Nutrition

Lecturer 1
Introduction for Nutrition
Nutritionist Clinical /Dr. Hamas Swiaed
Introduction for Nutrition
Human nutrition is a complex, multifaceted scientific domain indicating how substances in foods
provide essential nourishment for the maintenance of life.
• To understand, study, research, and practice nutrition, a holistic integrated approach from molecular
to societal level is needed.
• Optimal, balanced nutrition is a major determinant of health.
It can be used to promote health and well-being, to prevent ill health and to treat disease.
• The study of the structure, chemical and physical characteristics, and physiological and biochemical
effects of the more than 50 nutrients found in foods underpins the understanding of
The hundreds of millions of food- and nutrition-insecure people globally, the coexistence of
undernutrition and overnutrition, and inappropriate nutritional behaviors are challenges that face the
nutritionist of today.
• Nutrition practice has a firm and well-developed research and knowledge base. There are, however,
many areas where more information is needed to solve global, regional, communal and individual
nutrition problems.
• The development of ethical norms, standards, and values in nutrition research and practice is
needed.
Relationship between nutrition and health.
Nutritional situation Health consequences, out comes

Optimum nutrition Health, well-being, normal development,

Food-secure individuals with high quality of life
adequate, balanced and prudent
diets
Decreased physical and mental development
Undernutrition: hunger − Compromised immune systems
Food-insecure individuals living − Increased infectious diseases
in poverty, ignorance, politically − Vicious circle of undernutrition,
unstable environments, underdevelopment, poverty
disrupted societies, war

Overnutrition Obesity, metabolic syndrome, cardiovascular

Overconsumption of food, disease, type 2 diabetes mellitus, certain
especially macronutrients, plus: cancers: chronic NCDs, often characterized
− low physical activity by overnutrition of macronutrients and
− smoking, stress, alcohol abuse undernutrition of micronutrients.

Double burden of infectious diseases plus NCDs,

Malnutrition often characterized by overnutrition of
Nutrition transition: Individuals macronutrients and undernutrition of micronutrients
and communities previously
food insecure confronted with
abundance of palatable
foods some undernourished,
others too many macronutrients
and too few micronutrients
Nutrients: the basics
People eat food, not nutrients; however, it is the combination and amounts of nutrients in
consumed foods that determine health. To read one must know the letters of the alphabet; to do
sums one must be able to count, add, subtract, multiply, and divide.
To understand nutrition, one must know ab nutrients. The study of nutrients, the ABC and
numeric calculations of nutrition, will form a major part of the student’s nutrition journey, and
should include

1-The chemical and physical structure and characteristics of the nutrient

2- The food sources of the nutrient, including food composition, the way in which foods are
grown, harvested, stored, processed and prepared, and the
effects of these on nutrient composition and nutritional value
3- The digestion, absorption, circulatory transport,
and cellular uptake of the nutrient, as well as regulation
of all these processes
4- The metabolism of the nutrient, its functions, storage, and excretion
5- physiological needs (demands or requirements) for
the nutrient in health and disease, and during
special circumstances (pregnancy, lactation, sport
events), as well as individual variability
6- Interactions with other nutrients, no nutrients
(phytochemicals), antinutrients, and drugs
Classes of nutrients for nutrition
Class/category Subclass/category
Carbohydrates (macronutrients) Monosaccharides
Disaccharides
Polysaccharides
Proteins (macronutrients)
Plant and animal source proteins
Fats and oils (lipids)
(macronutrients) Saturated fatty acids
Monounsaturated fatty acids
Polyunsaturated fatty acids
Minerals (micronutrients)
Minerals and electrolytes
Trace elements
Nutrient examples
Glucose, fructose, galactose
Sucrose, maltose, lactose
Starch and dietary fiber
Amino acids (n = 20):
aliphatic, aromatic, sulfur-
containing, acidic, basic
Palmitic and stearic acid
Oleic (cis) and elaidic (trans) fatty
acids
Linoleic, -linolenic, arachidonic,
eicosatetraenoic,
docosahexaenoic acid
Calcium, sodium, phosphate,
potassium, iron, zinc,
selenium, copper, manganese,
molybdenum, fluoride,
chromium

Retinol (A), calciferols (D),

tocopherols (E), vitamin K
Ascorbic acid (C), thiamine (B1),
Vitamins (micronutrients) ribofl vain (B2), niacin (B3),
Fat soluble
Water soluble pyridoxine (B6), folate, cobalamin
(B12)

water
water
water

NATIONAL GUIDELINES

Eating can be one of life’s greatest pleasures. People eat for enjoyment and to obtain energy and
nutrients. Although many genetic, environmental, behavioral, and cultural factors affect health,
diet is equally important for promoting health and preventing disease. Over the past several
decades, attention has been focused increasingly on the relationship of nutrition to chronic
diseases and conditions. Although this interest derives some whiten from the increasing
percentage of older adults in the population as well as their longevity, it also is prompted by the
desire to prevent premature deaths from diseases such as coronary heart disease, diabetes
mellitus, and cancer. Approximately two third of deaths in the United States are caused by
chronic disease
 Nutrition
Lecturer 2
Nutrition al Considerations in Children
Nutritionist Clinical /Dr. Hamas Swiaed

GROWTH AND DEVELOPMENT

Growth Patterns
The rate of growth slows considerably after the first year of life Increments of change are small
compared with those of infancy and adolescence; weight typically increases an average of 1.6 to
3.3 kg (3½ to 7 lb.) per year until the child is 9 or 10 years old. Then the rate increases, signaling
the approach of puberty. Height increase increments average 5 to 9 cm (2 to 3½ inches) per
year until the individual growth spurt seen in puberty. Growth is generally steady and slow
during the preschool and school age years, but it can be erratic in individual children, with
periods of no growth followed by growth spurts. These patterns usually parallel similar changes
in appetite and food intake. For parents, periods of slow growth and poor appetite can cause
anxiety, leading to mealtime struggles

NUTRIENT REQUIREMENTS
Because children are growing and developing bones, teeth, muscles, and blood, they need more nutritious food in
proportion to their size than do adults. They may be at risk for malnutrition when they have a poor appetite for a long
period, eat a limited number of foods, or dilute their diets significantly with
nutrient-poor foods. The dietary reference intakes (DRIs) are based on current knowledge of nutrient intakes needed for
optimal health Most data for preschool and school age children are values interpolated from data on infants and
adults. The DRIs are meant to improve the long-term health of the population by reducing the risk of chronic disease
and preventing nutritional deficiencies. Thus, when intakes are less than the recommended level, it cannot be assumed
that a particular child is inadequately nourished.
 Feeding, Nutrition, and Piaget’s Theory of Cognitive Development
Developmental Cognitive Characteristics Relationships to Feeding and Nutrition
Period
Neonate progresses from Progression involves advancing from sucking and rooting
autonomic reflexes to a young reflexes to the acquisition of self-feeding skills.
child with intentional interaction
Sensorimotor with the environment and
(birth-2 yr) the beginning use of symbols.
Food is used primarily to satisfy
hunger, as a medium to explore
the environment, and as an
opportunity to practice
fine motor skills.
Thought processes become
internalized; they are
unsystematic
and intuitive.
Use of symbols increases.
Reasoning is based on
appearances and happenstance.

The child’s approach to

Preoperational classification is functional and Eating becomes less the center of attention and is
(2-7 yrs. unsystematic. secondary to
The child’s world is viewed social, language, and cognitive growth.
egocentrically
Food is described by color, shape, and quantity, but the
child
has only a limited ability to classify food into “groups.”
Foods tend to be categorized into “like” and “don’t like.”
Foods can be identified as “good for you,” but reasons why
they are healthy are unknown or mistaken.
The child can focus on several
Concrete The child begins to realize that nutritious food has a
aspects of a situation
operational positive
simultaneously.
(7-11 yr.) effect on growth and health but has a limited
Cause-and-effect reasoning
understanding
becomes more rational and
of how or why.
systematic.
The ability to classify, reclassify,
and generalize emerges.
A decrease in egocentrism
permits the child,

The concept of nutrients from food functioning at

Hypothetical and abstract physiologic
Formal thought expand and biochemical levels can be understood.
operational
Conflicts in making food choices may be realized (i.e.,
(11 yrs. and
knowledge of the nutritious value of foods may conflict
beyond)
with preferences
and nonnutritive influences).
 Sequence of Development and Feeding Skills in Healthy,

Infant’s Mouth Patterns Hand and Body Skills Feeding Skills or Hunger and Satiety (Fullness)
Approximate Age Abilities Cues
Birth through 5 Suck/swallow -Poor control of -Swallows' liquids Hunger cues:
months reflex head, neck but pushes most -Wakes and tosses
- Tongue thrust reflex Trunk solid objects from - Sucks on fist
-Rooting reflex - Needs head the mouth. - Cries or fusses
- Gag reflex support -Coordinates suck -Opens mouth while
- Brings hands to swallow-breathe - feeding to indicate
mouth while breast or wanting more
around 3 months bottle feeding Satiety cues:
-Moves tongue Seals lips together
forward and back - Turns head away
to suck - Decreases or stops
sucking
- Spits out the nipple or
falls asleep
when full
4 months -Up-and-down Sits with support Takes in a spoonful Hunger cues:
through 6 munching - Good head of pureed or -Cries or fusses
months Movement control - strained food and - Smiles, gazes at
-Transfers food from - Uses whole hand swallows without caregiver, or coos
front to back to grasp choking -Drinks during feeding to indicate
of tongue to swallow - objects (palmer small amounts from wanting more --Moves
-Draws in upper or grasp) -Recognizes cup head toward spoon or
lower lip as spoon and when held by tries to swipe food
spoon is removed from holds mouth open another person, towards mouth
mouth as spoon with spilling Satiety cues:
- Tongue thrust and approaches - Decreases rate of sucking
rooting reflexes begin or
to disappear - stops sucking when full
- Gag reflex diminishes Spits out the nipple
-Opens mouth when - Turns head away
sees spoon - May be distracted or pay
Approaching attention
to surroundings more
5 months -Begins to control the -Begins to sit alone -Begins to eat Hunger cues:
through 9 position of unsupported mashed foods - Reaches for spoon or
months food in the mouth - Follows food with - Eats from a spoon food
- Up-and-down eyes easily - Points to food
munching movement - Transfers food - Drinks from a cup Satiety cues:
-Positions food from one hand with some spilling - Eating slows down
between jaws to the other - Begins to feed self - Clenches mouth shut or
for chewing - Tries to grasp with hands pushes food away
foods such as
toast, crackers,
and teething
 biscuits with all
fingers and pull
them into the
palm.
8 months -Moves food from side -Sits alone easily -Begins to eat Hunger cues:
through 11 to side in -Transfers objects ground or finely - Reaches for food
months mouth -Begins to use from hand to chopped food and - Points to food
jaw and tongue to mouth -Begins to small pieces of soft - Gets excited when food
mash food use thumb and food is presented
-Begins to curve lips index -Begins to Satiety cues:
around rim - finger to pick up experiment with -Eating slows down
of cup -Begins to chew objects (pincer spoon but prefers - Pushes food away
in rotary pattern grasp) to feed self with
(diagonal movement of - Feeds self-finger hand
the jaw as food is foods -Drinks from a cup
moved to the side or - Plays with spoon with less spilling
center of the mouth) at mealtimes,
but does not
spoon- feed yet
10 months -Rotary chewing -Feeds self easily -Begins to eat Hunger cues:
through 12 (diagonal with fingers chopped food and -Expresses desire for
months movement of the jaw - Begins to put small pieces of soft, specific food with words
as food is moved to the spoon in mouth cooked table food or sounds
side or center of the -Dips spoon in -Begins spoon- Satiety cues:
mouth) food rather than feeding self with Shakes head to say “no
scooping help -Bites more
-Demands to through a variety of
spoon-feed self textures
-Begins to hold
cup with two
hands -Drinks from
a straw
-Good eye hand-
mouth
coordination

Factors affecting nutritional status

Factors affecting nutrition status are biological factors include age, gender, diet
& genetic makeup, economic factors include affordability & accessibility,
cognitive factors include deep thinking, interaction, social factors include
lifestyle, marital status and physiological factors include mood and food.