Nutrition Sensitive Agriculture

Module 1+2 – Introduction to Nutrition

Israel 2020
Editors: Dana Efrati Philip & Tzori Brickner
 Why do we grow food?
Food as a commodity vs a source for nutrition
 What is an adequate nutrition?

‘Food security’ exists when all people, at all times, have

physical, social and economic access to sufficient, safe
and nutritious food to meet their dietary needs
and food preferences for an active and healthy life.

FAO. Trade reforms and food security. Rome

 Sustainability

Food Security
Availability: Access: Utilization:
The “supply side” of Physical, social and good care and
Availabilit
food security. feeding practices, food

Utilizatio
economic access.

Determined by:
food production, stock
levels and net trade.
y
Stability
Access
Economic access is preparation, diversity of the diet
determined by: and intra-household distribution of
incomes, expenditure, food, health status.

n
Global/national level. markets and prices. This determines the nutritional
Often household level. status of individuals.
Why is an adequate nutrition important?
 General Definitions
• Nutrients are chemical substances in foods that are
used by the body for sustenance and growth.
There are 6 categories of nutrients: Carbohydrates,
proteins, lipids, vitamins, minerals and water.
• Calories (Kcals, Kilocalories) are a unit of measure of
the amount of energy supplied by food
What is the difference between a Food item and a
Nutrient?
 Nutrients - Macronutrients
Carbohydrates Protein Fats and oils (Lipids)

Legumes, Dairy, Meat

 Nutrients - Micronutrients
Vitamins and minerals
 Essential nutrients

Nutrients required for sustenance and growth, which

cannot be synthesized by the body, and must therefore
be provided by the diet, are considered essential.

Essential Amino Acids Essential Fatty Acids Vitamins and Minerals

Fast Track Diet: WHAT SHOULD WE EAT
In a way, Even the genetic and epigenetic
differences we posses cannot change the
mere fact that we are rather similar in so
many aspects.
So does in our nutritional requirements, in
many senses.
Fast Track Diet: WHAT SHOULD WE EAT
Eat Plenty of Fruits and Vegetables.
Cut Refined Sugars.
Focus on Enough Proteins.
Consume at least a cup of cooked Pulses
and Legumes.
Drink water, not sugar-sweetened drinks.
Macronutrients
Carbohydrates
Why Do We Consume Carbohydrates?
Energy.

But also for other Anabolic reasons:

Glycolipids, Glycoproteins
Not all carbohydrate sources are equal
Q: Why do we
consume so many
refined grains and
flour products?

A: The whole-grain
flour has shorter
shelf life and takes
longer to mill.
Refined carbohydrates increase blood sugar level
Mono and disaccharides and Morbidity/Mortality
Problem: The in vitro and in vivo
mechanisms involved are precarious What is the status in different
Are fruits the same as soft drinks?
and may cause increased regions in the world?
lipogenesis under certain conditions

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463205/ Yang, L., et al 2017. Am J of Pub H, 107(7),

Dietary fiber
Benefits of Dietary Fiber
Benefits of Dietary Fiber
Maki et al. 2018, Cell Host and Microbiome Muller et al. Nutrients. 2018 Mar; 10(3): 275.
https://doi.org/10.1016/j.chom.2018.05.012 10.3390/nu10030275
 Protein
• Polymers made of amino acids, nitrogen containing
compounds, linked by peptide bonds.
• There are structural proteins (like collagen) and functional
proteins (like enzymes, receptors, transporters).
Protein metabolism
Nitrogen Balance
Essential amino acids
 Essential
Amino Acids
Protein Sources and Quality
Lipids and Fatty Acids (FA)
 Lipids Functions
• Function as the main form of energy storage in the body –
9 kcal/g in the form of triacylglycerol.
• Main constituents of cell membrane and regulate membrane
permeability
• Protect internal organs from trauma and shock, serve as
insulating material to maintain body temperature.
• Serve as storage of fat soluble vitamins – A, K, E, D
• Essential fatty acids are useful for transporting cholesterol and
formation of lipoproteins
 Monounsaturated FA (MUFA) – Ω9 (Oleic)
• MUFAs, monounsaturated fats, are fatty
acids that have one double bond in the
fatty acid chain
• Oleic acid 18:1 (n-9) has 18 carbon atoms
with the first double bond occurring 9
carbon atoms away from the carboxylic
acid group
 Polyunsaturated FA (PUFA) – Ω3
• Contain more than one double bond in their
backbone. This class includes many important
compounds, such as essential fatty acids.
 Polyunsaturated FA (PUFA) – Ω3

Omega-3s can
promote brain
health during
pregnancy and early
life and improve risk
factors for heart
disease.
Omega 3 – food sources
Vitamins and Minerals
 Vitamin A – Retinol and Beta-carotene
• Vitamin A is the name of a group of fat-soluble retinoids,
including retinol, retinal, and retinyl- esters.

https://www.youtube.com/watch?v=B53de17Isnc
 Vitamin A – Functions
• Vision
• Gene transcription
• Immune function
• Embryonic development
• Bone metabolism and growth
• Necessary for normal functioning of epithelial cells – in
the intestinal, respiratory, urinary tract, skin and eyes
• Antioxidant activity
The role of vitamin A in vision
 Vitamin A – Sources

1 IU is the biological equivalent of 0.3 mcg

retinol, or of 0.6 mcg beta-carotene.
 Vitamin A - Deficiency
• Inflammation of the eye, poor vision and night blindness.
• Cell keratinization –
– Xerophthalmia – dryness of the cornea & conjunctiva.
– Dry skin
• Reproductive failure
• Immune disfunction
• Respiratory infections
• Abnormal skeletal development or maintenance
 Xerophthalmia
Top left:
Bitot’s spots

Top right:
Corneal xerosis

Bottom left:
Corneal ulcerations –
Keratomalacia

Bottom right:
Corneal scars –
permanent blindness
 Measles
• A highly contagious infection caused by the measles virus.
• Initial signs and symptoms typically include fever, cough, runny nose,
and inflamed eyes.
• Koplik's spots.
• A rash which usually starts on the face and
then spreads to the rest of the body.
• Complications may include diarrhea,
blindness, inflammation of the brain,
and pneumonia among others.
 Vitamin A excess from supplements
• Excess amounts are stored primarily in the liver, and
can accumulate
• Excess preformed vitamin A can have significant
toxicity (known as hypervitaminosis A)
• Large amounts of beta-carotene and other
provitamin A carotenoids are not associated with
major adverse effects
Daddy says I can
eat a Polar Bear,
That is so 1943.
And Now, This
 Vitamin C – Ascorbic Acid
• Water-soluble
• Required for the biosynthesis of collagen, L-carnitine,
and certain neurotransmitters;
• Protein metabolism
• Reducing agent – antioxidant activity
• Immune function
• Absorption enhancer of cations like (non-haem) iron
The Interesting Tale of Vitamin C
Once upon a time…
 Vitamin C - Sources
• Strawberries, raspberries, blueberries, and cranberries
• Citrus fruits and juices, such as orange and grapefruit
• Kiwi fruit
• Mango
• Papaya
• Broccoli
• Watermelon
• Bell peppers
• Cantaloupe
 Vitamin C - Deficiency
Insufficient vitamin C intake causes scurvy, which is
characterized by
• fatigue or lassitude
• widespread connective tissue
weakness
• capillary fragility
 Vitamin C food preparation notice

Vitamin C is sensitive to heat and gets destroyed when

food is boiled!
B1 - Thiamin
 BeriBeri – It’s still here

PLoS Negl Trop Dis. 2017 Sep; 11(9): e0005814.

B3 - Niacin

???
In short, the problem with a very limited diet is
the direct inadequacies that may result from it.
Such as the case of Pellagra an its three D’s –
Diarrhea, Dementia and Dermatitis.
 Folate (B9)
• Nucleic acid synthesis –
DNA synthesis and methylation
• Cellular methylation reactions, growth and repair
• Synthesis and conversion of amino acids
• Neural system development
• Cognitive functions
One Carbon Metabolism
 Folate - Sources
• Leafy greens
• Liver
• Broccoli and
cauliflower
• Oranges
• Kidney beans
Folate - Deficiency
 Vitamin B12 (Cobalamin)
• Works as an enzyme in the process of DNA synthesis
and one-carbon metabolism
• Found in animal food sources only
(and bacteria)
• Lower absorption with age
 Vitamin B12 - Deficiency
• Megaloblastic anemia caused by impaired DNA
synthesis
• Can lead demyelination of nerve fibers, which can
result in severe, irreversible neurological damage
• Neuropsychiatric symptoms: Cognitive impairment,
hallucinations, dementia.
 Iron
• An essential mineral
needed to form
Haemoglobin
Haem and non-heam iron - Sources
Iron absorption – Haem and non-haem
 Iron - Deficiency
Iron deficiency anemia
(IDA) is a condition in which
the body lacks enough red
blood cells to transport
oxygen-rich blood to body
tissue.
 Untreated iron deficiency anaemia:
• Increases risk of illness and infection due to effect on
the immune system
• Increases risk of developing complications that affect
the heart or lungs – such as an abnormally fast
heartbeat (tachycardia) or heart failure
• In pregnancy - can cause a greater risk of
complications – before and after birth
 Iodine
• Iodine is an important component of the
hormone Thyroxine secreted by the
thyroid gland.
• The hormone Thyroxine regulates
physical and cognitive growth and
development of the body.
 Iodine - Sources
• Seafood
• Dairy, where iodine exists in soil and feed
• Iodized salt
 Iodine - Deficiency
• Cretinism
• Goiter
• Hypothyroidism
• Sub-clinical – lowered IQ
 Zinc
• Epidermal integrity and resistance
• Antioxidant
• Sex hormones, insulin and serotonin
• Gene transcription and genome stability
• MMPs - metalloproteins
• Immunity – neutrophils, killer cells, macrophages
Zinc - Sources
 Zinc - Deficiency
• Weakened immune system
• Inability to protect cells’ membranes from viruses, toxins
complement, and venoms
• Poor appetite
• Mental lethargy
• Chronic diarrhea
• Growth failure
• Vision problems
 Calcium
• Skeletal mineralization
• Maintenance of normal muscle
tone and muscle excitability
• Neural transmission
• Blood coagulation
• Plasma buffering
• Enzyme activity
 Calcium - Sources
• Dairy products
• Small fish
• Leafy greens (bioavailability)
• Pulses
• Almonds
• Sesame seeds
 Calcium - Deficiency
• Bones –
osteopenia and
osteoporosis
Phytochemicals
 Nutrient-rich vs nutrient-poor foods
• Nutrient density
– How much nutrients per 100g or 100kcal of food?
• Whole foods vs processed foods
– Nutrients are lost during food processing
• Ultra-processed foods
– Are very poor in nutrients even if high in energy
 Bioavailability
• The proportion of the element consumed that is utilized for
biochemical or physiological functions (O’Dell 1977)
 Absorption inhibitors “Anti-nutrients”
• Phytic acid
• Polyphenols
• Tannins
• Oxalates
Phytic Acid in Cereals
Phytic Acid in Legumes
 Oxalates
Oxalates are compounds derived from
oxalic acid and found in foods such as
spinach, kale, beets, nuts, chocolate,
tea, wheat bran, rhubarb, strawberries
and herbs such as oregano, basil, and
parsley.
It binds with Fe, Ca, and Mg, rendering
these minerals unavailable to animals.
 Calcium bioavailability and oxalate

Kale, turnip greens, Chinese

50% High oxalate – Low bioavailability
cabbage, and bok choy

White beans, almonds, tahini, 20%

figs, and oranges

Spinach, beet greens, and 5% High oxalate – Low bioavailability

Swiss chard
 Nutrient content of foods – Composition tables
COMPOSITION IN TERMS OF 100 GRAMS EDIBLE PORTION
FOOD AND LOCAL NAME
DESCRIPTION Food
LOCAL NAMEMoistu Nitroge Protei Fat CHO Fiber Ash Calcium Phospho Iron Zinc Copper SodiumPotassi RE Thiamin Ribofla Ascorbic
ITEM No. Food Moisture Nitrogen Protein Fat CHO Fiber Ash Calcium Phosphorou iron β-carotene Thiamine Riboflavin Niacin Tryptopha Ascorbic Refuse
DESCRIPTION Energy re n Energyn (inc.fib (inc.fiber) rous s Equiv. um e n vin
acid Acid
CEREALS & CEREAL PRODUCTS Calories % Gramser) Grams Grams Grams Grams Grams Milligrams Milligrams Milligrams Micrograms Milligrams Milligrams Milligrams Milligrams Milligrams %

CEREALS & CEREAL

1 Calorie
Barley, black, Hordeum vulgare Percen
Gebs, t'iqur, duqyet Grams
370.90GramsGram
8.10 1.60Grams
10.10 Gram
1.70 Gra 78.80Milligra
2.40 Milligra
1.30 Milligra290.00
28.00 Milligra9.60
Milligra0.00
Milligra Milligra- Microgr
0.27 - Milligra
- Milligra
0.00 Milligram
-
L.: flour
BASED PRODUCTS2 t injera
Barley, black, Hordeum vulgare Gebs, t'iqur, 124.90 68.30 s 0.54 3.40 s 0.10 ms27.60ms 0.80 ms0.60 ms
34.00 ms
96.00 ms
3.60 ms 0.13ms 0.07ams 1.00 m -
0.00 ms
0.00 s
0.00
L.: enjera
3 Barley, black, Hordeum vulgare Gebs, fiqur, dabbo 195.50 50.50 0.81 5.10 0.40 42.90 1.10 1.10 13.00 144.00 5.10 0.00 0.20 0.09 1.90 - 0.00 0.00
L.: bread
Barley flour 4 Buratu (Bale)
Barley, black,
556.00 4.60 1.06
Hordeum vulgare Gebs, t'iqur, genfo 150.30
6.60
68.50
37.20
0.39
49.90
2.40
1.30
6.30 21.00
18.60
0.80
147.40
1.80
3.20
20.00
1.24
76.00 2.70
0.25 0.00207.500.10222.50
0.15
28.10
1.10
0.02
-
0.30
0.00 0.00
0.00
L.: porridge
(roasted) + butter
S
+ Barley, black, Hordeum vulgare Gebs, t'iqur, kikk, 374.80 7.00 1.63 8.90 1.60 81.20 2.00 1.30 22.00 274.00 7.40 0.00 0.27 - 3.70 - 0.00 16

spices 6
L.: split, raw
Barley, black, Hordeum vulgare
yalteqeqqele
Gebs, t'iqur, kikk, genfo 134.60 74.50 0.26 1.60 7.40 15.40 0.20 1.10 27.00 58.00 1.20 0.00 0.07 0.03 0.60 - 0.00 0

Barley flour 7 HazoL.: split porridge

76.00 80.10 0.50 3.10 0.70 15.10 0.70 1.00 49.30 106.60 2.60 0.52 0.45 135.30 152.60 70.00 0.06 0.04 0.00
Barley, black, Hordeum vulgare Gebs, t'iqur, kikk, nifro 69.00 81.40 0.27 1.70 0.30 14.90 40.00 1.70 32.00 56.00 1.50 0.00 0.08 0.03 0.40 - 0.00 0
(roasted) + whey + (Tigray/Eastern
L.: spilt,boiled

chili + salt: sauce Zone)

Barley flour Firfiro (Bale) 232.00 39.70 0.76 4.80 9.30 45.00 1.00 1.20 22.90 84.90 3.40 1.14 0.39 263.30 183.20 16.50 0.04 0.03 0.00
(roasted) + butter +
spices
Barley, Hordeum Benga-shasha 373.00 2.90 1.44 9.00 2.00 83.80 4.10 2.30 76.00 344.00 31.50 1.80 1.75 34.00 539.00 8.00 0.03 0.09 0.00
vulgare L.: roasted (Dorze)

Barley flour Michiro (Bale) 447.00 7.20 1.34 8.40 18.00 64.60 1.70 1.80 26.90 299.20 3.40 1.80 0.32 287.70 275.70 10.30 0.03 0.11 0.00
(roasted) + butter +
spices
?(So, How Much Should We Eat (Adults Only
Carbohydrates: Proteins:
45-65% of Total Energy 0.6-1.2~ grams/kg

Fat:
30-50%~
Mostly PUFA and MUFA, 10% SFA

Vitamins and Minerals:

According to DRI
 Food Patterns
Or as some call it: Diets
The Favorite: Mediterranean Diet
 Show me the evidence!
Systematic Review Here, and Here
The Cool Kid: Low Carb
Show me the evidence!
Rather Controversial.
The Future? Vegan/Vegetarian Diet
Show me the evidence!
So 2019: Intermittent Fasting
Show me the evidence!

Special attributes
Remain uncertain
Detox: The Lie
So, Who’s better?
Let’s discuss!