Applied Nutrition Course Specification PDF, 2024-2025, Tanta University

Tanta University ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Faculty of Nursing Applied Nutrition 2024/2025 2024/2025 2024/2025...

Tanta University ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Faculty of Nursing Applied Nutrition 2024/2025 2024/2025 2024/2025 By Prof Dr. Rahma Soliman Bahgat Prof Dr. Amaal Mohamed Elzeftawy Assist. Prof. Fatma A. Salem 2024-2025 1  ‫رؤية الكلية ‪-:‬‬ ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ ‫االبداع والتميز على المستوى المحلى واالقليمى فى مجاالت التعليم والتعلم‬ ‫‪.‬والبحث العلمى وخدمة المجتمع وتنمية البيئة‬ ‫رسالة الكلية ‪-:‬‬ ‫‪2024/2025‬بناء بيئة اكاديميه فاعلة تؤدى الى‬ ‫‪2024/2025‬‬ ‫التمريض – جامعة طنطا الى‬ ‫تسعى كلية‬ ‫‪2024/2025‬‬ ‫تخريج كوادر مهنيه متميزة فى علوم التمريض قادرة على المنافسة فى‬ ‫سوق العمل على المستوى المحلى واالقليمى وتساهم فى تقديم الخدمات‬ ‫الصحية للمجتمع ودفع مسيرة البحث العلمى المبتكر فى اطار قيم وتقاليد‬ ‫المجتمع وذلك من خالل برامج تعليمية حديثة وفق معايير اكاديمية معتمدة‪.‬‬ ‫‪2‬‬  Pediatric Nursing Department Community Health Nursing Department Medical Surgical Nursing Department ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Course Specification Applied Nutrition : ‫ بيانات المقرر‬-1 Med 201 :‫الرمزالكودي‬ Second year : ‫ الفر قة‬/‫التخصص‬ - ‫عملي‬ 30 ‫ نظري‬:‫عدد الوحدات الدراسية‬ To provide the students with Knowledge, skills and attitudes necessary to :‫ أهداف المقرر‬-2 enable them to assist patient with organic health problems, understand basic 2024/2025 2024/2025 2024/2025 diet therapy as well to comply with their nutritional regimen within their socio cultural environment :‫ المستهدف من تدريس المقرر‬-3 ‫بنهاية هذا المقرر يكون الطالب‬ :‫قادرا على أن‬ a.Knowledge and understanding domain : ‫ المعلومات‬-‫ا‬ a.1- Identify the basic of food requirements. :‫والمفاهيم‬ a.2- Describe the function of various nutritional elements. a.3- Explain diet for common diseases. a.4. Define terminologies related to applied nutrition. a.5. Recall concepts/principles of basic nutrition/dietetics. a.6. Identify each metabolic processes of main classes of molecules related to nutrition. a.7. Identify etiology/signs and symptoms/risk factors of selected nutritional disorders. a.8.Enumerate relevant health assessment/diagnostic techniques/procedures for nutritionally ill patients. a.9.List different types of nutrition therapy appropriate for selected dietary diseases. b. Cognitive skills : ‫ المهارات‬-‫ب‬ b.1. explain important /role of diet /nutrition in prevention/treatment of certain :‫الذهنية‬ dietary problems. 3  b.2-Discuss nutritional assessment format. b.3- Develop nutritional plan for different age group appropriate for patients with selected diseases. b.4- Explain The various dietary therapies. b.5- Indicate nursing interventions in the assessment phase of clients with nutrient related illnesses b.6- Discuss nursing implementations in dietary management/treatment of selected nutritional disorders. ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ b.7- Compose discharge plan / health teachings about food pattern / nutritional needs of various dietary diseases. c. Professional skills : ‫ المهارات‬-‫ج‬ c.1-Plan a therapeutic diet, which is suitable for different diseases as :‫المهنية الخاصة بالمقرر‬ cardiovascular, respiratory, gastro-intestinal, liver, renal or metabolic disease d. General skills : :‫ المهارات العامة‬-‫د‬ d.1-Identify parameters of adequate nutrition. d.2-Give a basic understanding of the use of drug therapy or the Interaction possibilities with foods. d.3- Use computer, internet and modern information technology for information retrieval. d.4.Interact with e-library and textbook that are available in CD. d.5.Use appropriate words, grammatically correct sentences during class discussions/presentations 2024/2025 and oral evaluation/examination 2024/2025. 2024/2025 d.6. Integrate relevant statistical/numerical data or formula for individual/group research work. d.7. Apply mathematical methods applicable in solving problems. d. ‫عدد الساعات‬ ‫الجدول‬ ‫الموضــــــــــــــــــــوع‬ ‫م‬ ‫محاضرة إجمالي‬ ‫الزمني‬ 2 2 Basic requirements. Important of 1 food, fat, protein, carbohydrate 2 2 Vitamins 2 2 2 Minerals 3. Water balance- Acid base balance 2 2 Regular hospital diet 4 5 2 2 Basic nutrition group-nutrition needs 2 2 Malnutrition diseases 6 2 2 Nutrition for the patient with 2 2 4  Elzahimer disease 2 2 2 2 Nutritional assessment 7 2 Nutrition for the patient with 8 2 hematological disease ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ 2 Nutrition for patient with 9 2 gastrointestinal disease-liver disease 2 2 Nutrition for patient with 10 2 cardiovascular disease 2 Congenital heart disease 11 Nutrition of patient with Endocrine disease 12 Nutrition of patient with urinary 2024/2025 2024/2025 2024/2025 disease Nutrition of patient with allergic disease 13 Nutrition of patient with Respiratory disease 14 Nutrition of patient with Cancer 15 Nutrition of patient with autoimmune disease 5.1-Lecture ‫ أساليب التعليم‬-5 5.2-Group discussion. :‫والتعلم‬ 5.3. research activities. 5.4. brain storming. 5.5. individual presentation --------------------------------------------- ‫ أساليب التعليم والتعلم‬-6 ‫للطالب ذوي القدرات‬ :‫المحدودة‬ 5  :‫ تقويم الطالب‬-7 7.1 Class participation. :‫ األساليب المستخدمة‬-‫ا‬ 7.2 Video analysis. 7. 3. Posters assessment and quizzes. 7.4 Oral exam 7.5 Final written exam At 15 weeks :‫ التوقيت لكل منها‬-‫ب‬ ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Oral exam 20% :‫ توزيع الدرجات‬-‫ج‬ Final written exam 80% :‫ قائمة الكتب الدراسية والمراجع‬-8 Dr's. Handouts :‫ مذكرات‬-‫ا‬ 1. Lutiz, C., & Przytulski, K.. Nutrition and Diet Therapy, :‫ كتب ملزمة‬-‫ب‬ 3rd ed., Philadelphia : USA..Davis Co., 2015 ‫ كتب مقترحة‬-‫ج‬ 2. John S., Devaselvam J. Essentials of Nutrition and Dietetics for Nursing , 2nd edition, Wolters Ktuwer health 2016. 3. Dudek SG. Nutrition Essentials for Nursing Practice 8th ed. Wolters Ktuwer Health 2018. 2024/2025 2024/2025 2024/2025 ‫د دوريات علمية أو‬ ‫نشرات‬ 4. J.S. Smolen, D. Aletaha, A. Barton, G.R. Burmester, P. Emery, G.S. Firest ein, et al.Rheumatoid arthritis Nat Rev Dis Primers, 2018; 4(1) 5. Y. Matsumoto, Y. Sugioka, M. Tada, T. Okano, K. Mamoto, K. Inui,. Monounsaturated fatty acids might be key factors in the Mediterranean diet that suppress rheumatoid arthritis disease activity: The Tomorrow study. Journal Clinical Nutrition , 2018; 675-680 6. A.K.E. Vadell, L. Bärebring, E. Hulander, I. Gjertsson, H. Lindqvist, A. Winkvist , Anti-inflammatory diet in rheumatoid arthritis– a randomized, controlled crossover trial indicating effects on disease activity American Journal of Clinical Nutrition 2020; 111 (6): 1203-1213 Prof. Dr. Rahma Soliman Bahgat Prof Dr. Amaal Mohamed Elzeftawy Assist. Prof. Fatma A. Salem 6  Distribution of Applying Nutrition 2024-2025 Weeks TOPICS Staff Members Time Week 1 Unit 1 ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Prof. 2hours Introduction Rahma Soliman Basic requirements. Important of food, Fat, protein, carbohydrate Nutrition Element protein, fat, carbohydrate Week 2 Unit 2 2hours Vitamins: Importance of vitamins, causes of vitamin deficiency in the body Prof Amaal Fat soluble vitamins –sources, signs of Elzeftawy deficiency , dietary treatment Water soluble vitamins –sources, signs of 2024/2025 deficiency , dietary treatment 2024/2025 2024/2025 Week 3 Unit 3 2hours Major minerals: sources, signs of deficiency Prof Amaal dietary treatment Elzeftawy Trace minerals Week 4 Unit 4 2hours Water balance- Acid base balance Assist. Prof. Regular hospital diet Fatma A. Salem Week 5 Unit 5 2hours Basic nutritional for vulnerable groups Prof Amaal Elzeftawy and nutritional needs Week 6 Unit 6 Prof. 2hours Routine hospital diet Rahma Soliman Nutrition assessment 7  Week 7 Unit 7 2hours Malnutrition disease Prof Amaal Elzeftawy Elzahimer disease Week 8 Unit 8: Prof. 2hours Nutrition for patient with hematologic Rahma Soliman disorder (Beta thalassemia- favism- ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ thrombocytopenic purpura –sckilcell anemia. Week 9 Unit 9 2hours Diet therapy for Patient with fever Prof Amaal Nutrition for patient with gastrointestinal Elzeftawy disease and liver disease Week 10 Unit 10 Assist. Prof. 2hours Nutrition for patient with cardiovascular Fatma A. Salem Congenital heart disease –Hypertension- Week 11 Unit 11 Prof 2hours Nutrition for patient with Endocrine Rahma Soliman disorders 2024/2025 2024/2025 2024/2025 Week 12 Unit 12 Prof. Nutrition for patient with urinary disease Rahma Soliman 2hours Nutrition for patient with allergic Week 13 Unit 13 Assist. Prof. 2hours Nutrition for patient with cancer disease Fatma A. Salem Week 14 Unit 14 Assist. Prof. 2hours Nutrition for patient with respiratory Fatma A. Salem diseases Unit 15 Assist. Prof. 2hours Week 15 Fatma A. Salem Nutrition for patient with Autoimmune disease Fibromyalgia Syndrome Rhumatic fever Revision 8  Importance of Food and Nutrition At the end of this lecture the student will be able to: ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ - Define nutrition, nutrient, dietetics, registered dietitian: -Identify function of food -Identify important of good nutrition -Describe Recommended Dietary Allowance (RDA) -Discuss factors that influence the RDA - Identify food sources Nutrition: is the study or science of how food nourishes the.body. It is based on the food requirements of humans for energy, growth, maintenance, reproduction, and lactation. 2024/2025 2024/2025 2024/2025 Nutrition: Refers to the processes in the body' making use of food. It includes: 1. Eating the correct foods, kinds & amounts for the body needs. 2. Digestion of foods that the body can make use of the nutrients 3. Absorption of the nutrients in the blood. 4. Metabolism of the nutrients by the cells for the production of energy; the maintenance and growth of tissues and organs. Nutrients: are chemical substances that the body uses from the foods that are consumed. Some nutrients are essential and must come from the foods that are consumed. Nonessential nutrients are nutrients that the body needs but is able to manufacture. 9  Macronutrients: is nutrients needed in large quantities for building the body, such as carbohydrates, protein, and fat. Micronutrients: is nutrients needed in small quantities for healthy body function, such as vitamins and minerals. ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Dietetics: management of diet and the use of food, the science concerned with the nutritional planning and preparation of food Registered dietitian: a professional dietitian accredited with an academic degree course from a university or graduate study program Health: a state of optimal well being physical, mental and social relative freedom from disease or disability Function of Food 2024/2025 1- Provide energy sources 2024/2025 2024/2025 2- Build tissue 3- Regulate metabolic processes Good Nutrition Optimal nutrition : means that a person receives and uses substances that are obtained from a varied diet containing CHo, fats, protein, mineral and vitamins, water and dietary fiber in optimal amounts.The optimal amount should be greater than the minimum requirements to cover variations in health and disease and provide reserves Importance of good Nutrition 1- promotes health and may prevent the onset of conditions like Pcardiovascular disease, some forms of diabetes mellitus, and cancer. 2- Promotes a sense of well-being. 10  3- Well-chosen foods that are consumed in moderation can supply enough of each nutrient to prevent malnutrition. Malnutrition includes excess, deficient, or an imbalance of nutrients that lead to disease state 4- Nutrition also meets the energy needs of the body to allow for ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ basic physiological functions like respiration and any physical activity. Estimated Average Requirements (EAR) The average daily intake expected to satisfy the needs of 50% of the people in that age group. Recommended Dietary Allowance (RDA) The average daily dietary intake level of a nutrient considered sufficient to meet the requirements of nearly all (97-98%) healthy individuals in each life stage and gender group. 2024/2025 2024/2025 2024/2025 Factors that influence the RDA Age: The RDA for a number of nutrients varies from infancy to adulthood. For example, adults require about 0.8 g of protein per kg of body weight, whereas infants need over 2.0 g per kg body weight per day. Sex: Dietary allowances for men are approximately 20% greater than those for women, reflecting the generally larger body mass of men. The allowance for iron is an exception. because women must replace iron lost during menstruation. Other factors: The recommended allowances for most nutrients are increased about 20% to 30% above normal in pregnant and lactating women. Patients with injury or illness also show an increased requirement for some nutrients 11  Energy source: -CHo such as starch and sugar provide the body primary source for heat and energy. It is more concentrated form of energy 4 kacl for each gm consumed, should provide 55- to 60 % ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ -Fats: from both animal and plants sources provide the body, secondary or storage form of heat and energy. It is more concentrated form of energy 9 kcal for each gm consumed, should provide 25% to 30 % Proteins: 4 kcal / gm provide 10- 15 % of the total calorie Daily Estimated Energy Requirements Age Sex Calories / day Birth – 6 months - 115 cal 6 months – 1 year 2024/2025 - 2024/2025 105 cal 2024/2025 1-3 years - 1300 cal 4-6 years - 1700 cal 7-10 years - 2400 cal 11-14 years Males 2700 cal 11-14 years Females 2200 cal 15-18 years Males 2800 cal 15-18 years Females 2100 cal 19-22 years Males 2900 cal 19-22 years Females 2100 cal 12  Protein Protein provides the human body with its primary tissue building units amino acids is Joined in unique chain sequence to form specific proteins Classes' of amino acid There are 22 common amino acid all are vital of human life and health ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ classified into essential and nonessential amino acid Essential amino acid 10 are classified as essential amino acid because the body cannot manufacture than in sufficient quantity its necessary in the diet and in growth of infancy Non essential amino acids Is misleading the remaining 12 amino acids that the body can synthesize , they Are not essential in the diet 2024/2025 2024/2025 2024/2025 Repair tissue damage and build up new tissue , protein meet growth needs and maintain tissue health during adulthood Protein balance The intake and output of substance in the body to maintain the normal levels of these substances necessary for health during life Function of protein 1- Primary tissue building :protein is fundamental structure material of every cell in the body 2- Energy system 3- Water balance: plasma protein especially albumin , help to control water balance through out of the body by exerting osmotic pressure to maintain normal circulation of tissue fluids and capacity blood flow 4-Metabolism: combing with iron to form hemoglobin , the vital oxygen carrier in the red cells 13  5- Body defense system: protein is used to build special white blood cells and antibodies as part of the body to help defend against disease and infection 6- Producing antibodies 7- Keep constant body PH level ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Food source of protein  Complete protein: 10 essential amino acids is essential quantity to meet the body needs , these proteins are of animal organ eg: egg, milk, cheese and meet  Incomplete protein: Plant protein because lack of essential amino acids. Vegetarian diet Complementary protein: foods providing adequate amount of essential 2024/2025 2024/2025 2024/2025 amino acid forms the basis planning vegetarian diet : use plant protein but may used milk and egg Protein requirement 1- Tissue growth: maintain tissue human growth and rapid during fetal , mother pregnancy , infant, lactation need for breast feeding Dietary protein quality Determine by four basic measures 1- chemical score: is a value derived from the amino acidic valued pattern of food using a high-quality protein food ex egg 2- Biologic value: based on nitrogen balance 3- Net protein utilization :NPU is based on biologic value 4-Protien efficiency ratio: (PER )is based on the weight gain of growing test animal in relation to protein intake 14  Dietary guideline Recommended dietary Allowances (RDAs): dietary guidelines: for Americans recommended that for adults about 10% -15% of the diet total calories come from protein 3- Illness or disease: after surgery extra protein is needed for wound ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ healing and restoring losses In case of extensive tissue destruction as in case of burn requires a large protein increase for healing and grafting process. Carbohydrate The name of CHO comes from its chemical nature.It is composed of Carbon (c), Hydrogen (H) and Oxygen (O) ratio (2 to 1) as it in water Classification of carbohydrate: 1- Simple : simple structure of one or two single sugar saccharide 2024/2025 1- Monosaccharides : Glucose, 2024/2025 2024/2025 Fructose, Galactose : is composed of one sugar unit 2- Disaccharides: composed of two Monosaccharide e.g: Sucrose, Lactose, Maltose 3- Complex CHO: Polysaccharides: starch and dietary fiber larger more complex molecules of CHO composed of many sugar units - Starch: present in wheat, rice, cereals and potato Glycogen: Only animal source of starch , composed of duplicated units of glucose. It is more complicated than starch. Glycogen usually stored in liver and muscles. Human can store 500 gm of glycogen in liver and muscles Dietary fiber a- Water soluble fibers: important in reducing cholesterol 15  b- Insoluble fibers: reduce constipation Importance of fibers: 1- Reduce body weight 2- Regulate body cholesterol 3- Regulate blood sugar ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ 4- Prevent colon cancer Functions of Carbohydrates a-Simple and Complex Carbohydrates: 1-Supply energy from glucose — 4 kcal/gm 2-Spare protein 3-prevent ketosis 4-Provide substrate to make ribose, keratin, and glycoproteins b-Fiber 2024/2025 2024/2025 2024/2025 1-Promotes laxation 2-Treats constipation 3-Soluble fiber absorbs intestinal cholesterol founding bile 4-Soluble fiber delays gastric emptying and lower postprandial (post meal) blood glucose Food source of CHO 1- Animal source : only glycogen and lactose 2- Plant sources Starches: Provide important sources of fiber and other nutrient Sugar: high sugar diet carry health risk such as dental caries and obesity Rich sources : cereal grains ( rice, wheat and corn) Good source: Potatoes, sweet potatoes, rice. Bananas, dates , honey and dried fruits 16  Recommended Dietary Allowance of carbohydrate CHO share increase body weighty and Obesity in 50-60% of the used energy in daily food ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ 2024/2025 2024/2025 2024/2025 Added sugar in common foods The increase of CHO leads to 1- Tooth decay 2- Increase body weight 3- Increase body fat which lead to coronary artery disease 4- Hyperglycemia Carbohydrate Calculations Carbohydrate should comprise 45% to 65% of the total kilocalories per day. The nurse can translate that recommendation into grams of carbohydrate per day for an individual using these steps: 1. Total estimated kcal needs x 45% to 65% (or 0.45 to 0.65) = total kcal/day from carbohydrate 17  2. Total kcal/day from carbohydrate , 4 kcal/gm recommended grams of carbohydrate/day. Example: Nellie requires 2,000 kcal/day. 1. 2,000 kcal x 0.45 to 0.65 = 900 to 1,300 total kcal/day from carbohydrate ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ 2. 900 to 1,300 kcal from carbohydrate/day 4 kcal/gm carbohydrate = 225 to 325 gm carbohydrate/day Fat Fats, also called lipids, are organic compounds that are necessary for good health. Lipids differ in many ways from the other macronutrients—carbohydrates and proteins—despite the fact that they contain the same three elements, carbon, hydrogen, and oxygen. In addition to the different chemical structure, lipids are not water 2024/2025 2024/2025 2024/2025 soluble Fat supply storage from of concentrated fuel for the human energy system Food fats include materials such as fat liquid Fats are not soluble in water Classes of fat: Lipids: the group name lipid appearance in combination words used for fat related health problems Hyperlipedemia: elevated level of blood its fat Triglyceride Composed of glycerol with fatty acids attached in food or in the body tissue , fatty acid Fatty acids combine with monoglycerides, diglycerides and triglyceride are found in animal and vegetable fat and oils 18  Triglycerides: chemical name for fats in the body or food compound of three fatty acids to glycerol base Compounded of fat according to saturated Saturated fatty acids: state of being filled components of fats being filled in all an available carbon bonds with hydrogen making the fat ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ harder and more solid food fats are from animal sources Unsaturated fatty acid: monounsaturated fat ex. olives and olives oil, peanuts oil Polyunsaturated fat Vegetable oil , cotton seed and soybean , fats from plant source usually unsaturated Essential fatty acids: nutrient is essential because the body cannot manufacture and must obtain it from the diet 2024/2025 2024/2025 2024/2025 Fat source: are meat, chicken, fish, milk, yogurt products, plant oils and seed oils Lipoprotein: Chemical complexes of fat with protein Cholesterol: fat related compound a sterol It is a vital substance are egg yolks and organ meats such as liver, kidney in human metabolism that occurs naturally in all animal foods , no cholesterol in plant foods The main source of cholesterol Functions of Fat a-Functions of Fat in the Body 1-Transports fat-soluble vitamins A, D, E, and K 2- Cushions and protects organs 3-Insulates body to maintain core temperature 19  4-Provides lubrication 5-Source of stored energy 6-Component of cell membranes Component of myelin in the nervous system 7- Building block for synthesis of other lipid-based ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ compounds, such as hormones, vitamin D, prostaglandins, and bile b-Functions of Fat in Foods 1-Provides essential fatty acids 2-Source of energy with 9 kcalories/gm 3- Emulsifying agent 4-Taste and aroma 5-Texture 6-Transfers heat in cooking 2024/2025 2024/2025 2024/2025 7-Causes satiety of fullness Fat Recommendations: Dietary Guidelines 1. Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans-fatty acid consumption as low as possible. 2. Keep total fat intake between 20% and 35% of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids such as fish, nuts, and vegetable oils. 3. When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low fat, or fat free. 4-Limit intake of fats and oils high in saturated and/or trans-fatty acids, and choose products low in such fats and oils 20  Vitamins At the end of this lecture the students will be able to: 1. Identify vitamins 2. Discuss classification of vitamins ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ 3. Discuss differentiate between types of vitamins 4. Identify functions and sources of vitamins 5. Describe manifestations of vitamins deficiency and toxicity. Good nutrition: An adequate, well-balanced diet combined with regular physical activity is a cornerstone of good health. Poor nutrition can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced 2024/2025 2024/2025 2024/2025 productivity” (http://www.who.int/topics/nutrition/en/) The dietary requirement for a micronutrient is defined as an intake level which meets specified criteria for adequacy, thereby minimizing risk of nutrient deficit or excess. These criteria cover a gradient of biological effects related to a range of nutrient intakes which, at the extremes, include the intake required to prevent death associated with nutrient deficit or excess. -Vitamins are organic compounds required by the body in small amounts for metabolism, for protection, for maintenance of health and proper growth -They cannot be synthesized by the body. Must be obtained by outside sources like diet, rumen of bacteria & sun. 21  -Vitamins also assist in the formation of hormones, blood vessels, nervous system chemicals and genetic materials. -They generally act as catalysts, combining with proteins to create metabolically active enzymes that are essential for life reactions -Without enzymes, many of the reactions essential to life would slow down. ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Classification of Vitamins -Vitamins are classified according to their ability to be absorbed in fat or water into two main groups, fat soluble and water-soluble vitamins -Group one: Fat-soluble vitamins: A, D, E, K -Group two: Water-soluble vitamins: B’s and C. -Vitamin B’s include , B1, thiamine; B2, riboflavin; B3, niacin; B5, pantothenic acid; B6, pyridoxine, pyridoxal, or pyridoxamine; B7, 2024/2025biotin; B9, folate; B12, cobalamin. 2024/2025 2024/2025 Vitamins functions and sources Nutrient Functions Sources Water soluble vitamins Thiamine (vitamin B1 Part of an enzyme Found in all nitrous foods in , needed for moderate amounts, whole grain Recommended allowances energy foods or enriched bread and (RDA): for men 1.2mg/d, metabolism, cereals , legumes , nuts and seeds for women 1.1 mg/d important to nerve function Riboflavin( vitamin B2) Part of an enzyme Milk and milk products green RDA: for men 1.3 mg/d, , Needed for leafy vegetables, whole grain for women 1.1 mg/d energy foods, enriched breads and cereals.Requirements are higher metabolism, 22  during pregnancy and important for lactation normal vision and skin health Niacin (vitamin B3) Part of an enzyme, Fifty percent (50 %) is Needed for energy bioavailable from diet.Meat , ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ RDA : 16 mg/d for men metabolism, poultry , fish, whole grain foods, and 14 mg/d for women important to enriched breads and cereals, Needs increase by one nervous system, vegetables especially Mushrooms, third in pregnancy and digestive system asparagus and leafy green lactation and skin health. It vegetables , peanut , butter is absorbed by passive diffusion and active 2024/2025 2024/2025 2024/2025 transport in the jejunum Pantothenic acid : RDA/ Part of an enzyme, Widespread in foods For adults’ women and needed for energy men 5mg/d metabolism Biotin : RDA/ For adults’ Part of an enzyme, Widespread in foods, also men and women 30mg/ Needed for energy produced in intestinal tract by day metabolism bacteria Pyridoxine (vitamin B6 ) Part of an enzyme, Meat , poultry , fish ,vegetables, RDA: For men 1.3- needed for protein fruits 1.7mg/d for women 1.3 - metabolism and 1.5 mg/d helps in making new cells 23  especially red blood cells Folic acid (Vit. B9): RDA / Part of an enzyme, Green leafy vegetables, and For adults 400 mcg, For needed for making legume, seeds, orange juice, liver, pregnant women 600 mcg DNA and new ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ for lactating women 500 cells especially mcg red blood cells Cobalamin (vitamin B12) Part of an enzyme, Meat , poultry , fish ,, sea food, RDA for Adults 2.4 mcg. - needed for making eggs, milk and milk products not For Pregnant women need new cells, found in plants foods 2.6 µg. For Lactating important to nerve women need 2.8 µg function Ascorbic acid (Vitamin C) Part of an enzyme Found only in fruits and 2024/2025 2024/2025 2024/2025 needed for protein vegetables in the cabbage family, RDA/ For men need 90 mg metabolism, cantaloupe, strawberries, peppers, , smokers need an extra 35 Antioxidants tomatoes, potatoes, lettuce, mg daily. For women important for mangoes, kiwifruits 75mg and teens boys , For immune system Pregnant 85 mg and health, aids in iron Lactating 120 mg absorption. Fat soluble vitamins 24  Needed for vision Vitamin A: two forms especially at night Vitamin A (RDA): Retinol from animal sources: , Healthy skin & Liver, milk, butter, cream, cheese , For men 900 mg/d mucous fortified margarine , fish ,Egg For women 700mg/d membranes, bone ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ yolks,-Beta carotene from plant ,tooth and nerve sources: (Leafy dark green growth, Immune vegetables , dark orange , fruits, system health apricots , cantaloupe ), vegetables especially against ( carrots, winter squash, sweet measles , Gene potatoes, pump skin). 90% of regulation, Vitamin A stored in liver Prevention of early miscarriage 2024/2025 2024/2025 2024/2025 Vitamin D Needed for proper -Egg yolks, liver, fish, milk, absorption of fortified margarine. -When (RDA) : 400- 800 IU calcium , stored in exposed to sunlight the skin can bones make vitamin D Vitamin E: Antioxidant Poly unsaturated plant oils protects cell wall RDA/ For Adults and ( soybeans, corn, cottonseeds, children 50 µg / day , safflower), Leafy green During the first year of vegetables, wheat germ, whole life 25µg / day is used. grain products , liver egg yolks There is a decreased nuts and seeds production from the skin with aging. For adults aged 51 and older 10 µg / 25  day, For adults 71 years and older 15 µg / day Vitamin K : RDA / For Needed for proper Leafy green vegetables as Spinach men 120 mg / day for blood clotting , green vegetables especially women 90mg/ day broccoli, Brussels sprouts and ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ asparagus also produced in intestinal tract by bacteria Storage and excretion of vitamins -Fat-soluble vitamins: ADEK – Well retained in the body and tend to be stored in fatty tissues: adipose, muscles, liver therefore, it takes time to reach a deficiency state. - Fat Soluble Vitamins: these are 2024/2025 oily and hydrophobic compounds; 2024/2025 2024/2025 they are stored in the liver and not excreted out of the body. Bile salts and fats are needed for their absorption. Vitamins A,D,E and K are fat soluble – More likely to cause toxicity on over-dosage because of the slow clearance. -Water-soluble vitamins: B, C – Excreted rapidly and not well retained – Need regular replacement – Vitamin B12 and B9 retained and stored at significant level in the body 26  Vitamins Deficiency& Excess Vitamin name Physical signs of Vulnerable people Physical signs of deficiency for deficiency excess Vitamin A Impaired vision is the Cancer ,Burns, Headache, Blurred first sign ,Night cirrhosis ,Common vision, Papilledema ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ blindness (nyctalopia) in children, Drowsiness, and eye changes are kwashiorkor , Irritability early signs, anorexia nervosa, Peripheral neuritis, xerophthalmia, dryness celiac disease, Muscle weakness, of white of the eyes, pneumonia , biliary Peeling of skin spots on the eyes obstruction, ,.Hypercarotenemia ,reduced growth , hepatitis infections , due to beta failure of tooth enamel, pancreatic disease carotene excess 2024/2025 2024/2025 2024/2025 follicular hyperkeratosis ,rheumatic fever, lead to yellowing , loss of taste and smell, zinc deficiency , of skin and the infection and death drug use e.g. white of the eyes neomycin Vitamin D Hypocalcemic tetany Pregnant women, Headache, stupor, individual with dark confusion, Hypovitaminosis D is skin,Low level may weakness, common in general increase risk of hypertension, medical in- patients. breast cancer, colon nausea, cardiac Bowed legs, rickets in and prostate cancer, arrhythmias, renal children and depression, poor stones, polyuria osteomalacia in adults brain function, gastrointestinal may occur severe dementia in upset anorexia, 27  older adults, vomiting, pneumonia, constipation, itchy tuberculosis, skin, bone fragility, autoimmune disease increased bone such as multiple density, retarded ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ sclerosis and type1 growth, diabetes, drug use e.g. glucocorticoids , living near pole in winter Vitamin E Loss of deep tendon Alzheimer’s, Fatigue, pruritus , reflexes Impaired arthritis, biliary acne , vibratory & position cirrhosis , vasodilatation , 2024/2025 2024/2025 2024/2025 sensation, change in respiratory or impaired balance & coordination, cardiac diseases, coagulation , muscle weakness visual pancreatic / muscle damage, disturbances, rupture of musculoskeletal Isolated case of RBCs, impaired vitamin disorder dermatitis , A storage & prolonged malabsorption hypoglycemia blood coagulation syndrome ,drug use such as oral contraceptives Vitamin K 1.Hemorrhage with People have Excessive dose is prolonged clotting time calcium disorders , toxic is the key sign of hepatocellular Prolonged bleeding deficiency diseases , small 28  2. Vitamin k deficiency bowel disease drug Severe jaundice in can be found in lipid use as Phenytoin, infants or malabsorption , chronic Neomycin, or other hemolytic anemia antibiotic therapy and antibiotics, large liver disease dose of aspirin ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Anticoagulant, malabsorption syndrome Water soluble vitamins Name Signs of Deficiency Vulnerable people Signs of excess for deficiency Thiamin Anorexia, calf muscle Common in heart Headache , (Vitamin B1) weakness, weight loss, failure patients, Convulsion , 2024/2025 2024/2025 2024/2025 TPN without alcoholics, cancers, Allergic reactions , multivitamin use can persons with poor massive doses lead to Wernicke’s quality diet, before greater than 1000 encephalopathy which and after surgery, times the estimated often associated with high parenteral needs suppress malnutrition and glucose, fever, respiratory center& alcoholism thyrotoxicosis, lead to Respiratory pregnancy and failure & Death Impairment of lactation cardiovascular, nervous, and gastrointestinal systems , Edema, peripheral neuropathy & energy deprivation 29  Riboflavin Seborrheic dermatitis of Cancers nasolabial folds, ears Chronic infection Vitamin B2 and or eye lids, itchy Alcoholism and burning eyes or Drug use e.g. broad- There is no known lips, mouth and tongue spectrum antibiotics toxicity ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ Lacrimation, Gastrectomy Photophobia Low oral intake Neuropathy during the Normochromic following: - normocytic anemia , Childhood Most commonly found Pregnancy in developing countries Lactation e.g. India and can lead 2024/2025 2024/2025 2024/2025 to deficiency of vitamin B6 and vitamin B2 Niacin Absorbed in stomach Cancers , diabetes Toxicity is and small intestine chronic diarrhea , generally low but Nicotinic acid Stomatitis, beefy tuberculosis , may cause release tongue, soreness of oral alcoholic , liver histamine , mucosa genitourinary cirrhosis flushing of skin pigmented rashes undernourished when using 1-2 g Gastritis and diarrhea people in Africa of nicotinic acid in severe deficiency daily in an effort Pellagra occur to control cholesterol level or even liver toxicity , 30  - Mega doses should be avoided Vitamin B 5 Impair lipid synthesis & Alcoholism, Liver Rarely excess Pantothenic energy production / disease , Pregnancy, causes mild acid symptoms: Paresthesia elderly women Intestinal distress ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ in toes and soles of the Chronic ulcerative or diarrhea feet , burning sensation colitis in feet , depression , fatigue , insomnia & weakness Vitamin B6 Deficiency is rare but Alcoholism , Drug Toxicity is Pyridoxine presents with use: Dilantin relatively low Convulsion in infants, hydralazine, Sensory 2024/2025 2024/2025 2024/2025 confusion, irritability, isoniazid, Elderly, neuropathy with depression, peripheral Schizophrenia Oral Gait changes neuropathy, dermatitis contraceptives , No Muscle in face and neck angular vitamin replacement incoordination stomatitis, hypochromic for tuberculosis microcytic anemia Vitamin B7 Inflammation of skin & Inadequate intake There are no Biotin lips other symptoms: - known toxic effects Long term dermatitis , alopecia , parenteral nutrition paralysis, depression , glossitis , hypercholesterolemia Vitamin B9 Large RBCs with Cancers, alcoholism There are no 31  Folic acid Macrocytic or Drug use: - aspirin, known toxic effects megaloblastic anemia Dilantin, Neural tube defects methotrexate, oral such as spina bifida or contraceptive anencephaly may result Hematologic ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ from impaired diseases e.g. biosynthesis of DNA thalassemia , sickle and RNA cell anemia pernicious anemia. , pregnancy ,vitamin B12 deficiency, malabsorption syndrome 2024/2025 2024/2025 2024/2025 Vitamin B12 Loss of appetite, Poor Adolescents with Cobalamin , tolerance, constipation, poor diet with low There are no cyanocobalamin numbness and tingling intake of meat/ fish/ known toxic effects in hands and feet, dairy products or megaloblastic anemia, strict vegetarian diet depression, poor are at risk , severe memory, confusion and chronic malnutrition dementia , pernicious anemia , disorders of gastric mucosa , Crohn’s disease, HIV infection , ileal resection ,gastric 32  bypass ,prolonged exposure to nitrous oxide or mega doses of folic acid, drugs used as omeprazole ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ , zantac , Tagamet Vitamin C The first symptom of Alzheimer’s , burns GI distress Ascorbic acid deficiency is fatigue. , cancers , chronic diarrhea is most Aching pain , mood diarrhea , trauma , common changes , irritability , surgical wounds and failure of wound to tuberculosis , gout , heal, bleeding gums , steroid use , petechial hemorrhage , hypertension , 2024/2025 2024/2025 2024/2025 follicular diabetes exposure to hyperkeratosis, pollution rheumatic pain in legs, eventual teeth loss, depression , weak bone , cartilage and connective tissues Life cycle needs for vitamin Infancy: supplement for breast feeding infants vitamin D, K and fluoride Aging: may increase the need for some nutrient because decrease food intake and impaired nutrients absorption, storage and usage. Marginal deficiencies of ascorbic acid, thiamine 33  Lifestyle: personal lifestyle choices and habits may influence individual needs for nutrient supplementation Oral contraceptive : women using oral contraceptive agent ( pills) supplement need for vitamin B, C Smoking : if smoking cannot stop the habit, a small supplement of vit c ( ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ 100 mg / day) help compensation Alcohol: chronic or abusive use of alcohol can interfere with absorption of vitamin B 12 ( cobalamin) because sources of animal proteins Restricted diet: person who always restrict in diet : need supplements of vitamin b 12 because sources of animal proteins Caffeine : small supplements of B vitamin and ascorbic acid may help 2024/2025 2024/2025 2024/2025 34  Minerals At the end of this lecture the students will be able to: 1. Define minerals 2. Identify food choices for minerals element 3. Enumerate macro and micro minerals ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ 4. Identify function of minerals 5. Describe food source of minerals 6. Describe minerals deficiency and excess problems  Minerals are inorganic substances required by the body in small amounts for a variety of different functions. The body requires different amounts of each mineral.  People have different requirements of minerals, according to their age, sex, physiological state (e.g. pregnancy) and sometimes their state of 2024/2025 health. 2024/2025 2024/2025  Minerals vary in amount from Ca 1000-1500 milligrams (mg) to trace element measured in micrograms (mcg or µg). The minerals required for physiologic functions may be divided into 2 groups: Macro minerals which are required in amount greater than 100 mg/day Micro minerals (trace elements) which are required in amounts less than 100 mg/day Food choices for minerals element:- Recommended amounts of foods from the four groups provide sufficient amount of all the minerals elements needed by humans. But certain therapeutic diets required the calculation of sodium and/or/potassium. 35  General functions of minerals:-  Formation of bones and teeth.  They are essential constituents of body fluids and tissues.  They are components of enzyme and hormones: small amount of ‫ﺍﻻﺀ ﻣﺠﺪﻯ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ ﻋﺒﺪ ﺍﻟﻌﺰﻳﺰ‬ minerals is constituted of specific enzymes or hormones. They activated or catalyze the activity of enzymes.e.g. Cu is required for incorporation of Fe into HB molecule, Zn is necessary for the formation of insulin by pancreas, Co is a constituent of vitamin B12 , and Mg activates some enzymes.  They are involved in normal nerve function and muscle contraction, Na, K, Ca, and Mg regulate the transmission of the nerve impulses and the contraction of muscles. Potassium when changed in concentration may affect the muscle and heart. 2024/2025 2024/2025 2024/2025  Water balance between intracellular and extracellular fluid.  Acid –base balances: the body fluid is always maintained at a constant PH. Calcium: Symbol: Ca Function of Calcium : 1. 99% present in bones and teeth. 2. It is required for blood coagulation.