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Nutrient Metabolism
NTR 4150

Course Description
• Course addresses the metabolism of carbohydrates, proteins, fats,
vitamins, and minerals. Associations with dietary requirements and disease
processes, nutrient interactions, nutrient stability and bioavailability, and
food sources will be covered.
• In order to accomplish the above, this includes an understanding of cell
biology, the organs involved in digestion, and the biochemical processes
that transform nutrients.
• This course also demonstrates the regulation of nutrient processing and
changes of the process in metabolic diseases. Integration of knowledge
from different disciplines such as physiology and biochemistry are used to
create a holistic understanding of human nutrient metabolism.

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Nutrition
• Consuming food and nutrients and using them to function
• Both cause and result of good or poor health
• Not the same as “food” and “nutrients”
• Food = products eaten or taken into the body that contain
nutrients for
−Development, growth, and maintenance of tissues and cells
−Resisting and fighting infection
−Producing energy, warmth, and movement
−Carrying out the body’s chemical functions

“Nutrition is the science or practice of consuming and

utilizing foods”
-Medical New Today

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Study of Nutrition - 2020

• Driven by developments in:
• Molecular biology
• Biochemistry
• Genetics
• New focus on biochemical pathways
• Medical Nutrition
• Disease prevention through healthy diet
• Food allergies and intolerance

Dietician vrs. Nutritionist

• Registered Dietitian Nutritionist (RD or RDN)
• studies food, nutrition, and dietetics through an accredited university and
approved curriculum, then completes a rigorous internship and passes a licensure
exam to become a registered dietitian
• Employed by hospitals, nursing homes, sports facilities, industry
• Nutritionist
• studies nutrition via self-study or through formal
education but does not meet the requirements to use
the titles RD or RDN
• Similar employment, unless specifically requiring
licensure

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Essential Nutrients
• Macronutrients - those that provide energy:
−Carbohydrates
−Fats (lipids)
−Proteins
• Macronutrients - those that do not provide energy:
• Fiber (soluble and insoluble)
• Water
• Micronutrients
−Vitamins - Organic
−Minerals - Inorganic

Macronutrients: Carbohydrates
• Energy-giving foods composed of sugars
• Common staple eaten regularly, accounting for up to
80% of the diet in developing countries
• Quickly absorbed by the body
• Sources
−Cereals (e.g., millet, sorghum, maize, rice)
−Root crops (e.g., cassava, potatoes)
−Starchy fruits (e.g., bananas)

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Macronutrients: Fats and Oils (Lipids)

• Energy-giving foods
• Absorbed more slowly than carbohydrates
• Account for small part of diet in developing countries
• Fats (solids): Butter, lard, margarine
• Oils (liquids): Corn oil, soybean oil, peanut oil

Macronutrients: Proteins

• Body-building foods
• Form main structural components of cells
• Help produce and maintain tissues and muscles
• Sources
−Plants (e.g., beans, nuts, chickpeas)
−Animals (meat, poultry, fish, dairy products, insects)

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Micronutrients: Vitamins
• Organic compounds mostly from outside the body
• Do not provide energy
• Fat soluble: Dissolve in lipids, can be stored, not needed
daily (e.g., vitamins A, D, E, K)
• Water soluble: Dissolve in water, absorbed into
bloodstream immediately, needed daily
• Sources
−Fruits
−Dark leafy vegetables

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Micronutrients: Minerals
• Inorganic compounds not synthesized by the body
(sodium, potassium, iron)
• Needed in very small quantities but possibly essential
• Important for biochemical processes and formation of
cells and tissues
• Sources
−Plants
−Animal products

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Water
• Main component of the body (60
percent of body mass)
• Needed for digestion, absorption, and
other body functions
• Regularly lost through sweating,
excretion, and breathing
• Approximately 1,000 ml (4−8 cups)
needed each day

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Undernutrition
• The manifestation of inadequate nutrition
• Common in sub-Saharan Africa
• 1/3 of all children < 5 years old underweight
• 38% of children with low height for age
• Many causes
• Inadequate access to food/nutrients
• Improper care of mothers and children
• Limited health services
• Unhealthy environment

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Conditions Associated
with Under- and Overnutrition
• Vitamin deficiency disorders
• Scurvy (deficiency of vitamin C)
• Rickets (deficiency of vitamin D)
• Mental, adrenal disorders (deficiency of B vitamins)
• Mineral deficiency
• Osteoporosis (deficiency of calcium)
• Diet-related non-communicable diseases
• Diabetes
• Coronary heart disease
• Obesity
• High blood pressure

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Obesity - Epidemic
• Fad Diets over the years:
• 175 BC – Cabbage and Urine Diet
• 1820 Vinegar and Water Diet
• 1825 Low Carbohydrate Diet
• Late 1800’s – Arsenic Diet
• 1903 Horace Fletcher promotes “Fletcherizing” Chew food 32 times, spit it out
• 1910 Tapeworm Diet
• 1925 Cigarette Diet - “Reach for a Lucky instead of a sweet”
• 1950 Cabbage Soup Diet & Grapefruit Diet
• 1970 Sleeping Beauty Diet - Individuals heavily sedated for several days
• 1981 High Protein, Low Carb Diet - Dr. Atkin’s
• 1985 Caveman (Paleo)
• 2005 Cheater’s Diet - Expected to ‘cheat’ on the weekends
• 2020: Mediterranean, South Beach, Keto, WW, etc.

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Causes of Undernutrition

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Nutritional Status Determined by Anthropometry

• Underweight: Low weight for age compared to reference
standard, a composite measure of stunting and wasting
• Stunting: Low height for age compared to reference standard,
an indicator of chronic or past growth failure
• Wasting: Low weight for height, an indicator of short-term
nutritional stress

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Other Anthropometric Measurements

• MUAC (mid-upper arm circumference)
• BMI (body mass index): Compares BMI Classification
<18.5 Underweight
height and weight < 16.0 Severe Thinness
16.0-16.9 Moderate Thinness
BMI = Weight (kg) ÷ height (m)2 17.0-18.4 Mild Thinness
• 18.5-24. Normal weight
BMI = Weight (lb) ÷ height (in)2 x 703 • 25-29.9 Overweight
• 30-34.9 Obesity Class I
• 35-39.9 Obesity Class II
• 40-49.9 Obesity Class III
• 50 and above Morbid Obesity

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BMI for Children

• Varies from adult
• Concern for growth problems,
non-communicable diseases
(diabetes)

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Body Volume Index (BVI)

• Currently under evaluation (2020)
• Weight distribution
• Concern over “central obesity”

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Manifestations of Protein-Energy Malnutrition (PEM)

• Kwashiorkor – diet mainly carbs (rice)
• Weight 60−80% weight for age
• Swelling (abdomen and feet), dry flaky
skin, changes in skin and hair, appetite
loss, lethargy
• Marasmus – severe lack of food
• Weight < 60% weight for age
• Frailty, thinness, wrinkled skin, drawn-in
face, possible extreme hunger

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Strategies to Prevent and Control Undernutrition

• Improve household food security
• Improve diversity of diet
• Improve maternal nutrition and health care
• Improve child feeding practices
• Ensure child health care (immunization, medical
care, growth monitoring)
• Provide nutrition rehabilitation

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Nutritional Anemia
• Most common type of anemia
• Caused by malaria, hookworm, and inadequate iron and
vitamin intake resulting in low hemoglobin levels
• Affects mainly children < 5 years old and pregnant women
• Detected by measuring blood hemoglobin levels

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Effects of Anemia
• Adults
• Reduced work capacity
• Reduced mental capacity
• Reduced immune competence
• Poor pregnancy outcomes
• Increased risk of maternal death
• Infants and children
• Reduced cognitive development
• Reduced immune competence
• Reduced work capacity

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Strategies to Prevent and Control Anemia

• Promote iron, folic acid, and B12-rich foods.
• Treat and prevent anemia-related diseases (malaria and
worms).
• Provide iron and folic acid supplements to infants and
pregnant and lactating women.
• Fortify foods.
• Promote vitamin C-rich foods with meals.
• Discourage drinking coffee or tea with meals.
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Case Study 1
• You are working as a nutritionist in a foreign country where food has
been in short supply. A mother brings her 3 year-old daughter to the
clinic. She is worried because the child has a poor appetite, skin
conditions that won’t go away, and excessive diarrhea. Her hair has
gotten lighter. You notice swelling around the child’s ankles. What
might she suffer from? What is the appropriate course of action?

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Case Study 2
• A 28-year-old pregnant woman attending the antenatal clinic
complains of shortness of breath, dizziness, a fast heart rate, and
extreme fatigue. When asked about the foods she has been
eating, she says she’s had little access to meat and fish since her
pregnancy. What nutrition deficiency might she be suffering
from? What action would you recommend?

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Case Study 3
• You and a nurse are community health workers making rounds
to households to assess the general health of children under
five. You notice that most children seem small or thin for their
age and decide to assess weight for age and height for age using
a hanging scale and height board. In the first household, a 24-
month-old boy weighs 13 kg and is 80 cm tall. How would you
characterize this child?

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Introduction Assignment

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