CHAPTER I: Basic Concepts in Nutrition and Diet Therapy

LEARNING OUTCOME:
1. Integrate relevant principles of anatomy and physiology, biochemistry, health
assessment and health education in nutrition and diet therapy.
a. Define Nutrient
b. List the nutrient classification
c. Identify the six major nutrients
d. Describe the stages of digestion
2. Discuss the importance of macronutrients and micronutrients in nutrition.
3. Identify food sources for each group of nutrients.
MODULE TOPICS:
A. Definition of terms
B. Nutrition Concepts
C. Classification of Nutrients
a. Macronutrients
 Vitamins
 Fats (lipids)
 Protein
b. Micronutrients
 Vitamins
 Minerals and electrolytes
c. Water
Definition of Terms
Nutrition is the study of food and how the body makes use of it.
 It is the science that interprets the nutrients and other substances in food in relation to
growth, reproduction, maintenance, health and disease of an organism.
 It deals not only with the quantity and quality of food consumed but also with the process
of ingestion, absorption, assimilation, biosynthesis, catabolism (break down) and excretion.
https://courses.lumenlearning.com/boundless-ap/chapter/absorption/

Diet therapies are specially designed and prescribed for medical and/or general nutritional
reasons. It promotes a balanced selection of foods vital for good health. By combining foods
appropriate for each individual and drinking enough water, one can help maintain the best
possible health.
Individualized diet therapy can provide the patient important insight into food-related illnesses
and education regarding how various nutrients (protein, carbohydrate, fat, alcohol) affect
illness,
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diseases, or obesity. Dietary therapy can be tailored to meet the treatment needs of patients on
diagnosis of specific illnesses, can help reduce complications and/or side effects, and can
improve general well-being.
Nutrients are chemical substances found in food, components that are indispensable to the
body’s functioning. They provide energy, serve as building material, help maintain or repair
body parts, and support growth. Since nutrients are found primarily in natural foods, adequate
intake of these nutrients is necessary to carry out physiological functions.
Food when taken and digested nourishes the body. Medically, any substance that the body can
take and assimilate that will enable to stay alive and to grow; socially, a more limited number of
such substances defined as acceptable by each culture.
Digestion is defined as the process of breaking down food and substances like carbohydrates,
proteins, fats, and vitamins that aid the body in its different functions. The digestive system is
made up of the gastrointestinal tract also called the GI tract or digestive tract, the liver,
pancreas, gallbladder. The GI tract is a chain of hollow organs connected in a long, twisting tube
from the mouth to the anus. The hollow organs that make up the GI tract are the mouth,
esophagus, stomach, small intestine, large intestine, and anus. The liver, pancreas, and
gallbladder are the solid organs of the digestive system.
The Digestive Process – Four steps of Digestion
Step 1: Ingestion

 Begins in the mouth where food is broken down by chewing, mixed with saliva into
a form the body can absorb and use.
 The esophagus is a muscular tube from the pharynx which transfers food to the stomach
via peristalsis.
Step 2: Mechanical and chemical breakdown of food

 The stomach is a sac-like organ that holds mixes & grinds food, mixes with the acid
& powerful enzymes secreted in the stomach to break food into liquid or paste
consistency to pass on to the small intestine.
 The small intestine made up of the duodenum, jejunum and ileum, the duodenum
continues the process of breaking down food
Step 3: Absorption

 and are then absorbed in the jejunum and ileum into the bloodstream.
 The stomach and small intestine are supported by the pancreas, liver and gallbladder
in digesting food with the enzymes present to break down carbohydrates, proteins,
and fats.

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Step 4: Elimination of indigestible food

 The large intestine composed of the ascending colon, transverse colon, descending colon
and the sigmoid colon through the peristaltic movements passes food in liquid state and
finally in solid form –the stool which empties into the rectum which holds it until
defecation releasing it into,The anus which prompted by the anal sphincters control the
elimination of the stool/feces.

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Nutrition Concepts
The basic function of nutrition is to maintain life by allowing an individual to grow and be in a state of
optimum health. The following are reasons why nutrition science is applied to nursing care:

1. the recognition of the role of nutrition in preventing diseases or illnesses;

2. the concern for adapting food patterns of individuals to their nutritional needs within the
framework of their cultural, economic, and psychological situations and styles; and
3. the awareness of the need in specified disease states to modify nutritional factors
for therapeutic purpose.
Classification of Nutrients

Nutrients are classified according to the following:

1. Function – those that form tissues in the body are body-building nutrients while those that
furnish heat and energy are fats, carbohydrates, and proteins.
2. Chemical properties – Nutrients are classified are either organic or inorganic.
3. Essentiality – Nutrients are classified based on their significant contribution to the body’s
physiological functioning.
a. Essential – nutrients required for human life; cannot be synthesized by the body, must
be consumed in food.
b. Nonessential – nutrients that the body can synthesize, need not be directly obtained
from food
4. Concentration – Nutrients are either in
a. large amounts (high nutrient density)
b. in little amounts (low nutrient density)

What are Macronutrients?

Macronutrients are nutrients that provide calories or energy and are required in large amounts to
maintain body functions and carry out the activities of daily life.

There are three broad classes of macronutrient classified by Atwater’s Physiological Factors (Kcalories
per gram): carbohydrates (4 kcal/g of energy), fats (9 kcal/g energy), and proteins (4 kcal/g of energy).

1. Carbohydrates

Carbohydrates are organic compounds (saccharides – starches and sugars) composed of carbon,
hydrogen, and oxygen; hydrogen and oxygen usually occur in ratio of 2:1 as in H2O. They are
polyhydroxy aldehydes and ketones which vary from simple sugars containing from 3 to 7 carbon atoms
to very complex polymers. They provided the major source of energy for the body or as much as 80 to
100% of calories.

 The average minimum amount of carbohydrates needed to fuel the brain is 130 g/day. Median
carbohydrate intake is 200 to 330 g/day among men and 180-230 g/day among women. The
acceptable macronutrients distribution range for carbohydrates is 45% to 65% of calories.
 Carbohydrates provide energy for cellular work, and help to regulate protein and fat
metabolism. They are essential for normal cardiac and central nervous system (CNS) functioning.

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  As complex carbohydrates are ingested and broken down, they are easily absorbed in the
intestine and into the bloodstream where they are stored in the liver and muscles for energy
needs.
o Digestible carbohydrates together with fats and protein add bulk to food and provide
energy and other benefits to the body
o Indigestible carbohydrates – includes most of the fibers in food, yield little or no energy
but provide other important benefit. IT IS IMPORTANT FOR BOWEL ELIMINATION AND
HELPS LOWER CHOLESTEROL LEVELS.
 Glycogen is the stored carbohydrate energy source found in the liver and muscles. It is a vital
source of backup energy.
 Carbohydrates provide 4 cal/g of energy
 Fiber is categorized as a carbohydrate, but it does not yield energy for the body.
o Dietary fiber is the substance in plant foods that is indigestible.
o Fibers enhance the health of the large intestine for proper bowel elimination. It adds
bulk to the feces and stimulates peristalsis to ease elimination.
o Fibers rich in complex carbohydrates tend to be low in fat and added sugars and can
promote weight loss.
o High –carbohydrate diets, rich in whole grains, can protect an individual against heart
disease and stroke.
o High-carbohydrate diets can help prevent many types of cancer.
o Soluble fiber - derived from inside plant cells and decreases cholesterol, regulates blood
glucose levels, and increases satiety (sources: oatmeal and broccoli)
o Insoluble fiber – derived from structural parts of plants that promote regularity and
decreased risk of cancer and diverticular diseases. (sources: wheat bran and nuts)

Classification of Carbohydrates

Carbohydrates are divided into three groups: monosaccharides, disaccharides, and polysaccharides.

Type Example (sources) Function

A. Monosaccharides or 1. Glucose (dextrose) or blood  Glucose is the principal form in
simple sugars are the sugar which carbohydrates is used in the
simplest form of source: abundant in fruits, body.
carbohydrates. They sweet corn, and corn  It fuels the work of the body cells.
are sweet and since syrup moderate in sweet  Only glucose can provide energy
they require no sugar for the brain, other nerve cells, and
digestion, they can be developing red blood cells.
absorbed directly into  Gluconeogenesis is the process in
the bloodstream from which protein is converted to
the small intestine. glucose. It happens when the person
does not reload used up glycogen
stores, body protein dismantled
allowing glucose
to fuel these special cells.

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 2. Fructose (levulose) is the It is converted into glucose in the body.
sweetest of simple sugars.
Source: honey, most fruits, and
some vegetables

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 3. Galactose is not found in
foods. Breakdown of milk
sugar
Source: milk sugar broken
down
B. Disaccharides or 1. Sucrose (ordinary table
double sugars are made sugar – granulated,
up of 2 powdered, or brown).
monosaccharides. They Source: fruits, sugar beets
are sweet and, unlike vegetables, sugar cane, and
monosaccharides, they sweet food production
must be changed to 2. Lactose (milk sugar)
simple sugars by glucose+galactose
hydrolysis before they Source: milk and milk products
can be absorbed. except cheese
It is converted into glucose in the body.
Some infants are born with an inability
to metabolize galactose, a condition
called galactosemia.
It is converted into glucose and
galactose upon digestion. It is
composed of glucose and fructose.
It is converted into glucose and
galactose in digestion and is less
soluble and less sweet than sucrose. It
remains in the intestine longer than
other sugars and encourages the
growth of certain useful bacteria.

It favors calcium and phosphorus

assimilation.
3. Maltose is not found in It is converted into glucose in digestion.
foods and is produced by
hydrolysis of starch.
Glucose+glucose
Source: sweeteners, certain
infant formulas, beer, malt
beverage products.
C. Polysaccharides are 1. Starch is the most It is converted entirely into glucose
composed of many significant upon digestion.
molecules of simple polysaccharides in human
sugars. They are nutrition. Energy storage – it supplies energy
commonly known as Source: cereal grains, root over a longer period of time
complex sugars. vegetables, legumes
2. Dextrins is not found in
food. They are formed as
intermediate products in
the breakdown of starch.

3. Cellulose forms the Digestive aid (fiber)

framework of plants found
in unrefined grains,
vegetables, and fruits. It is
non-digestible by humans.
Source:
Soluble – fruits, legumes,
barleys, oats
Soluble - delay gastrointestinal transit
and glucose absorption, and lower
blood cholesterol.
Insoluble – accelerate gastrointestinal
transit, increase fecal weight, slow

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 Insoluble – wheat brans, corn
brans, whole grain breads,
cereals, and vegetables
4. Pectins are non-digestible,
colloidal polysaccharides
having a gel quality.
Source: mostly fruits and are
often used as based of jellies
5. Glycogens (animal starch)
are formed from glucose
and stored in liver and
muscle tissues and helps to
sustain glucose levels
Source: meats and seafoods
down starch hydrolysis, and delay
glucose absorption.
Use to treat diarrhea as they absorb
toxins and bacteria in the intestine.
Bind cholesterol reducing the amount
the blood can absorb.
Converted entirely into glucose upon
digestion.
The hormones glucagons help the liver
convert glycogen into glucose every
time the body needs energy.

Health Concerns related to Carbohydrates:

1. Blood glucose regulation – hormonal response (include insulin, glucagon and epinephrine)
a. Insulin- release by beta cells of the pancreas in response to blood glucose elevations
b. Glucagon – released after meals in response to decreased blood glucose levels
c. Epinephrine – (adrenal gland stress hormone) acts to release glucose from storage in
the liver
2. Glycemic Index (GI) – provides an estimate of how foods affect serum blood glucose levels.
a. Foods with high glycemic index (potatoes and bread) raise blood glucose rapidly.
b. Foods with low glycemic index (dairy products and pasta) do not raise blood glucose
levels rapidly
3. Nursing Bottle Syndrome
a. Development of dental caries can occur due to prolonged contact of infant with bottle if
infant/child is put to sleep with a bottle as a pacifier
b. Periodontal disease is also promoted due to bacterial interaction with dietary proteins
and production of acids
4. Proportional amount of CHO in the diet
a. Changes in CHO metabolism may lead to prone to developing diabetes
b. Excess CHO is converted to glycogen and stored as fat
c. Increased dietary fiber has significant health benefits with regard to lower risk of bowel
disorders, heart disease, and colon cancer
d. Decreased levels of CHO in the diet may lead to tissue breakdown leading to ketosis and
metabolic acidosis

Fiber-Rich Foods –Best known health benefits include:

 Promotion of normal cholesterol concentrations and reduced risk of heart and artery disease.
 Modulation of blood glucose concentrations (reduced risk of diabetes)
 Maintenance of healthy bowel function (reduced risk of bowel disease)
 Promotion of a healthy body weight.
 Note: Very high fiber vegetarian diet may pose nutritional risks for some people

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Low Fiber Diet may lead to these problems:

 Constipation
 Hemorrhoids
 Diverticula – sacs or pouches that balloon out of the intestinal wall, caused by the weakening of
the muscle layers that encase the intestines
 Development of digestive tract cancers

Digestion of Carbohydrates

1. Mouth – mechanical digestion

a. Enzyme – amylase (an enzyme of the saliva, secreted by the parotid glands, acts on
starch to begin its breakdown to dextrins and maltose)
b. Action – usually, however, the food does not stay in the mouth long enough for much of
this change to be completed, so that food is conveyed into stomach mostly in starch
form.

2. Stomach – chemical digestion 2-4 hours to digest and push to intestine

a. Enzyme – none for the carbohydrates
b. Action – none; above action by ptyalin may continue to minor degree

3. Small Intestine – 24 hrs. to digest

a. Enzyme – pancreatin enzyme, amylopsin, converts starch into dextrins and maltose
b. Intestinal Juice – contains three disaccharides – sucrose, lactose, and maltose (which
acts on their respective disaccharides – sucrose, lactose and maltose to produce
monosaccharides – glucose, galactose, and fructose)

2. FATS OR LIPIDS

Fats are organic compounds composed of carbon, hydrogen, and oxygen. Triglycerides or fats and oils
are fatty acid esters of glycerol. They belong to class of fats and fat-related compounds called lipids. Fats
constitute 34% of the energy in the human body. They include substances such as fats, oil, waxes, and
related compounds that are greasy to the touch and insoluble in water. They provide a more
concentrated source of energy compared to carbohydrates.

Some fats deposits are not used and are considered structural fat. They hold the body organs and
nerves in position and protect them against shock and injury.

 Fats is an essential nutrient for the body. It serves as a concentrated form of energy for the
body (second to carbohydrates) and supplies important tissue needs (hormone production,
structural material for cell walls, protective padding for vital organs, insulation to maintain body
temperature, covering for nerve fibers, aid in the absorption of fat-soluble vitamins).
 Generally, no more than 20% to 35% of total calories should come from fat (10% or less from
saturated fat sources).
o A diet high in fat is linked to cardiovascular disease, hypertension, and diabetes mellitus.

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 o The exception is for children under 2 years of age, who need a higher amount of fat to
form brain tissue.
 Conversely, a diet with less than 10% fat cannot supply adequate amounts of essential fatty
acids and results in a cachectic (wasting) state.
 The majority of lipid metabolism occurs after fat reaches the small intestine, where the
gallbladder secretes concentrated bile and acts as an emulsifier to break fat into smaller
particles. At the same time, the pancreas secretes pancreatic lipase, which breaks down fat. The
small intestine secretes an enzyme for further breakdown. The muscles, liver, and adipose
tissue cause the release of fatty acids, and the liver produces lipoproteins to carry lipids.
o Very-low-density lipoproteins (VLDL) carry triglycerides to the tissues (51-197mg/dL)*
o Low-density lipoproteins (LDL) carry cholesterol to the tissues (60-180mg/dL*
o High-density lipoproteins (HDL) remove excess cholesterol from the tissues. HDL is
considered “good” cholesterol (35-70mg/dL)*
 Lipids provides 9 cal/g of energy and are the densest form of stored energy.

CLASSIFICATION OF FATS

Fats are divided into the following classes: simple lipids, compound lipids, and derived lipids.

Classification Types Functions

A. ? are called neutral fats. The They combine with glycerol to
chemical name for this basic supply energy to the body,
fats is ? This name indicates allow fat-soluble vitamin
their chemical structure, a transport, and form adipose
glycerol base with three fatty tissue that protects the body.
acids attached.
? is derived from a water-
soluble form of
carbohydrates.

B. ? are various combinations
of fats with other components.
Three types of compound
lipids are important in human
nutrition – phospholipids,
glycolipids, and lipoproteins.
1. ? are compound fatty acids, They are important to cell
phosphoric acids, and membrane structure.
nitrogenous bases
a. ? are most widely
distributed of the
phospholipids.
b. ? are needed to form
thromboplatin for the
blood-clothing process.
c. ? are found in the
brain and other nerve
tissues as
components of
myelin
sheath.
2. ?are compound  An essential part of
of fatty acids combined with cell membranes.

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 carbohydrates and
nitrogenous bases.
a. ?are components of
nerve tissue and certain
cell membranes where
they play a vital role in
fat transport. Their
carbohydrate
component is galactose.
b. ?are made up of certain
glucose, galactose, and a
complex compound
containing an
amino sugar.
 Their role is to maintain the
stability of the cell
membrane and to facilitate
cellular recognition, which is
crucial to the immune
response and in the
connections that allow cells
to connect to one another
to form tissues.

3. ? are lipids combined with They are insoluble in water and

C. ? are simple derivatives from
fat digestion or other more
complex products. They are
fat substances produced
from fats and fat
compounds during digestive
breakdown.
proteins. They are formed are combined in protein
primarily in the liver and complex for their transport and
are found in cell and activity in aqueous medium.
organelle membranes,
mitochondria, and
lysosomes. They contain
cholesterol, neutral
fat, and fatty acids.
1. ? are the key refined fuel Unsaturated fats help reduce
forms of fat that the cell health risks
burns for energy. They are
basic structural units of fat Essential fatty acids, including
and may be saturated or omega-3, omega-6, are used to
unsaturated in nature. support blood clothing, blood
a. ? are those into which no pressure, inflammatory
hydrogen can be added. responses, and many other
Palmitic and stearic acids metabolic processes.
are two examples of such
fatty acids. They are
abundant in animal facts
including beef.
b. ? acids are those in which
two of the carbon atoms
are joined by double
bond. Olive and peanut
oils are especially high in
oleic acid, but most fats
contain generous amounts
of this
fatty acid.

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 c. ? acids are those in which
two or more double bonds
are present. Linoleic acid
has two double bonds and
is the most common of
the polyunsaturated acids.
Source: abundant in most
vegetable oils.

2. ?is a water-soluble After becomes broken off in

component of triglycerides digestion, it becomes available
and is inconvertible with for the formation of glucose in
carbohydrate. It comes out the diet.
10% of the fat.
3. ? are a class of fat- related It is necessary for cell
substances that contain membrane stability and the
sterols. A main member of production of certain hormones
this group is cholesterol. It and bile salts for digestion.
is a complex fat-like
compound found If cholesterol is consumed in
practically in all body excess, it can build up in the
tissues, especially in the tissues causing congestion and
brain and nerve tissues, increasing the risk of
bile, blood, and liver where cardiovascular disease.
most cholesterol is
synthesized.
Source: abundant in egg yolk,
organ meats, shellfish, and dairy
fats.
Small amount in other animal
fat products including butter,
cream, whole milk, whole milk
cheese, ice cream, and meat.

The Omega-6/Omega-3 Ratio

?make omega-3 and omega-6 oils, but the latter is more widely distributed in plants. Humans should
consume more omega-3 fatty acids from vegetable and marine sources like cod liver oil, mackerel,
salmon, and sardines as well as crabs, shrimps, and ousters.

DIGESTION OF FATS

Organ Enzyme Activity

Mouth None Mechanical mastication
Stomach No major enzyme Mechanical separation of fats as protein
and starch digested out

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 Small amount of gastric lipase, Tributyria (butter fat) to fatty acids and
tributyrinase glycerols
Small Intestine Gall bladder (bile salts) emulsifier Emulsifies fats
Pancreatic lipase Triglycerides to diglycerides and
monoglycerides in turn, then fatty acids
and glycerols

LIPIDS FOOD SOURCES

A. ? include lard, butter, margarine, shortenings, salad oils, and visible fats of meat.
- ? are made from relatively less expensive vegetable oils such as cottonseed oil, soybean oil,
corn oil, and coconut oil by the introduction of hydrogen into fat molecule under
carefully controlled condition. Margarine is then further processed by churning the
cultural mild to give the flavor if butter. It is usually fortified with vitamins A and D.
B. ? are those available in milk, cheese, eggs, nuts, and meat.

SOURCES OF FATTY ACIDS

SATURATED (of animal origin, solid at room UNSATURATED (of plant origin, liquid at room
temperature) temperature)
Animal Fat Plant Oil
Beef Mutton Vegetable oil Corn
Seafood Egg Peanut Cotton
Red meat Poultry Soybean Olives
Dairy Tallow yolk Cauliflower Olive oil
Suet
Food High in Saturated fatty Acids Food High in Polyunsaturated Fatty Acids
 Whole milk, Cream, Ice cream, Cheese made  Vegetable oils, safflower, corn, cotton seeds,
from whole milk, Egg yolk soybean, sesame, sunflower.
 Medium fat or fatty meats: beef, lamb pork,  Salad dressings made from above oils:
ham mayonnaise, French dressings
 Bacon, butter, coconut oil, lamb fat, lard,  Special margarine: liquid oil listed first
regular margarine, salt pork, on label
hydrogenated shortenings.  Fatty fish: salmon, tuna, herring
 Chocolates, chocolate candies, cakes cookies,
pies, rich pudding

The essential fatty acids are not manufactured in the body and must be supplied in the diet.

1. ? is the primary member of the omega-6 family. It is found in vegetable oils like corn, safflower,
soybean, and cottonseed, and poultry fats. It can be made into arachidonic acid which is
abundant in meats.
2. ? is the primary member of the omega-3 gamily. It is found in oils like flaxseed, canola, walnut,
wheat germ, and soy bean; nuts and seeds like butternuts, walnuts, and soybean kernels;

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 and vegetables like soybeans. Linolenic acid can be made into eicosapentaenoic acid (EPA) and
decosahexaenoic acid (DHA) which are essential for growth and development, prevention or
treatment of heart disease, hypertension, arthritis, and cancer. It is also found in human milk,
shellfish, and fish.

Health Effects of Lipids

1. Heart disease – Elevated blood cholesterol is a major risk factor for cardiovascular diseases.
2. Risk from saturated fats – Lauric, myristic, and palmitic acid raise ?. Stearic acid does not.
3. Benefits from monounsaturated fats – olive oil lowers risks of ?.
4. Benefits from omega-3 polyunsaturated fats – Omega polyunsaturated fats lower blood
cholesterol and prevent heart disease. EPA sources like fish, eaten once a week, can lower blood
cholesterol and risk of heart attack and stroke.
5. Cancer – Fat does not instigate cancer development but can promote it once it has arisen. ? is
related to increased fat and low fiber diet; breast cancer is related to increased levels of
saturated fats in the diet*
6. Obesity – high fat diets tend to store body fat ably.

Daily Allowances

No specific recommendation for the level of fat intake has been made by the Food and Nutrition Board.
The requirement for linoleic acid is low and easily met. For infant formulas, linoleic acid should supply
3% of the calories.

Example: If an individual has risk factors for heart disease, he/she should not consume more than 200
milligrams of cholesterol a day.

If risk factor for heart disease exist, then cholesterol intake should be limited to not more than 300
milligrams a day.

3. PROTEINS

Proteins is a term taken from a Greek work ? meaning primary, ranking first, or occupying the first
position. Similarly, protein is the first substance recognized a vital part of a living tissue. It contains
nitrogen aside from the basic carbon, hydrogen, and oxygen. ? are more complex compounds of high
molecular weights and structured in specific arrangements and numbers of their simpler building units, ?
They are organic substances that, upon digestion, yield these amino acids.

 Proteins have many metabolic functions? (tissue-building and maintenance, balance of nitrogen
and water, backup energy, support of metabolic processes [nitrogen balance, transportation of
nutrients, other vital substances], support of the immune system).
 The recommended dietary requirement of protein for adults is ?% of intake, or ?g/day for
women and ? g/day for men.
 Protein provides ? cal/g of energy.
 Protein transport component includes:
o ?- helps to transport free fatty acids and binds with certain medications in the body

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 o ? is a protein that has oxygen-carrying capacity
o ? and ? are protein carriers connected with iron storage and transfer
o ? (protein+fat) help to carry cholesterol and fat-soluble vitamins in the body

Classification of Protein

TYPE
A. ? are those which yield only
amino acids upon hydrolysis.
B. ? conjugated proteins or
proteids are combinations of
simple proteins and some
other non-protein substance
called a prosthetic group
attached to a molecule. They
perform functions that a
constituent could not
properly perform by itself.
C. ? are products formed in the
various stages of hydrolysis
of a protein molecule.
EXAMPLE
1. Albumins
2. Globulins
3. Glutelins
4. Prolamins
5. Albuminoids
6. Histones and protamines
1. ?s are combination of simple proteins and nucleic acid. ? are
necessary for the synthesis of proteins in the cytoplasm.
2. ?s and ?are combination of a protein and large quantities of complex
polysaccharides such as mucin found in
secretion from gastric mucous membranes.
3. ? are compounds of a protein and a triglyceride or other lipids such as
phospholipids or cholesterol found in cell and
organelle membranes.
4. ? are compounds of a phosphoric acid joined in
ester linkage to protein found in casein of milk.
5. ?are compounds of proteins and non-protein
pigments found in flavor proteins, hemoglobin, and cytochromes.
6. ? are compounds or metals (Cu, Mg, Zn, and Fe)
attached to proteins found in ferritin, hemosiderin, and transferrin.

Chemical stages of protein

A. As indicated by its name, an ? has a chemical structure that combines both acid and base
(amino) factors. This important structure gives amino acids a unique buffering capacity. This
acid-base nature of amino acids also enables them to join one another to form the characteristic
chain structure of protein. The amino (base) group of one amino acid joins the acid (carboxyl)
group of another. This characteristic chain structure of amino acids is called ?. Long chains of
amino acids that are linked in this manner are called ?

B. Essential and non-essential amino acids

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 1. Essential amino acids cannot be synthesized by the body and are necessary in the diet.
Example: Threonine, Leucine, Isoleucine, Valine, Lysine, Methionine, Phenylalanine,
Tryptophan
2. Non-essential amino acids can be manufactured by the body and, therefore, are not as
necessary for consideration in the diet.
Example: Glycine, Alanine, Aspartic acid, Glutamic acid, Proline, Hydroxyproline, Cystine,
Tyrosine, Serine, Arginine, Histidine

C. Complete, incomplete and complementary proteins

1. ? are those that contain all the essential amino acids in sufficient quantity and ration to
supply the body’s needs. These proteins are of animal origin – meat, milk, cheese, and
eggs. There are nine (9) essential amino acids.
2. ? are those deficient in one or more of the essential amino acids. They are of plant
origin – grains, legumes, seeds, and nuts.
3. ? are those food sources that, when eaten together, provide all the essential amino
acids.
D. Amino Acids added to food
1. ?: artificial sweetener (phenylalanine and aspartic acid found in Equal and Nutra Sweet
2. ? – spice/preservative composed of amino acid, an additional source of sodium in the
diet.

Digestion of Protein

Organ Enzyme Action

Mouth None Only mechanical mastication
Stomach ?, produced first as inactive Convert protein into
precursor to ?, then activated proteoses and peptones
by the hydrochloric acid

In infants, enzyme rennin Converts casein into

coagulated curd.
Small intestine
a. Pancreas ?– produced first as inactive Converts proteins, proteoses,
precursor trypsinogen and then and peptones into
activated by polypeptides and peptides.
enterokinase
?– produced first as inactive Converts proteoses and
precursor chymotrypsinogen peptones into polypeptides
and then and dipeptides; also
activated by active trypsin coagulates milk
Carboxypeptidase Converts polypeptides into
simpler peptides, dipeptides,
and amino acids.

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 b. Intestine Aminopeptidase Converts polypeptides into
peptides and amino acids
Dipeptidase Converts dipeptides into
amino acids

Function of Proteins

1. Proteins are used in repairing worn-out body tissue proteins (?) caused by the continue wear
and tear (?) going in the body.
2. Proteins are used to build new tissue by supplying the necessary amino acid building blocks.
3. Proteins are source of ?. One gram of protein contains ? calories (4 cal/g).
4. Proteins contribute to numerous essential body secretions and fluids, enzymes, and proteins.
Some hormones have protein or amino acid components. ? and ? are largely protein. Sperm
cells are likewise largely protein as is the fluids in which the sperm cells are contained.
5. Proteins are important in the maintenance of normal osmotic relations among the various body
fluids.
6. Proteins play a vital role in the resistance of the body to diseases. Antibodies to specific diseases
are found as part of the plasma globulin, especially in what is known as the gamma globulin
fraction of plasma.
7. Dietary proteins furnish the amino acids for a variety of metabolic functions.

Requirements for Human Nutrition

1. Quality of protein fundamental to health and life

2. General daily recommendation of the Food and Nutrition Board
a. Adult – 0-9 g/kg BW (the recommended dietary requirement of protein for adults is 10%
of intake, or 46 g/day for women and 56 g/day for men.
b. Children – growth needs vary according to age growth patterns.
c. Pregnancy – Rapid growth requires an increase of 30g over that of a non-pregnant
woman.
d. Lactation – it requires an increase of 20g
3. Protein-Energy Malnutrition (PEM) –is a condition resulting from insufficiency of protein or
energy or both in the diet. There are two types of PEM:
a. Marasmus – severe deprivation of food over a long period of time characterized by
insufficiency of protein and energy intake.
b. Kwashiorkor – This condition reflects an abrupt and recent deprivation of food which
develops rapidly as a consequence of protein deficiency or an illness like measles.

Source of Protein

The complete protein foods – meat, fish, poultry, egg, milk, cheese. Other sources are legumes,
nuts, bread and cereals.

Measures of Protein Quality

A. ? – it measures the effectiveness of protein quality in supporting the body’s need.

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 B. ? – it also measures how capably a protein is used by the body. The difference is that NPU
measures retention of food nitrogen consumed while BV measures food nitrogen absorbed.
C. ? – it measures the increase in weight of a growing animal and compares it with the intake.

Health Effects of Protein

1. ? – Food rich in animal protein tend to be rich in saturated fats.

2. ? – studies suggest a relationship between high intake of animal protein and some types of
cancer like cancer of the prostate gland, pancreas, kidneys, breast, and colon.
3. ? – Calcium excretion rises as protein intake increase.
4. ?– Protein-rich foods are also rich in fat which can lead to obesity with associated health risks.
5. ? – Excretion of end products of protein metabolism depends on a sufficient fluid intake and
healthy kidneys. A high-protein diet increases the work of the kidneys.
6. Protein Energy malnutrition -

What are Micronutrients?

It is called micronutrients because they are needed only in minuscule amounts, these substances are the
“magic wands” that enable the body to produce enzymes, hormones and other substances essential for
proper growth and development. As tiny as the amounts are, however, the consequences of their
absence are severe. (WHO nutrition)

I. Vitamins

Vitamins are a group of unrelated organic compounds found in food which are needed only in minute
quantities in the diet but essential for specific metabolic reactions within the cell and necessary for
normal growth and maintenance of health. They are also crucial in the growth, repair, and healthy
functioning body tissues.

Classification of Vitamins on the Basis of Solubility

1. Fat-soluble vitamins ? in association with lipids are found in foods.

 All fat-soluble vitamins have the possibility for toxicity due to their ability to be stored in the
body for long periods of time.
 Absorption of fat-soluble vitamins is dependent on the body’s ability to absorb dietary fat.
 Patients who have liver disease should be careful not to take more than the daily
recommendations of fat-soluble vitamins, as level can build up.

ABSORPTION,
VITAMINS STORAGE, FUNCTION DEFICIENCY FINDINGS OF SOURCE
STABILITY EXCESS
Vitamin A - Absorption aided Normal Vision cycle – it - Poor adaptation -Spleen and Liver Orange/yellow colored
(retinol) by bile salts, is a necessary or night blindness Damage foods, liver, dairy:
pancreatic lipase component of visual - Dry / thick eyes -Hair loss -Preformed vitamin A –
and dietary fat purple (rhodopsin), - Mocusa changes -Bone damage animal sources (liver,

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 - Absorbed through light-sensitive pigment - Retarded growth -Potential birth egg yolk, milk, cream,
lymphatic system in the retina enabling to - Lower resistance defects butter, and cheese)
and portal blood make adjustment to to infection -Hypercarotenimi -Provitamin A –
to liver light and darkness. - Faulty skeletal a precursor carotene;
- Carotene Tissue Strength – it play and dental -Violent pigment found in green
converted into Vit a vital role in proper development headache and yellow plants
A in intestinal wall synthesis and - Keratinization of -Nausea and (malunggay, sweet
Storage: Large maintenance of epithelial linings vomiting potato/kamote, pechay,
storage capacity epithelial tissue, hence - Disturbances in -Swollen, painful squash, spinach,
in liver, hence the integrity of skin and the respiratory, long bones alugbati, gabi, saluyot,
potential toxicity internal mucosa, and GI, genitourinary -Thickening of bitter gourd, etc)
levels with large growth and formation tracts the skin with -Fortified margarine or
intakes. of tooth buds. - Skin Lesion peeling off skim milk fortified with
Growth and Bone -In young girls, Vit A
Stability: stable to Development – it is there is -Fishes – dilis, clams,
light and heat, but necessary for the cessation of mussels or tahong, and
prolonged heating growth and menstruation other shellfish
in contact with air development of skeletal
destroys it. Easily and soft tissue through
destroyed by is effect upon protein
oxidation and synthesis and
ultraviolet light. differentiation of bone
cells.
Preservation: cool Normal Reproduction
atmosphere and and lactation – Vitamin
refrigeration A intake must be
increased to assure
normal reproduction
and lactation.

Vitamin D - Absorption - Maintain - Low serum - Severe high Animal Source: fortified
(calcifero) accompanies that serum calcium calcium blood calcium margarine, butter, milk,
of calcium and and - Fragile bones - Brain Damage cheese; liver and other
phosphorus in the phosphorus - Rickets - Heart Damage glandular organs; eggyolk
small intestine - Aid in bone and teeth - In infants: - Potential Fish – sardines and
- It is formed by development dentition and birth defects salmon
sunlight in the closing of the
skin absorbed fontanel are Plant Source: not
into systemic delayed significant
circulation as
hormones
Storage: stored in
liver, but not as
great as that of
Vitamin A
Stability:
remarkably stable
Preservation:
Foods containing
it can be warmed
or
kept for a long

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 periods without
deteriorating.
Vitamin E - Absorbed with - Protects cells from - Hemolytic Hypervitaminosis Animal Source: egg yolk,
(tocopherol) other fat-soluble oxidation – it acts in anemia E has not been (liver), butter, milk
vitamins, aided by vitro as a lipid (hemolysis of reported largely
bile and fats antioxidant. RBC) because the Plant Source: vegetable
Storage: stored - Help sustain - CNS changes nutrient could oils, germ oils of wheat,
especially in tissue integrity - Low levels of not be stored to corn, cottonseed or
adipose tissue tocopherols in a large extent in soybean; grains, nuts and
the blood the body. If any, some legumes; dark
Stability: fairly - Increased the following are green vegetables
stable to heat and urinary symptoms of
acids. No loss by excretion of overdose:
extraction in creatine and - Cramps,
cooking. Unstable decreased diarrhea
to alkalis, excretion of - Dizziness,
ultraviolet light, creatinine blurred vision,
and oxygen. Also headaches
destroyed in - Increased
contact with rancid serum
fats, lead, and iron. triglycerides in
Preservation: women
storage, deep- - Decreased
freeze food serum thyroid
processing and hormone in
deep-fat frying men and
destroy much of women
the Vitamin E
present.
Vitamin K Absorbed by usual - Normal blood clothing Increased - Formation of Liver, dark green leaves,
(menaquinone route for fats – (prothrombin bleeding times blood cloths wheat bran, vegetable
and lacteals, portal production) – it is - Hemorrhage - Jaundice in oils, especially vegetable
phylloquinone) blood to liver necessary for the disease in infants oils, especially soybean
Storage: stored in maintenance of newborn oil and wheat germ oil
liver in small prothrombin level in - Delayed blood - Vomiting are excellent food source
amount the blood plasma. clotting time in - Hemolysis
Stability: fairly - Aids in bone adults - Albuminuria Good amounts are
resistant to hear, metabolism – - Kernicterus present in tomatoes,
but sunlight - Needed for tubers, seeds and
destroys the Vit K. phosphorylation – a legumes, and egg yolk
It is not destroyed chemical process that
by ordinary adds the phosphate
cooking method. radical to glucose so
that its passage
through the cell
membrane is
hastened.

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 2. Water-soluble vitamins are B complex and Vitamin C

ABSORPTION,
VITAMINS STORAGE, FUNCTION DEFICIENCY FINDINGS OF SOURCE (mg)
STABILITY EXCESS
Vitamin C - Easily absorbed - Needed in the - Irritability no toxicity or Citrus Fruits and Juices
(ascorbic acid) by the small formation and - General hypervitaminosis Datiles Cereza (1c) = 155
intestine maintenance of weakness C since the Kamatsili (8 pods) = 133
Storage: Not intercellular - Lack of appetite vitamin cannot be Guava,red(4pcs
stored in tissue cementing substance. - Lowered stored in the small)=126
depots; - Aids in tissue building resistance to body. If any,
distributed to and metabolic infections symptoms of
tissue saturation reactions (wound and - Pallor overdose are:
levels in general fracture healing) - Scurvy (bleeding, - Diarrhea
circulation, - Converts folic acid swollen gums, - Nausea, cramps
remainder being into its active form, loose teeth, - Formation of Vegetable:
excreted; large folinic acid swollen and excess oxalic (1/2 cup/serving)
amount present - Collagen formation tender joints, acid in the body Alugbati : 76mg
in adrenal tissues. - Adrenaline internal - Acidification of Bitter gourd leaves : 66
Stability: much production hemorrhages urine Malunggay : 67mg
ascorbic acid is - Iron absorption underneath the - Interference Cauliflower : 33mg
lost in cooking - Cellular adhesion skin, capillary with the use Gabi leaves : 39mg
and thrown out in - Helps build body fragility, and of therapeutic Mongo sprouts : 22mg
the cooking resistance against megaloblastic drugs Sitaw (talbos):36mg
water. infections. anemia) - Conditioning to Sitsaro : 53mg
Preservation: - has an antioxidant - a higher Spinach : 25mg
-quick cooking in action requirement Sweet Potato(1pc):25mg
small amount of - Necessary for both in infants Sweet Potato leaves :
boiling water and tyrosine and and adults 63mg
covered tightly phenylalanine - Intestinal Talinum : 56mg
-quick freezing of metabolism. obstruction
food; - Plays a vital role in - False positive
refrigeration aids brain metabolism urine diabetic
retention of test
Vitamin C
Vitamin B- It is a group of water-soluble vitamins that need to be continually replaced because of their short “life”. The
Complex complex consists of the vitamins thiamin (B1), Riboflavin (B2), niacin (B 3), pantothenic acid (B5), pyridoxine (B6),
Lipoic Acid, biotin, folate, calabamin (B12), insitol,and choline
- Water-soluble nutrients that play important roles in the normal growth and maintenance of body
processes.
- Many partner with other B vitamins for metabolic reactions. Most affect energy, metabolism, and
neurological function.
- The B vitamins transform increased amount of proteins, carbohydrates, and fats into extra energy. They
provide energy necessary for muscle contraction.
Vitamin B1 Stability: (Muscle energy, GI Beriberi - No toxic reactions Outstanding Source:
(Thiamine) -Loss in cooking support, (nutritional of excessive lean pork, pork liver and
depending on the CV support) polyneuritis) thiamine intake in other glandular organs
pH of the food, -Necessary for proper Loss of appetite the body of pork and some
time, digestion, peristalsis, CNS and CV shellfish
temperature, and providing energy to problems
quantity of water the smooth muscles, Weakness Excellent source: liver
Easy fatigability and organ of meats of

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 used and glands, the CNS, and Indigestion other animals, egg yolk,
discarded. blood vessels. Severe unpolished rice, whole
-Loss when It is an integral part of constipation grains, legumes and nuts
sodium the coenzyme factor, Gastric atony
bicarbonate is thiamine Poor reflexes and
used to enhance pyrophosphate or TPP, irritability
the green color of needed for Retarded growth
vegetables. carbohydrate Numbness of
metabolism. extremities
Preservation : Cardiovascular
freezing has little problems
or no effect on
the thiamine
content of foods.
Riboflavin Stability: stable to -required for proper - Ariboflavinosis Toxicity does not Animal Source: cheese,
(Vitamin B2) heat, oxidation, growth development - Cheilosis – occur from oral milk, eggs, liver, and
and acid. and tissue healing manifestations doses but other glandular organs
- very little is lost - helps maintain include scales and possible when
in cooking and healthy skin, tongue, cracks on lips and massive doses are Plant Source: whole
processing of mouth, and normal mouth given by injection. grains, legumes, leafy
food due to its vision; - Smooth/swollen green vegetables, and
heat stability. - needed for conversion red tongue seaweeds
- the addition of of tryptophan into (glossitis)
baking soda to niacin - Dermatitis –
soften dried peas - essential component particularly in skin
or beans for of coenzymes, flavin folds
faster cooking mononucleotide (FMN)
destroys much of and flavin adenine
their riboflavin dinucleotide (FAD)
content because - essential for protein,
it is sensitive to fat, and carbohydrate
alkali. metabolism
Niacin (B3) Stability: more - It acts as Pellagra – classic Toxicity: Animal Source: liver,
(nicotinic acid) stable than hydrogen and deficiency disease - Hypermotility glandular organs, lean
thiamine and electron characterized by - Acidity of the meats, fish, poultry,
riboflavin acceptor. 4Ds, namely Stomach milk, cheese and eggs.
-Remarkably - It plays dermatitis, - Parlysis in the
resistant to heat, important role dementia, respiratory Plant Source: legumes,
light, air, acids, in energy diarrhea, and center nuts, whole grains,
and alkalis metabolism, death. enriched cereals, and
- Small amounts fatty acid Anorexia Symptoms of green vegetables
may be lost in synthesis Indigestion Overdose: Skin
discarded /oxidation, Skin changes Burning, flushing,
cooking water. and protein and itching
synthesis Nausea, vomiting,
catabolism. diarrhea
- It is needed for Liver and eye
photosynthesis damage
in plants and
fixation of CO2
in animal cells.

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Pantothenic Stability: stable in B5 Major actions: fatty - Insomnia No toxic effects of Rich sources: Liver,
acid (B5) moist heat acid metabolism, cell - Muscle cramps this substance are other glandular organs,
synthesis, heme - Tingling known meats, eggs, milk,
production sensation of cheese, avocados,
- Essential for extremeties cashew nuts and
carbohydrate, protein, - Vomiting peanuts, brown rice,
and fat metabolism - Anemia soy, legumes and
- Helps maintain normal - CNS changes broccoli
growth, healthy skin,
and integrity of the
central nervous
system.
- As part of coenzyme A,
it has many metabolic
roles in the cells.
Pyridoxine Major actions: cellular Anemia Toxicity is Vegetable oils of corn,
(B6) function, heme and CNS hyper- observed only in cottonseed, linseed,
neurotransmitter irritability rats olive, peanut, wheat
- It plays an Dermatitis germ, wheat and rice
essential role germ, lard and legumes
in many
biochemical
processes by
which foods
are
metabolized
by the body
Lipoic acid - a sulfur- -serves as coenzyme in Concentrated source:
containing fatty energy metabolism yeast and liver
acid and is not a converting pyruvic acid
true vitamin into acetyl CoA
because it can be
synthesized in
adequate
amount in the
body.
Biotin Stability: stable -serves as coenzyme True biotin No toxic effects of Liver or other glandular
to heat, soluble factor in CO2 fixation deficiency does not excessive biotin organs, meats, egg yolk,
in water and - helps in the synthesis occur, even in poor have been milk, molasses, whole
alcohol, and of purine, pyrimidines, diet observed in grains, legumes, and
susceptible to fatty acids, and humans nuts
oxidation, alkali, carbohydrates together
and strong acids. with active acetate
(CoA).
Folic Acid Stability: Major Action: synthesis - Megaloblastic Best source: Liver,
(folate) unstable to heat of amino acids and anemia and kidney, beans, lima
in acid media and hemoglobin, lover other blood beans, and fresh dark
stable in sunlight neutral tube defect in disorder green leafy vegetables
when in solution. fetus - Poor growth especially spinach,
- Glossitis asparagus, and broccoli
Storage: loss of - plays a vital role in the - GIT
folic acid in transfer of one-carbon disturbances
arising for

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 vegetables during units to appropriate
storage at room metabolities in the
temperature synthesis of DNA, RNA,
methionine, and serine
Loss occur in - essential for the
processing food at formation of both
high temperature. RBC and WBC in the
bone marrow and for
their maturation
- required for one-step
conversion of histidine
into glutamic acid
Cobalamin Stability: Major Actions:
(B12) approximately Hemoglobin synthesis,
70% of vitamin fatty acid metabolism
activity is retained - condition
during cooking
Inositol Its chemistry is - a lipotropic agent.
closely similar to Inositol is linked with
glucose, hence it phospholipids as
is alternatively phosphoinositols which
called “muscle help in the
sugar”. transportation and
metabolism of fats.
Choline - A lipotropic agent, i.e.,
it mobilizes fat and
prevents the build-up
of fatty acids.
- Needed for fat
transport as a
constituent of
phospholipids,
namely lecithin,
cephalin, and
sphingomyelin.
- Helps in the
transmission of
nerve
impulses
General Properties and Stability
Besides solubility properties, fat-soluble vitamins differ from water-soluble vitamins based on the
following factual criteria.
1. Fat-soluble vitamins generally have precursors or provitamins.
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inadequate Other sources: lean
dietary intake beef, potatoes, whole-
- Impaired wheat bread, dried
absorption beans.
- Metabolic
derangements Poor source: meats,
- Excessive milk, eggs, most fruits,
demands by and root vegetables
tissues of the
body
Pernicious anemia No toxic effects Organ meats, clams,
GI findings are known oysters, grains
Poor muscle
Symptoms of
overdose: Allergic
shock, especially
when vitamin is
injected
Occurs in: meat and
meat extractives, muscle
and glandular organs,
brain, legumes and nuts,
fruits, vegetables, and
grains
It is abundant in the
diet; minimum
requirements for
inositol is unknown
Fatty livers as seen Rich source: egg yolk
in cases of chronic
alcoholism and Other sources: liver,
kwashiorkor brain, kidney, heart,
meats, legumes and
nuts, and yeast and
wheat germ.
Page 24 of 28
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 2. Because they can be stored in the body, deficiencies are slow to develop.
3. They are not absolutely needed daily from food resources.
4. They are generally stable, especially in ordinary cooking methods.

On the other hand, water- soluble vitamins have the following general characteristics:

1. They must be supplied every day in the diet.

2. They do not have precursors.
3. They are not stored significantly in the body and any excess is excreted in the urine.
4. Deficiency symptoms develop relatively fast.
5. Being water-soluble, they are most likely to be destroyed in ordinary cooking.

II. MINERALS

Minerals pertain to the elements in their simple inorganic form. In nutrition, they are commonly
referred to as mineral elements or, in the case of those present or required in small amounts, they are
known as trace elements or trace minerals.

- Minerals are divided into major and trace

o Major minerals occur in larger amounts in the body
o Trace elements, also called micronutrients, are required by the body in amounts of less
than 100mg per day.

Mineral Composition of the Body

There are 21 mineral elements now known to be essential in nutrition. Analysis of minerals, however,
shows the presence of more than 25. Minerals are divided into major minerals (macronutrients
essentials) and traces (micronutrients essentials). Mineral elements exist in the body and in food in
organic and inorganic combinations.

Minerals of the Adult Body

Classification
Macronutrients essential at
level of 100 mg or more/day
Micronutrients essential at
levels higher than a few mg/day
Micronutrients essential, but
amounts needed for humans
cannot be estimated at present
Minerals present in humans
with unknown function
Minerals
Calcium, Phosphorus, Sulfur, Potassium, Chloride, Sodium,
Magnesium
Iron, Flouring, Zinc, Copper, Iodine, Chromium, Cobalt
Silicon, Vanadium, Tin, Selenium, Manganese, Nickel,
Molybdenum
Strontium, Bromine, Gold, Silver, Aluminum, Bismuth,
Arsenic, Boron

A. Group 1: Major Minerals

Calcium (Ca)
Distribution Approximately 1.5% to 2.2% of the total body weight is calcium

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Major Functions Hard materials of bone and teeth; promotes blood coagulation; participates
in muscular contraction and relaxation; nerve transmission, cardiovascular
support
Findings of Deficiency Osteoporosis, tentany, Chvostek’s and Trousseau’s signs, ECG changes,
retarded growth, rickets
Findings of Excess Constipation, kidney stones, hypercalcemia
Sources Kuhol, seaweed gamet, malunggay leaves, saluyot, carabao’s milk, dilis,
hipon, tagunton, susong pilipit, talangka, silinyasi, cheese, bagoong, dried
fish, alakaak, biya, galunggong, sardines, dried ayungin, dried dilis, dried
hibi, evaporated milk
Nursing Implications Monitor ECG and muscle tone. Give PO tabs with vitamin D
Chloride (CI)
Distribution A major anion in the extracellular fluid; cerebrospinal fluid has the highest
concentration; normal range of plasma level is from 95-105 mEq/liter or
350-370 mg/100mL.
Major Functions Fluid and electrolyte balance and acid-base balance; contributes to the
acidity necessary for the stomach (HCI); bonds to other minerals (especially
sodium) to facilitate cellular actions and reactions
Findings of Deficiency Rare: alkalosis
Findings of Excess In concert with sodium, results in high blood pressure
Source Table salt (NaCI)
Nursing Implications Monitor sodium level
Magnesium(Mg)
Distribution About 50% of magnesium in the body is present in the bones in
combination with phosphate and calcium; approx. 0.5 gm/kg fat-free of
body weight; plasma contains approx. 1.5 to 2 mEq/liter of magnesium;
next to potassium as the predominant cation in living cells.
Major Functions Bone nourishment, catalyst for many enzyme reactions, nerve or muscle
functions, CV support - regulates blood phosphorus level, increase the
stability of calcium in the tooth enamel
Findings of Deficiency Hypomagnesemic tetany on infants and children, weakness, dysrhythamias,
tetany, seizure, reduced blood clothing, eclampsia
Findings of Excess Diarrhea, kidney stones, decreased muscle control, CV changes
Source Nuts, soybeans, meat, milk, cocoa, seafoods, whole grains, dried beans,
peas, green plants
Nursing Implications Incompatible with some antibiotics. Give PO,2 hr apart
Phosphorus(P)
Distribution About 1% of normal human body contains phosphorus (12 gm/kg fat-free
weight); about 85% in the inorganic phase of bones and teeth in
combination with calcium;
Major Functions Bone and teeth formation, acid-base balance, component of every cell,
energy transfer of RNA/DNA
Findings of Deficiency Calcium level changes, muscle weakness
Findings of Excess Skeletal porosity, decreased calcium levels, must stay in balance with
calcium
Source Cheese, milk, dairy products, meat, poultry, fish, eggs, dried beans
Nursing Implications Evaluate the use of antacids (note type) and the use of alcohol.

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Potassium
Distribution Potassium is the principal cation present with the cells or in the
intracellular; about 2.6 gm/kg fat-free of body weight (0.35% of body
weight)
Major Functions Maintain fluid volume inside/outside cells, muscle action/relaxant, blood
pressure, cardiovascular support
Findings of Deficiency Dysrhythmias, muscle cramps, mental confusion, abdominal distension,
apathy
Findings of Excess Hypokalemia, Dysrhythmias (caused by supplements, potassium-sparing
diuretics ACE inhibitors, inadequate kidney function, diabetes)
Source Met, legumes, milk, raw and dried fruits, fruit juice, dark green vegetables,
unrefined cereals
Nursing Implications Monitor ECG and muscle tone, PO tabs irritate the GI system. Give with
meals
Sodium(Na)
Distribution Sodium is a monovalent cation; About 50% is found in the extracellular
fuilds; 40% is found in the skeleton bound in the surface of bone crystals;
10% if found within the cells;
Major Functions Maintains fluid volume, allows muscle contractions, cardiovascular support
Findings of Deficiency Muscle cramping, cardiac changes
Findings of Excess Fluid retention, hypertension, CVA
Source Table salt, added salts, processed foods, canned goods, butter, carrots,
celery, beets, soy souce(toyo), catsup, spinach, peas, vetsin, fish sauce
(patis), preservatives and additives
Nursing Implications Monitor ECG, edema, and blood pressure
Sulfur (S)
Distribution Sulfur occurs in almost every protein cell and comprises about 0.25% of
body weight; highest concentration is found in hair, skin, and nails
Major Functions A component of vitamin structure, by-product of protein metabolism,
activate enzymes; participates in detoxification reactions
Findings of Deficiency Only seen in severe protein malnourishment
Findings of Excess Toxicity has a very low risk
Source Protein contains 1% of sulfur, dried fruits (dates, raisins, apples), meats, red
and white wines.
Nursing Implications Sulfur levels are not usually monitored.

B. Group II: Trace Minerals (Selected)

Iron (fe)
Distribution About 75 mg/kg fat-free of body weight (3-5gm); 60%-75% of this amount is
present as part of hemoglobin and 5% as myoglobin; about 26% is found in
liver, spleen, and bone marrow.
Major Functions Carrier of oxygen needed for cellular respiration, hemoglobin formation,
component of tissue enzyme involved in the conversion of betacarotene
into vitamin A, antibody production, collagen synthesis
Findings of Deficiency Anemia

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 Findings of Excess Hemosiderosis - supplements that are unneeded can become toxic
Hemochromatosis –patients absorb unusually amount of iron and stored
them in tissue
Source Organ meats, egg yolks, whole grains, and green leafy vegetables
Iodine (I)
Distribution Adult body normally contain 20 to 30 mg of iodine. About 70% to 80% or
about 8 mg is concentrated in the thyroid gland and the rest is widely
diffused throughout all tissue.
Major Functions Use for synthesis of thyroxine,
Findings of Deficiency Goiter - Enlargement of thyroid gland , cretinism, myxedema
Findings of Excess
Source Seafoods, seaweeds, iodized salt
Copper (Cu)
Distribution All tissues in the body contain traces of copper. Large amount are found in
the liver, brain, heart, and kidney.
Major Functions Hemoglobin formation, promotes iron absorption and transportation,
oxidation-reduction mechanism of living cells, bone formation, melanin
pigment formation as part of tyrosinase, support myelin sheath
surrounding the nerve fibers
Findings of Deficiency Depigmentation of skin and hair, CNS abnormalities, hypotonia,
hypothermia, chronic microcytic anemia, skeletal mineralization in infants
and children
Findings of Excess Wilson’s Disease
Source Organ meats, shellfish (oysters), nuts, cocoa, cherries, mushroom, whole
grain, cereals
Zinc (Zn)
Distribution The body contains about 2 to 5 gms of zinc. The blood concentration of zinc
is 700 to 800 mg, where 80% of which is present in RBC, 4% in WBC and
platelets.
Major Functions Cellular function support being an integral part of several metaloenzymes,
present in RNA, enhances wound healing, help maintain normal sense of
taste,
Findings of Deficiency Slow growth, alopecia, disturbances in the keratinization process in the skin
and esophagus, hypospermia, delayed sexual maturation, white cell defects
Findings of Excess Nausea, vomiting, abdominal cramps, diarrhea, fever
Source Milk, meat, liver, oyster, eggs, nuts, legumes, whole-grain cereals, wheat,
bran

WATER

Water is the most basic of nutrients. The body can maintain itself for several days or weeks on its food
stores or energy, but it cannot survive without water/hydration for more than a few days. Water makes
up the largest portion of our total body weight and it is crucial for all fluids and cellular functions.

 Fluid balance is essential for optimum health and bodily function.

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 A balance input/output ratio is almost 1:1. The minimum daily fluid output for healthy adult is
1,500ml, therefore, the minimum daily amount of water needed is 1.5 L/day.
 Under normal condition, recommended adult fluid intake is 3 to 4 L/day for men and 2 to 3
L/day for women.
 Assessment for proper hydration should include skin turgor, mental status, orthostatic blood
pressures, urine output and concentration, and moistness of mucous membranes.

References:

Cruz-Caudal, M.L. (2019). Basic Nutrition and Diet Therapy(2nd ed). Philippines:C&E Publishing, Inc.

Sommer, S. etc,(2013). Nutrition for Nursing 5th ed., ATI Nursing Education

Diet therapy: https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-

maps/diet-therapy

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