Nutrition And Diet Therapy (NCM 105) Midterm Reviewer PDF

**NUTRITION AND DIET THERAPY (NCM 105) REVIEWER** **Health** - A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. - The maintenance of health involves preventive, diagnostic, curative, and restorative measures on the individ...

**NUTRITION AND DIET THERAPY (NCM 105) REVIEWER** **Health** - A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. - The maintenance of health involves preventive, diagnostic, curative, and restorative measures on the individual or community. **Illness** - A deviation of bodily functions from normal or usual well-feeling and its perception is both physiological and psychological. - The etiology of an ill person is under various stress factors such as: pain, anxiety, fever, distention, anorexia, nausea, and others A hospitalized patient has to adjust to hospital conditions including food service, personal routine, state of immobility, atmosphere, and other. **Nutrition** - The study of food in relation to health. - The science of food, the nutrients and other substances therein, their action, interaction, and balance in relation to health and disease, and the process by which organism ingest, digest, absorbs, transports, utilizes, and excretes food substances. - The study of nutrients in foods and the body's handling of these (including ingestion, digestion, absorption, transport, metabolism, interaction, storage and excretion). It is broadly defined as the study of environment and of human behavior as it relates to these process. - Nutrition is a unique discipline due to its specific goal: that of improving human health by understanding the role of diet and supplying that knowledge in everyday living -- accdg. to Brody **Food** - Anything, that, when taken into the body, serves to nourish, build, and repair tissues, supplies energy, or regulate body processes. - Material containing nutrients taken into the body for the maintenance of life and growth and repair tissues. **Nutritional status/nutriture** - State of the body resulting from the consumption and utilization of nutrients **Malnutrition** - State of impaired biologic activity or development due to discrepancy between the nutrient supply and the nutrient demand of cells. - An imbalance of nutrient intake - either an underconsumption or an overconsumption of energy or nutrients. 1. the recognition of the role of nutrition in preventing diseases or illnesses; 2. the concern for radapting food patterns of individuals uals to their nutritional needs within the framework of their cultural, economic and psychological situations and styles; and 3. the awareness of the need in specified disease states to modify nutritional factors for therapeutic purpose. **Nutrients** - are chemical substances found in food. They perform diverse roles in the body such as to provide heat and energy, to build and repair body tissues, and to regulate body processes. Found primarily in natural foods, adequate intake of these nutrients is necessary to carry out physiological functions. - Classified according to the following: 1. Function - Those that form tissues in the body are body-building nutrients while those that furnish heat and energy are fats, carbohydrates and proteins 2. Chemical properties - Nutrients are either organic or inorganic. 3. Essentiality - Nutrients are classified based on their significant contribution to the body\'s physiological functioning 4. Concentration - Nutrients are 5. either in large amounts or in little amounts. 1. Carbohydrates 2. Lipid 3. Protein 4. Vitamins 5. Mineral 6. Water **Food** - When taken and digested nourishes the body. It is a vital need which a person cannot live. It is likewise culturally acceptable as it supplies heat and energy, builds and repairs body tissues and regulates body processes. - Tray service is the type of food services in hospitals. Standard-sized trays (8x12) are used. An underliner is always placed to improve the appearance of the set-up 1. Rice and vegetable plate 2. Soup plate 3. Glass 4. Desserts 5. Fork 6. Dinner plate with rice 7. Knife 8. Tablespoon 9. Teaspoon 10. Cup and saucer **Laboratory Procedure** 1. Here are the following rules to follow: a. Wear the complete cooking outfit: laboratory gown (must be clean and neat-looking, not crumpled or torn), hair net or hair cap, closed shoes. b. Wash hand and arms with soap and water before and after the laboratory activity. c. Remove rings, bracelets, and wristwatches. d. Refrain from painting your fingernails with dark colored nail polish. e. Bring your own hand towel. 2. Always observe cleanliness and sanitation. 3. Utilize the cooking tools properly. 4. Clean and clear the cooking area, sinks, tables, and working/preparation areas before leaving the laboratory. 5. Weigh and measure all food items before and after cooking to make diet computation easier. 6. During the food evaluation period, be ready to discuss the observations made on the exercise performed. 7. If diet computations are involved in doing the exercises, show all your calculations on separate sheets and indicate unit measurements. 8. Submit the completed written exercise/s ate the end of each laboratory activity. **The ABCs of Food Preparation** **TECHNIQUES IN FOOD PREPARATION** - Getting food ready to cook is just as important as the actual cooking. Measuring, chopping, slicing. coring, and peeling the ingredients are just some of the necessary preparation tasks. The success or failure of many dishes depends on how well you know the ABCs of food preparation. If you do them right, you can finish preparing the food fast, with little effort. 1. **Measuring Dry Ingredients** - Pour spoon-sifted or unsifted dry ingredients into the dry measuring cup until overflowing. catching excess on kitchen wrap. Level off the contents of the cup with the straight edge of a knife or metal spatula. Never tap the cup on counter to level; do not press or pack down the ingredients unless the recipe specifies (as with brown sugar). 2. **Measuring Powder Ingredients** - Dip the measuring spoon into the baking powder, salt, or spice, and stir to break up lumps. Fill the spoon to overflowing and then level it off with the straight edge of a knife or metal spatula Scrape out with a rubber spatula. 3. **Measuring Liquids** - Place the liquid measure on a level surface and fill to desired mark. Bend over to check at eye level for accuracy. 4. **Peeling Raw Tomatoes and Potatoes** - Put tomato and potato in boiling water for 10 to 30 seconds (shorter time for riper fruits) Remove and rinse in a cold water to stop cooking. Peel will lift off. 5. **Peeling Firm Fruits and Vegetables (carrots, turnips, apples, and pears)** - Hold the fruit or the vegetable in one hand, and with a floating blade peeler in the other hand peel from top to bottom, turning the fruit or the vegetable as you progress. Trim the stem and/or root with a small paring knife. 6. **Cutting Meat or Vegetables in Julienne Strips or Match Sticks** - Cut meat or vegetables into ½\" slices. Stack 3 or 4 slices together and cut into w\" wide strips. 7. **Slicing Firm Fruits and Vegetables** - Peel the firm fruit or vegetable if necessary. Leave it whole or half lengthwise; slice straight up and down, pushing knife slightly forward with each down stroke. Slide knuckles of left hand and allow the fruit or vegetable to control thickness of each slice. 8. **Dicing Celery, Carrots, and Green Pepper** - Cut vegetables into long strips across to make fairly neat cubes. Make slices much closer when the recipe calls for \"finely cut\" or \"minced.\" 9. **Chopping, Dicing, and Mincing Onion** - Halve peeled onions lengthwise. Hold on board with cut side down and root end to your left. Make several slices from tip to root. Do not cut through root. Next, slice from side to side. Then alice from tip to root again, cutting across the first slices. Make all slices as close together as possible for minced onions, about ½\" apart for chopped. **PURCHASING** - Purchasing is an important activity because the quality and cost materials at the time of purchase largely determine the quality and cost of the finished product. - Effective purchasing aims to provide an adequate supply of food, the right quality in the right quantity, and at the right price. To make this possible, it is important for the food to be purchased at the right time from the right source. **TIPS IN PURCHASING** 1. Choose whole-grain cereals and bread rather than refined ones. The greatest concentration of B-vitamins and minerals is in the wheat germ and outer layers of the grain. The entire germ and most of the outer layers are removed during milling to refine or whiten the grain. Some, but not all, of the essential nutrients are restored when flour or cereals are enriched. In the other words, enriched foods are much better than unenriched refined products, but whole-grain products are best, Rice and pasta, as well as breads and cereals, are readily available in enriched forms. Brown rice contains more vitamins than white rice, and parboiled white rice (\"converted\") has more vitamins than polished rice. 2. If you buy skim milk or non-fat dry milk, be sure it has been fortified with vitamins A and D. These vitamins are lost when fat is removed from the milk. Margarine should also be fortified with vitamins A and D. 3. Buy fresh or frozen fruits and vegetables rather than canned ones. Many vitamins are soluble in water (all B-vitamins and C) and many are destroyed by high temperature involved in canning. As a result, canned foods may retain half or less of the original content of many vitamins; additional vitamins are lost during storage. 4. Shop for fresh produce and, if possible, pick fruits and vegetables that have been ripened in the vine. 5. Choose bright orange carrots, deep orange sweet potatoes, and dark leaf lettuce for maximum vitamin A content. **STEPS IN PURCHASING** 1. Determine what items or products should be purchased, specifying the quality and quantity. 2. Know the market situation about the products, such as the supply, demand, market availability, and other related information. 3. Contact potential suppliers or visit possible sources to know what products are being offered and at what price. 4. Compare the products available from different sources with your product specifications. 5. Evaluate what the supplier has to offer against your needs, as in the quality available, prices, terma conditions of delivery, methods of payment, and the like. 6. Decide on the supplier or vendor. **TIPS FOR A PURCHASER/MARKETER** 1. Know what to buy and where to buy quality foods. 2. Determine beforehand how much you can afford to spend. 3. Make a flexible marketing list. 4. Use polite expressions when buying and asking for goods. 5. Avoid unnecessary remarks if you do not approve of the price. **HOW TO BUY FRUITS** 1. Buy fruits in season. 2. Citrus fruits should be heavy for their size. 3. Fruits should be firm, even-colored, and free from signs of decay. 4. Fruits that are just ripe are richer in nutrients; overripe fruits have less food value. **HOW TO BUY VEGETABLES** 1. Select those without signs of decay. 2. Tomatoes and eggplants should be firm and free from scars and spots. 3. Cabbage should be firm and heavy. 4. Avoid buying vegetables that are cut and diced into pieces or peeled. **HOW TO BUY EGGS** 1. A fresh egg will sink if it is placed in a basin of water. 2. It has a rough shell. 3. It is heavy. **HOW TO BUY MEAT** 1. Pork is pinkish red while beef is dark red. 2. Know the desired part of meat before buying. **HOW TO BUY CHICKEN** 1. Young chicken has smooth legs. 2. Know the desired part of chicken for cooking needs. 3. There should be traces of fat under the skin. 4. The meat should be yellowish pink. **HOW TO BUY FISH** 1. The flesh is firm and scales are fully shiny. 2. The odor is not unpleasant. 3. The belly walls are intact. 4. The eyes are full and bright. 5. The gills are red, not gray or brown. **EQUIVALENTS AND MEASUREMENTS** **Liquid Measure Volume Equivalents**  **Dry Measure Volume Equivalents** **Weight or Avoirdupois Equivalents**  **Liquid Measure Volume Equivalents** **Liquid Measure Volume Equivalents**  **Dry Measure Volume Equivalents** **Weight Equivalents**  **Metric Capacity Measure** **Metric Dry Measure Volume Equivalents** **Metric Weight Measure** **Weight Equivalents in Grams**  **Equivalents** **Human Cell Anatomy**  **Cell Membrane** - also known as the plasma membrane. This is the outer border of the cell which has a sheetlike structure made up mainly of lipids and proteins. - The lipid portion consists primarily of phospholipids - with a hydrophobic and hydrophilic portion. - **Hydrophobic core** - the bilayer retards the movement of water-soluble substances to stay inside the cell. - Regulate and select the kinds and amounts of substances entering and leaving the cells. - The membrane proteins serve as pumps, gates, receptors, energy transducers and enzymes. - The proteins in the cell membrane form pores or openings to permit passage of materials by: - acting as enzymes to help substances enter the cell - acting as antigen markers to identify the cell as \"self\" - serving as receptor sites for hormone **Cytoplasm** - is a watery solution of minerals, gases, and organic molecules found between the cell membrane and the nucleus and is a location of chemical reactions. - A fluid with a gel-like consistency due to the high concentration of protein. - This is the site where most of the biochemical reactions of the cell takes place. **Cell Organelles** - are intracellular structures that are bound by their own membranes, each having a definite function. **Endoplasmic Reticulum (ER)** - A network of interconnected tubules in the cytoplasm, providing continuity between the nuclear envelope. - a passageway for the transport of materials within the cell. - **Rough endoplasmic Reticulum** (granular with ribosomes) - protein synthesis is the main function. - **Smooth endoplasmic Reticulum** (agranular without ribosomes) - synthesis of lipids and carbohydrates. It is abundant in cells that synthesize steroid hormones and in liver cells where drug detoxification and synthesis of fat transport molecule (VLDLS) take place. **Ribosomes** - Site of protein synthesis bound to the outside of the endoplasmic reticulum. **Golgi Apparatus** - a string of flat membranous sacs that synthesize carbohydrates. They package material for secretion from the cell by breaking off some of their small sacs and fusing with the cell membrane in order to release the contained substance to the outside of the cell. - Believed to be an extension of the endoplasmic reticulum. Consists of secretory vesicles which carry materials synthesized in the endoplasmic reticulum - Site of the packaging of protein synthesis in the RER and destined for secretion from the cell via secretory vesicles **Mitochondria** - organelles inside the cytoplasm, that is the site of energy production (ATP). A double membrane binds them and has an inner layer with folds called cristae. - The energy producers of the cell; hundreds to thousands of oxidative enzymes that catalyze the breakdown of carbohydrates, protein, and lipid producing ATP in the process. **Lysosomes** - a single-membrane structures inside the cytoplasm that contain digestive enzymes that destroy engulfed bacteria and other cellular debris. - abundant in cells that perform digestive functions (macrophages, leukocytes). - Contain about 36 powerful enzymes that can split proteins, polysaccharides, nucleic acids and phospholipids. - Catabolic Function: - Phagocytosis, process in which foreign substances taken up by the cell are digested or rendered harmless. - Autolysis, a process in which intracellular components (including organelles) are digested due to the cellular degeneration or injury. - Bone resorption, an essential process in normal bone modeling. Lysosomes of the osteoclasts dissolve the mineral and digest collagen. These actions are important in bone resorption to maintain calcium and phosphorus homeostasis. **Centrioles** - a pair of rod-shaped structures that lie perpendicular to one another and located just outside the nucleus. Their function is to organize the spindle fibers during cell division. **Cilia and Flagella** - mobile thread-like projections through the cell membrane. Cilia are shorter than flagella. They sweep materials across the cell surface. The sperm cell is the only human cell with a flagellum that aids motility. **Nucleus** - the largest of the organelles; surrounded by a nuclear envelope composed of two membranes which enable communication between the vesicles and the cytoplasmic matrix. A continuous channel between the nucleus and endoplasmic reticulum is thus possible. - Contains the genetic material (DNA) of the cell. Due to the DNA content, it is the initiator and regulator of most cellular activities. - Site of the synthesis of new DNA molecules (replication) and of RNA molecules (transcription). - The control center of the cell that contains the chromosomes. The forty-six chromosomes of the human cell are long threads called chromatin that is made of DNA and protein. **Prokaryotic and Eukaryotic Organisms** - Prokaryotic organisms are those that do not have true nucleus and membrane-bound cell organelles. - Eukaryotic organisms are those that have true nucleus and nucleolus and also contain all membrane-bound cell organelles **Energy-Yielding Nutrients** - Carbohydrates: 1g = 4 kcal - Protein: 1g = 4 kcal - Fats: 1g = 9 kcal **NUTRITION** - is the science of nourishment. Nutrients from food must be made available for use by the body cells. This is made possible by the digestive system which processes the food (through digestion), releasing the nutrients and/or converting them into molecules that can be utilized by the cells. The digestive system also promotes the movement of nutrients from the gastrointestinal tract (GIT) or alimentary canal into the body through the process of absorption. These absorbed nutrients can now be transported to the cells and enter into the various pathways. **DIGESTION** - The mechanical and chemical breakdown of complex substances into their constituents parts; the conversion of food into smaller and simpler units that can be absorbed by the body. - The process by which complex foods are broken down chemically into their simpler parts in the GIT. - The breakdown of food materials mechanically (through chewing) and chemically (by the action of digestive enzymes) until it is in a form from which its nutrients can be absorbed from the GIT into the blood and lymph. **Digestive System** Human model showing the digestive system, which includes the mouth, salivary glands, esophagus, stomach, liver, gallbladder, pancreas, large and small intestines, appendix, rectum, and anus. - is made up of gastrointestinal tract also called as GIT or digestive tract, the liver, pancreas and gallbladder - GIT is a chain of hollow organs connected in a long, twisting tube from mouth to the anus. Such as mouth, stomach, small intestine, large intestine and anus. - The liver, pancreas and gallbadder are the solid organs. **Parts of the Human Digestive System** **Mouth** - Digestion begins in the mouth where food is broken down to pieces by chewing. Food then mixes with the saliva and broken down into a form that the body can absorb and use. - The mucus like saliva performs three functions: a. It mixes with food, lubricating dry foods and diluting thicker foods; b. It provides alpha amylase, a polysaccharide digesting enzyme, and lingual lipase, a lipid digesting enzyme; c. it dissolves some molecules in food, allowing them to interact with chemoreceptors in the mouth giving rice to the taste sensation. **Throat** - also known as the pharynx, transfers food from the mouth to the esophagus and warms, moisten, and filters air before food is moved into the trachea. **Pharynx Function** - Passageway for air and food - Epiglottis is fold of tissue determines the pathway - Food movement continues to esophagus via peristalsis **Esophagus** - is a muscular tube extending from the pharynx to the stomach. Measuring about 10 inches long, connects the mouth to the stomach. **Bolus** - small ball rolled composed of food that is lubricated with saliva. **Epiglottis** - a small flap at the top of the windpipe (trachea). Prevented the food from entering the respiratory tract and lung. **Peristalsis** - a rhythmic contraction and relaxation of the esophageal muscles - propelled the bolus in the esophagus to the stomach. It also reduces further the size of food particles and mixes them thoroughly with digestive secretions. **Stomach** - is a sac-like organ with tough muscular walls. It holds, mixes, and grinds food. It secretes acid and powerful enzymes that carry on the process of breaking down food. - The stomach has three sets of muscles surrounding a cavity that can expand to accommodate the ingested food and fluid. The pH level is maintained at pH 1.5-1.7. **Chyme** - a semiliquid homogeneous mass formed from between the esophagus mixes and gastric secretions. **Cardiac Sphincter Muscle** - found at the entrance of the stomach which controls the amount of food entering the stomach. **Hydrochloric Acid** - secretion is responsible for the strongly acidic condition of the stomach. With such acidic environment, ingested proteins are denatured thus facilitating their digestion. **Small Intestine** - is a long loosely coiled tube in the abdomen which when spread out, would be more than 20ft long. It is the body\'s longest organ. Its diameter of about 1.5 inches is much smaller than that of the large intestine. - Small intestine has 3 sections: a. Duodenum - continues the process of breaking down food. responsible for the absorption of nutrients into the bloodstream. b. Jejunum c. Ileum Chyme leaving the stomach bypasses the opening from the common bile duct which receives secretions from the gallbladder and the pancreas. Then the liquefied chyme travels down to the 3 sections of the small intestine. **Bile** - Bile, which is made in the liver and stored in the gallbladder, is emptied into the small intestine to aid lipid digestion. **Secretin and cholecystokinin** - the two gastrointestinal hormones release through the presence of chyme in the small intestine. 2 actions a. They stimulate the pancreas to release its digestive enzymes and sodium bicarbonate, an alkali that neutralizes the acidic chyme. b. They stimulate the gallbladder to contract to release the stored bile. **Large Intestine/Colon** - is a long muscular tube approx. 5 to 6 ft that connects the caecum (first part of the large intestine) to the rectum (last part of the large intestine). - 5 parts: a. Caecum b. Ascending right colon c. Transverse (across) colon d. Descending left colon e. Sigmoid colon - connected to the rectum. **Stool,** made up of mostly food debris and bacteria. It normally takes about 36 hours to get through the colon. **Rectum** - is an 8 inches chamber that connects the colon to the anus. It receives stool from the colon and holds it until defecation. **Anus** - the digestive tract ends here which consist of the pelvic floor muscles and the two anal sphincter. The lining of the upper anus is specialized to detect rectal contents. The pelvic floor muscle creates an angle between the rectum and anus that stops stool from coming out. The anal sphincters provide control in the elimination of stool. **PHYSIOLOGIC VALUE OF FOOD** **Food** - refers to the solid and liquid materials taken into the digestive tract that are utilized to maintain and build body tissues, regulate body processes, and supply heat, thereby sustaining life. **Metabolism** - is the chemical process of transforming food into complex tissue elements and of transforming complex body substances into simpler ones along with the production of heat and energy. - Derived from the Greek word "metabolismos" which means to change or alter. **Energy** - is the force or power that enables the body to do its work. In nutrition, energy pertains to the chemical energy locked in the foodstuffs brought about by metabolism. **Energy from Food** - **Calorie**, the unit of energy commonly used in human nutrition. It is the unit of measurement for the energy that the body gets from food. - 1000 small calories = 1 kilocalorie or calorie - Calories are not rate. They are the byproducts of carbohydrates, proteins and fats that are oxidized in the body. One kilocalorie is the amount of heat energy required to raise the temperature of 1 kilogram of water by 1°C. 1. Fuel factor of carbohydrates = 4 calories per gram 2. Fuel factor of fat = 9 calories per gram 3. Fuel factor of protein = 4 calories per gram - **Bomb Calorimeter**, device used to measure the total calorie content available from food. **JOULE**, is the measure of energy in the metric system. - 1 calorie (kilocalorie) = 4.184 joule (kilojoules) - Example: 1 cup of milk = 170 kcal\ 170 kcal x 4.184 joules = 711.28 kjoules **CALCULATION OF FOOD VALUE** Example: 1 cup of milk contains approximately: 12g carbohydrates x 4 cal/g = 48 kcal 8g proteins x 4 cal/g = 32 kcal 10g fats x 9 cal/g = 90 kcal TOTAL: 170 kcal Percentage of Nutrient: 90 fat kcal / 170 kcal = 0.529 or 0.53 0.53 = 53% **\ COMPONENTS OF ENERGY EXPENDITURE\ \ Basal Metabolism** - also known as REE, required energy expenditure, is the measure of energy needed by the body at rest for all its internal chemical activities which is approximately 1 calorie per kilogram of body weight per hour for an adult. - It is the minimum amount of energy needed by the body at rest in the fasting state. - It also indicates the amount of energy needed to suction the life processes: respiration, cellular metabolism, circulation, glandular activity, and the maintenance of body temperature. **Basal Metabolic Rate (BMR)** - is the rate of basal metabolism in a given person at a given time and situation. **Conditions Necessary for BMR Test:** 1. The subject must be in fasting or post-absorptive state, at least 12 hours hours after meal. 2. The subject must be awake, lying quietly, and free from physical fatigue, nervousness, or tension as this cause an increase in heat production. 3. The environmental temperature should be between 20°C -25°C so that the subject can maintain his/her body temperature. **Calculation of BMR** BMR is to use the rule of thumb: **For adult male:** 1 kcal per kg per hour **For adult female:** 0.9 kcal per kg per hour Example: Male, 75kg = 1kcal x 75 (weight) x 24 (hours) = 1,800 kcal Female, 65kg = 0.9 kcal x 65 x 24 = 1,404 kcal **Harris-Benedict Formula (1909),** which uses information on weight, height, age, and sex. Example: **Males** REE = 66 + \[13.7 x wt (kg)\] + \[5 x ht (cm)\] -- \[6.8 x age (yr)\] **Females** REE = 665 + \[9.6 x wt (kg)\] + \[1.8 x ht (cm)\] -- \[4.7 x age (yr)\] **Biologic Body Weight raised to the ¾ power** - Once metabolic body size is known based on weight in kilograms, the figure is multiplied by 70, a value which applies to all animals. Example: A 50kg man's REE = 18.8 x 70 = 70 = 1,316 kcal  **Factors that Affect the Basal Metabolic Rate (BMR)** 1. **Surface area**- The greater the body surface area or skin area, the greater the amount of heat loss, and, in turn, the greater the necessary heat produced by the body. Muscle tissue requires more oxygen than adipose tissue. 2. **Sex** - Women, in general, have a metabolism of about 5% to 10% less than that of men even when they are of the same weight and height. Women have little more fat and less muscular development than men. 3. **Age** - The metabolic rate is highest during the periods of rapid growth, chiefly during the first and second years, and reaches a lesser peak through the ages of puberty and adolescence in both sexes. 4. **Body Composition** - a large proportion of inactive adipose tissue lowers the BMR. Athletes with great muscular development shows about 5% increase in basal metabolism over non-athletic individuals. 5. **State of Nutrition** - a decrease in the mass of active tissue such as in the case of undernourishment or starvation causes a lowered metabolism often as much as 50% below normal. 6. **Sleep** - metabolic rate falls approximately to 15% below that of waking levels. This decreased rate is due to muscular relaxation and decreased activity of the sympathetic nervous system. 7. **Endocrine glands** - secrete hormones into the blood stream, are the principal regulators of the metabolic rate. The male sex hormone increase the BMR about 10% to 15% and the female sex hormones a little less. 8. **Fever --** It increases the BMR about 7% for each degree rise in the body temperature about 98.6°F **COMPUTATION OF DBW (DESIRABLE BODY WEIGHT)** 1. **Ador Dionisio's Method --** height (every 5 ft = 100 lbs for females and for males, and age between 25 to 50 multiply by 2 then divide by 5. 2. **Tannhauser's Method**  **Physical Activity** - Calorie requirements depend on the type and amount of exercise. The more vigorous the physical work, the greater the calorie cost. **Types of Activities** **Approx. %** ------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------- Bed rest 10-20% Sedentary (reading, writing, eating, watching TV, office work, sitting at work) 30% Light Activity (cooking, washing dishes, ironing, welding, standing at work, rapid typing) 50-60% Moderate Activity (mopping, scrubbing, sweeping, gardening, carpentry, walking fast, standing at work with moderate arm movement, sitting at work vigorous arm movement 60-70% Severely Active (heavy scrubbing, handwashing, walking fast, bowling, golfing, heavy gradening) 90-110% **Distribution of Total Energy Allowance** Nutrients \% --------------- -------- Carbohydrates 50-70% Protein 10-15% Fats 20-30% **Physiologic Fuel Values** Nutrients Kcal/g --------------- -------- Carbohydrates 4 Protein 4 Fats 9 **Carbohydrates** - Carbohydrates are organic compounds composed of carbon, hydrogen, and oxygen. They provide the major source of energy for the body or as much as 80 to 100% calories. - The storage form of carbohydrates in plants is starch; the storage form of carbohydrates in animal is glycogen **CLASSIFICATION OF CARBOHYDRATES:** 1. **Monosaccharides** or simple sugars are the simplest form of carbohydrates. They are sweetand since they require no digestion, they can be absorbed directly into the blood stream from the small intestine. 1a. **Glucose (dextrose)** or blood sugar is the principal form in which carbohydrates is used by the body. Abundant in fruits, sweet corn and corn syrup. The body\'s major fuel to provide energy; formed in the body from starch digestion; also known as grape sugar and corn sugar. The liver stores ½ of the body\'s total glycogen and liberates glucose as needed. Muscle cells can also store glucose as glycogen but it is used during exercise. - Provide energy for the brain, other nerve cells, and developing red blood cells. - **Gluconeogenesis**, the process in which protein is converted to glucose. Happens when a person does not reload used up glycogen stores, body protein dismantled allowing glucose to fuel these special cells. - **Ketosis**, a state that disturbs the body\'s normal acid-base balance. With less available carbohydrates for energy, more fats maybe broken down, but not all the way to energy. Instead fat fragments combine with each other and form ketone bodies. Synthesized in mammary glands to make lactose of milk. 2. **Disaccharides** or double sugars are made up of 2 monosaccharides. They are sweet and, they must be changed to simple sugars by hydrolysis before they can be absorbed. 2a. **Sucrose (table sugar)**, is processed from cane and beet sugar. it is found in fruits, vegetables, syrups, and sweet food production and is converted into glucose and galactose upon digestion. (cane and beet sugar, molasses, pineapple, carrots)\ \ 2.b **Lactose (milk sugar)** is found in milk and milk products except cheese. It is converted into glucose and galactose in digestion and is less soluble and less sweet than sucrose. it remains in the intestine longer than other sugars and encourages the growth of certain bacteria - Forms approx. 40% of milk solids. Cow\'s milk contains 4.8 lactose while human milk has 7%. It favors calcium and phosphorus assimilation. 3. **Oligosaccharides,** made of less than 15 monosaccharide units. 4. **Polysaccharides,** they commonly called as complex sugars. Complex carbohydrates composed of many (\>15) monosaccharide units - starch, glycogen, several forms of dietary fiber, dextrins. 4.a **Starch** is the most significant in human nutrition. Its major food sources include cereal grains, potatoes and other root vegetables, and legumes. It is converted entirely into glucose upon digestion; is more complex than sugars; and requires a longer time to digest. Thus it supplies energy over a longer period of time. - yields glucose upon hydrolysis. - Provides immediate fuel for muscle action and helps sustain normal blood sugar levels during fasting periods such as sleep hours. - **Glucagon**, hormones that help the liver convert glycogen into glucose every time the body needs energy. 5\. **Pectins** are non-digestible, colloidal polysaccharides having a gel quality. Sources include mostly fruits and are often used as base for jellies. Used to treat diarrhea as they absorb toxins and bacteria in the intestines. They bind cholesterol reducing the amount the blood can absorb **Digestion in Carbohydrates** 1. **Mouth** a. **Enzyme** - amylase (an enzyme of the saliva, secreted by the parotid glands, acts on starch to begin its breakdown to dextrins and maltose. b. **Action** - the food does not stay in the mouth long enough for much of this change to be completed, so that food is conveyed into the stomach mostly in starch form. 2. **Stomach** a. **Enzyme** - none for the carbohydrates b. **Action** - none; above action by ptyalin may continue to a minor degree. **Functions of Carbohydrates** 1. The principal function of carbohydrates is to serve as a major source of energy for the body. it must be supplied regularly and at frequent intervals to meet the energy needs of the body. 2. Carbohydrates exert a protein-sparring action. 3. The presence of carbohydrates is necessary for normal fat metabolism. 4. Cellulose and closely related insoluble indigestible carbohydrates aid in the normal elimination. 5. They also supply significant quantities of proteins, mineral and B-vitamins. 6. Lactose remains in the intestine longer than other disaccharides, and this encourages the growth of the beneficial bacteria, resulting in a laxative action. 7. Glucose has specific influences; it is indispensable for the maintenance of the functional integrity of the nerve tissue and it is the sole source of energy for the brain. **Sources of Carbohydrates:** 1. Whole grains rich in iron, thiamine, niacin, and other nutrients. 2. Sweet potatoes and white potatoes. Fruits such as bananas and dried fruits and corns and lima beans. 3. Milk is unique in that it is the only dietary source of lactose. 4. Sugars and sweets are important source next to breads and cereals, cane and beet sugars, honey, maple syrup, jellies, jams, and candies. Empty calories are foods that contains only carbohydrates. **Health Effects of Starch and Fibers:** 1. Weight Control - Fibers rich in complex carbohydrates tend to be low in fat and added sugars and can promote weight loss. 2. Heart Disease - High-carbohydrate diets rich in whole grains, can protect an individual againts heart disease and stroke. 3. Cancer-High-carbohydrate diet can help prevent many types of cancer. 4. Diabetes - High-carbohydrate, low fat diets help control weight. 5. Gastrointestinal health - Dietary fibers enhance the health of the large intestine Proteins - is taken from the Greek word protos meaning primary, ranking first, or occupying the first position. The first substance recognized as a vital part of a living tissue. They are organic substance that upon digestion, yields amino acids. **Classification of Proteins** A. Simple Proteins are those which yield only amino acids upon hydrolysis. 1. **Albumins** are soluble in water and coagulated by heat. 2. **Globulins** are insoluble in water, soluble in dilute salt solution, coagulated by heat. Important source of protein in seed plants and are found in minute amounts in cereals. Globulins found in animal fluids are enzymes, antibodies, and fibrous and contractile proteins usually contained in the blood plasma. 3. **Glutelins** are insoluble in neutral solvents but soluble in weak acids and alkalis; they are coagulated by heat. It is found in wheat and is responsible for some of the refined baking properties in bread wheat. 4. **Prolamins** are soluble in 70% to 80% alcohol but insoluble in absolute alcohol, water, and salt solutions. 5. **Albuminoids** are insoluble in all neutral solvents and in dilute acids and alkalis. 6. **Histones and protamines**, which are basic polypeptides are soluble in water but not coagulated by heat; they are found in the nuclei of cells. B. 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. They perform functions that a constituent could not properly by itself. 1. **Nucleoproteins**, combinations of simple proteins and nucleic acid. Deoxyribonucleic nucleoproteins are necessary for the synthesis of proteins in the cytoplasm. 2. **Mucoproteins and glycoproteins** are combination of a protein and large quantities of complex polysaccharides such as Mucin found in the secretion from gastric mucous membranes. 3. **Lipoproteins** are compounds of a protein and a triglyceride or other lipids such as phospholipids or cholesterol found in cell and organelle membranes. 4. **Phosphoproteins** are compounds of phosphoric acid joined in ester linkage to protein found in casein of milk. 5. **Chromoproteins** are compounds of protein and non-protein pigments found in flavoproteins, hemoglobin, and cytochromes. 6. **Metalloproteins** are compounds or metals (Cu, Mg, Zn, and Fe) attached to proteins found in ferritin, hemosiderin, and transferin. C. Derived Proteins are products formed in the various stages of hydrolysis of a protein molecule **Chemical Stages of a Protein** A. An amino acid has a chemical structure that combines both acid and base (amino) factors. The structure gives amino acids a uniques buffering capacity. This enables them to join one another to form the characteristic chain structure of protein. The amino group of one amino acid joins the acid carboxyl group of another. This characteristic chain structure of amino acids is called a peptide linkage. Long chains of amino acids that are linked in this manner called polypeptides. B. Essential and Non-essential Amino Acids 1. **Essential Amino Acids** cannot be synthesized by the body and are necessary in the diet.\ Ex. Threonine, Leucine, Isoleucine, Valine Lysine, Methionine, Phenylalanine, Tryptophan 2. **Non-essential amino acids** can be manufactured by the body and, therefore, are not as necessary for consideration in the diet.\ Ex. Glycine, Alanine. Aspartic Acid, Glutamic Acid, Proline. Hydroxyproline, Cystine, Tyrosine, Serine, Arginine, Histidine C. Complete and incomplete proteins 1. 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. 2. Incomplete proteins are those deficient in one or more of the essential amino acids. They are plant origin- grains, legumes, seeds, and nuts **Digestion of Protein** 1. **Mouth** a. Enzyme -- none b. Action - only mechanical mastication 2. **Stomach** a. Enzyme - pepsin, produced first as inactive precursor to pepsinogen, then activated by the hydrochloric acid. b. Action - converts proteins into proteoses and peptones. c. In infants, enzyme rennin converts casein into coagulated curd. \*Peptone: a soluble protein formed in the early stage of protein breakdown during digestion.\ \*Proteose: A proteose is any of various water-soluble compounds that are produced during digestion by the hydrolytic breakdown of proteins short of the amino acid stage. 3. **Small intestine (Alkaline)** a. Pancreas\ \ a.1 Trypsin (produced first as inactive precursor trypsinogen and then activated by enterokinase) converts proteins, proteoses, and peptones into polypeptides and peptides.\ \ \*proteins and peptides are made up of amino acids, but peptides contain far fewer amino acids than proteins. Like proteins, peptides are naturally present in foods.\ \ \* Polypeptides are chains of amino acids, which are linked by peptide bonds.\ \ a.2 Chymotrypsin (produced first as an inactive precursor of chymotrypsinogen and then activated by active trypsin) converts proteoses and peptones into polypeptides and dipeptides; also coagulates milk.\ \ a.3 Carboxypeptidase converts polypeptides into simper peptides, dipeptides, and amino acids b. Intestine\ \ b.1 Aminopeptides converts polypeptides into peptides and amino acids.\ \ b.2 Dipeptidase convets dipeptides into amino acids. **Functions of Proteins:** 1. Used in repairing worn-out body tissue proteins (anabolism, is a biochemical process in metabolism where the simple molecules combine to generate complex molecules.) caused by the continued wear and tear (catabolism, large molecules in living cells are broken down, or degraded.) going on in the body. 2. Used to build new tissues by supplying the necessary amino acid building blocks. 3. Source of heat and energy 4. Contribute to numerous essential body secretions and fluids, enzymes, and proteins. Some hormones have protein or amino acid components 5. Important in the maintenance of normal osmotic relations among the various body fluids. 6. Plays a vital role in the resistance of the body to diseases. 7. Dietary proteins furnish the amino acids for a variety of metabolic functions. **Sources of Protein:** 1. Complete protein foods-meat, fish, poultry, egg, milk, cheese. 2. Legumes, nuts 3. Breads and cereals **Requirement for Human Nutrition** A. Quality of protein fundamental to health and life. B. General daily recommendation of the Food and Nutrition Board 1. Adult-0.9g/kg BW 2. Children - Growth needs vary according to age and growth patterns. 3. Pregnancy - Rapid growth requires an increase of 30g over that of a non-pregnant woman. 4. Lactation - It requires an increase of 20g **Health Effects of Protein** 1. Heart disease - Foods rich in animal protein tend to be rich in saturated fats. 2. Cancer - Studies suggest a relationship between high intake of animal protein and so some types of cancer like cancer of the prostate gland, pancreas, kidneys, breast, and colon. 3. Osteoporosis - Calcium excretion rises as protein intake increases. 4. Weight control - Protein-rich foods are also rich in fat which can lead to obesity with associated health risks. 5. Kidney disease - A high protein diet increases the work of the kidneys **Protein** - Energy Malnutrition (PEM) 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. **2 Forms of PEM:** 1. **Marasmus** - Severe deprivation of food over a long period of time characterized by insufficiency of protein and energy intake. 2. **Kwashiorkor** - This condition reflects an abrupt and recent deprivation of food which develops rapidly as a consequence of protein deficiency or an illness like measles.