Nutritional Disorders

1. An adequate diet should contain:

§ Energy, essential AA and fatty acid, vitamins and minerals

2. Protein energy Marasmus Kwashiorkor

malnutrition (PEM) ↓ protein, carbs, fat ↓Protein
§ in third world countries
§ a range of clinical syndromes Weaned children, fed on
§ ↓protein and calories CARBS
a. There are 2 protein
Only
No Enlarged fatty liver
compartments in the body
§ Somatic è skeletal muscles
0
of
No edema Edema, skin lesion, hair
§ Visceral è liver changes, apathy, 2nd
infections

3. Eating disorders
Anorexia Nervosa Bulimia

is self-induced starvation è marked weight loss. patient binges on food and then induces vomiting.
Hypokalemia è Cardiac arrhythmias and sudden 1. Electrolyte imbalances (hypokalemia)è

F
death cardiac arrhythmias
2. pulmonary aspiration of gastric Contents
3. esophageal and stomach cardiac rupture.

4. Vitamin Deficiencies
§ 30 vit necessary for health
IBA
§ Fat soluble: D E A K ! ‫دﯾﻚ‬
§ The rest are water soluble
§ Vitamin synthesized endogenously?
- D, K, Niacin
 VIT. D
VIT. A
function: maintenance of normal plasma levels of
Function:
calcium
Ca 2T
1. normal vision
deficiency: (hypocalcemia)
2. differentiation of specialized epithelial
Childrenà rickets cells
3. ↑ immunity
Adultà osteomalacia
deficiency:
Complications of rickets (children) :
1. Night blindness
1. Craniotabes 2. epithelial metaplasia
2. Frontal bossing due to excess osteoid
3. Squared appearance of the head
4. Rachitic rosary
5. Pigeon breast deformity VIT. E
6. Harrison’s groove function: antioxidants
7. Lumbar lordosis
8. Bowing of the legs VIT.K:
Complication (adults): function: cofactor for liver microsomal
carboxylase (glutamyl residues àγ-
1. Weak bone, vulnerable to gross fractures or carboxyglutamates)
microfractures
2. unmineralized osteoid à thickened layer of deficiency:
matrix arranged about the more basophilic,
normally mineralized trabecula - Bleeding diathesis characterized by
f hematomas

II
Response to excess vitamin D is hypercalcemia à - Hematuria
- Malena
1. nephrolithiasis - ecchymoses mainartiaaing
2. nephrocalcinosis - bleeding from the gums
3. ectopic calcification - prophylactic vitamin K therapy for all
newborns

B-Complex Vitamins (conenzymes)

1. Thiamine Deficiencyè Beriberi
- Dry beriberi (polyneuropathy)
- Wet beriberi (cardiovascular) neuro dB YE
w 9sEgg
- Wernicke-Korsakoff syndrome
2. Folate Deficiencyè neural tube defects

NTDs
 VIT.B12

Deficiency: seen in è PERNICIOUS ANEMIA =↓intrinsic factor è no absorption of

vitamin

T.net
↓ Vit.B12 + ↓ Folic Acid = megaloblastic/macrocytic anemia

EI
VIT.C (ACORBIC ACID)
- involved oxidation-reduction reactions and in proton transfer
- Proline hydroxylation to form the hydroxyproline of collagen
- Wound healing and immune functions
• Deficiency à SCURVY
1. Poor wound healing
2. Poor collagen synthesis
3. Ecchymoses and purpura in skin and gingival mucosa
4. Hematomas
5. Skeletal changes

MINERALS
Trace Minerals:

1. IODINE à thyroid function

2. IRON à hemoglobin
feMicrocystic Miheralsf
Mineral Deficiencies Macaronecmygetic
bfnatei.BR
1. Hypochromic microcytic anemia (defective heme synthesis)

OBESITY
• Central obesity= ↑risk for several diseases
• balance is maintained by an internal set point, or "lipostat," that can sense the
quantity of the energy stores (adipose tissue) and appropriately regulate the food
intake as well as the energy expenditure.
• LEPTIN à INHIBIT HUNGER

C
• GHERLIN à HUNGER HORMONE
• a-MSH, CART = reduce food intake