Introduction to Nutrition

• Importance of Nutrition in Health & Disease

• Principles of Nutrition
Learning objectives

• Why is Nutrition important? Why do we need to know it?

• Define Nutrition and know what is meant by Clinical Nutrition.

• Define the terms (principles) Nutrient Balance, Flux and Turnover, Metabolic
Pools and Adaptation to altered nutrient supply.
“A leading GP estimated that up to 80% of his
patients had conditions linked to lifestyle and diet.”

Dr Fiona Godlee, editor-in-chief of the BMJ: "It's time we recognised

that food and nutrition are core to health. There is a growing body of
research out there that needs to be published - and we want to
contribute to that effort."
http://nutritank.com/about/
https://blogs.bmj.com/bmj/2017/09/07/medical-schools-should-be-
prioritising-nutrition-and-lifestyle-education/
 Obesity 'biggest threat to
women's health' in England

“Tackling obesity in the whole population is an

accepted public health priority. However, I
advocate recognising obesity at the level of a
“national risk”.

Annual Report of the Chief Medical Officer, December 2015

The Health of the 51%: Women

 Food for thought
•30% of patients are undernourished at admission to hospital
•Majority of doctors can identify patients at risk of malnutrition
•Only 25% stated they were able to calculate nutritional requirements

Awad S, Herrod PJ, Forbes E, Lobo DN

(2010). Knowledge and attitudes of surgical
trainees towards nutritional support: food
for thought. Clin Nutr 29243-8.
 What you are going to learn:
• The basics of nutrition and the evidence for a
healthy, balanced diet
• Malnutrition – causes and consequences
• Ways to assess nutritional status
• Role of dietetics
• Consider nutrition for every patient
NUTRITION

= The provision of nourishment

to cells, tissues, organs, systems and the
body as a whole.
= How food influences our body function
and health

Includes:

Social Public Health

Agriculture Animal Production
Biochemistry Physiology
 Clinical Nutrition

Feeding patients Dietetics – diet as

therapy/prevention of disease

Concentrate on:

1)Integration of biochemistry and

physiology in normal nutrition

2) Clinical nutrition and dietetics

3) Public health aspects – obesity, diabetes,

CHD, cancer,
cachexia,sarcopenia
 Core concepts of nutrition

• Nutrient balance

• Nutrient turnover

• Nutrient flux

• Metabolic pools

• Adaptation to altered nutrient supply

Nutrient Balance

Intake – Output (loss) = Change in Body Stores

Buffering effect of body stores

Malnutrition

Overnutrition

Undernutrition
 Nutrient turnover

• Metabolic substrates are

continually being utilised and
replaced

• Allows for rapid adjustments to

changes in metabolic state

• Potential for dysfunction if rates of

utilisation and synthesis are
mismatched
 Nutrient flux

• Nutrient flux through a

metabolic pathway is a
measure of the activity of the
pathway

• Not necessarily related to the

size of the metabolic pool
 Metabolic pools
Nutrients and metabolites are present in
several pools:

• Functional pool – direct involvement in

body function(s)-eg glucose pool (blood
glucose pool=10g- changes over course
of day and well regulated)
• Storage pool – provides buffering effect
i.e. can be made available to the
functional pool when and as required
• Precursor pool – provides the substrate
for nutrient/metabolite synthesis-eg in
gluconeogenesis (glycerol can be used in
liver to do this!! Also lactate can do this)
 Adaptation to altered
nutrient supply

• Minimises the consequences of

such alterations

• The greater the capacity to

respond to adverse nutritional
states the greater the capacity
to survive those states