotting of blood; aids in normal functioning of nervous system; and tendency to bleed easily; and promotes growth. hemorrhage following operations or in the umbilical cord - Lack of riboflavin results in: of newborn infants. The food sources are green leafy sores in angles of mouth and fold of nose, itching burning vegetables. eyes; sore, swollen and chapped lips, swollen, fissured, and Water Soluble Vitamins – fresh food vitamins painful tongues; and Vitamin C retarded growth. The food sources such as pork, grains, - It is also known as ascorbic acid, anti-oxidant vitamin and cereal products, meats, fish, green leafy vegetables. easily absorbed from small intestines. Vitamin B3 - The functions of vitamin C: - It is also known as niacin or nicotinic acid and co-enzyme for increases the body resistance to infection; energy metabolism. helps keep gums and teeth healthy; - The functions are: aids in the absorption of iron and calcium in the body; Promotes normal digestion and keep nerve in healthy helps in the formation of red blood cells; and condition; prevents scurvy. keeps skin healthy; and - Lack of ascorbic acid results in: promotes growth. bleeding gums; loose teeth; - Lack of niacin results in: skin hemorrhages (black and blue spots); rough, red skin which later becomes pigmented; slow wound healing; sore mouth, tongue and throat; bone changes; digestive and nervous disturbances; anemia; and loss of appetite and weight; scurvy in severe deficiency. The food sources are citrus pellagra or “3D disease” (dementia, dermatitis, diarrhea) fruits, broccoli, cantaloupe, kiwi, cabbage, strawberries, in severe deficiency; and tomatoes, melons. irritability and mental confusion. - Vitamin B Complex – short life that needs to be replaced Vitamin B5 continually; if food rich in vitamin B complex especially - It is also known as panthothenic acid with the following vitamin B2 and need to be boiled losses of Vitamin B is 15- functions: 40%. When frying – 40-50% and roasting – 30-60%. That’s essential for carbohydrate, protein and fat metabolism; why lost vitamins from cooking are transferred to the cooking maintenance of normal growth, healthy skin and integrity liquids and best turn these liquids to sauces and gravies. of CNS; and Vitamin B1 co-enzyme for energy metabolism. - It is also known as thiamine and the functions of vitamin B1: - Lack of Panthothenic acid resulted in insomnia, tingling prevents beri-beri / nutritional polyneuritis; sensation of the extremities, muscle cramps and vomiting. keeps nerves in healthy condition, muscle nerve function; Vitamin B6 promotes good appetite and normal digestion; and - It is also known as pyridoxine with functions of metabolism of promotes good growth. amino acids and protein; helps the body use carbohydrate, fat - Lack of thiamine results in: and protein; neurotransmitter synthesis, avoided to patient mental confusion/depression; with parkinson’s; supplemented in anti-TB therapy; and J.A.K.E 5 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 converts tryptophan to niacin and linoleic acid to arachidonic bones or osteomalacia in adults, decreased bone density, acid. increased porosity (demineralization) of the bones; called - Lack of pyridoxine results in: osteoporosis. low peak bone mass, increased risk to fracture. loss of appetite, nausea and vomiting; The food sources are milk products, dark green leafy vegetable, nervous irritability and convulsions; salmon, orange juice and tofu. dermatitis around the eyes, mouth, on the nose and behind Magnesium (Mg) the ears. The food sources are whole grains, spinach, - a blood serum normal value 1.5 to 3.0 mEq/liter. The broccoli, legumes, vegestable oils of corn. following functions are; Vitamin B9 helps regulate body processes including regulation of - It is also known as folic acid or folate with functions of aids in normal heart rhythm; metabolism of genetic material (DNA, RNA); helps cure a aids in the normal functioning of the body enzymes; form of anemia, poor growth, and birth defects; synthesizes relaxes muscle after contraction; and DNA which control cell function, heredity and tissue growth; promotes resistance to tooth decay by holding calcium in and regenerates red blood cell and essential formation of WBC the tooth enamel. in the bone marrow. - Lack of Magnesium resulted to irritability, emotional tension, - Lack of folic acid results in: depression, and muscular weakness. Excess in Magnesium poor growth; resulted to nausea and vomiting and the food sources are fatigue, depression and confusion; whole grain, nuts, legumes, soy beans, dark green leafy macrocytic anemia; vegetables. glossitis; Sodium (Na) diarrhea; - a chief cat-ion in the extracellular fluid (ECF) with blood malformation in the offspring especially neural tube serum normal value of 135 to 145 mEq/ liter. defect; - The functions are maintains proper water balance within the gastrointestinal disturbances. body and preserves the normal movement of the muscles, Vitamin B12 nerve impulse transmission. - It is also known as cyanocobalamin or cobalamin, consider as - Lacking of sodium resulted to nausea, vertigo, mental apathy, folate metabolism, nerve function and problem with intrinsic muscular weakness and cramps, Excessive sodium intake factor in pernicious anemia with lifetime treatment. resulted to edema, hypertension, and kidney disease. The food - The functions are facilitates maturation of red blood cells; sources are spinach, celery, pickles, canned soup, processed protects the “myelin” the fatty material - transmit electrical cheese, condiments. impulses (messages) between nerve cells; and metabolizes Potassium (K) carbohydrate, protein, fat, nucleic and folic acid in the body - a chief cat-ion in the Intra-cellular Fluid (ICF) with blood and normal functioning of all cells. serum normal value 3.5 to 5.5 mEq/ liter. - Lack of cobalamin results in: - The following functions of potassium are helps in muscle contraction, nerve impulses, and the proper functioning of the pernicious anemia; heart and kidneys, regulates blood pressure and water balance changes in the nervous system; and in the cells, important in CHO and CHON metabolism. retarded growth. The food sources are foods of animal in - Lacking of potassium resulted to hypokalemia (decrease level origin, fermented foods. of K), muscular weakness, increased nervous irritability, mental disorientation, and cardiac irregularities. Excessive Minerals potassium will lead to hyperkalemia (increase level of K), and - These are the element in their simple inorganic form. Primary heart block. function of the small intestine is the absorption of nutrients - The food sources are bananas, meat, milk, legumes, potato. and minerals found in food. The phytates, oxalates & tannins Bananas, oranges, cantaloupe, honeydew, apricots, grapefruit which are compounds found in foods that can bind to calcium, (some dried fruits, such as prunes, raisins, and dates, are also iron, zinc and other minerals and interfere with their high in potassium), cooked spinach, cooked broccoli, potatoes, absorption. The following macro-nutrient minerals –Ca, Na, P, sweet potatoes, mushrooms, peas and cucumbers. Some low- K, S, Cl, Mg and the micro-nutrient minerals –Fe, I, Zn, Se, potassium foods include: berries, such as strawberries and Mn, Cu, Mo, Co, Cr. blueberries, apples, pineapple, cranberries and cranberry juice Calcium (Ca) and cauliflower. - 99% present in the bone, major component of renal calculi, Phosphorous (P) with blood serum of normal value 4.5 to 5.5 mEq/liter. - an important in pH regulation and principal anion in the Intra- - The following functions are: cellular cell (ICF). build and maintain strong bones and teeth; - The following functions are helps in proper bone and tooth promotes normal blood clotting, regular heartbeat, cell development, facilitates quick release of energy for muscle metabolism and other muscle contractions; contraction, transports lipids and fatty acid in the blood, prevents rickets in children and osteomalacia in adults; transports nutrient in and out of the cell, and prevents rickets, and demineralization of bone, lowers risk to fracture. - Lacking of Phosphorous resulted to weakness of the muscles, - Lack of calcium results in: stunted growth, defective structure stunted growth and defective structure of teeth and bones. of teeth and bones called rickets in very young children, soft J.A.K.E 6 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 Excessive intake of Phosphorus may lead to impairment of the - Lacking of this mineral will lead to anemia, anorexia, body’s use of iron and calcium. hypotonia, edema and retarded growth (CNS abnormalities). - The following food sources are milk products, meat and organ - Excessive of copper will lead to wilson’s disease which is a meat, poultry, sea foods, legume, cheese, dried beans, genetic disorder in which excess copper builds up in the body. sunflower and pumpkin seeds, nuts and whole grains. Symptoms are typically related to the brain and liver. Liver- Sulfur (S) related symptoms include vomiting, weakness, fluid build-up - plays an important role in crucial functions in body, such as in the abdomen, swelling of the legs, yellowish skin and making protein, regulating gene expression, building and itchiness. The food sources are organ meat, egg yolk, oysters, repairing DNA, and helping body metabolize food. The nuts, cereals, whole grains. function of Sulfur is of the function of protein. Iodine (I) - Lacking of sulfur is related sulfur-containing amino acid in - a mineral component of the hormone thyroxine. cases of severe deficiency and food sources are protein - The functions are helps in normal functioning of the thyroid containing foods. gland in regulating energy metabolism, helps in protein Chloride (Cl) synthesis, tissue growth and reproduction, and prevents goiter. - a major anion in the Extracellular Fluid (ECF) and serve as - Lacking of Iodine resulted to enlarged thyroid gland (Goiter), formation of gastric juice. painful swallowing, cretinism (mental and physical retardation - The main functions are helps maintain the osmotic pressure accompanied by irreversible hearing and speech problem – and acid-base equilibrium in the body, helps balance the ph insufficient of iodine intake by the mother during pregnancy), level of the blood and maintains the strong acidity of the myxedema is experience by adults who had problem with low stomach as part of hydrochloric acid. iodine throughout their childhood and adolescence, and - The effects of chloride in the body can be alkalosis and increased risk of abortion, stillbirths, miscarriage and infant acidosis. Alkalosis is an excessive loss of Chloride ions from deaths the gastric secretions; vomiting and gastric lavage or - Excessive Iodine resulted to thyrotoxicosis, induced acne-like suctioning. Acidosis is an excessive supply of Chloride ions skin lesions, worsening of pre-existing acne. The food sources from the gastric secretions; diarrhea, during the state of NPO are seafood, seaweeds,and iodized salt. or diet. The food sources are pickles, canned soup, processed Manganese (Mn) foods, condiments and canned foods. - a mineral constituents of vitamin B1, contributes to many Iron (Fe) bodily functions, including the metabolism of amino acids, - a components of hemoglobin. Ferrous SO4 is taken with meals cholesterol, glucose, and carbohydrates. The human body and with orange juice (Vitamin C) for better absorption. cannot produce manganese, but it can store it in the liver, Watch out for any black tarry stools if given orally and pancreas, bones, kidneys, and brain. A person usually obtains nothing to do because it is a normal assessment. The Z-track manganese from their diet. method is being used if given IM injection and straw as not to - The functions of manganese are an essential constituent for stain the teeth. Ferrous is better absorbed than ferric, iron in bone structure, reproduction and normal functioning of green leafy vegetable is poorly absorbed and coffee taking iron nervous system, and takes part in enzymatic actions in the – iron absorption is reduced. body. - There are two type of Iron: heme iron that is found only in - Lacking of manganese is having a problem with skeletal meat, fish and poultry and non-heme iron and found in cereals abnormality and food sources are nuts, cereals, legumes, dried and vegetables. fruits, green leafy and non-leafy vegetables. - The main functions are helps build and maintain blood supply Cobalt (Co) and give healthy red color to the blood, and prevents simple - a mineral constituents of B12, with deficiency of pernicious anemia. anemia and polycythemia vera for excessive intake. They - Lacking of iron may lead to nutritional iron deficiency anemia; forms of cobalamin or vitamin B12 that helps treat a certain easy fatigability; general weakness; poor physical type of anemia. performance; paleness in the face, conjunctiva, lips and - Lacking of cobalt resulted to poor growth, poor appetite, fingernails, weight loss and koilonychias which is spoon restlessness, and progressive emaciation. The food sources are shaped nail, a nail deformity in which the outer surface liver, oysters, clams, poultry, salt water fish. becomes concave. Zinc (Zn) - Excessive iron may lead to high iron stores leading to iron - an anti-oxidant mineral. toxicity like hemochromatosis and hemosiderosis. The food - The following functions are helps the body use protein and sources are liver, red meat, organ meat, egg yolk, green and carbohydrates; vital for growth and development, synthesis of red mongo, soy beans. cell protein (formation of DNA & RNA), proper functioning Copper (Cu) of the immune system; vital for the development of male - essential trace mineral necessary for survival, plays a role in reproductive function, specifically the formation of making red blood cells and maintaining nerve cells and the testosterone, making of sperm; helps hasten wound healing; immune system. It also helps the body form collagen and and taste acuity (geusia). absorb iron, and plays a role in energy production. - Lacking of zinc resulted to growth failure, impaired wound - The functions are helps the body to use iron; helps build healing, impaired sense of taste and smell, and sexual hemoglobin in the blood; takes part in the metabolism of infantilism in teenagers. ascorbic acid in the body; and helps the body use fatty acids. - Excessive intake of zinc may lead to nausea and vomiting, abdominal cramps, diarrhea, and gastrointestinal irritation. The J.A.K.E 7 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 food sources are meat, milk, legumes, nuts, poultry, fish, MACRONUTRIENTS AND MICRONUTRIENTS whole grain cereals and breads. Discussed by Prof. Gerardo Nicolas and Prof. Donato Mirador Fluoride (Fl) Nutrition - helps prevent tooth decay and favors deposition of calcium - the sum of all the interaction between an organism and the thereby strengthening the bones. food it consumes - Lacking of fluoride resulted to lowered resistance to dental - what the person eats and how the body uses it caries and excessive intake may lead to mottling of the tooth - Function: enamel (dental fluorosis) and stained and corroded appearance To maintain life by allowing one to grow and be in state of the teeth. The sources are fluoridated water and toothpastes. of optimum health Selenium (Se) Food - an anti-oxidant mineral, serves as an integral component of Nutrients certain enzymes, acts as an antioxidants which help fight cell Calorie damage, helps prevent certain types of protein-energy Carbohydrate → 4 calories per gram malnutrition, regulates proper immune response, and aids in Protein → 4 calories per gram proper functioning of the heart muscle. Fat → 9 calories per gram - Lacking of selenium cause keshan’s disease, cancer and less Are organic or inorganic substances found in foods that able immune system to fight off diseases and excessive intake are required for body functioning o selenium causes liver damage. The food sources are organ Nutritive value – the nutrient content of a specified meats, cereals dairy products. amount of food Chronium (Cr) No food provides all essential nutrients - takes part in glucose metabolism, helps the body use 6 Essential Nutrients carbohydrates and fats, and stimulates synthesis of fatty acids Organic and cholesterol in the liver. - Lacking of chromium may lead to impaired action of insulin, CHO and low blood glucose level. The food sources corn oil, clams, CHON cereals, vegetables and meats. FATS VIT There are nutrients to take – or avoid taking together for best Inorganic absorption: H20 Individual can take iron + vitamin C; vitamin D + calcium; Minerals vitamin B12 + folate; vitamin D + Omega-3s and avoid taking combination of iron and calcium. MACRONUTRIENTS Water (H2O) is 60-70% total body weight; deprivation of 10% Carbohydrates water – illness; 20% - death; next to O2 for maintenance of - Considered as the primary source of fuel for the brain and the life; 45 liters – water found in the body of normal adult; 30 rest of the body. liters intracellular (inside or within the cells); 15 liters - 50% - 70% of total energy requirement extracellular (outside the cells); and large intestine absorbs - 1 gram CHO= 4 calories upon complete hydrolysis water and changes the waste from liquid into stool. The - C, H, O, derived from the Greek word saccharide meaning functions of water are acts as solvent for all products of starches and sugars. digestion (universal solvent); carries nutrients to the tissues; - Organic compounds composed of carbon, hydrogen and removes waste products from the tissue; helps regulate body oxygen temperature and the acid-base balance; sends messages - produced by the process of photosynthesis from - H2O, CO2 between cells so individual can think, see, touch, hear, feel and and sun. move. Lack water results in: dehydration with the following - The Total Energy Requirement is ranging from 50% to 70% of symptoms of fatigue decrease blood pressure increase body body energy needs is from CHO. temperature, headache, weight loss and collapse, and decrease - CHO has 1 gram of CHO which is equivalent to 4 calories urine output. There are three (3) possible sources of water for upon complete hydrolysis. the body are: water contained in foods; fluids taken as such and water formed by the oxidation of foods in the body. Input can be fluids in the form of water, juices, and parenteral and output are urine, vomitus, feces, stomach content, drainage, bleeding, and perspiration. The approximate average daily Intake and Output is 2200 to 2500 ml/day. The abnormality of water balance is over hydration versus dehydration. 2 forms Animals sources – glycogen (10% - 20%) Plant sources – glucose (80% - 90%) J.A.K.E 8 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 Classification of Carbohydrates 2) Dextrin Monosaccharides - used in many glue products due to its adhesive - Simplest form of sugar qualities and safety. The indigestible form - The building blocks are called monosaccharide. of dextrin is often used as a fiber supplement. - The absorption process begins around 3-6 hours after eating. 3) Glycogen - 3 types of monosaccharide: - “animal starch”, storage form of CHO in the body 1) Glucose found in the liver and muscle - ”Physiologic sugar” or “blood sugar”, “dextrose”, - Muscle glycogen supplies energy directly to “grape sugar” - principal form used by the body surrounding tissues during work and exercise - moderately sweet sugar works for the body’s brain, - Liver glycogen is converted to glucose to be used in nerve cells, RBC the body through the process called “glycogenolysis” - stores last for only hours - Source: liver, oysters, muscle meat Gluconeogenesis – process where protein is - A glycogen storage disease (GSD, also glycogenosis converted to glucose and dextrinosis) is a metabolic disorder caused by Ketosis – less available CHO for energy – more enzyme deficiencies affecting either fats to be broken down – form ketone bodies glycogen synthesis, glycogen breakdown or - sources: abundant in fruits, sweet corn, corn syrup glycolysis (glucose breakdown), typically within - Color Identification muscles and/or liver cells. GSD has two classes of cause: genetic and acquired. Lycopene-red - Glycogen storage disease type I (GSD I) or von Carotene-orange, yellow Gierke disease, is the most common of the glycogen Anthocyanin-blue, violet storage diseases. This genetic disease results from Cruciferae – green, white deficiency of the enzyme glucose-6-phosphatase, and 2) Fructose has an incidence in the American population of - “fruit sugar”, sweetest of all sugar, “levulose” approximately 1 in 50,000 to 100,000 births. - sources: ripe fruits and honey - Liver Biopsy – confirmatory test 3) Galactose 4) Fibers - not found in nature, not found in free foods - The building blocks are called monosaccharide. - produced from lactose (milk sugar) by digestion and - The absorption process begins around 3-6 hours after is converted to glucose eating. - Galactosemia – Infants born with an inability to - Considered as roughage because they form bulk of metabolize galactose the diet, act as broom in the digestive tract, - Republic Act 9288 – Newborn Screening Test indigestible part of food and primary constituent of Disaccharides plant cell wall, not digested by human due to lack of - two sugar molecules enzyme that will split or break it. The body - hindi maabsorb requirement is 20 to 35 g/day. - 3 types of disaccharides: Functions of Carbohydrates 1) Sucrose Chief source of energy, protein sparing - ”cane sugar”, “table sugar”, “beet sugar” Supplies energy to the body - Sucrose = glucose + fructose Takes part in building body tissues to some limited extent 2) Maltose Regulator of intestinal peristalsis and provider of bulk - ”malt sugar” Lack of Carbohydrate Results to: - Derived from the digestion of starch - Underweight and/or rapid weight loss - Maltose = glucose + glucose - General weakness 3) Lactose - Poor physical performance - ”milk sugar” - Fainting or collapse in severe deficiency - Least sweet among sugars - Hypoglycemia in acute carbohydrate deficiency - Lactose = glucose + galactose Excessive carbohydrate may results in: - Source: milk and milk products - Dental caries Complex carbohydrates or polysaccharides - Obesity/overweight - contains many monosaccharides linked together - Diabetes mellitus 1) Starch - Gas formation - storage form of carbohydrates in plants Hypoglycemia – weight loss - supply energy for a long period of time Hyperglycemia – Obesity and Diabetes Mellitus - Source: cereal grains, rice, wheat Health Effects of Starch and Fibers - Derived from dextrose (glucose), dextrin is a low- Promote weight loss/ weight control – increase fibers, low fats molecular-weight carbohydrate produced from the and added sugar hydrolysis of starches. Protect against heart disease and stroke – high in - An intermediate product of starch digestion plus acid carbohydrates with application of heat of 150-200 C. Protect against cancer – high in carbohydrates - Starch (dextrin) =maltose + 2 glucose units J.A.K.E 9 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 Fight against diabetes – high in carbohydrates and low fats cereals and ↓ in quality and quantity protein; usual onset is control weight from 1-6 years old with signs and symptoms of edema, Promote gastrointestinal health – increase fibers enhances enlarged liver due to accumulation of fat, altered skin and hair healthy large intestine pigmentation and moon’s face. - Marasmus is a protein caloric deficiency, disease caused by Proteins inadequate protein and calories, from semi-starvation resulting - organic compound containing C,H,O,N and derived from the from mother’s failure to nurse her infant. The onset is from 6 Greek word “proteios” months-4 years old with signs and symptoms of loss of - meaning to hold first place or is the prime importance. subcutaneous fat-very underweight and old man’s face. - The building blocks are called ‘’amino acid’’. Marasmus Kwashiorkor - Complete and Incomplete Proteins Food - Has amino acids which serve as the building units of the body Severe Semi-starvation deprivation tissues - Organic compounds composed of carbon, hydrogen, oxygen Onset 6 mon – 4 years 1 – 6 years and nitrogen - Normal osmotic relations in body fluids (albumin) Deficiency Protein and Calories Protein only - 10%-15% of total energy needs is supplied by CHON Appearance Old Man’s Face Moon’s Face - 1 gram CHON= 4 calories upon complete hydrolysis - Protein digestion occurs in the stomach and duodenum in which 3 main enzymes, pepsin secreted by the stomach and Functions of Proteins trypsin and chymotrypsin secreted by the pancreas, Builds and repairs body tissue for growth and maintenance - break down food proteins into polypeptides that are then Anabolism – repairing worn out body tissue broken down by various exopeptidases and dipeptidases into Catabolism – continued wear and tear going on in the body amino acids, Builds resistance to infection by helping form antibodies - protein is digested and absorbed in the small intestine. Supplies additional energy - It has simple proteins which comprises of albumins that is Contributes to numerous body secretions and fluids soluble in water, coagulated by heat and globulins that is Maintain water balance insoluble in water, soluble in salt solution, coagulated by heat. Sources of Protein - The essential amino acid (EAA) or indispensable amino acid is - Animal Source- egg, milk, milk products, meat, fish, one that cannot be synthesized by the body. poultry and seafoods - Simple proteins - Plant Source- cereals (wheat, rice, corn), legumes (munggo albumins – soluble in water, coagulated by heat beans, peas, peanuts, soybeans), processed vegetable globulins – insoluble in water, soluble in salt solution, protein (vegemeat, tofu) coagulated by heat Lack of protein results in: - Retarded growth in children According to Essentiality - Low resistance to infection at any age Essential Amino Acid (EAA) or Indispensable - Slow recovery from illness - Amino Acid – Is one that cannot be synthesized by the body - Low birth weight - Histidine, Phenylalanine, isoleucine, threonine, leucine. - Protein energy malnutrition- Marasmus and Kwashiorkor Tryptophan, leucine, tryptophan, lysine, valine, methionine. - Loss of weight - Edema, skin lesions, mental sluggishness Effects of excessive protein intake - Kidney function – high CHON diet - increase work of kidneys - Mineral losses – increase CHON diet - calcium excretion rises - Obesity – high CHON diet – increase intake rich fat foods - Heart disease – foods rich in animal protein – rich n saturated fats Semi-Essential Amino Acid or Semi-Indispensable Amino Acid - Cancer – increase in CHON diet – increases rich saturated - reduce a need for a particular EAA and partially spares it fats foods intake - Arginine, Tyrosine, Cystine, Glycine, Serine Non-Essential Amino Acid (NEAA) Fats - not dietary essential because the body can synthesize it - Also known as Lipids, consider as organic nutrient containing - Glutamic acid, Aspartic acid, Alanine, Proline, Norleucine, C, H, O attached in a glycerol base. Citrulline, Hydroxyglycine, Hydroxyproline - Facilitates absorption of the fat soluble vitamins (A, D, E, K) - As insulator and protector Kwashiorkor and Marasmus - Two Fatty Acids – basic structural unit of fat. They are the key - Kwashiorkor and Marasmus are protein-energy malnutrition. refined fuel forms of fat that the cell burns for energy - Kwashiorkor is a protein deficiency, disease caused by severe - Serve as the continuing supply of energy each and every hour shortage of protein; associated with post weaning diets ↑ - Organic nutrient containing C,H,O attached in a glycerol base. J.A.K.E 10 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 - 1 gram fat = 9 calories - 20%-30% of TER is from fat. - Remains in the stomach for the longest period of time. - A good approach when it comes to breaking up fat calories is to eat 40 percent of daily fat grams at breakfast, 40 percent between midday meal, and 20 percent at dinner. - Avoid fatty foods at night. It can take 2-4 hours for fat to digest, - Bile contains bile salts, which act as an emulsifier of lipids. - breaks the large fat droplets into smaller droplets that are then easier for the fat-digesting enzyme pancreatic lipase to digest. - Fats are mainly digested in the small intestine. Steatorrhea is the presence of excess fat in feces. 2) Monounsaturated – Oleic Acid (Omega 9), examples are avocado, peanut butter, peanut oil, pili nut, olive oil, shortening; 3) Polyunsaturated Fatty Acids – Inolenic acid, Vitamin F, Omega 3, Linoleic acid – omega 6. examples are corn, soybean, rapeseed, canola, sunflower, sesame seeds. Classification of Fats Simple Lipids - Neutral fats - chemical name is triglycerides - glycerol is derived from a water soluble form of CHO Compound lipids - combination of fats with other components important in human nutrition a) Phospholipids - fatty acids, phosphoric acids and nitrogenous base o Lecithin - most widely distributed, traces placed in liver, egg yolk and vegetable oil; added to food products such as cheese and margarine to aid emulsification o Cephalin - needed to form thromboplastin for blood clotting o Sphigomyelin - found in brain and other nerve tissue; serves as insulator around nerve fibers b) Glycolipids – fatty acids combined with CHO and Glycerol - water soluble component of triglycerides, available nitrogen for the formation of glucose in the diet c) Lipoprotein - lipids combination of protein Steroids - fat related substances that contain sterols, main o Chylomicrons – transport diet-derived lipids, mostly member is cholesterol – important constituent of body cells triglycerides and tissues. o Pre-beta lipoprotein – VLDL (very low density lipoprotein), fat circulating in the blood during Functions of Fats fasting state Supplies food energy in concentrated form for body activities. o Beta lipoprotein – LDL (low density lipoprotein), Protects vital body tissue and insulates body transport in the artery wall Supplies essential fatty acids. o Alpha lipoprotein – scavengers Serves as a carrier of the fat-soluble vitamins (A,D,E,K) Derived lipids Adds palatability and satiety value (sense of fullness) to your - Fat substances produced from fats and fat compounds meals. - Fatty Acids – basic structural unit of fat Lack of fat in the diet results in: 1) Saturated fatty acids – palmitic and stearic acids. - Underweight Examples are: bacon, butter, grated coconut, coconut - Sluggishness cream, coconut oil, margarine, mayonnaise, cream cheese, - Skin irritation similar to eczema in infants sandwich spread whipping cream, chicharron, cholesterol - Signs and symptoms of fat-soluble vitamin deficiency rich foods. Excess intake of fat results in: - obesity/overweight - cardiovascular diseases J.A.K.E 11 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 Food - Water soluble vitamins that is dissolve in water and are not Nutrients Deficiency Excess Sources stored in the body; absolutely needed daily because excess Sugar as one Acute: Acute: excreted in the urine; do not have precursor and deficiency of the main Hypoglycemi Hyperglycemia develops fast; and with example of Vitamin B complex and ingredients of a Chronic: Vitamin C Carbohydra the food Chronic: Diabetes and Fat Soluble Water Soluble tes product Weight loss Obesity Not absolutely needed daily Must be supplied everyday in Ripe fruits from food sources the diet Grains, Legumes Have precursors Do not have precursors Poultry, Eggs Protein Cardiovascular Not stored in the body, any Stored in the body Meat, Milk Energy Diseases excess is excreted in urine Seafoods, Malnutrition Obesity Deficiency develops slow Deficiency develops fast SOYBEAN 1. Mar Cancer – Proteins Cereals, asm prostate, Grains us pancreas, Vit. Uses Deficiency Vegetables, 2. Kwa kidney, breast Normal function of the heart, Legumes shior and colon B1 Beri beri muscles, nerves kor Kidney Disease Ariboflavinosis Red meat ADEK Magenta red Egg, Poultry deficiency Maintain health tongue, mouth B2 tongue (Glossitis) Dairy Underweight and ocular Cheilosis Products Photophobia Fats Seafoods Vegetable Keeps normal activity of the GIT oils B3 and CNS Pellagra (4D) Nuts, Tuna Maintain healthy skin Soybean Essential for the formation of tryptophan and conversion to Vit. B6 Peripheral neuritis MICRONUTRITENTS B3 Vitamins Taken with Isoniazid (INH) - The word vitamin coming from a Latin word meaning vita – life and amine means nitrogen compound. Megaloblastic Essential for formation of RBC - They do not give energy but merely help convert food into Anemia B9 Taken with Iron supplements energy. Neural Tube during pregnancy - Bile is needed for the absorption of fat-soluble vitamins. Defects - acts as co-enzyme for energy metabolism of CHO, CHON and Essential for formation of RBC fats. B12 Pernicious anemia Helps maintain nerve cells - Precursors / Provitamins is a compound that can be changed to active vitamins. Antioxidant - Preformed Vitamins is a occurring vitamins that are inactive Immune system C Scurvy form and ready for biological use. Iron absorption - Avitaminosis is a lack of vitamins, Healing of wounds and fracture - Hypervitaminosis is a vitamin toxicity, excessive accumulation of vitamins in the body. Fat soluble Vitamins - Vitamin malnutrition is bad (mal); too much or too little is not Vitamin A good for the health. - also known as retinol with precursor of carotene, - Vitamin like compounds are substances have physiological - absorbed through lymphatic system and portal blood to liver. roles like vitamins but in large amounts partially synthesized - An antioxidant and never be given for pregnant mother for the in the body like inositol, choline etc. first trimester because causes teratogenic to the baby. - Antivitamins or vitamin antagonist is a substance that interfere - The following functions are: the normal functioning of the vitamin like dicumerol against helps maintain normal vision; Vitamin K, avidin against biotin. helps keep lining of the mouth, nose, throat and respiratory tract healthy; Classifications of Vitamins helps skin and hair glossy, teeth strong; - Fat soluble vitamins that is dissolve in fat before they are promotes growth; absorbed in the blood stream; not absolutely needed daily from maintains the stability of the cell membrane; food sources; have precursors, stored in the body and assists in immune reaction. deficiency develops slow; with examples of Vitamins A, D, E, - Lacking vitamin A results in: K. J.A.K.E 12 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022 Bitot’ s Spot a mild form and Xeropthalmia a severe form slow clotting of blood; of blindness; tendency to bleed easily; inability to see in dim light or “night blindness”; hemorrhage following operations or in the umbilical cord eyes sensitive to bright light; of newborn infants. rough dry skin and membranes of nose and throat; - The food sources are green leafy vegetables. low body resistance to disease; and Vit. Uses Deficiency Excess affects health of skin, hair, nails and poor growth. Night blindness Antioxidant - Excess intake of vitamin A results in: Bitot’s spot Growth and yellow discoloration of the skin or “carotenemia”; Xerophthalmia development of dry, itchy skin and coarse hair; A (SEVERE) Hepatomegaly skeletal and nausea and headache; Faulty skeletal muscle tissues irritability; and loss of appetite. and dental Eyesight Vitamin D development - Also known as calciferol with precursor of ergosterol, Calcium and - also produced endogenously when ultraviolet rays from phosphorus Muscle spasms sunlight strike the skin and trigger vitamin D synthesis. absorption Rickets in Demineralization - needed for calcium and phosphorous absorption, bone ↓ children of bones and D mineralization. Important for Osteomalacia in deposits in soft - Functions: the formation of adult tissues helps build and maintain strong bones and sound teeth; normal bones Kidney stones and teeth absorbs calcium and phosphorus; and Anemia Cramps, diarrhea promotes normal growth and development. Antioxidant Nerve Dizzines - Lack of Vitamin D results in: E functions degeneration Blurred vision tetany – muscle twitching; Healthy skin Weakness Headaches malformed or soft bones (rickets for children and Essential for Excessive osteomalmacia for adult); K BLOOD bleeding poor development of teeth; CLOTTING Easy bruising stunted growth (osteoporosis); NOTE: Vitamin content is highest in FRESH FOODS that are lowered amount of calcium and phosphorus in blood. consumed as soon as possible after harvest - Excess intake of Vitamin D results in: loss of appetite; Water soluble Vitamins nausea and vomiting; Vitamin C intense thirst and frequent urination; - Also known as ascorbic acid, anti-oxidant vitamin and easily severe constipation and/or diarrhea; absorbed from small intestines. muscular weakness; and - The functions of vitamin C: headache and drowsiness. Food sources are dairy  increases the body resistance to infection; products, eggs, yolks and fatty fish.  helps keep gums and teeth healthy; Vitamin E  aids in the absorption of iron and calcium in the body; - an antioxidant vitamin with precursor of tocopherol, stored in  helps in the formation of red blood cells; adipose tissue, aided by bile and fats and stable to heat and  prevents scurvy. acid. - Lack of ascorbic acid results in: - The functions of vitamin E are:  bleeding gums; loose teeth; maintains nerves, muscles and a healthy reproductive  skin hemorrhages (black and blue spots); system;  slow wound healing; helps protect tissues and membranes against the damage  bone changes; of oxidation;  anemia; and scurvy in severe deficiency. helps in the formation of red blood cells and in the - The food sources are citrus fruits, broccoli, cantaloupe, kiwi, utilization of Vitamin K. cabbage, strawberries, tomatoes, melons. - The food sources are vegetable oils, nuts, seeds, whole grains. Vitamin B Complex Vitamin K - if food rich in vitamin B complex especially vitamin B2 and - also known as menadione, pytomenadione and phylloquinone. need to be boiled losses of Vitamin B is 15-40%. When frying - It is synthesized by normal intestinal flora and maintenance of – 40-50% and roasting – 30-60%. That’s why lost vitamins prothrombin level in blood plasma. from cooking are transferred to the cooking liquids and best turn these liquids to sauces and gravies. - The functions of vitamin K are: helps in the normal clotting of the blood; Vitamin B1 increases calcium absorption; and - also known as thiamine maintains strong healthy bones. - the functions of vitamin B1 are: - Lacking of vitamin K results in:  prevents beri-beri / nutritional polyneuritis;  keeps nerves in healthy condition, muscle nerve function; J.A.K.E 13 of 34  NUTRITION AND DIET THERAPY – BSN 2ND YEAR SUMMER MIDTERM 2022  promotes good appetite and normal digestion; co-enzyme for energy metabolism.  promotes good growth. - Lack of Panthothenic acid resulted in insomnia, tingling - Lack of thiamine results in: sensation of the extremities, muscle cramps and vomiting. mental confusion/depression; - The food sources are liver, meats, eggs, milk cheese and poor appetite; legumes. nervousness; Vitamin B6 Loss of ankle and knee jerk reflexes; - also known as pyridoxine with functions of metabolism of painful calf muscles (cramps) amino acids and protein; helps the body use carbohydrate, fat constipation; and protein; neurotransmitter synthesis, avoided to patient fatigue, weakness; with parkinson’s; supplemented in anti-TB therapy; and converts tryptophan to niacin and linoleic acid to arachidonic retarded growth. acid. - The food sources are whole grains, pork, cereals, legumes, - Lack of pyridoxine results in: seeds and nuts. There are types of beri-beri such as infantile - occurs in infant 2 to 5 months of age, gets the disease from loss of appetite, nausea and vomiting; mother’s milk suffering from beri-beri and symptoms like loss nervous irritability and convulsions; of voice (aphoria) and cyanosis. dermatitis around the eyes, mouth, on the nose and behind  Wet - edema on both extremities progress upwards to the ears. heart and lungs. - The food sources are whole grains, spinach, broccoli, legumes,  Dry – involves peripheral nerves causing paresthesia vegestable oils of corn. leading to paralysis. Vitamin B9 Vitamin B2 - also known as folic acid or folate with functions of aids in - also known as riboflavin, co-enzyme for energy metabolism, metabolism of genetic material (DNA, RNA); helps cure a essential for protein, fat and carbohydrates metabolism and form of anemia, poor growth, and birth defects; synthesizes vitamin readily destroyed in cooking. DNA which control cell function, heredity and tissue growth; - The functions of vitamin B2 are: and regenerates red blood cell and essential formation of WBC  keeps eyes and skin healthy; in the bone marrow.  aids in normal functioning of nervous system; - Lack of folic acid results in:  promotes growth. poor growth; - Lack of riboflavin results in: fatigue, depression and confusion; sores in angles of mouth and fold of nose, itching burning macrocytic anemia; eyes; glossitis; sore, swollen and chapped lips, swollen, fissured, and diarrhea; painful tongues; malformation in the offspring especially neural tube retarded growth. defect; - The food sources such as pork, grains, cereal products, meats, gastrointestinal disturbances. fish, green leafy vegetables. - The food sources are green leafy vegetables, nuts, legumes, Vitamin B3 grain products. - Also known as niacin or nicotinic acid and co-enzyme for Vitamin B12 energy metabolism. - also known as cyanocobalamin or cobalamin, consider as - The functions are: folate metabolism, nerve function and problem with intrinsic promotes normal digestion and keep nerve in healthy factor in pernicious anemia with lifetime treatment. condition; - The functions are facilitates matura