HSM 212

PRICIPLES OF NUTRITION (2 CREDIT UNITS)

 DEFINATION OF NUTRITION
Food provides both the energy and all the materials needed to maintain all the body cells.
Nutrients are the nourishing substances we must obtain from the food we consume. These
essential substances are vital for the growth and maintenance of a healthy body all through life.
For a nutrient to be essential, it possesses two characteristics. First, its omission from the diet
could lead to a decline in health in certain aspects of the human health such as the functioning of
the nervous system. Secondly, when the omitted nutrient is restored to the diet before a
permanent damage occurs, those aspects of the human health vulnerable by its absence should
regain normal function. These are further classified in to the macro (needed in large quantity by
the body e.g carbohydrate, protein, fat) and micro nutrients (needed in smaller quantity such as
the vitamins and minerals).. An essential nutrient is a nutrient that the body cannot synthesis on
its own, and must be provided by the diet. These nutrients are necessary for the body to function
properly. The six essential nutrients are carbohydrates, fat, protein, vitamins, minerals and water.
Nutrition as defined by the Council on Food and Nutrition of the American Medical association
is “the science of food, the nutrients and the substances therein, their action, interaction, and
balance in relation to health and disease, and the process by which the organism ingests, digests,
absorbs, transports, utilizes, and excretes food substances”.
Nutrition is vital to developing and maintaining a state of health that is optimal for an individual.
A poor diet together with an inactive life style is known to be risk factors for threatening chronic
diseases (such as heart diseases, strokes, hypertension, diabetes) and deaths.
 FUNCTIONS AND INTER-RELATIONSHIP OF NUTRIENTS TO THE BODY
IN HEALTH AND MALNUTRITION
IDENTIFICATION OF ESSETIAL NUTRIENTS
From the elementary nutrition studies we are familiar with the terms carbohydrates, lipids
(fats and oil), proteins, vitamins and minerals. These, plus water make up the six classes of
nutrients found in food. The nutrients obtained from the food we consume could be
apportioned into three functional categories:
1. Those that primarily provide the body with energy (expressed in kcal) which are
carbohydrates, proteins and lipids
2. Those that are necessary for growth, development, and maintenance: proteins, lipids,
vitamins, minerals, water
3. Those that help to keep the body functions running smoothly: proteins, lipids, vitamins,
minerals water.
The initial scientific researches on food and nutrition were focused on identifying the
essential nutrients and quantifying the amount required of them all to the body through life
span. The essential nutrients could be widely divided into two groups
a. The macronutrients – these nutrients (carbohydrates, fats and proteins) are needed in
relatively large quantities and act as dietary source of energy.
b. The micronutrients – these are vitamins and minerals usually required in small amounts
(milligram or microgram quantities) and do not act as source of energy.
A lack or shortage of any of the essential micronutrients could lead to adverse symptoms
often characterized by deficiency diseases.

FUNCTIONS AND SOURCES OF THE NUTRIENTS

1. Carbohydrates: carbohydrates are composed mainly of carbon, hydrogen and oxygen.
Carbohydrates provide a major source of fuel for the body, an average of 4kcal per gram
(4kcal/g). The general formula for carbohydrate is (CH2O)n the n represents the number
of times the ratio is repeated. The smaller carbohydrate structures are called sugars or
simple sugars, examples are table sugar (sucrose). There are two types of carbohydrates;
these are the simple and the complex carbohydrates. Examples of simple carbohydrates
are monosaccharide and disaccharides. The disaccharides are two molecules of sugar
such as maltose, lactose and sucrose. Sucrose is broken down to fructose and glucose,
while maltose is broken down to fructose and glucose. Lactose is popularly referred to as
milk sugar. Upon digestion it yields glucose and galactose. Galactose, fructose are
examples of monosaccharide. The most important of the monosaccharaides is glucose,
glucose is needed every second by the brain to function Examples of Simple sugars can
link chemically to form large storage of carbohydrates. Complex carbohydrate is
polysaccharides that contain as many as 2000 simple carbohydrates units in long chains.
Starch, glycogen, and cellulose are examples of complex carbohydrates. Common
sources of carbohydrates are cereals such as maize, rice, oats, millets; tubers such as
yams, cassava, cocoyam, potatoes etc.

Functions of carbohydrates
a. These are the major source of energy
b. It supplies glucose to the body especially the brain
c. Carbohydrates spare proteins, in the absence of carbohydrate, proteins will be burnt
off to produce energy
d. Carbohydrate adds bulk to faecies. This function is carried out by the dietary fibre
which have the ability to absorb and hold water
e. It assist the complete oxidation of fats and oil in the body
f. It helps in the formation of genetic materials (deoxyribonucleic acid DNA and
Ribonucleic acid RNA)
Digestion of carbohydrates
The digestion of carbohydrates is the hydrolysis of carbohydrate by digestive enzymes
into their component monosaccharides. The digestion begins from the mouth and ends in
the small intestine. In the mouth, the food is chewed and broken down into small pieces
and mixed with saliva which is secreted from the salivary gland in the mouth which
secretes an enzyme known as salivary amylase, which initiates the breakdown of starch (a
polysaccharide) to maltose (a disaccharide). This process continues as the as partially
digested food moves through the esophagus being lubricated with mucus in to the
duodenal cavity. The digestion continues in the duodenum (the first part of the small
intestine). As the chime reaches the stomach, the hydrolysis continues until food is
acidified by mixing with gastric juice. The complete conversion of starch to maltose is
done by the pancreatic amylase. The other enzymes in the intestine are maltase, sucrase
 and lactase. Maltase breaks down maltose into two molecules of glucose. Lactase breaks
down lactose into one molecule of glucose and one molecule of galactose. Sucrase
coverts sucrose into one molecule of glucose and one molecule of fructose. The end
product of carbohydrate digestion is glucose.
2. Lipids: these are compounds that are made up triglycerides (fats and oils), phospholipids
and sterols. Fatty acids and triglycerides just like carbohydrates are composed of
elements carbon and hydrogen and less oxygen than the carbohydrates. Every triglyceride
contains one molecule of glycerol and three fatty acids. A fatty acid is an organic acid, a
chain of carbon atoms with hydrogen attached. An acid group (COOH) is attached at one
end known as the alpha end and the methyl group (CH3) at the other end called the omega
group. Due to this compositional difference, lipids yield more energy per gram than the
carbohydrates (9kcal/g). There are two types of fats in a diet; animal fats and plant fats.
Some fats are high in saturated acids while some are not. Lipids are insoluble in water but
dissolve in certain organic solvents. Examples of food sources are: lard (butter,
margarine), oily fishes, vegetable oil, and groundnut/oil, palm produce/oil, liver etc.
Lipids are classified into two groups, simple and compound lipids. Simple lipids are the
esters of fatty acids and alcohol. Examples of ester of fatty acids include animal and
vegetable fats. Compound lipids are esters of fatty acids containing groups in addition to
and alcohol and a fatty acid. Examples of these lipids include phospholipids such a
lecithin found in egg yolk and milk sterol, such as cholesterol. Generally lipids are are 58
fats and oils. Fats are solid at room temperature while oils are liquid. Fats and oils are
greasy and oily to touch and commonly found in plants and animals.

Functions of Lipids (fat/oil)

a. They are good sources of energy.
b. They provide body backup fuel, having twice the calorific value of carbohydrates.
c. Fats provides satiety ( feeling of satisfaction)
d. They spare protein because of their ability to reduce the need to burn protein for
energy
e. They assist in the maintenance of consistent body temperature by producing effective
insulation underneath the skin
f. They assist to cushion the delicate organs in the body e.g heart,
g. They facilitate the absorption of the fat soluble vitamins
h. They contribute to flavour and palatability of the diet
Types of fats
a. Saturated fats
Fatty acids that is high in saturated fats present carbon that is single connections which
are filled with hydrogen. Naturally fatty acids contain even number of carbon such as 18,
24 etc. examples of the simplex fatty acids is steric acid which contains 18 carbon fatty
acid present in most of our diets.
H-c-c-c-c-c-c-c-c-c-c-c-c-c-c-c-c-c-c-o-H
Digestion of lipids fats/oils
 The digestion of fats begins in the small intestine. The digestion od lipids starts
minimally in the stomach with the aid of the lingual and gastic lipase. The major
digestion of lipids takes place in the smallintestine due to the presence of the enzyme
known as the pancreatic lipase. As the chime finds its way into the duodenum, the
hormonal responses trigger the release of the bile from the gall bladder. The bile is
secreted by the liver. It is the bile fluid and bile salts that serve as the emulsifying
agents. This bile salts also accelerate the pancreatic lipase (enzymes that break fats)
and it also neutralize the acidity of the chyme. The end products of fats are fatty
acids, glycerol and glycerides.

3. Proteins: like carbohydrates and fats, proteins equally are composed of elements carbon,
hydrogen and oxygen, but unlike the previous, they also contain a large amount of
nitrogen. Proteins are the main structural material of the body, they constitute a major
part of the bones and muscles; they are important components of the in the blood, cell
membrane and immune factors. Proteins an also provide energy to the body of 4kcal/g.
the body uses little protein for meeting energy needs. Proteins are formed by linking of
amino acids. Food sources of proteins are: meat, poultry, eggs, milk, fish, legumes e.g
beans, soy beans.

Functions of proteins
a. The major function of protein is that it promotes growth and the repair of worn out
tissues
b. They can serve as a source of energy in the absence of carbohydrates and fats
c. They are responsible for the transmission of the hereditary characteristics from
parents to off-springs
d. The hormones and antibiotics are protein in nature and hence they assist in the
regulation of the body processes and fighting against diseases and infections
Digestion of protein
Digestion of protein is the breakdown of protein into amino acids. Protein digestion starts
from the stomach when the masticated acts to the stomach. The stomach releases gastric juice
which contains hydrochloric acid and pepsin. This begins the digestion process of protein.
The hydrochloric acid makes the pH of the stomach to be very acidic thereby killing any
bacteria that must have been swallowed with the food during ingestion. The long chains of
protein are split into smaller units by an inactive enzyme pepsinogen that converted to pepsin
upon being in contact with hydrochloric acid.
In the stomach of infants, an enzyme known as renin also present in the gastric juice helps to
coagulate casein which is a component of milk and helps in the breakdown of milk protein
pepsin secreted by cells living in the stomach disintegrates protein chains into small
fragments. The main protein connective tissue called collagen is digested by pepsin. The vast
majority of protein digestion occurs in duodenum. The liquefied mass of food called chyme
passes through the pyloric sphincter into small intestine where the activation of enterokinase
an enzyme that activates pancreatic trypsinogen into trypsin. Trypsin, chymotrypsin and
carboxypolypetidase breakdown the links of polypeptide chains and further subdivide them
into small polypeptides. These result in free amino acids.
 Protein digestion in the stomach takes more time than carbohydrates and less time than fats,
that is to say the satiety values of fat is higher than that of protein, followed by
carbohydrates.
4. Vitamins: they exhibit a wider variety of chemical structures and can contain elements
carbon, hydrogen, nitrogen, oxygen, phosphorous, Sulphur etc. their main functions are
to enable many chemical reactions to take place in the body some of which help to
release the energy trapped in carbohydrate, lipids and proteins. However, vitamins
themselves yield no useable energy for the body. There are 13 vitamins which are divided
into two groups.
a. Fat soluble (vitamins A, D, E and K) there four in number
b. Water soluble ( the B vitamins) also known as the B-complex B 1, B2, B6, B12) vitamin
C, niacin, folic, pantothenic acid, biotin
The two groups of vitamins act differently; cooking destroys the water soluble vitamins easily
than it does to the fat soluble vitamins. Water soluble vitamins are excreted more readily from
the body than the fat soluble vitamins therefore the fat soluble vitamins like A and D are more
likely to accumulate in the body in excessive amount that could cause toxicity. The food sources
of vitamin B1 (thiamine) are enriched and whole cereals, dried legumes, such as peas, beans,
nuts, milk, pork, beef, liver etc.
Vitamin B2 (riboflavin): are muscle meat, liver, enriched cereals, yeast, legumes, green leafy
vegetables, offal.
Vitamin B6 (pyridoxine): are muscle meat, milk, whole grain, brewed yeast, fish, nuts etc.
Vitamin B12 (cobalamin): sources are liver, eggs, milk, kidney, cheese etc.
Vitamin C: food sources are citrus fruits, oranges, grape fruits, lemons, guavas, cabbage, okra,
tomatoes etc.
Niacin: sources are legumes, milk, poultry, liver, kidney etc. Folic acids sources are liver, offal,
green leafy vegetables, legumes, nuts, whole grain cereals etc. Pantothenic acid: are muscle
meat, legumes, nuts, fish, whole grain cereals etc. Biotin: sources are brewed yeast, legumes, egg
yolk, whole grains cereals, and offal.
Vitamins A (retinol): the food sources include liver, margarine, eggs, milk, and herrings
Vitamin D (calciferol) : butter, milk, egg yolks, fish, liver, liver oils, foods fortified with vitamin
D, dairy products, sunshine
Vitamin E (tocopherol) : green leaf plants, vegetable oils, cotton seeds, whole grain, cereals,
eggs, pulses etc
Vitamin K (pylloquinone): cabbage, green leafy vegetables, liver, eggs, milk and soya beans
Functions of Vitamin B1 (thiamin)
a. They are involved in the normal functioning of the heart, nerves and muscles
b. They promote growth by stimulating metabolic rate
c. Promote digestion
d. Protest the body from certain brain disease
e. Increases appetite
Functions of Vitamin B2 (Riboflavin)
a. It functions as a coenzyme in several enzymes in the body and therefore it is an essential
link in the metabolism of amino acids, fatty acids and carbohydrates
b. It also assist in antibody and red blood cell formation

Functions of Vitamin B12 (Cobalamin)

a. Its major function is that it assist in the prevention of anemia
b. It also promotes appetite and a healthy nervous system

Functions of Vitamin B6 (pyridoxine)

a. It assist in antibody formation and the synthesis of genetic materials
b. It serves as co-enzyme in a number of enzymes systems and therefore assist in fat and
protein utilization
Functions of Vitamin B15
a. It assists in cell oxidation, respiration and metabolism of protein, fat and sugar.
Functions of Vitamin C
a. It is necessary for the proper formation of intercellular ground substance or matrix that
binds together the cells in such tissues as capillaries, bone, teeth and connective tissues
b. It assist in the rapid healing of wounds
c. It also helps in the prevention of infection
d. It is used in food processing as an antioxidant
e. It prevents scurvy
Functions of Niacin
a. It is involved in the metabolism of carbohydrate, fats, and proteins
b. It also aids the effective utilization of these nutrients in the body
c. It is essential for growth and normal functioning of the skin and the digestive tract
d. Niacin can be synthesized from the essential amino acids and tryptophan in the body
Functions of Folic acid
a. The vitamin is necessary for the formation of red blood cells in the body
b. It plays and active role in the prevention and treatment of certain types of anemia

5. Minerals: they are divided into major and trace minerals depending on the amount we
need per day. A major mineral (macro mineral elements) is that which required in a
relatively large quantity. It is required in the diet in amounts greater than 100mg/day
while the trace (micro mineral elements are those required in small amounts. These are
mineral vital to the health but required in amounts less than 100mg/day.
The amount of mineral and their functions varies. Some mineral such as copper and selenium
function as cofactor enabling enzymes to carry out chemical reactions. Minerals are also
components of many body compounds. For example, iron is a component of hemoglobin in
the red blood cells. Sodium, potassium and calcium aid in transmission of nerve impulse
throughout the body. Body growth and development also depends on some minerals such as
calcium and phosphorus. Water balance in the body also requires sodium, potassium,
phosphorus and calcium.
The food sources for minerals could be either plants or animals
 Major mineral (macro)
Calcium: milk, cheese, tinned or canned fish, green vegetables, hard water, flour fortified
with calcium carbonate
Phosphorus: liver, milk, fish, meat, legumes, wholes grains, egg yolk
Magnesium: leafy vegetables, whole grains, beans, nuts, seeds, chocolates, milk, meat
Sulphur: a diet adequate in protein will usually provide a generous amount of Sulphur
Sodium: table salt, meat, root vegetables, eggs, baking soda, green leafy vegetables.
Potassium: meat potatoes, dried fruits, oranges, grape fruits, carrots, butter, pumpkin leaves,
eggs, milk etc
Trace minerals (micro)
Iron : meat, liver, kidney, whole cereals, whole meal, wheat germ, legumes, green
vegetables, and dried fruits, unripen plantain, sea foods etc
Iodine: iodized salt, sea foods, vegetables, fruits grown in soils rich in iodine
Zinc: meat, eggs, sea foods, legumes, nuts, whole grains, cereals
Fluorine: fluorinated water, milk, eggs, fish
Other minerals are copper, chromium, cobalt
6. Water
Water is the largest component of the body making up to 50 to 70% of the body’s weight (about
10 gallons or 40litres). Depending on how much fat has been stored, an adult can survive about
8weeks without eating food but only a few days without drinking water. Because of the unique
chemical and physical characteristics, water plays vital key roles in metabolic processes. It
serves as a solvent for many chemical compounds and serves as a medium in which many
chemical reactions occur. It is also a transport medium in the body. Water contributes to
temperature regulation, water helps remove waste products from the body, it is incompressible
and so helps in the lubrication found in kneels and other joints of the body.
Water sources include adequate water intake, water can be found in abundance from fruits and
vegetables such as tomatoes, lettuce, water cress, water packed tuna, milk, grape fruits, skinless
chicken, banana, cheese, potatoes. etc.
 NUTRIENT INTERIRELATIONSHIP TO THE BODY IN HEALTH AND
MALNUTRITION
The general nutritional health of the body could be determined by the nutritional status with
regards to each needed nutrients. There are three categories which are generally recognized:
desirable nutrition, under nutrition, and over nutrition. The common term malnutrition could
refer to either under nutrition or over nutrition.
DESIRABLE NUTRITION: this is a nutritional status where the tissues have enough of a
particular nutrient required to carry out metabolic functions as well as surplus stores that could
be mobilized in times of increased need. A desirable nutritional state can be achieved by
obtaining essential nutrients from a variety of foods.
MALNUTRITION is a failing health that results from long standing dietary practice that do not
correspond with nutritional needs of the body which could be in the form of over nutrition or
under nutrition.
Under nutrition: this is a failing health condition that results from a long standing dietary intake
that does not meet up the nutritional requirements of the body. When the nutrient intake does not
meet the nutritional requirements, the stores of nutrient soon become depleted (washed-out or
used up) by the ongoing body use. Some occur sooner than others, this results in under nutrition.
The demands for these nutrients occur partly because the body is a continuous state of turnover,
for example, the red blood cell live for only 120 days, to support this turn over, body stores may
support for the inadequate diet for a brief period but at the long run serious problems may arise
as a result of the inadequate diet.
Over nutrition is a state in which the nutritional intakes exceed the body’s requirements. The
prolong consumption of more nutrients than the body’s requirements could lead to over nutrition.
In a short run for instance in a few weeks/months, over nutrition may result to no sign or
symptom but in continuation for a longer period, some nutrients may increase to toxic amounts
especially in people who are susceptible as a result of inherited health challenges example
diabetes. This could lead to very serious diseases; iron over load for example can lead to liver
failure.
Marasmus is a nutritional disease in children that results from consuming diets totally
insufficient amount of protein and energy and other nutrients. The disease typically occurs in
children who are starving to death. When experienced by older children and adults, the disease is
referred to as protein-energy malnutrition. The word marasmus means to waste away.
Signs and symptoms
The deficiency eventually results in body wasting, primarily lean tissues, and an increased
vulnerability to other infections. There is also retardation in growth and reduction in body
weight. The victims have a “skin and bone” appearance with little or no subcutaneous fat.
Kwashiorkor is a common disease condition in children who have existing disease conditions
and consume minimal amounts of energy and significantly insufficient protein in relation to the
needs.
Signs and symptoms
The child generally suffers from infections, and exhibits edema (accumulation of body fluids
under the skin), poor growth (failure to grow and add weight), weakness, and increased
susceptibility to other illness, withdrawal from the environment. Further signs include change in
hair color, potassium deficiency, flaky skin, fatty infiltration in the liver, reduced muscle mass
and massive edema in the abdomen and legs.
If children with kwashiorkor are helped in good time, the existing infections are treated and diet
sufficient in protein, energy and other nutrients is provided, the disease condition reverses. The
child begins to grow well and shows no signs of the previous condition.
Obesity or overweight
Obesity is a condition characterized by excess body fat deposit, typically defined in clinical
index as body mass index (BMI) ≥ 30 (an obese individual has a body weight 20% or more
greater than the ideal body weight). Obesity could be juvenile onset or adult onset. When obesity
develops at childhood numerous adipose cells develop with ability to grow larger. In adult
obesity, fewer adipose cells are present but contain excess fat deposits. Childhood obesity
presents a greater challenge because as the adipose cells increase, it may increase the body’s
resistance on cutting down fat stores.
There are majorly two types of obesity:
a. The upper-body (android) obesity which is a condition in which the fat deposit is stored
primarily in the abdominal area. It is define by a waist circumference > 40 inches
(102cm) in men and >30 inches (89cm) in women leading to a pear shape. This kind of
obesity have high risk of cardiovascular diseases, hypertension, and type 2 diabetes
b. Lower-body (gyneciod, gyniod) obesity is a condition where the fat deposits are stored
majorly in the buttocks and thigh areas leading to an apple shape.
Obesity has numerous causes which could be genetic (inherited from parents), it could be as a
result of excessive food intake with a sedentary life style (low physical activity), culture and
traditions in the society. Obesity and overweight in time past was seen as a mark of affluence,
and a beauty to behold.
 PATTERN AND TREND OF FOOD CONSUMPTIONS IN RELATION TO
NUTRITIONAL REQUIREMENTS OVER THE LIFESPAN.
The lifespan (life time or life cycle) refers to the various stages an individual passes through
during the course of his/her physical, intellectual, psychological and emotional development in
life. Principally refers to developments from birth through to old age. Life cycle nutrition
provides nutrition education and guidance for all stages of life dealing with nutritional needs
from the uterus all through all age. These stages include nutrition before and during pregnancy,
lactation, infancy, childhood, adolescence, adulthood, older adulthood and the aged.
The nutritional requirements of human beings vary according to their physiological stage. The
nutritional requirements of the infants for example are different from that of the pregnant
woman. Therefore, factors that affect the nutritional requirements are: age, sex, size and body
composition, occupation, climate, stress, types of recreational activities engaged in etc.
Nutrition before pregnancy
This is a crucial time to establish a state of optimal health and nutritional status for a mother-to-
before conception. Recommendations for food nutrients intake for a woman who may become
pregnant differ from those for adult women in general in several ways. It is recommended that
women intending to get pregnant should consume 400ug of folate from fortified grain products,
vegetables, fruits, or supplements. They should not take more than 500iu of vitamin A (retinol or
retinoic acid) from supplements daily and limit or omit consumption of alchohol beverages.
Pregnant women
Pregnancy can be defined as a period of conception to birth. Usually a full term pregnancy last
for 40 weeks, starting from the first day of the woman’s last menstrual flow. This period is
divided into three trimesters each lasting for three months. Pregnancy or gestation period may be
the most sensitive stage of the life cycle as nutrients and calorie supplies at this time impacts the
final outcome.
Pregnant woman needs to be on good nutrition because of the various effects of poor nutrition on
the outcome of pregnancy. The source of nutrients for developing foetus is the mother.
Consequently, if the mother is not well, the foetus will not have enough nutrients to live on. The
nutritional need of the foetus imposes an additional nutrient requirement on the pregnant woman
who will need a large amount of protein since this is the nutrient the foetus requires for growth
and development. An adequate consumption of protein will provide a sufficient amount for the
foetus with enough left for the normal body maintenance of the woman.
The pregnant woman also needs extra energy to be able to move the new increased weight and
also perform some other activities. The consumption of adequate energy will spare her protein.
However, the pregnant woman should watch her energy consumption as it is not good for her to
be overweight during this period.
The iron requirement of the woman is also high because the foetus will derive its own iron store
for use after birth at least for the first 22 days from the mother. Some iron will further more be
loss during child birth. Apart from iron, pregnant woman also needs to increase her calcium,
phosphorous and magnesium consumption so as to allow for that required by the foetus.
Due to increased energy requirement, her vitamin requirements especially thiamin, riboflavin
and niacin are on the increase, so also the need for vitamin C, folic acid and vitamin B 12. She
should therefore consume a generous amount of leafy green vegetables, fruits, milk, eggs, meat
and fish. All these will supply her with the additional nutritional needs.
Lactating mother
A lactating mother is one that is breastfeeding one or more than one infant. She is therefore
constantly loosing milk to the infant. The lactating mother stands the risk of nutrient depletion if
she is not on good nutrition to replace those nutrients lost during breastfeeding.
The most important nutrient required by the lactating mother is energy. She loses a lot of energy
through milk secretion. She must therefore consume adequate food to supply this extra energy in
addition to her normal energy requirement.
Protein: an additional amount of protein must be consumed to take care of the lost during breast
feeding.
Vitamins and minerals: Since the infant is dependent on the mother for all his/her nutritional
needs, the diet of the lactating mother must also be rich in vitamins and minerals especially iron,
calcium, phosphorous, and B-complex vitamins.

Infants and children

Food is very vital during infancy than any other stage in life. This is because it is at this stage
that the rate of growth is highest. Also at this stage, the infants are more susceptible to infections
and therefore, the need food to develop effective antibodies. For the infants to be able to meet
both conditions, an adequate diet is required and must be given.
Since the function of grow is performed by proteins, infants require a generous amount of
proteins. Bothe the quantity as well as the quality of the protein must be adequate. The protein
must be in a form that could be easily digested by the infant for it to be useful.
The energy content of the infants’ diet must also be adequate. This is because, if the energy
content of the food is not enough for the body requirement, part of the protein will be used in
providing energy and growth will therefore be retarded.
Adequate vitamins should supply through the infants meal. At this stage, the teeth and bones are
still being developed. The infants’ diet must be rich in vitamins and minerals such as calcium,
phosphorous, magnesium and fluorine, iron and vitamin C are also very important in their diets
as they need a lot of these nutrients.
The requirements for vitamins A, D and C are constant as growth progresses while that of
thiamine, riboflavin and niacin increases with growth. The increase in the requirement for
thiamin, riboflavin and niacin is due to their involvement in energy release and since the energy
requirement increases with growth, the increase in the requirement of these vitamins should
therefore be expected. As the infants grow, their diet should generally be modified to including
some chewing but it must still be rich in body building foods. Since the capacity of the infants’
stomach is very small, their food should be concentrated in the body building, energy giving and
other nutrients such that the little food consumed will be able to meet their nutritional
requirements.
Adolescent
At ages between 11-20 years, growth still continues, therefore energy and growth nutrients are
still required. However, because of the increased activities at this age, the need for energy
nutrients becomes higher. Children’s food should be rich in energy giving items as well as
vitamins that aid the liberation of energy especially those for the growth of teeth and bone
formation.
The higher nutrient requirement for males than that of females should be expected because the
males are usually more involved in energy demanding activities. For girls, this is the age which
menstruation commences. This periodic loss of blood will necessitate an additional requirement
for iron, folic acid, vitamin B12 and ascorbic acid so as to make good for the loss during
menstruation.
Therefore adolescents need carbohydrate, protein, vitamins and mineral elements. They should
avoid an excessive consumption of sugar and fats to avoid been obese.
Adults
Adults, unlike infants, children and adolescent are no longer growing. However, the body
undergoes rapid wear and it would need some nutrients for maintenance. Adults protein and
energy vary a lot being influenced mainly by the type and nature of activity performed. Those
who lead an active life require more energy than those that lead a sedentary life. Stress, either
mental or physical also increases the nutritional needs of adults.
Invalid
An invalid is a person who is sick and confined to home or bed because of illness, disability or
injury; one who is too sick or weak to care for him or herself. People suffering from gastric or
intestinal disorders, certain allergies or diseases and require special diets are called invalids. Also
sick people that are confined to the bed are called invalids.
Their diets are prescribed by dieticians or doctors and must take into account special needs. The
diet prescribed will depend on the type of ailment. Example, A diabetic patient should avoid
carbohydrate and fatty foods. Thus before recommending diet for an invalid, the underlying
sickness must be identified.
However, there are some important rules to observe when planning an invalid’s diet. These are:
1. If the meal is on doctor’s advice, it must be strictly followed.
2. If there are no restrictions, foods that are easy to digest should be served. Such foods
should contain the necessary nutrients
3. The food should be fresh and of good quality. Dairy products, good cuts of meat, fresh
fruits and vegetables should be the basic foundation of an invalid’s food.
4. Appropriate cooking methods that will make the food easily digestible should be
employed. Example steaming. Oily foods should be avoided because they make food less
digestible.
5. Foods should be palatable
6. Absolute cleanliness should be maintained both during the preparation and serving of the
food.
7. Food should be served attractively and in small portions.
Convalescent
A convalescent is one who is just recovering from an illness. One who is just returning to health
after illness or debility (incapacity). It is a gradual recovery of health and strength after an illness
or injury. It refers to the later stage of an infectious disease or illness when a patient recovers and
returns to normal but may be a source of infection even if the person is feeling better. What such
person needs most is strength; therefore his/her food should be rich in energy giving nutrients.
However, as the appetite may still be dull, small portions of food but very concentrated in
nutrient should be served. He/she should be given generous amount of fluids to aid digestion of
the food. As the appetite improves, substantial dishes should be introduced and large portions
served. The food should also be balanced with respect to vitamins and minerals.
Some characteristics of convalescence include loss of appetite, loss of weight, general weakness
etc.
Elderly
Older adults need the same nutrients as younger people, but in differing amounts. As one gets
older, the number of calories needed is usually less than when he/she were younger. This is
because basic body processes require less energy when there is a decline in physical activities
and loss of muscles. However, contrary to popular belief, basic nutrient needs do not decrease
with age. In actual sense, some nutrients are needed in increased amounts as one age. The
challenge is to develop an eating plan that supplies plenty of nutrients, but not too many calories.
Also, be sure to include low-fat dairy products and protein like foods like egg, meat, poultry,
fish, beans and eggs. Sweets and other foods high in sugar such as chocolates can be enjoyed
once in a while, but he key is to eat them sparingly. Other nutrients required by the elderly
include fibre-rich foods to stay healthy. Fibre can help to lower the risk of heart diseases, control
weight and prevent type 2 diabetes. They should eat whole grain bread and cereals such as
maize, sorghum, millet, and more beans and peas. Increasing potassium and reducing sodium
(salt) may lower the risk of high blood pressure. Fruits, vegetables, and low-fat or fat free milk
and yoghurt are good sources of potassium. Magnesium is also helpful and needed to regulate
blood pressure and is especially needed by women that are above 40 years of age who are at risk
of high blood pressure. It helps to the body to absorb calcium and plays a role in muscle, nerve
and heart functions as well as blood glucose control. It is found in dark green leafy vegetables,
beans, soy, nuts, seeds and avocados. Women 40 and above are recommended to take 320mg of
magnesium a day. Other required nutrients are sodium which is found naturally in foods such as
milk, sea foods, eggs, processed foods such as tomato juice etc. For healthy adults it is
recommended that not more than (3g or 300mg) of sodium is taken per day. Omega-3s,
probiotics (live microorganisms that provide health benefits when consumed). Sources of
probiotics include yoghurts which contain healthy bacteria such as lactic bacteria and bifido
bacteria can improve health. Key nutrients needed at old age include vitamin B12, calcium,
vitamin D and potassium.
NUTRIENT METABOLISM
Key concepts

 Metabolism refers to the body’s chemical processes that maintain life. These processes
occur in cells.
 ATP is the major form of energy used for cellular metabolism. This energy is used to
pump ions, promote enzyme activity, and contract and later relax muscles.
 In glycolysis, glucose (carbohydrate) is degraded into two pyruvate molecules, yielding
NAD + H+ ( a form of potential energy) and pyruvate can proceed through an aerobic
pathway to form carbon dioxide and water. Pyruvate also can react NAD + H+ in an
anaerobic pathway to form lactate.
 Pyruvate enters the mitochondria, in which the remaining energy is eventually extracted
from the molecules using the citric acid cycle.
 NAD + H+ and FADH2 produced by citric acid cycle activity then enter the electron
transport chain. This is where about 90% of the total possible ATP molecules from
glucose are produced, using the combined activity of the citric acid cycle and electron
transport chain. Carbon dioxide and water are by-products.
 Fatty acid metabolism is aided by various enzymes and the carrier carnitine. The
breakdown products enter the citric acid cycle and electron transport chain to yield ATP,
carbon dioxide and water.
 Incomplete metabolism leads to the production of ketone bodies; this can be caused by
starvation, uncontrolled type 1 diabetes and very low carbohydrate diet.
 Amino acids lose their amino group and become carbon skeletons. These carbon
skeletons can be metabolized to other compounds which enter the citric cycle eventually
 yielding energy for ATP synthesis. Some carbon skeleton can be converted to glucose.
Converting the carbon skeleton of amino acid to glucose is part of a process known as
gluconeogenesis. Fatty acids and alcohol cannot participate in gluconeogenesis.
 Glycolysis occurs in the cytosol of a cell, whereas the citric acid cycle and the electron
transport chain occur in the mitochondria. Fatty acid metabolism also occurs in the
mitochondria
 The vitamins thiamin, niacin, riboflavin, biotin, pantothenic acid, and vitamin B-6 and
the minerals magnesium, iron and copper play vital roles in metabolic pathways.
Carbohydrate Metabolism
Glycolysis – glucose to pyruvate
The metabolism of carbohydrate begins with glycolysis. Glycolysis is the breaking down of
glucose. The glycolysis pathway found in the cytosol of cells has two roles. First, it breaks down
monosaccharide to generate energy and secondly it provides building blocks for synthesizing cell
compounds such as glycerol for triglyceride synthesis.
Before glycolysis begins, a cell must obtain glucose. Only few cells such as the liver and kidney
cells can produce their own glucose from amino acids; also only the liver and muscle cells have
the ability to store glucose to a major extent. The glucose is stored in the form of glycogen. The
liver and muscle cells break down the glycogen to glucose. However, other body cells must
obtain glucose from the blood stream; therefor e the body needs to maintain glucose at a fairly
constant concentration in the blood so as to survive.

The product from glycolysis is two (2) units of a three (3) carbon compound called pyruvic acid
(pyruvate), some other cells convert pyruvate to lactic acid (lactate). In the beginning of the
glycolytic pathway (i.e glycolysis), a phosphate group is added to glucose which makes the
glucose more reactive. Another phosphate is added to the newly formed glucose-phosphate
compound which in turn splits into two(2)three carbon compounds. This conversion is achieved
through a series of steps into two molecules of the three carbon compound pyruvate. In
glycolysis, the cells begin with a six (6) carbon glucose molecule and then produce two (2)
molecules of the three carbon compound pyruvate. In this process, 4 hydrogen containing a total
of 4 electrons are removed and 4 ATP are generated. The removed electrons and hydrogen ions
are picked up by a carrier nicotinamide adenine dinucleotide (NAD). Each NAD (oxidized
form)is accepts two electrons each and one hydrogen ion yielding NADH + H+ (reduced form) .
Thus, the end result of glycolysis is also the synthesis of two NADH+ H+ with the release of two
hydrogen ions.
Anaerobic Glycolysis
Lactate production is the endpoint of anaerobic glycolysis. Some cells lack the
oxygen-required (aerobic) pathway needed for using NADH + H+ back to NAD.
The red blood cell is an example. Thus as red blood cell converts glucose to
pyruvate, NADH + H+ builds up in the cell. Eventually, the NAD concentration
falls too low to permit glycolysis to continue, since most of NAD present is the
form NADH + H+ and a free hydrogen ion to form lactate. In the process, NADH +
H+ turn into NAD. This process allows the red blood cell to resupply itself with
NAD as these cells do not contain mitochondria. Exercise muscles also produce
lactate when they run out of NAD. The increase in lactate in turn contributes to
muscle fatigue.

The production of lactate by a cell allows anaerobic glycolysis to continue, as

there remains a steady supply of NAD. Again, this pathway yields only about 5%
of the potential ATP per glucose molecule. But for some cells, such as red blood
cells, anaerobic glycolysis is the only available method ATP. The lactate is
released into the bloodstream, picked up primarily by the liver and synthesized into
glucose.

Glucose Catabolism

The citric acid cycle completes the glucose catabolism. The two pyruvate (or
lactate) molecules formed at the end of glycolysis still contained much stored
energy. Pyruvate passes from the cell cytosol into the mitochondria. A cell then
uses pathways found there to extract the remaining energy from pyruvate to form
ATP. A key pathway is called the citric acid cycle.

Pyruvate to Acetyl CoA is an Irreversible step

Before the citric acid cycle can begin, pyruvate must lose a carbon dioxide group
and eventually form Acetyl-CoA. This overall reaction is irreversible which has
important metabolic consequences. A pyruvate is converted to acetyl-CoA, another
NADH + H+ is formed from NAD, so more potential ATP molecules are produced.
The conversion of pyruvate to acetyl-CoA requires the B vitamins thiamin,
riboflavin, niacin, and pantothenic acid. Therefore, dietary carbohydrates
metabolism depends on the presence of these vitamins.

Citric Acid Cycle

The citric acid cycle is an elegant sequence of chemical reactions used by cells to
convert the carbons of acetate to carbon dioxide and to yield energy. Acetyl – CoA
enter the cycle, and the reactions eventually yield two molecules of carbon dioxide.
In the process, the cell produces NADH + H + and other related molecules, which
eventually are used to form many ATP.

To begin the citric acid cycle, acetl-CoA combines with four-carbon compound,
oxoloacetic acid (or oxaloacetate) to form six carbon compound citric acid (or
citrate). In the process, the CoA molecule is released. During a single turn of the
six-carbon citric acid molecule is metabolized to the four-carbon oxaloacetate
molecule and two carbon dioxide molecules are released at this point, the cycle is
ready to begin again. Each turn of the cycle yields potential ATP in the form of
guanosine Triphosphate (GTP). NADH + H + and FADH2. FAD is another
hydrogen carrier; It can pick up a pair of hydrogen. Each FADH2 energy to
synthesize 1.5 ATP, one less than NADH + H +.

Glycogen Metabolism

Glycogen synthesis uses a form of glucose (glucose 1-phosphate), adding more

glucose molecule to an existing glycogen chain. This provides liver and muscle
cells with a short-term storage form of glucose. Later when glucose is needed as in
the case of a fast, glycogen break down yields glucose as glucose phosphate
compound which eventually begins glycolysis. An enzyme in the glycogen
breakdown uses vitamin B-6.

Protein Metabolism
Protein metabolism begins after protein has been degraded into amino acids. For
the cell to use amino acids as fuel, cells must first split off the amino group (-
NH2). This pathway always requires vitamin B to function. The removal of the
amino group produces carbon skeleton which mostly enter the citric acid cycle.
Some carbon skeletons also yield acetyl-CoA or pyruvate. Amino acid metabolism
mostly takes place in the liver. Only branched chain amino acids- leucine,
isoleucine and valine are metabolized primarily at other sites in this case, the
muscle. Branched chain amino acids are added to some liquid meal replacement
supplements given to hospitalized patients. It is important to note that some branch
carbon skeleton enter the citric acid cycle acetyl-CoA whereas others form
intermediate of the citric acid cycle or glycolysis. Any part of the carbon skeleton
that can bypass the acetyl-CoA and enter the citric acid cycle directly or form
pyruvate can eventually become part of glucose via gluconeogenesis. This is true
as in the case of amino acids alanine, methionine, histidine, arginine, aspartic acid
and others.
Gluconeogenesis
This is a pathway or process through which glucose molecules are produced from
amino acids and other compounds. The entire gluconeogenesis pathway is present
only in the liver cell and some kidney cells. The starting material for
gluconeogenesis is oxaloacetate (four carbon atom). Which is derived primarily
from the carbon skeleton of some amino acids mostly the amino acid alanine. The
oxaloacetate losses one carbon dioxide and converts to a three carbon compound
which then reverses the pathway back through glycolysis to glucose. It takes two
three-carbon compounds to produce the six-carbon glucose. Some steps in
gluconeogenesis are simply a reversal or variation of the glycolysis pathway. This
entire process requires ATP as well as the coenzyme form of the B vitamins biotin,
riboflavin, niacin and B6.
Fat Breakdown (Lipolysis)
Lipolysis is the process of splitting or breaking fatty triglycerides into free fatty
acids and glycerol. The further breakdown of the fatty acids for energy production
is called fatty acid oxidation, since the donation of electron from fatty acids to
oxygen is the net reaction in the energy yielding process. This takes place in the
mitochondria and peroxisomes of the cell, but the mitochondria can use the energy
released to form ATP.
Fatty acids are liberated from lipid storage in the adipose e cells by an enzyme
called hormone – sensitive lipase. The activity of this enzyme is increased by the
hormone glucagon, growth hormone, epinephrine (adrenaline) and others, and it is
decreased by the hormone insulin. The fatty acids are taken up in the blood stream
by cells and are transported from the cytosol into the mitochondria using a carrier
called carnitine. In healthy people, the cells produce the carnitine needed for the
process. During acute illness in hospitalized patients, carnitine synthesis may not
meet their needs. Hence it may be added to intravenous nutrition solutions used by
the patients.
Almost all fatty acids in nature are composed of an even number of carbons
ranging from 2-26.the first step in fatty acid oxidation (transferring energy in fatty
acids to ATP) is to cleave to the carbons, two at a time, and convert the two-carbon
fragments to acetyl –CoA. This process of converting a free fatty acid to multiple
acetyl CoA molecules is more specifically know as beta-oxidation since the second
carbon on a fatty acid (counting after the acid end) is called the beta-carbon.
This is where the reaction begins. During the beta-oxidation, NADH +H+ and
FADH2 are produce, so as with glucose; a fatty acid is eventually degraded into the
two carbon compound acetate in the form of acetyl-CoA. Some of the chemical
energy is transferred to NADH +H+ and FADH2 .
The acetyl-CoA enters the citric acid cycle and two carbon dioxide are released,
just as with the acetyl CoA produced from Glucose. Thus the breakdown product
of both glucose and fatty acid, acetyl CoA uses the same pathway—the citric acid
cycle.