ENERGY METABOLISM

AND NUTRITION PART II

Dr Mir Altaf Ahmad
MBBS, MD(PGI)
Assistant Professor
 Balanced Diet
“A diet is said to be a balanced one, when it includes
proportionate quantities of food items selected from the different
basic food groups to supply the essential nutrients in complete
fulfilment of the requirement of the body”
Defined as one which contains a variety of foods in such quantities
and proportions that
1. Need for energy, amino acids, vitamins, minerals, fats,
carbohydrate and other nutrients is adequately met
2. For maintaining health, vitality and general well-being and
3. Also makes a small provision for extra nutrients to withstand
short duration of illness
 Basis
A balanced diet should be based on:
• Locally available foods
• Within the economic means
• Fit with the local food habits
• Easily digestible and palatable
• Contain enough roughage
materials
Dietary pattern varies widely in
different parts of world
Generally developed according
to:
I. Kinds of food produced (which
depends upon the climatic
conditions of the region)
II. Economic capacity
III. Religion
IV. Customs
V. Tastes and habits of the people
Basic Food Groups
• Basic food groups have been put mainly into 4 (four) groups:
• Milk group: Including dairy products
• Meat group: Including meat, fish, eggs and
pulses/beans/nuts, etc.
• Green leafy vegetables and fruits group.
• Cereal groups: Bread, rice, wheat, barley, etc
• Balanced diet comprises an intelligent assortment of items from
each of these four basic food groups
• Different foods can contribute to the total nutritive value of the
diet
Basic functions of foods (nutrients)
How to Plan a Balanced Diet?
• Age, sex and calorie requirements must
be considered in determining total daily
requirement of nutrients
• Required quantities of food items are to
be selected from the four basic food
groups in such a way that their total
nutritive values satisfy the estimated
requirements
• Diet should be within the purchasing
capacity of the individual
• Cheaper items must be selected and at the same time care should be taken that
nutritional and calorie requirements are fulfilled
Balanced diet suggested by ICMR
ICMR has suggested balanced diet for different age groups, sex, and
under various occupations for physical activity
Contd…
During pregnancy and lactation, additional food is required:

For non vegetarians, ICMR has recommended substitution of a part

of pulses by animal food:
Nutrients and their types
o Are the necessary constituents of food required by organisms for
growth and the maintenance of life
o Five classes of nutrients that contribute to an adequate diet
o Each plays a special role
These may be divided into
Macronutrients
Micronutrients
Macronutrients:
• Are proteins, fats and carbohydrates
Contd…
Form main bulk of food.
Indian dietary pattern, they contribute to total energy intake in following
proportions:
1) Proteins 7 to 15%
2) Fats 35 to 45%
3) Carbohydrates 50 to 70%
Micronutrients
Are vitamins and minerals
Are called micronutrients because they are required in small amounts which
may vary from a microgram to several grams
Do not supply energy but they play an important role in the regulation of the
metabolic activity
Contd…
Help in
Utilization of proteins, fats and carbohydrates
Minerals are also used for the formation of body structure and skeleton
Protein-Energy Malnutrition (PEM)
What is Malnutrition?
Malnutrition is a state arising from:
1. An insufficient calorie intake causing undernutrition or inanition
and/or
2. Insufficient intake of one or more of the essential nutrients,
specially proteins causing deficiency
These two are primary causes and responsible for Marasmus and
Kwashiorkor, respectively
o Most widespread nutritional problem in developing countries
o Predominantly affecting children
Contd…
oPrevalence rate varies from 20–50% in different
areas
Depending on
1. Socioeconomic status and
2. Level of education and awareness

o
Spectrum of PEM
o At one end of malnutrition is marasmus (Greek word, “to
waste”),
o Results from a continued severe deficiency of both dietary
energy and proteins
Contd…
oPrimary calorie inadequacy and secondary protein
deficiency
oAt the other end of the spectrum is Kwashiorkor

oIsolated deficiency of proteins along with adequate

calorie intake is seen.

o Kwashiorkor means “sickness the older child gets, when

the next child is born”

o Term from the local language of Ga tribe of Ghana

WHO classification of malnutrition
% of Body wt. wt. Deficiency in
Type of PEM % compared to Edema weight for height
standard weight
80–60 + +
Kwashiorkor
+ ++
Marasmic <60
Kwashiorkor
<60 Nil ++
Marasmus
<60 Nil Nil
Nutritional
dwarfism
80–60 Nil Nil
Underweight child
Biochemical Alterations in PEM
o Hallmarks of Kwashiorkor are hypoalbuminemia, poor
wound healing and edema.
Kwashiorkor: Hypoalbuminemia is a biochemical
marker (less than 2 g/dL)
In marasmus, this may not be so low

o IgG increases due to associated infections

o Fatty liver is seen in some cases of Kwashiorkor, but
not in marasmus
Contd…
o Fatty liver is due to decreased lipoprotein synthesis

o Glucose tolerance is often normal, but hypoglycemia may

be seen in marasmic children

o Hypokalemia and dehydration may be seen when there is

diarrhea

o Hypomagnesemia is a usual finding

Comparison between Kwashiorkor and
marasmus
Contd…
Contd…
 Treatment of Protein-Energy Malnutrition
o Optimal response is observed with diets providing 150–200 kcal/ kg body
weight and 3–4 g of protein/ kg body weight
o Mixture of three parts of vegetable proteins (Bengal gram or peanuts) and
one part of milk protein is found to be very effective
o Response is monitored by disappearance of edema, rise in serum albumin
level and gain in weight
Sequelae of Protein Calorie Malnutrition
o May not be any sequelae where the moderate and mild forms are corrected
in time

o Severe malnutrition in early life can lead to

Permanent and irreversible
Physical and
Functional deficits.
Deleterious effects on the intellectual capacity in later life
Cachexia
o Seen in advanced cancer, AIDS (HIV infection), tuberculosis, etc
o Patient is seem as seen as undernourished
o Looks like to marasmus
o Loss of body protein is more than that seen in simple malnutrition

Explanation of Cachexiac Mechanism

Production of inflammatory cytokines
o Leads to breakdown of protein by
Ubiquitin or
Proteasome pathway.
o Increase in energy expenditure
o BMR is considerably increased
Contd…
Cytokines stimulate uncouplers, such as thermogenin, leading to
increased oxidation without trapping energy
Futile cycling of lipids occurs, as the hormone sensitive lipase is
activated by proteoglycans secreted by tumors
Most of the tumors preferentially use anaerobic glycolysis, the end
result being lactic acid
This enters the gluconeogenesis pathway in liver, which is an energy
consuming reaction
RECOMMENDED DAILY ALLOWANCE (RDA)
o Defined as the amount of nutrient sufficient for the maintenance
of health in nearly all individuals

o Estimates of allowances are based on the defined minimum

requirement plus a safety margin for most individuals.
 Components of the Dietary Reference Intakes
(DRIs)
• Estimates of the amounts of nutrients required to prevent deficiencies
and maintain optimal health and growth
• DRIs replace and expand on the Recommended Dietary Allowances
(RDA)
• DRI consist of four dietary reference standards for the intake of
nutrients designated for specific age groups, physiologic states, and
gender
1. Estimated Average Requirement (EAR):
• Average daily nutrient intake level estimated to
meet the requirement of one half of the
healthy individuals in a particular life stage
and gender group
• Useful in estimating the actual requirements
in groups and individuals
 Dietary reference intakes
2. Recommended Dietary Allowance (RDA):
o Average daily dietary intake level that is sufficient to meet the nutrient
requirements of nearly all (97–98%) the individuals in a life stage
and gender group.
o RDA is not the minimal requirement for healthy individuals; rather, it
is intentionally set to provide a margin of safety for most individuals
o EAR serves as the foundation for setting the RDA
o If the standard deviation (SD) of the EAR is available and the requirement
for the nutrient is normally distributed, the RDA is set at 2 SDs above the
EAR, that is, RDA = EAR+ 2SDEAR
3. Adequate Intake (AI):
o AI is set instead of an RDA if sufficient scientific evidence is not available
to calculate an EAR or RDA
 Dietary reference intakes
o AI is based on estimates of nutrient intake by a group (or groups) of
apparently healthy people that are assumed to be adequate.
o For example, the AI for young infants, for whom human milk is the
recommended sole source of food for the first 4–6 months, is based on the
estimated daily mean nutrient intake supplied by human milk for
healthy, full-term infants who are exclusively breast-fed
4. Tolerable Upper Intake Level (UL):
• UL is the highest average daily nutrient intake level that is likely to
pose no risk of adverse health effects to almost all individuals in the
general population
• UL is not intended to be a recommended level of intake.
• UL are useful because of the increased availability of fortified foods
and the increased use of dietary supplements.
• UL applies to chronic daily use.
Obesity
Difficult to define obesity

“Anyone who is more than: 20 per cent above the ‘Standard’ weight
for people of the same age, sex and race must generally be considered to be at
least overweight”

“Obesity is that physical state in which the amount of fat stored in the
body is excessive”

“Obesity is due to excess of adipose tissue and is defined as that body

weight over 20 per cent above mean ideal body weight”
Types of Obesity
A. Immediate cause of obesity is always a positive energy balance
Pathological state resulting from consumption of excessive
quantity of food over an extended period
Thus obesity is often divided into 2 types:
a. Exogenous obesity
b. Endogenous obesity
a. Exogenous Obesity:
• Overfeeding and gluttony with less physical activity
• Too fond of their foods which is a pleasure, or are unhappy, foods
give them solace.
Contd…
b. Endogenous Obesity
• May be one or more endogenous factors: endocrinal, metabolic,
hypothalamic lesion
B. Pathologically, the types of obesity are:
a. Hyperplastic type
b. Hypertrophic type
a. Hyperplastic type:
Lifelong obesity
Characterized by an increase in adipose cell number as well as
increase in adipose cell size
Fat distribution is usually peripheral as well as central.
Contd…
After weight reduction, adipose cell size may shrink but the
increased number of cells persist
b. Hypertrophic type:
Adult onset type- after twenty years
Hypertrophy of adipose tissue cells without increase in adipose
cells number
Increase in cell size only
Fat distribution is usually central
Long term response to treatment is good
Anatomic differences in fat deposition
Waist to hip ratio of more than 0.8 for women and more than 1.0 for
men is defined as android, “apple-shaped,” or upper body obesity
Associated with more fat deposition in trunk
Lower waist to hip ratio reflects a preponderance of fat
distributed in the hips and thighs and is called
gynoid, “pear-shaped,” or lower body obesity
Defined as a waist to hip ratio of less than 0.8 for
women and less than 1.0 for men.
Pear shape, more commonly found in women, presents
a much lower risk of metabolic disease, and some studies
indicate it may be protective
Distribution of fat depots
Subcutaneous Depots:
• About 80–90% of the fat stored in the human body is in
subcutaneous depots, just under the skin, in the abdominal (upper
body) and the gluteal-femoral (lower body) regions
Visceral depots:
• 10–20% of body fat is stored in so-called visceral depots (omental
and mesenteric), which are located within the abdominal cavity in
close association with the digestive tract
Excess fat in visceral stores (and in abdominal subcutaneous fat)
increases health risks associated with obesity.
How are regional fat depots biochemically
different
Subcutaneous adipocytes from gluteal-femoral, particularly in
women, are larger, very efficient at fat deposition, and tend to
mobilize fatty acids more slowly than those from the abdominal
subcutaneous depots
Visceral adipocytes are the most metabolically active
Both abdominal subcutaneous and visceral depots of obese
subjects have high rates of lipolysis and contribute to increased
availability of free fatty acids
Adiponectin, an adipocyte-derived cytokine, reduces levels of
blood free fatty acids and has been associated with improved lipid
profiles, better glycemic control, and reduced inflammation in
diabetic patients.
Contd…
Cytokines well as free fatty acids released from abdominal fat,
enter the portal vein and, therefore, have direct access to the liver
Fatty acids and inflammatory cytokines released from visceral
adipose tissue are taken up by the liver
They may lead to insulin resistance and increased synthesis of
triacylglycerols, which are released as very-low-density
lipoprotein (VLDL) particles and contribute to
hypertriglyceridemia
Free fatty acids from subcutaneous body adipose depots enter the
general circulation where they can be oxidized in muscle and,
therefore, reach the liver in lower concentration.
Assessment of obesity
• Indirect measure
• Degree of obesity is commonly assessed by means of the body
mass index (BMI)

• Measuring the waist size

with a tape measure is also
used
• Reflects amount of fat in
the central abdominal area
of the body
Causes of Obesity
Commonly due to overeating than the caloric requirement
Obesity can be encountered with other diseases, viz. certain
metabolic disorders, and endocrine disorders
Causes of obesity as listed below:
a. Genetic influences
b. Physiological:
• Overeating than caloric requirement.
• Pregnancy.
• Postmenopausal women.
• Use of oral contraceptives for prolonged periods.
Contd…
c. Metabolic:
• Diabetes mellitus maturity onset (Type II).
• Hyperlipidaemic states specially, type IV and type V

d. Hypothalamic injuries or abnormalities (e.g. Prader-Willi

syndrome)

e. Miscellaneous and endocrine disorders:

Hypothyroidism, Cushing’s disease and Cushing’s syndrome,
pseudohypoparathyroidism, islet cell tumour (insulinoma),
polycystic ovary syndrome
Pathogenesis of obesity
Genetic and Other Factors in Obesity
Age:
• Immoderate accumulation of adipose tissue may occur at any age but is
more common in middle life
Sex:
• Adult women are more prone to obesity as compared to men
• Normal fat content of an average young woman, approximately 15 per
cent of body weight, is twice that of young men of comparable age
• Women in menopausal period become usually obese
• Also more frequent in pregnancy and women on oral contraceptives
Contd…
Genetic factor:
• A genetic factor may be identified in many cases, but its mode of
transmission and operation is still not known
Psychological factors:
• People who are suffering from anxieties, worries, and under constant tension
or are frustrated, they eat more to compensate
Hypothalamic factor:
• Two mechanisms within the hypothalamus
• If certain lateral centers are bilaterally destroyed, aphagia results
• When the medially controlled centers are bilaterally destroyed, the lateral
“feeding” areas are freed of their usual regulatory checking action and
hyperphagia occurs.
Contd…
Epidemic encephalitis:
• Such cases hypothalamic lesions have been found which resemble
those known to cause experimental obesity
Endocrine factors:
Fröhlich’s syndrome:
• Characterised by hypogonadism and obesity, has been considered
the result of hypopituitarism
Cushing’s syndrome: Adrenocortical hyperfunction
• Often associated with an increase in body fat mainly confined to
the head, neck and trunk (turncal obesity and buffalo hump)
Contd…
Functional or organic hypoglycaemia (hyperinsulinism)
• Frequently associated with abnormal hunger leading to excessive
food intake and obesity
Hypothyroidism
Hypogonadism
METABOLIC CHANGES IN OBESITY
• Various metabolic abnormalities observed in obesity are not
permanent in nature
1. Changes in Fat Metabolism:
• Serum triglyceride level increase is seen characteristically in
obesity
Contd…
• Obesity associated with type IV and type V
hyperlipoproteinemia's, along with hypertriglyceridemia, there
may be slight to moderate hypercholesterolemia
• Fatty acid mobilization from adipose tissue appears to be less
affected and is normal in obesity
• Lipoprotein lipase activity has been found to be increased in
adult-onset type of obesity (hypertrophic type)
2. Changes in carbohydrate metabolism:
• Obesity is associated with hyperinsulinaemia
• Aggravate obesity by promoting lipogenesis and inhibiting
lipolysis
Contd…
• Insulin resistance is associated with obesity
• Through internalization of the insulin-receptor complex
3. Changes in acid-base status:
• Massive obesity may be associated with alveolar hypoventilation
leading to CO2 retention
• PCO2 may be high ↑
• This can bring about certain personality changes, fatiguability,
dyspnoea and somnolence, called as “obesity-hypoventilation
syndrome” (Pickwickian syndrome).
Contd…
4. Energy metabolism in obesity:
• BMR is usually normal in obese subjects
• Energy expenditure per unit mass is the same as in normal people
• Since BMR of an obese person is normal and his surface area large,
his total O2 consumption must be greater than normal
• May be as much as 25 per cent more than that of normal persons of
the same age
Clinical Importance Of Obesity
• More prone than the average populations to certain disease
processes
Clinical Importance Of Obesity Contd…
• Diabetes mellitus type II (maturity-onset).
• Cardiovascular disorders: Hypertension, angina of efforts, widespread
atherosclerosis, varicose veins and thromboembolism.
• Liver diseases: Prone to develop fatty liver, cholelithiasis and
cholecystitis.
• Physical consequences of too much fat:
– Bronchitis
– Alveolar hypoventilation associated with massive obesity eventually
leading to CO2 retention
– Backache, arthritis of hips and knee joints, flat feet
– Hernias, ventral and diaphragmatic.
Clinical Importance Of Obesity Contd…
• Metabolic diseases: Like gout (hyperuricaemia).
• Skin disorders: Intertriginous dermatitis. Intertrigo is quite
common in the folds below the breasts and in the inguinal regions.
• Gynaecological disorders:
Amenorrhoea, oligomenorrhoea, Toxaemia of pregnancy; and
Endometrial carcinoma.
• Surgical postoperative complication: Surgical “risks” in general is
greater in obesity.
• Industrial, household and street accidents: Obese persons are
susceptible to these accidents.
 Hormones of Adipose Tissue and Its Role in
Obesity
Two peptide hormones are produced by adipocytes
1. Leptin
2. Adiponectin
Leptin
• 16 kDa protein hormone
• Discovered in 1994 by Jeffrey M Friedman and colleagues at the
Rockefeller University
• Gene “ob (lep)” is located in humans on chromosome 7.
• Hormone because it is produced by adipose tissue cells abut acts
through brain receptors
• Circulates at levels proportional to body fat
Contd…
• Receptors for leptin are found in brain neurons involved in
regulating energy intake and expenditure
• It also controls food intake (appetite) and energy expenditure by
acting on receptors in mediobasal hypothalamus
• Leptin interacts with six types of receptors which in turn are
encoded by single gene LEPR
• Ob-rb is the receptor isoform present in hypothalamic nuclei
• One of the main effects on gene expression is the down regulation
of the expression of “endocannabinoids”, responsible for
increasing appetite.
Contd…
• When we consume fewer calories than we need, body fat declines and
leptin production from the fat cell decreases
• Body adapts by minimizing energy utilization (decreasing activity) and
increasing appetite, closing the feedback loop that regulates body
weight.
• Meal or overeating increases leptin and this should, in theory, dampen
appetite and prevent overconsumption of calories
• Other cues that stimulate appetite can apparently overcome the leptin
system in many individuals.
• Obese individuals are also hyperinsulinemic
• Like leptin, insulin acts on hypothalamic neurons to dampen appetite.
Contd…
• Leptins can also be produced in small amounts by other tissues,
viz. brown adipose tissue, placenta (syncytio trophoblasts), ovaries,
mammary epithelial cells, bone marrow pituitary and liver
• Leptin is a circulating signal that reduces appetite
• Obese people have an unusually high circulating concentration of
leptin
• Obese people are thus considered to be resistant to the effects of
leptin same way that people with type 2 diabetes are resistant to
the effects of insulin
• Mutation in leptin produces hyperphagia
Contd…
• Absence of food intake (between meals), stomach produces ghrelin,
an orexigenic (appetite-stimulating) hormone that drives hunger
• During a meal, gut hormones, including cholecystokinin (CCK)
and peptide YY (PYY), through actions on the gastric emptying and
neural signals to the hypothalamus, cause satiety and meals are
terminated.
• Within the hypothalamus, neuropeptides such as NPY and α-
melanocyte stimulating hormone (α-MSH), and neurotransmitters
such as serotonin and dopamine are important in regulating
hunger and satiety
Contd…
Adiponectin
• Polypeptide consisting of 244 amino acids
• Produced and secreted by adipocytes
• Encoded by the ADIPOQ gene
• Automatically self associates into larger polymeric
forms, viz. homotrimers, hexamers, etc
• Females have increased proportions of high molecular weight forms
• Exerts its effects through brain
• Action similar to leptin
• Two hormones perform complementary actions and can have additive
effects.
Contd…
Structure of Adiponectin:
Structurally it has 4 distinct regions:
• First is a short signal sequence that targets the hormone for
secretion outside the cell
• Next is a short region that varies between species
• Third is a 65 amino acid region with similarity to collagenous
proteins
• Last is a globular domain
• Globular region was determined, a striking similarity to TNFα was
observed
Contd…
• So far three receptors have been identified
• These receptors are:
1. ADIPOR 1—Adiponectin receptor 1.
2. ADIPOR 2—Adiponectin receptor 2.
3. T-Cad—T-Cadherin
• Receptors affect the downstream target “AMP kinase”
Metabolic effects and functions of adiponectin:
• Increases glucose by glucose uptake and gluconeogenesis (glucose flux)
• Lipid catabolism—β-oxidation increases and triglyceride clearance
Contd…
o Protection from endothelial dysfunction (important facet in
atherosclerosis formation).
o Insulin sensitivity.
o Weight loss—Adiponectin exerts some of its weight reduction
effects via the brain.
o Control of energy metabolism
o Levels are inversely correlated with body fat percentage in adults
o Plays a role in the suppression of the metabolic derangements
that may result in type-2 diabetes, obesity, atherosclerosis,
nonalcoholic fatty liver disease (NAFLD)
Antiobesity Vaccine
Scripp’s vaccine:
o Recently, scientists at the Scripp’s Research Institute claim they
have developed an antiobesity vaccine that significantly slows
weight gain in experimental mice, by tackling the “ghrelin”
o Naturally occurring hormone that helps regulate energy balance
in the body
Cytos antiobesity vaccine:
• Cytos, a swiss based biotechnology company is already testing
different vaccines on humans.
• Cytos vaccine works in adifferent way than the Scripp’s vaccine,
preventing the uptake of ghrelin by the brain.
Metabolic syndrome
o Abdominal obesity is associated with a cluster of metabolic
abnormalities referred to as the metabolic syndrome
o Includes glucose intolerance, insulin resistance, hyperinsulinemia,
dyslipidemia (low HDL and elevated triacylglycerols), and
hypertension
o Metabolic syndrome is also associated with a state of chronic
systemic inflammation that contributes to the pathogenesis of
insulin resistance and atherosclerosis
o In obesity, low levels of the adipocyte hormone adiponectin hat
normally dampens inflammation and sensitizes tissues, especially
the liver, to insulin, may contribute to the metabolic syndrome and
therefore the risk of type 2 diabetes and heart disease.
Nutritive value of milk
• No other single food has as many nutritional virtues as that of milk
• Milk supplies proteins of high biological value, easily digestible fats,
lactose (milk sugar) and calcium, phosphorus, vit A and certain B-
vitamins in sufficient amounts
• It is not a perfect food since it lacks Fe, Cu and vitamin C
Chemistry of Milk
(a) Proteins
Chief proteins are:
1. Caseinogen
2. Lactalbumin and
3. Lactoglobulin.
Contd…
Caseinogen:
• Is a phosphoprotein (0.7% P)
• Carries Ca++ bound with it
• Is more in amount in cow’s milk (2.8%) as compared to human
milk (0.5%)
• Boiling of milk increases digestibility of casein
• Bovine caseins are more difficult to digest than human milk casein,
as bovine caseins form harder calcium paracaseinate during milk
digestion due to higher Ca++: casein ratios
Contd…
Lactalbumin and Lactoglobulin
• Have also very high biologic values and both are good proteins
• Lactalbumin is heat-coagulable and is most easily digested
(b) Lipids:
• Milk fats are in the form of very fine and stable emulsion
• Are the most palatable and digestible fats known
• Differs from other fats in containing all saturated even carbon FA from butyric
(C4) to lignoceric acid (C24)
• As well as a variety of unsaturated FA, viz. oleic acid, linoleic, linolenic and
arachidonic acid.
• About 30 per cent of FA in milk TG contains polyunsaturated fatty acids
• Human milk differs from cow’s milk in FA composition.
Contd…
• 10 per cent of human milk FA are highly unsaturated (linoleic,
linolenic, etc.) as opposed to 0.5% of cow’s milk

• Total fat content in human milk is 4.0 gm% as compared to cow’s

milk 5.0 g%
• Other lipids include cholesterol and phospholipids in small
quantities

• Boiling reduces the fat content of milk as some of the fat separates
along with some of the coagulated lactalbumin as a floating layer
of clotted cream
Contd…
(c) Carbohydrates:
• Principal carbohydrate present is the disaccharide Lactose (milk
sugar)
• Human milk contains 7.0 g% as compared to cow’s milk 5.0 g%
(d) Minerals:
• Milk is rich in mineral elements specially calcium, phosphorus,
potassium, sodium, chloride and zinc
• Milk is poor in iron and copper
• About 120 mg Ca and 90 mg of P are present in 100 ml of cow’s
milk
Contd…
• Amounts are higher in buffalo’s milk but much lower (Ca = 40
mg% and P = 30 mg%) in human milk.
• Calcium is present in combination with casein, as free Ca++ and as
inorganic phosphates.
• Phosphorus is present as phosphoprotein casein, as inorganic
phosphates and non-protein organic PO4 esters
(e) Vitamins:
• Milk is a good source of vitamin A but it contains very little
vitamin D
• Unless it is fortified and enriched by adding vit D or by
irradiation with UV rays
Contd…
• α-Tocopherol content of human milk is about twice that of bovine
milk.
• Vitamin C content of milk is very low
• Pasteurisation destroys ½ of the original content
• Milk has rather low concentrations of soluble B-vitamin group,
but comparatively rich in riboflavine (B2) and good in thiamine (B1)
Human milk:
Differs markedly from cow’s milk in several ways:
• Protein content of human milk is far lower
• Lactose content is much higher
Contd…
Humanisation of cow’s milk:
• Cow’s milk, when fed to newborn babies must be diluted with
water
• To lower its protein content to that of human milk
• Lactose, glucose, maltose or sucrose must be added to it to raise its
sugar content to the level of human milk
• This process is known as humanization of cow’s milk
Colostrum:
• Secretion of the lactating mammary glands during the first few
days of lactation (first 4 to 5 days) after parturition is called
colostrum.
Contd…
• Thick, viscous yellow liquid and is heat coagulable due to
presence of increased amounts of globulins and lactalbumins

• Colostrum is richer than mature milk in proteins, vit. A and D, α-

tocopherols and calcium, but comparatively poorer than mature
milk in casein, fats and lactose

• Total protein content is twice as much

• Globulins which are the highest include some lactoglobulins and
various Igs (immunoglobulins) coming from the maternal blood
Contd…

• These immunoglobulins may be absorbed from the small intestine

of newborns probably by ‘pinocytosis’ and confer temporary
immunity

• A trypsin-like inhibitor present in colostrum may help to preserve

the Igs in the alimentary canal of newborns by preventing
hydrolysis.

• Colostrum also contains larger amounts of B-vitamins like

thiamine, riboflavine and folic acid.
Thank You