Nutrition and Diet Therapy (LAB)
Bioavailability
Nutrition
 The science of food, the nutrient and other
substances therein, their action, interaction
and balance in relation to health and
disease
 the process by which the organism ingest,
digest, absorbs, transports, utilizes and
excretes food substances
 A broader definition includes the social,
economic, cultural and psychological
implication of food and eating.
 Therefore nutrients are for growth,
maintenance and source of energy for
human being to function.
Nutrients
 Chemical substances needed by the body
for one or more of the ff. functions:
 to provide heat or energy
 to build and repair muscle tissues
 to regulate life processes.
Essential Nutrients
 Substances required for normal growth and
health that the body cannot generally
produce or produce in sufficient amounts
thus, must be obtain in the diet
Nonessential Nutrients
 Substances required for normal growth and
health that the body can manufacture in
sufficient quantities from other components
of the diet. A dietary source of nonessential
nutrients is required
Foods
 Products derived from plants and animals
that when taken into the body, serves to
nourish, build and repair tissues; supply
energy; regulate body processes
 Amount of nutrient consume that is
available for absorption and used by the
body
Calorie
 Unit of measure used to express the
amount of energy produced by the foods in
the form of heat. The calories used in
nutrition is the large “Calorie”, or the
“kilocalorie” (kcal)
 Kilojoule (kJ) :
- 1 kcal= 4.2 (4.184) kJ
 KCAL TO KJ
- 100 kcal = 420 kJ
Empty-Calorie Foods
 Foods that provide an excess of calories inn
relation to nutrients.
 “Caloric-Dense Food”
 High in Calories, Sodium, Sugar, saturated
fats
Nutrient-Dense Foods
 Foods that contain relatively high amounts
of nutrients compared to their calorie value.
 High in essential Amino Acids, Essential
Fatty Acids, Vitamins, Mineral, fiber and
antioxidants
Nutritional Status
 State of the body as a result of consumption
and utilization of nutrients in the body.
 To determine Nut. Status: Clinical
Observations, Biochemical analysis,
anthropometric measurements and dietary
studies

Health
 State of physical, mental and emotional
well-being and not merely freedom from
disease or which absence of any ailment.
Malnutrition
 Any condition caused by excess or deficient
food energy or nutrient intake or by an
imbalance of nutrients.
 Overnutrition – excess energy or
nutrient intake
 Undernutrition – deficient energy or
nutrient intake
KEY CONCEPTS IN NUTRITION
Concept # 1 “Food is a basic need of humans”.
- Individuals need adequate food in order
to survive and the right variety of foods
for optimal health.
 Food Security - access at all times to a
sufficient supply of safe, nutritious foods.
 Food insecurity - limited or uncertain
availability of safe, nutritious foods. – can
lead to poor health, increase risk to certain
diseases and lowered academic
achievement in children
 Food terrorism - food can be a potential
weapon of bioterrorism
 e.g. food and water can be used to
intentionally spread illness
 toxic substances (botulism toxin, ricin,
radioactive particles, microorganisms
such as salmonella, E.coli, etc
- RICIN- poison found in castor beans
Nutrition and Health
How nutrition is related to health?
 The basic study of nutrition is of primary
importance as:
1. It is fundamental for our own health
2. It is essential for the health and well
being of our patients and clients from
the time of eating till it is utilized for
various functions
Functions:
Nutrition helps growth and development
Prevents malnutrition
resists infection and
prevents diseases (decreased morbidity
and mortality)
 Morbidity is the state of having illness or
disease or acute condition
 Mortality is death
FACTORS INFLUENCING FOOD
HABITS
Superstitions, Social and cultural factors
  Food habits are handed over from bread, biscuits, cakes etc., due to
generation to generation. variation in recipes and basic
 Though these factors have very little or ingredients used in different regions.
no scientific basis, people rigidly adhere
to them. Advertising and media
- In many parts of India pregnant
women are not allowed to take
papaya and Pineapple (cause
abortion)
 milk with saffron result in a baby with a
very fair complexion

Religions factors

 Hindus do not eat beef, and among

Hindus some communities do not eat
fruits, onions and garlic. Many Hindus
are vegetarians. To eat meat is to
destroy the seeds of compassion.
 Islamic food laws prohibit the
consumption of "unclean" foods such as Calorie Value of Food
swine and animals killed in a manner (Kilocalories/gm):
that prevents their blood from being fully
drained from their bodies Carbohydrates 4
 Jews do not eat pork and shellfish
Fat 4
Income Proteins 4

 Financial resources determine the type Basal Metabolic Rate (BMR)

of food we consume.
 Depending on the availability one
selects the food. People in lower income
groups in India consume, a combination
of cereals and cheaply available green
leafy vegetables, roots and tubers.
 People of higher income groups, can
choose food from all groups irrespective
of season.
Geography/availability
 In the olden days, man would eat
whatever was available to satisfy his
hunger. The food he got was the type he
could cultivate in his locality.
 The nutrition value of natural foods do
not vary from country to country. But
there is a great variation in the
composition of prepared foods such as
 defined as the energy expenditure of a
subject at complete physical and mental
rest, awake (and not during sleep)
 having normal body temperature and in the
post absorption state (12 hours after the
last meal) and 8-12 hours after any
significant physical activity.
Basal needs:
Male: 1kcal per kg DBW/HOUR
Female: 0.9kcal per kg DBW/HOUR
Ex:
Basal need ___x ____kg(DBW) X 24 = _____
Kcal
 The BMR is the energy expenditure  Protein:
necessary to maintain basic physiologic
 Infant, children, adolescents 10%
conditions such as:
 Adults: 10-12%
a. The activity of the heart
b. Respiration  Fats:
c. Conduction of nerve impulses  Normal adults, mod active: 20-25%
d. lon transport across membranes  Children adolescent, very active: 30-
e. Reabsorption in the kidney, and 35%
f. Metabolic activity such as synthesis of
macromolecules under standard Total calorie requirement:
conditions.
 2,100 (CHO 60%-CHON10%-FATS-
Energy requirement (above basal) 30%)—should be 100%
Bed Rest 10% - 2,100 kcal- CHO 315g- CHON 53g-
Sedentary 30% FAT 70g
Light Activity 50% - 2,100 X 60% (.60)-----------1,260kcal
Moderate Activity 75% - 2,100 X 10% (.10)--------- 212 kcal
Severely Active 100% - 2,100 x30% (.30)----------630 kcal
2,102
Energy requirement (above basal) NPC: wt. 80kgs. > 80kg body wt x 1.1g protein
Bed Rest 27.5% per kg body wt= 88g CHON
Sedentary 30%
2,100 kcal – CHO262g,-CHON 88g, FAT 78g
Light Activity 35%
Moderate Activity 40% 88gx4=352_kcal
Severely Active 45%
2,100 TCR – 352 kcal from CHON= 1,748 kcal
1748 kcal=
Energy requirement (above basal)
Male female Cho:50% or 60% or 70%
Bed Rest 35 30 Fat: 50% or 40% or 30%
Light Activity 40 35
Moderate Activity 45 40
Severely Active 50
NPC
(NON-PROTEIN CALORIE)
Pregnant women:
Infants: 1.5g/kg body wt
 TER/day= normal requirement +300kcal
Children: 2.0 g/kg body wt
Lactating women: Adolescent: 1.3g/kg body wt
 TER/day: TER/day +500 Adults:0.8- 1.1g/kg body wt
Sick Adults: 1.2-2.0g/kg body wt.
DISTRIBUTION OF TOTAL ENERGY Children: varies
REQUIREMENT
Pregnant: additional 30g
 Carbohydrate: 50-70% Lactation: additional 20g
Renal: 0.6-0.8g /kg body wt (pre-dialysis) , 1.2- DBW(kg)= (age in yrs x2kg) +8(kg)
1.7g /kg body wt (dialysis)
Ex. 7 yrs old
DBW(kg)= (7x2) +8
=14 +8
DBW=22kg
+2KG EVERY YEAR

3. Adults
BMI = kg/m2
ESTIMATING THE DESIRABLE BODY
WEIGHT (DBW) Ex. 50kg HT: 5’3” (160.02cm or 1.60m)
BMI 19.5

Infants CLASSIFICATION OF WEIGHT STATUS

WEIGHT STATUS BODY MASS INDEX
DBW(gms)= Birth wt (gms) + (age in months x (BMI), kg/m2
600) Underweight ˂18.5
Normal range 18.5 – 24.9
**if birth wt is not known, use 3000gms
Overweight 25.0 – 2.9
Obese ≥ 30
Obese class I 30.0 – 39.9
Ex. 4mos old infant Obese class II 35.0 – 39.9
DBW= 3000 + (4x600) Obese class II ≥ 40

=3000 + 2400
Obesity classification according to WHO and
=5400gms or 5.4kg Asia-Pacific guidelines

WHO (BMI) ASIA

7 to 12 mos PACIFIC
DBW(gms)= Birth wt (gms) + (age in months x (BMI)
500)
Underweight ˂18.5 ˂18.5
**if birth wt is not known, use 3000gms Normal 18.5 – 24.9 18.5 – 24.9
Overweight 25.0 – 29.9 23-24.9
Obese ≥30 ≥25
Ex. 8mos old infant
DBW= 3000 + (8x500) DESIRABLE BODY WEIGHT
=3000 + 4000 Tannhauser formula
=7000gms or 7kg
 DBW (kg) – (Ht (cm) – 100) ± 10%
2. Children
NDAP
  Males: 112 lbs for 5 ft +/- 4 lbs for every
inch above or below 5 ft
 Females: 106 lbs for 5 ft +/- 4 lbs for
every inch above or below 5 ft
DBW= 160.02 (Ht in cm) -100 = 60.02
60.02-6.0= 54kg
BMI=21

First, convert 5 feet to inches: 5 feet × 12

inches/foot = 60 inches
Add up our inches: 60 + 2 = 62 inches
Convert inches to cm: 62 inches × 2.54
cm/inch = 157.48 cm
5’3
5x 12inches= 60 inches
60+3inches+ 63 inches
63x 2.54= 160.02cm or 1.60