Module 1: Basic Nutrition Introduction PDF

Basic Nutrition MODULE 1: BASIC NUTRITION: INTRODUCTION Learning Outcomes: Upon completion of this module, you will be able to: Define major concepts and terms used in nutrition; Discuss the highlights in the histo...

Basic Nutrition MODULE 1: BASIC NUTRITION: INTRODUCTION Learning Outcomes: Upon completion of this module, you will be able to: Define major concepts and terms used in nutrition; Discuss the highlights in the history of nutrition from international and national point of view. Identify the six classes of nutrients. Learning Guide Teaching Learning Activities (TLA) Resources 1. Read Module 1: Basic Nutrition:  Module 1: Basic Nutrition: Introduction Introduction 2. Answer: Self-Assessment Questions  Self-Assessment Questions (SAQs) 3. Compare to SAQs answer key  Self-Assessment Questions (SAQs) answer key 4. Answer online Quiz  Quiz  Computer or laptop, internet This module is NOT FOR SALE, DO NOT REPRODUCED 1|Page  Basic Nutrition MODULE 1: BASIC NUTRITION: INTRODUCTION Introduction Nutrition has played a significant role in our life, even from before our birth, although we may not always have been aware of it. And it will continue to affect us in major ways, depending on the foods we select. Optimal health and well-being require that the body be supplied with food in adequate and balanced amounts to provide the nutrients vital for normal organ development and functioning; for cell reproduction, growth, and maintenance; for high energy and working efficiency; for resistance to infection and disease; and for the ability to repair tissue damage or injury. No one nutrient works alone; each nutrient is dependent on the presence of others to bring desired results. Although everyone needs the same nutrients, each individual requires different amount of each nutrient depending on the age, gender, physiological make-up and physical activity. Knowledge about good nutrition is important because the quality of people’s lives and health depend on it. Definition of Terms in Nutrition A. FOOD  According to Biological Role “Food is any substance, organic or inorganic, when ingested or eaten, nourishes the body by building and repairing tissues, supplying heat and energy, and regulating bodily processes.”  According to Chemistry: “Food sustains life, second to oxygen.”  According to Food and Drug Administration (FDA) “Food includes articles used as drink or food, and the articles used for the component of such.” 2|Introduction B. HEALTH is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO definition) C. ILLNESS is a state of the body that is a deviation from the normal or usual well-feeling and its perception is biological or psychological. D. NUTRITION  “Nutrition is the study of food in relation to health of an individual, community or society and the process through which food are used to sustain life and growth.”  “Nutrition is the science of food, the nutrients and other substances therein, their action, interaction and balance in relation to health and disease, and the processes by which an organism ingest, digests, absorbs, transports, utilizes and excretes food substances.”  Nutrition is the study of foods in relation to health. E. DIETETICS  The combined science and art of regulating the planning, preparing and serving of meals to individuals of groups under various of health and disease according to the principles of nutrition and management with due consideration to economic; social, cultural and psychological factors (RA 2674).  Refers primarily to the therapeutic and food service aspects of the delivery of nutritional services in hospitals and other health care institutions (PD 1286). F. NUTRIENT the term nutrient is applied to chemical substances present in food and is used in the body for one or more of these three general functions: to provide energy, to build and repair tissues, to regulate life processes.  Nutrients are found chiefly in foods  Some nutrients are manufactured in the body (a process called “biosynthesis)  While some are made in the laboratory  Can be classified according to function, chemical properties, essentiality or concentration. Nutrient Distribution in the Body  “60-20-20 Rule” (for adult of normal weight)  Water is about 60% of total body weight  Fat/lipids are about 20% of total body weight  About 20% of total body weight is a combination of mostly protein (mainly muscle tissues or lean body mass) plus carbohydrates, minerals and vitamins. G. NUTRITIONAL STATUS (Nutriture) is the condition of how well-nourished the human body, depends on several criteria, such as physical signs, and symptoms of good nutrition, medical history, blood and urine tests, anatomical changes seen and imaging 3|Page  or x-rays and other medical instruments, and history of dietary intake up to current food habits. H. NUTRIENT DENSITY is the nutrient value of foods compared with number of calories.  Foods with low nutrient density provide an abundance of calories, but the nutrients are primarily carbohydrates and fats and, except for sodium, very limited amounts of proteins, vitamins and minerals. Examples are: Potato chips, cakes, sodas and candy. I. ENZYMES are organic catalysts that are protein in nature and are produced by living cells.  An enzyme system is composed of the protein part called Apo enzyme and a cofactor, which is sometimes called activator or coenzyme.  Most enzymes are recognized by the ending ase, like, maltase, lipase and transaminase. Examples are the digestive enzymes. J. HORMONES are organic substances produced by special cells of the body which are discharged into the blood to be circulated and brought to specific organs or tissues that are remote from the source or point of manufacture.  Most hormones are produced by endocrine or ductless glands.  Some protein in nature and others are related to lipids.  Examples are: insulin, thyroxin, adrenaline and progesterone. K. MALNUTRITION – opposite of good nutrition (mal-meaning bad). It is a condition of the body resulting from a lack of one or more essential nutrients (nutritional deficiency) or it may be due to an excessive nutrient supply to the point of creating toxic or harmful effects (e.g., overnutrition and hypervitaminosis). L. DIETARY REQUIREMENT OR MINIMUM REQUIREMENT  The minimum amount of specific nutrient needed by the body to attain a specific state of health.  The least amount of an ingested nutrient that will prevent symptoms and clinical signs of nutrient deficiency. M. DIETARY ALLOWANCE – The level of intake of a nutrient that is recommended for a population group. It includes an additional amount, called the “margin of safety” to cover variations in individual requirements and incomplete utilization of food. N. ESTIMATED AVERAGE REQUIREMENT (EAR) - Represents the average daily nutrient intake level estimated to meet the requirement half of the healthy individuals in a life stage and gender group (Institute of Medicine 2003)  They were developed from the perspective of preventing nutrient-deficiency disease. 4|Introduction   As an example, the EAR for phosphorus for women between the ages of 19 and 30 years represents the average daily intake of phosphorus that meets the requirement of half the women in this age group, if the EAR meets the needs of only half the people in a group, then the recommended intake will be higher. O. ADEQUATE INTAKE (AI) - A recommended intake value based on observed or experimentally determined estimates of nutrient intake by a group of healthy people that are assumed to be adequate (used when RDA cannot be determined). P. UPPER TOLERABLE LIMIT/ TOLERABLE UPPER INTAKE LEVELS (UL). The highest level of daily nutrient intakes that is likely to pose no risk or adverse health effects in almost all individuals in the general population. - This does not mean that we should consume this intake level or what we will receive more benefit from a nutrient by meeting or exceeding UL. In fact, as our intake of a nutrient increases in amounts above the UL, the potential for toxic effects and health risks increases. Q. RECOMMENDED ENERGY NUTRIENT INTAKES  RENIs “are levels of intakes of energy and essential nutrients which, on the basis of current scientific knowledge are considered adequate for the maintenance of health and wellbeing of nearly all healthy persons in populations.  In 1989 Philippine RDA was revised in 2002 and became the Recommended Energy and Nutrient Intake (RENI). RENI is a nutrient-based dietary standard recognized in the nutrition and healthy community as the source of information on recommended intakes of energy and nutrient for the, maintenance of good health. R. DIET – an allowance of food and drink consumed regularly by an individual. S. CLINICAL NUTRITION  The branch of the health science, having to do with the diagnosis, treatment and prevention of human disease caused by deficiency, excess or metabolic imbalance of dietary nutrients.  The treatment of patients requiring modifications in their nutritional requirement. Classification of Nutrients 1. According to FUNCTION:  Body building-they form tissues or are structural components, nutrients include water, protein, fat, carbohydrate and minerals.  Regulatory- nutrients include all six groups of nutrients. They maintain homeostasis of the body fluids and appetite metabolic processes.  Furnish energy- carbohydrate, fats & protein. They are sometimes referred to as “Fuel Nutrients”. (water, minerals and vitamins do not yield energy or are no- caloric nutrients,) 5|Page  Alcohol is another substance that contributes energy. It is not a nutrient, however, because it hinders growth and repair of the body. 2. According to CHEMICAL NATURE:  Organic nutrient. Organic substances are those carbon-containing compounds with the exception of carbonate and cyanide. Before the body can use organic nutrients, it must be breakdown into their smallest components.  Example: protein, fats, carbohydrate and vitamins  Inorganic nutrient. Minerals & water are inorganic nutrients since they do not contain carbon. Inorganic nutrients are already in their simplest forms when the body ingests them, except for water. 3. According to ESSENTIALITY:  Dietary Essential nutrients. Are those that the body cannot make in sufficient quantity to meet its requirements; they must be obtained from the diet.  Ex. Essential fatty acids are: linoleic and linolenic acids. Essential amino acids are: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.  Non-Dietary Essential Nutrients. Are those that can be produced in the body in enough amounts. Among them are: Cholesterol, and the amino acids alanine, aspartic acid, asparginine, cysteine, glutamic acid, glycine, hydroxylysine, hydroxyproline, proline and serine. 4. According to CONCENTRATION: Nutrients may be termed macronutrients or micronutrients. Water, Fat, Carbohydrate, Protein, are macronutrients since they are present in relatively large amounts in the body. Micronutrients include all Vitamins and the trace minerals, which are measured in milligrams or fractions thereof. a) Carbohydrates contain carbon, hydrogen, and oxygen. Carbohydrates are plant- derived foods composed of sugars. Starchy foods (rice, pasta, root crops, and breads) and those concentrated in sugars (candies, cookies, jam, and jellies) are common sources. Fruits and vegetables contain dietary fiber, also a complex form of carbohydrate. b) Proteins are made up of amino acids, which serve as the building units of the body tissues, thus they are vital for growth, repair, and maintenance of the body. c) Fat (or lipids) is a family of water-insoluble substances that include triglycerides (fats and oils), phospholipids (e.g. lecithin) and sterols (cholesterol and ergosterol).  Of the lipids in foods 95% are fats and oils and other 5% are other lipids. 6|Introduction  d) Minerals are pure inorganic elements (i.e., they occur in the simplest of chemical forms, as atom of a single element).  They are not metabolized, nor do they yield energy.  Major minerals are found in our bodies in amounts greater than 5 grams (or 5000mg), and we need to consume less than 100 mg of these minerals each day. The major minerals include sodium, potassium, calcium, phosphorus, chloride, Sulphur, and magnesium.  Trace minerals are found in our bodies in amounts less than 5 grams (or 5000mg), and we need to consume less than 100 mg of these minerals each day. Trace minerals are iron, zinc, copper fluoride, iodine, selenium, manganese, molybdenum, chromium, and cobalt. Minerals are indestructible and minerals in foods need not be handled with special care that vitamins require. e) Water-soluble and Fat-soluble are two subclasses of vitamins.  Water-soluble vitamins are soluble in water, and we excrete excess amounts in our urine: Vitamin C and eight vitamins namely, thiamine (B1), riboflavin (B2), Niacin, biotin, pantothenic acid, folic acid, pyridoxine (B6), and cobalamin (B12).  Fat-soluble vitamins are insoluble in water and can be stored in our tissues, these includes: vitamins A, D, E, K. vitamins are vital helpers in many body processes. However, they are vulnerable to destruction by heat, light, and chemical agents. thus, food must be handled carefully to preserve them. f) Water is a food as well as nutrient. it provides the environment in which nearly all the body’s activities are conducted. Categories of Nutritional Status 1. Optimum or Good Nutrition – means that the body has adequate supply of essential nutrient. 2. Malnutrition – opposite of good nutrition (mal-meaning bad). It is a condition of the body resulting from a lack of one or more essential nutrients (nutritional deficiency) or it may be due to an excessive nutrient supply to the point of creating toxic or harmful effects (e.g., overnutrition and hypervitaminosis). Nutritional Deficiencies may be caused by: a) Primary Factor – refers to a faulty diet, i.e., nutrient intake is lacking in quality and/or quantity for a given individual. The main factors that bring about faulty diets are as follows: poverty, ignorance, poor food habits, limited food supply due to overpopulation or low food production, poor distribution of food, cultural taboos, and many other factors causing nutrient intake to be less than what is needed. 7|Page  b) Secondary Factor – are multiple and include all conditions within the body that reduce the ultimate supply of nutrients to the cells after the food goes beyond the mouth. Factors that interfere with normal digestion are: gastrointestinal disorder, lack of appetite, poor teeth, lack of digestive enzymes etc. Methods of Evaluating Nutritional Status / Nutriture 1. Dietary surveys 2. Physical methods (anthropometry) 3. Clinical examination 4. Biochemical test 5. Functional assessment History of Nutrition as a Science The study of nutrition as a distinct science came about during the first half of the 20 th century, but long before that there had been a series of systematic inquiries into the subject. Guthrie, a well-known nutrition authority, identified four eras in the history of nutrition as a science:  Naturalistic era (400 B.C. to 1750 A.D.)  Chemical Analytical era (1750-1900)  Biological era (1900-1955)  Cellular era (1955-1980) The age of high technology and biotechnology, which is really a further development of the cellular era, started from 1981 to the present. Naturalistic Era (400 B.C. to 1750 A.D.)  In 400 B.C. the Greek physician Hippocrates, the “Father of Medicine” said, “Let thy food be thy medicine and thy medicine be thy food.” Hippocrates realized that food impacts a person’s health, body and mind to help prevent illness as well as maintain wellness.  Attempts to demonstrate the effect of food and exercise to one’s health.  Hippocrates known as the “Father of Medicine” was the first physician to show an interest in nutrition.  In Hippocrates, from pre-modern Europe and Asia since ancient times, foods were used to affect health. - For instance, the juice of liver was squeezed on the eye to treat eye diseases, connected to Vitamin A deficiency. - Garlic was used to cure athlete’s foot 8|Introduction  - Eating ginger was thought to stimulate the metabolism Chemical Analytical era (1750-1900)  During the Victorian age, scientific and medical development increased exponentially. The concept of metabolism, the transfer of food and oxygen into heat and water in the body, creating energy, was discovered in 1770 by Antoine Lavoisier, the “Father of Nutrition and Chemistry.”  And in the early 1800s, the elements of carbon, nitrogen, hydrogen and oxygen, the main components of food, were isolated and soon connected to health.  Work in the area of the chemical nature of foods—carbohydrates, fats and proteins—was done by Justus Liebig of Germany, and led to research in the area of vitamins in the early 20th century.  In 1912, a Polish doctor, Casimir Funk, discovered the term “vitamins” as essential factors in the diet. The term vitamin—first called “vitamine”—comes from “vital” and “amine,” because vitamins are required for life and they were originally thought to be amines—compounds derived from ammonia Biological era (1900-1955)  More discoveries of factors with vitamin-like properties.  Emphasis was made on the study of relationships existing between nutrients and their biological roles and determination of human dietary requirements.  Role of nutrition education was focused in this period. Cellular/ Molecular era (1955-1980)  Characterized by the many discoveries in the field of cellular metabolism.  More sophisticated equipment like radioactive isotopes, electron microscope, and micro technical techniques.  More information was obtained regarding the role of different nutrients play in growth, development and maintenance of the cells and ultimately to the whole body so that the deficiency at any one point adversely affects the whole body.  Genetic engineering or biotechnology, possible for the selection of genes for specific desired characteristics such as the improvement of livestock’s; improved resistance against diseases of crops; improved quality of food.  Biotechnology is also applied in the production of hormones and enzymes by bacteria. Historical Highlights of Nutrition in The Philippines The History of Nutrition in the Philippines may be divided into 5 periods: 1903-1923, 1923- 1943, from world war II to 1960, 1960-1980, 1981 to present.  1903-1923  Studies done by American and Foreign scientist, aided by Filipino workers 9|Page   Conducted studies on beriberi and the proximate composition of foods, and worked on Filipino physiological standards  Thus making possible the large scale manufacture of tiki-tiki extracts. These extracts reduced the infant mortality rate.  1923-1943  Fleming, Santos and others (1923) worked on basal metabolic standards for Filipino students.  Increased emphasis on food composition  Adriano worked on calcium content of foods.  1932- the National Research Council (NRC) of the Philippines was established  Santos, considered the Father of Nutrition in The Philippines.  from world war II to 1960  Highlighted the creation of nutrition agencies and councils which worked on organized activities in nutrition and food researched and the coordination of activities of the government and private agencies involved in nutrition work.  The Phil. Institute of Nutrition (PIN) was created 1947  Series of experiment on beriberi- found out that if enriched rice were given to beriberi patient the mortality rate caused by the disease was considerably lowered. As a result of these experiment.  R.A 832 known as the Rice Enrichment Law was passed.  1959- Nutrition Foundation of the Philippines (NFP)- a private agency, was organized by prominent men of Science, with the objective of helping improve the health of the people through assistance programs on foods and nutrition, and agriculture throughout the Philippines to solve the malnutrition problem in the country. The NFP was founded by National Scientist, Dr. Juan Salcedo, Jr.  1960-1980  1960, the National Coordinating Council on Foods and Nutrition (NCCFN) was organized under the initiative of Dr. Conrado Pascual. This marked the formal beginning of the coordination of applied nutrition, nutrition research as well as food researched activities.  July 1, 1960. The department of health established the National Nutrition Program.  June 25, 1974. The National Nutrition Council (NNC) was created.  July 2, 1974. The Nutrition Center of the Philippines (NCP) was established.  The Nutrition Dietetics Decree of 1977, P.D.1286, regulates the practice of nutrition and dietetics and sets minimum requirements for nutritionist- dietitians for hospitals and nutrition agencies. 10 | I n t r o d u c t i o n  Number of Nutritionist-Dietitian needed in the Hospital 25 to 75 bed capacity shall employ a minimum of one Nutritionist- Dietitian Above 75 to 150 bed capacity a minimum of 2 nutritionist-dietitians Above 150 to 250 bed capacity, a minimum of three nutritionist-dietitians Above 250 to 500 bed capacity, a minimum of four nutritionist-dietitians Above 500 to 1000 bed capacity, a minimum of 5 nutritionist-dietitians Provided, that no person shall be employed as nutritionist-dietitian in any hospital without having been registered in accordance with the provisions of this code  Latter part of the 1980s through the decade of the 1990s, a growing concern towards micronutrient deficiencies evolved, based on the results of the First through Third Nutritional Surveys conducted in 1978, 1982 and 1987 respectively, as well as special surveys such as those done by the DOH.  October 1993, the first National Micronutrient Day was conducted, providing vitamin A, iron and iodine supplements to at-risk population groups.  1986. The NUTRINET (Nutrition Research Information Network) was established.  In 2005, the Department of Health became the chair of the NNC, with the DA and DILG as vice-chairs. NNC was tasked to re-orient its operation to be more clients oriented and to prioritize addressing hunger and malnutrition. Republic Act n. 10862, May 25, 2016  An Act Regulating the Practice of Nutrition and Dietetics in The Philippines, repealing for The Purpose Presidential Decree No. 1286, Known as The “Nutrition and Dietetics Decree of 1977”  Sec. 3. Objectives. - This Act shall govern: (a) The standardization and regulation of nutrition and dietetics education; (b) The examination, registration and licensure of nutritionist-dietitians; (c) The standardization, supervision, control, and regulation of the practice of nutrition and dietetics; (d) The development of professional competence of nutritionist-dietitians through continuing professional development (CPD); and (e) The integration of the nutrition-dietetics profession.  Profession refers to the practice of the science and art or discipline of nutrition and dietetics combined.  The licensure examination/s for nutritionist-dietitians shall include, but not be limited to, the following: (a) Nutrition and Dietetics; (b) Foods and Food Service Systems; and (c) Community and Applied Nutrition. 11 | P a g e   Rating in the Licensure Examination a) To pass the licensure examination for nutritionist-dietitians, a candidate must obtain a general or weighted average rating of seventy-five percent (75%), with no rating below fifty percent (50%) in any subject: b) Provided, that an applicant who fails to obtain a passing average but who obtained at least seventy-five percent (75%) in each of at least one-half of the total subject given in the examination, may be permitted to take within two (2) years from the date of his/her examination, c) another examination, on the subjects in which he/she obtained a grade below seventy-five percent (75%). Should the examinee fail in the set of subjects repeated in the second examination, he/she shall be required to take all the subjects in the next examination.  Nutritionist-Dietitian refers to a registered and licensed person who holds a valid certificate of registration and a valid professional identification card issued by the Board and the Commission pursuant to this Act. Definitions of Position in the Dietetic Profession 1. Registered Nutritionist-Dietitian  Is a bona fide holder of a certificate of registration issued by the Board of nutrition and Dietetics. 2. Administrative Dietitian R.D  Administrative dietitian is a member of the management team and effects the nutritional care groups through the management of foodservice systems that provide optimal nutrition and quality food. 3. Clinical Dietitian, R.D – is a member of health care team and affects the nutritional care of individuals and groups for health maintenance  Assess nutritional needs, develops and implements nutritional care plans, and evaluates and reports these results appropriately. 4. Community Dietitian, R.D With specialized community dietetic preparation, function as a member of the community health team in assessing nutritional needs of individual and groups. 12 | I n t r o d u c t i o n   The community dietitian plans, organizes, coordinates and evaluates the nutritional component of health care services for an organization. 5. Consultant Dietitian, R.D With experience in administrative or clinical dietetic practice, affects the management of human effort and facilitating resources by advice or services in nutritional care. 6. Research Dietitian, R.D With advanced preparation in dietetics and research techniques, plans, investigates, interprets, evaluates, applies and expands knowledge in one or more phases of dietetics and communicate findings through reports and publications 7. Teaching Dietitian, R.D With advanced preparation in dietetics or education, plans, conducts, and evaluates educational programs in one or more dietetic subject matter areas. 8. Gerontological Nutritionist–Dietitians – often assigned in nursing homes, community sponsored homes for the aged and hospitals for people aged 60 and above whose health constitution requires special diet considerations due to their diminished metabolic rates. 9. Sports and Fitness Nutritionist – give private consultations to assess their client's lifestyle, eating habits, training schedule and use of medications and supplements, along with setting short and long-term goals. 10. Therapeutic Nutritionist-Dietitian – plan and conduct food service or nutritional programs to assist in the promotion of health and control of disease; supervise activities of a department providing quantity food services, counsel individuals, or conduct nutritional research. 11. Food Service Supervisor – responsible for the day to day management of food services in health care facilities, cafeterias, catering and hospitality establishments. 12. Canteen Supervisor – directly supervise and coordinate activities of workers engaged in preparing and serving food. 13. Nutritionist-Dietitian in Quality Control Department – supervises workers in the process of food production, ensures safety and sanitation and creating products that are of high quality 14. Nutritionist-Dietitian in the test kitchen (Product Development) – in charge in overseeing that food products are prepared properly not only considering palatability but as well as observing the nutritional content in each item. 15. Menu planner – well-versed in basic nutrition, differing dietary needs, appropriate and palatable food pairing options and seasonal food availability. 16. Food Service Manager – work in a wide variety of restaurants, including fast food, hotels and institutional cafeterias, such as hospitals and schools. In a small establishment, the food service manager may responsible for most of the activities in the kitchen and with service staff. 13 | P a g e 17. Culinary Nutrition Specialist – use their expert knowledge of nutrition to help others learn to make healthy food choices and plan meals that support their overall health and longevity. Nutritionists also plan and prepare meals for individuals and groups in various environments. 18. Corporate Wellness Program Consultant – helps people to lead physically as well as mentally healthier lifestyles. Wellness consultants advise people on healthier lifestyle choices in various areas including exercise, nutrition and stress management. 19. Weight Loss Consultant – also known as personal care consultants, advise clients on weight loss and healthy living. They may also provide advice on nutrition and relaxation. 20. Chief Nutritionist-Dietitian – head of the Nutrition department in a hospital or nutrition facility 14 | I n t r o d u c t i o n SELF-ASSESSMENT QUESTIONS (SAQS) MODULE 1: Basic Nutrition: Introduction Now that you have completed this module, you can assess how well you have achieved its Learning Outcomes by answering the questions below. Direction: Answer the following questions. 1. Define nutrient? Name the six classes of nutrients found in foods? 2. Which nutrients are inorganic, and which are organic? Discuss the significance of that distinction. 3. Which nutrient yield energy? 4. Why is nutrition as a field of study considered a science as well as an art? 5. Why are some foods called low-nutrient-density foods? Give some examples. 6. What happens when people get either too little or too much energy of nutrients? Define malnutrition, undernutrition, and overnutrition. What are the four methods used to detect energy and nutrient deficiencies and excesses. 7. Explain the difference between: protein and carbohydrate 8. Explain the difference between a trace mineral and a major mineral. 9. Explain the difference between Water-soluble vitamins and Fat-soluble vitamins. 10. List some highlights in the history of nutrition in the Philippines. 11. What is a registered Nutritionist –Dietitian? 12. The nutrient found most abundantly in both the human body and most food is: a. fat b. water c. minerals d. proteins 13. The inorganic nutrients are: a. Proteins and fats c. minerals and waters b. Vitamins and minerals d. vitamins and proteins 17. The diet-planning principle that provides all the essential nutrients in sufficient amounts to support health is: a. balance b. variety c. adequacy d. moderation 18. A deficiency caused by an adequate dietary intake is a(an): a. over deficiency c. primary deficiency b. covert deficiency d. secondary deficiency 19. Carbohydrates, lipids, and proteins all contain carbon, hydrogen, and oxygen. Which one also contains nitrogen? a. Carbohydrates b. proteins c. lipids d. none of the above 20. Essential nutrients: a. are made by the body c. include alcohol b. generally, must be supplied by food d. are enzymes 15 | P a g e SELF-ASSESSMENT QUESTIONS (SAQS) ANSWER KEY MODULE 1: Basic Nutrition: Introduction Now that you have completed this module, you can assess how well you have achieved its Learning Outcomes by answering the questions below. 1. Nutrient the term nutrient is applied to chemical substances present in food and is used in the body for one or more of these three general functions: to provide energy, to build and repair tissues, to regulate life processes. The six classes of nutrients found in foods are: carbohydrates, proteins, fats or lipids, minerals, vitamins and water. 2. Organic nutrients are organic substances that contain carbon compounds with the exception of carbonate and cyanide. Before the body can use organic nutrients, it must be breakdown into their smallest components. i.e. protein, fats, carbohydrate and vitamins while Inorganic nutrient are nutrients that do not contain carbon. Inorganic nutrients are already in their simplest forms when the body ingests them, except for water. i.e. minerals & water 3. In the body, three of the organic nutrients can be used to provide energy: carbohydrate, fat, and protein. In contrast to these energy-yielding nutrients, vitamins, minerals, and water do not yield energy in the human body. 4. The science of nutrition is the study of the nutrients and other substances in foods and the body’s handling of them. The scope of Nutrition is interrelated, not only with medicine and allied health sciences, but also in arts and managerial fields. 5. Nutrient density is the nutrient value of foods compared with number of calories. Foods with low nutrient density provide an abundance of calories, but the nutrients are primarily carbohydrates and fats and, except for sodium, very limited amounts of proteins, vitamins and minerals. Examples are: Potato chips, cakes, sodas and candy 6. If the deficiency or excess is significant overtime, the person experiences symptoms of malnutrition. With the deficiency of energy, the person may develop the symptoms of undernutrition, by becoming extremely thin, losing muscle tissue, and becoming prone to infection. With an excess of energy, the person may become obese and vulnerable to diseases associated with overnutrition such as heart disease and diabetes. Malnutrition – opposite of good nutrition (mal-meaning bad). It is a condition of the body resulting from a lack of one or more essential nutrients (nutritional deficiency) or it may be due to an excessive nutrient supply to the point of creating toxic or harmful effects (e.g., overnutrition and hypervitaminosis). Undernutrition – deficient energy or nutrients and Overnutrition – excess energy or nutrients. The methods of evaluating nutritional status / nutriture are; Dietary surveys, Physical methods (anthropometry), Clinical examination, and Biochemical test 16 | I n t r o d u c t i o n 7. Carbohydrates contain carbon, hydrogen, and oxygen. Carbohydrates are plant-derived foods composed of sugars. Starchy foods (rice, pasta, root crops, and breads) and those concentrated in sugars (candies, cookies, jam, and jellies) are common sources. Fruits and vegetables contain dietary fiber, also a complex form of carbohydrate. Proteins are made up of amino acids, which serve as the building units of the body tissues, thus they are vital for growth, repair, and maintenance of the body. 8. Major minerals are found in our bodies in amounts greater than 5 grams (or 5000mg), and we need to consume less than 100 mg of these minerals each day. The major minerals include sodium, potassium, calcium, phosphorus, chloride, Sulphur, and magnesium. While Trace minerals are found in our bodies in amounts less than 5 grams (or 5000mg), and we need to consume less than 100 mg of these minerals each day. Trace minerals are iron, zinc, copper fluoride, iodine, selenium, manganese, molybdenum, chromium, and cobalt. Minerals are indestructible and minerals in foods need not be handled with special care that vitamins require. 9. Water-soluble vitamins are soluble in water, and we excrete excess amounts in our urine: Vitamin C and eight vitamins namely, thiamine (B1), riboflavin (B2), Niacin, biotin, pantothenic acid, folic acid, pyridoxine (B6), and cobalamin (B12). while Fat-soluble vitamins are insoluble in water and can be stored in our tissues, these includes: vitamins A, D, E, K. vitamins are vital helpers in many body processes. 10. Historical Highlights of Nutrition in The Philippines  1903-1923 Conducted studies on beriberi and the proximate composition of foods, and worked on Filipino physiological standards  1932- the National Research Council (NRC) of the Philippines was established and Santos, considered the Father of Nutrition in The Philippines.  The Phil. Institute of Nutrition (PIN) was created 1947  R.A 832 known as the Rice Enrichment Law was passed.  1959- Nutrition Foundation of the Philippines (NFP)- a private agency, was organized by prominent men of Science, with the objective of helping improve the health of the people through assistance programs on foods and nutrition, and agriculture throughout the Philippines to solve the malnutrition problem in the country.  The National Coordinating Council on Foods and Nutrition (NCCFN) was organized under the initiative of Dr. Conrado Pascual.  July 1, 1960. The department of health established the National Nutrition Program.  June 25, 1974. The National Nutrition Council (NNC) was created.  July 2, 1974. The Nutrition Center of the Philippines (NCP) was established.  The Nutrition Dietetics Decree of 1977, P.D.1286, regulates the practice of nutrition and dietetics and sets minimum requirements for nutritionist-dietitians for hospitals and nutrition agencies. 11. Registered Nutritionist-Dietitian is a bona fide holder of a certificate of registration issued by the Board of nutrition and Dietetics in accordance with this code., Republic Act 17 | P a g e  no. 2674, an act to regulate the practice of dietetics in the Philippines took effect on June 18, 1960 12. b 16. c 17. c 18. c 19. b 20. b 18 | I n t r o d u c t i o n  APPENDIX Summary of Selected Hormones Hormone (Organ of Origin) Main Physiologic Functions Adrenaline See epinephrine Adrenocorticotropic or ACTH Stimulates the secretion of corticosteroids and other hormones. (anterior pituitary gland) Acts on the adrenal cortex to release its hormones. Aldosterone (adrenal cortex) Regulates water and electrolyte balance. Antidiuretic hormone or ADH See vasopressin. Calcitonin (thyroid gland) Controls the calcium level requirement. Cholecystokinin (duodenum and Stimulates the gallbladder and pancreas to release their contents jejunum) into small intestines. Corticotropin-releasing Stimulates the release of ACTH triggered by stress; but turned off hormones or CRH by ACTH when enough has been released. (hypothalamus) Cortisone See glucocorticoids Enterocrinin (intestinal mucosa) Stimulates intestinal juice secretion. Epinephrine (adrenal medulla) Accelerates cardiac action; constricts certain blood vessels; relaxes intestines and dilates the bronchi in the trachea. Erythropoietin (kidney) A glycoprotein hormone; stimulates the production of red blood cells. Estrogens (ovaries) Responsible for female characteristics and menstrual cycle. Promotes the maturation of female ovaries and sperm formation of the testes. Gastrin (stomach and Promotes the manufacture and release of acid and digestive duodenum) juices in the stomach and duodenum. GH-inhibiting hormone Checks and inhibits the release of growth hormones; Inhibits the (hypothalamus) release of TSH and GH; Also inhibits ACTH, glucagon, and insulin. GH-releasing hormone or GRH Promotes the release of growth hormone; stimulated by insulin. (hypothalamus) Growth Hormone or GH Promotes linear growth of long bones. Aids in nitrogen, calcium, (anterior pituitary gland) phosphorus, and carbohydrate metabolism. Glucagon (alpha cells of Increases blood glucose levels by stimulating the breakdown of pancreas) glycogen into glucose; activates gluconeogenesis. Glucorticoids: corticosterone, Maintain circulatory and vascular homeostasis. Aids in cortisone and hydrocortisone carbohydrate, protein, and lipid metabolism. (adrenal cortex) Insulin (beta cells of pancreas) Regulates glucose metabolism by lowering blood glucose levels; promotes transport and entry of glucose into the muscle cells and other tissues; promotes glycogen synthesis, lipogenesis, and gluconeogenesis. Oxytocin or Pitocin (anterior Stimulates uterine contraction labor and bleeding after delivery. pituitary gland), Pancreozymin Aids in the production of milk. Stimulates the secretion of (pancreas) pancreatic juice. Controls the calcium content in the blood. Parathyroid or PTH (parathyroid gland), Progesterone (uterus 19 | P a g e and mammary glands) Secretin (duodenum) Stimulates the pancreas to release acid-neutralizing bicarbonates into small intestines. Somatotropic hormone or STH Promotes protein synthesis in all cells; increases fat mobilization; (anterior pituitary gland) aids in CHO metabolism. Thyroid-stimulating hormone or Stimulates the release of TSH; excited by low body temperature TSH (anterior pituitary gland) and large meals. Stimulates the thyroid gland to promote and release thyroid hormones. Thyroxine, di-and Stimulates oxygen consumption. Regulates carbohydrate, lipid, triiodothyroxine (thyroid gland) and protein metabolism; excessive secretion leads to glucose intolerance and increased gluconeogenesis. Vasopressin or pitressin Also known as antidiuretic hormone; prevents water loss in urine (posterior pituitary gland) by the contraction of the kidneys. Turned on whenever the blood volume is depleted (either the blood pressure is too low or salt concentration is too high). Organ Systems and Their roles in Nutrition Bodily System( Major Organs ) Roles in Nutrition 1. Cardiovascular (heart, blood vessels, Transports nutrients, gases, waste products; regulates blood) body temperature; involved with the immune response. 2. Digestive (mouth, esophagus, Digests and absorbs nutrients; eliminates waste stomach, intestines, liver, pancreas) products. 3. Endocrine (endocrine glands, e.g., Helps regulates metabolism, reproduction water thyroid, pituitary, adrenal glands ) balance etc. (by hormones secreted). 4. Immune (white blood cells, lymph, Provides defense against foreign substances. spleen, thymus gland) 5. Integumentary (skin, hair, nails, sweat Protects the body; regulates temperature; aids in acid- glands). base and water balance; production of vitamin D. 6. Lymphatic (lymph vessels, nodes) Helps with fluid balance and fat absorption; removes foreign substances from the blood. 7. Muscular (skeletal, cardiac and Maintains posture; directs body movements; and smooth muscles) produces body heat. 8. Nervous (brain, spinal cord, nerves, Controls intellectual function; detects sensation and sensory organs and receptors) controls movements. 9. Respiratory (lungs and respiratory Regulates gas exchanges and acid-base balance. tract) 10. Reproductive Regulates sexual function and reproduction. 11. Skeletal (bones, joints, cartilages) Main frame body support; aids with body movements; stores minerals; produces blood cells. 12. Urinary (kidneys, urinary tract) Removes waste products; regulates fluids, acid-base balance; aids with homeostasis. 20 | I n t r o d u c t i o n References Local:  Jamorabo-Ruiz A and Claudio VS. 2010. Basic Nutrition for Filipinos 6th ed. Manila, Philippines: Merriam & Webster Bookstore Inc.  Jamorabo-Ruiz, A.et al. 2011. Nutrition and Diet Therapy for Nursing.  NDAP. 2010. Diet Manual. 5th Edition Foreign:  Anderson J., Root M. And Garner S. 2015. Human Nutrition: Healthy Options for Life. MA: Jones and Bartlett Publishers  Boyle MA 2016. Personal Nutrition 9th ed. MI: Cengage Learning  Brown, Judith. 2014. Nutrition Now. 7th ed. MI: Cengage Learning  Insel P, Ross D, McMahon K. And Bernstein M. 2014. Nutrition 5th ed. Burlington, Sudbury, MA: Jones and Bartlett Learning  Mahan LK. And Raymond JL. 2017. Krause’s Food and the Nutrition Care Process 14th ed. Philadelphia, PA: Elsevier/Saunders  Ross AC, Caballero B., Cousins RJ, Tucker KL and Ziegler TR. (editors). 2012. Modern Nutrition in Health and Disease 11th ed. Wolters Kluwer/Lippincott, Williams and Wilkins  Smolin, Lori A. and Grosvenor, Mary B. 2016. Nutrition: Science and Applications, 4th ed. NYC, NY: Wiley-Blackwell  Thompson, J. et al. 2010. Nutrition A Functional Approach. 2nd Canadian Edition.  Whitney E. and Rolfes S. 2016. Understanding Nutrition 14th ed. Belmont, Ca: Wadsworth/Cengage Learning. 21 | P a g e