Course Module

NCM 105
Nutrition and Diet Therapy
 Lesson Module 5

MACRONUTRIENTS:
PROTEINS

Alicia Lonzame-Lopena, RN MAN

Maria Seniz Calma, RN MAN
 Protein balance is essential to life
and health, and it must be
maintained . Many different proteins
in the body make human life
possible.
Each specific protein has a unique
structure that is designed to perform
an assigned task
Lesson Module Content
1. Amino acid as the building blocks of all
proteins.
2. Classes of amino acids
3. Protein balance
4. Functions of protein
5. Food sources of protein
6. The vegetarian diet
7. Digestion of protein
8. Dietary recommendation for protein
9. Protein deficiency/ excess
 Lesson Module Objectives
At the end of the lesson, the following objectives should be attained:
1. Explained the nature of protein and its dietary importance
2. List down the 20 common amino acids and the classification
of each
3. Explain the mechanism of nitrogen balance
4. Enumerate the functions of protein
5. Give examples of food sources of protein
6. Differentiate the different vegetarian diet
7. Discuss how protein is digested
8. Explain the different protein energy malnutrition
9. Adhere to the recommendations for dietary guidelines for
protein
 Nature of Proteins
When food rich in protein are eaten,
protein is broken down into amino
acids during the digestive process.
Amino Acids
Building blocks of protein
Formed in a chain sequence to form
specific protein
2 AA joined together - dipeptides
100 or more AA chain- polypeptides

(Amino acids – the nitrogen bearing

compound that form the structural
units of protein after digestion )
Examples of specific protein
casein – protein in milk and cheese
albumin – egg whites
gluten – wheat products
Protein basic structure – carbon, hydrogen and oxygen + 16% nitrogen
Classes of amino acids – 20 common amino acids. They are classified
into
a. indispensable – essential
b. dispensable - non-essential
c. conditionally indispensable – conditionally essential
There are a total of 20 AA
9 - Indispensable
it cannot be left out
must be present in the diet
5 - Dispensable
needed by the body
may not be present in the diet
synthesized from other AA
6 - Conditionally indispensable
normally synthesized in the
body
must be consumed in the
diet
Conditionally indispensable amino acids
are indispensable when indigenous source
cannot meet the metabolic demands.
Example:
The body can make cysteine from the
amino acids methionine. When the diet is
deficient in methionine, cysteine must be
consumed in the diet – making it
indispensable.
Protein Balance
Body protein are constantly broken down into
AA through the process of catabolism, then it
is re-synthesized into tissue protein through
the process of anabolism.
 To maintain nitrogen balance – part of the AA that
contains nitrogen must be removed. Nitrogen is
converted into ammonia, then excreted as urea in the
urine.
Tissue turnover is a continuous process of catabolism
and anabolism to maintain overall protein balance in
the body.

(Catabolism - the metabolic process of breaking down

large substances into smaller building blocks )
(Anabolism - the metabolic process of building up layer
of substances from smaller building blocks )
 Nitrogen Balance
The body’s nitrogen balance indicates how well its
tissue are being maintained.
1 g of urinary nitrogen results from the digestion and
metabolism of 6.25 g of protein thus, if 1 g of nitrogen
is excreted in the urine for every 6.25 g of protein
consumed, then the body is said to be in nitrogen
balance.
In state of malnutrition or illness, the balance may
shift to be either positive or negative.
Positive Nitrogen Balance exist
when the body holds on to more
nitrogen than it excretes, thus storing
more nitrogen (by building tissue)
than it is losing (by breaking down
tissue). This situation occurs during
periods of rapid growth, such as
infancy, childhood, adolescence,
pregnancy and lactation.
Negative Nitrogen Balance occurs
when the body holds on to less
nitrogen than it excretes. The body
has an inadequate protein intake and
is losing nitrogen by breaking down
more tissue than it is building up.
This arises in states of malnutrition
and illness. The classic protein
deficiency disease is known as
kwashiorkor. In children, negative
nitrogen balance for an extended
period causes growth retardation and
may be fatal.
Protein makes up the bulk of
the muscles, internal organs,
brain, nerves, skin, hair, and
nails. It is also a vital part of
substances like enzymes,
hormones and blood plasma
 Functions of Protein
• Structural tissue building-repair worn out tissues and build new
ones
• Water balance through osmotic pressure
• Digestion and metabolism
• Cell signaling
• Immunity (antibodies)
• Source of energy (4 kcal/g)

The normal pH of blood is between 7.35 and 7.45.

The unique structure of proteins – a combination of a carboxyl acid
group and a base group – allows them to act as buffering agents by
releasing or taking up excess acid within the body.
 Water and pH Balance

Body compartments are separated

with cell membranes that are not
Permeable to proteins.
Because water is attracted to
Protein, plasma protein like
Albumin help control water
balance in the body by exerting
osmotic pressure. This helps
maintains the normal circulation
of tissue fluids within the
appropriate compartments
Metabolism and transportation
Protein aids metabolic functions through
enzymes, transport agents, and hormones.
Enzymes amylase, lipase, and proteases are
all proteins in structure. Lipoproteins are
necessary to transport fats in the water-
soluble blood supply.
Body Defense System
Protein is used to build
special white blood cells
and antibodies as part of
the body’s immune system
to help defend against
disease and infection.
Energy System
In times of need, protein
may furnish additional
fuel to sustain body heat
and energy. The available
fuel factor of protein is 4
kcal/g.
Vegetarian Diets
A mixture of plant proteins can provide adequate
amounts of amino acids when the basic use of
various grain is expanded to include soy protein and
the other dried legume (i.e., beans and peas)
Vegetarians can mix plant foods so that the amino
acids missing in one food are supplied by another.
Types of vegetarian diets
Approximately 2.3% of adult population
follows a vegetarian diet. Reasons to
choose a vegetarian diet are animal cruelty
concerns, health incentives, religious
adherence. In some areas in the world,
vegetarianism is simply a result of the lack
of animal products.
Four Basic Types of Vegetarian diet:

1. Lacto-ovo-vegetarians: food pattern that allows

for the consumption of dairy products and eggs.
2. Lacto-vegetarians: only dairy products from
animal sources to complement their basic diet of
plant foods.
3. Ovo-vegetarian: animal foods included in the ovo-
vegetarian diet are eggs – they are excellent source
of complete protein.
4. Vegans: strict vegetarian diet and consume no
animal foods.
 Health Benefits and Risk
• Lower levels of dietary saturated fat and cholesterol
• Higher intake of fruits, vegetable, whole grains, nuts, soy
products, fiber, and phytochemicals
• Lower body mass index and prevents obesity
• Better lipid profiles and lower rates of death from
cardiovascular disease, including ischemic heart disease
and hypertension
• Lowered risk of renal disease
• Effective management of diabetes
• Lowered risk of dementia, diverticulitis, and gallstones
 FOOD SOURCES OF PROTEIN
Types of food proteins
Animal and plant foods provide a wide variety of
many nutrients, including protein. Food proteins
are classified as:
Complete Proteins
Protein food that contain all nine indispensable
amino acids. These proteins are primarily of
animal origin. (e.g., egg, milk, cheese, meat,
poultry, fish). However, soybeans and soy
products are the exception, the only plant
sources of complete proteins.
Incomplete Proteins
Protein foods that are deficient in one or more of
the nine indispensable amino acids are generally
of plant origin (e.g., grains, legumes, nuts,
seeds), but they are found in foods that make
valuable contributions to the total amount of
dietary protein
DIGESTION OF PROTEINS
Mouth
Protein broken down is necessary for
use as building blocks: amino acids.
This is done through the mechanical
and chemical digestion. The
mechanical breaking down of protein
begins with chewing in the mouth.

Stomach
Enzymes involved in protein
digestion are stored as inactive
proenzymes called zymogens.
Zymogens are then activated according
to need.
The chemical digestion of protein
begins in the stomach. Three agents in
the gastric secretions help with this
task.
Hydrochloric Acid
Hydrochloric acid works on the complex protein chains.
HCL provides the acid medium that is necessary to convert
pepsinogen into active pepsin, which is the gastric enzyme
that is specific to protein.
Pepsin
Pepsin begins splitting the bonds between the protein’s
amino acids, which changes the large protein into short
chains called polypeptides.
Rennin
The gastric enzyme rennin is only present during infancy
and childhood important for the infant’s digestion of milk.3
Small Intestine
Protein digestion is completed in the alkaline medium of the small
intestine. Enzymes from the secretions of both the pancreas and the
intestine take part in this process.
Pancreatic secretion
1. Trypsin – secreted first as inactive trypsinogen, is activated by the
enzyme enterokinase. Works on proteins and large polypeptide
fragments that are carried from the stomach. This enzymatic action
produces small polypeptides and dipeptides.
2. Chymotrypsin – secreted first as the inactive chymotrypsinogen, is
activated by trypsin.
3. Carboxypeptidase – attacks the acid, thereby producing small
peptides and some free amino acids.
Intestinal secretion
Glands in the intestinal wall produce two
protein splitting enzymes to complete the
breakdown and free the remaining amino
acids:
1. Aminopeptidase – attacks the nitrogen-
containing end of the peptide chain and
releases amino acids one at a time.
2. Dipeptidase – final enzyme in the
protein-splitting system, breaking the
remaining dipeptides into two free
amino acids.
This protein-splitting enzymes breaks
down the large, complex proteins into
smaller peptide chains and frees each
individual amino acid. The free amino acid
are now ready to be absorbed directly into
the portal blood circulation for use in the
building of body tissues.
Three factors influence the body’s requirement for protein: tissue
growth; the quality of the dietary protein; and the additional needs
that result from illness or disease.
Human growth is most rapid during fetal growth, infant growth
during the first year of life, and adolescent growth.
Nature of a protein and its pattern of amino acids significantly
influence its dietary quality. Sufficient intake is necessary to
conserve protein for tissue structure.
Egg and cow’s milk protein have the highest protein
quality score. Quality and digestibility of most plant proteins are
significantly lower than those of animal proteins. The dietary
protein needs of vegans who rely on plant foods of lower protein
quality may be higher than those of non-vegetarians.
Illness or disease, when accompanied by fever and
catabolic tissue breakdown, raises the body’s need for
protein and kilocalories for rebuilding tissues and to
meet the demands of an increased metabolic rate.
After surgery, extra protein is needed for wound
healing. Extensive tissue destruction which occurs
with burns and pressure sores, needs large protein
increase for the healing and grafting processes.
 Dietary Deficiency or Excess
Protein-Energy Malnutrition
Children are at the highest risk for developing PEM because of
their high needs during rapid growth and development. People with
poor nutrient intake (e.g., the elderly, those with eating disorders)
may suffer from PEM.
Two severe forms of PEM are kwashiorkor and marasmus.
Kwashiorkor is the more fatal of the two forms results from an
acute deficiency of protein. Marasmus results from a more chronic
deficiency of many nutrients. End result with either form is
stunted growth, a weakened immune system, and poor
development.
Kwashiorkor is more common
among children who are between the
ages of 18 and 24 months who have
been breastfed all their lives, and
who are then rapidly weaned, often
because of the arrival of a younger
sibling.
Characteristics of kwashiorkor is
inadequate protein intake to
maintain fluid balance and to
transport fat from the liver.
Marasmus have an emaciated
appearance with little or no body fat.
A chronic form of energy and protein
deficiency, it is a result of basic
starvation. Stunted growth and
development are more severe.
Dietary Reference Intakes
The RDA for both men and women is set at
0.8 g of high-quality protein per kilogram of
desirable body weight per day.
Dietary recommendations are higher for
infants and for pregnant and breastfeeding
women in order to meet metabolic needs.
Dietary Guidelines recommend the following with regard
to protein-rich foods.
• Variety of protein foods, including seafood, lean meat and
poultry, eggs, beans and peas, soy products, and
unsalted nuts.
• Increase the amount and variety of seafood consumed by
choosing seafood in place of some meat and poultry.
• Replace protein foods that are higher in solid fats with
choices that are lower in solid fats and calories and/or
are sources of oils.
 SUMMARY
To end today’s lesson, let us summarize some important key
points and concepts:
1. High quality nutrition is essential to good health throughout life
2. A well-balanced diet is a major component of health promotion
3. Health is a complex process that recognizes the individual as a
whole and relates health to both internal and external environment.
4. Health is interrelated to wellness which can lead to the full
development of potentials for all people within their given
environment.
5. We must focus on preventive approaches by identifying risk factors
and one must choose behaviors that will protect or minimize the
risk for disease.
6. Dietary guidelines for Filipinos serves as a useful general guide that
will help us evaluate our food habits and move toward general
improvements.
 LEARNING ACTIVITIES
A. Your best friend is on a strict vegan diet because working as
a fashion model, she has to maintain her body weight and
built. What recommendations are you going to offer her to
maintain her protein intake ?
B. For todays breakfast, you ate 2 slices of white bread, 2 whole
C. Large scrambled egg, 120 ml of skim milk and 2 tablespoon
of peanut butter for your 5 pieces of saltines.
D. How many grams of protein did you consumed ?
E. How many calories did you have for breakfast ?

Note: For Critical Thinking exercises, requirements must be

submitted in Google Classroom within 1 week before the start of Week
2.
NEXT LESSON MODULE
Lesson Module 6
Micronutrients:
Vitamins and Minerals
 ASSESSMENT

A summative assessment test

will be posted in the Google
classroom. The test will cover
Lesson module 2,3,4,and 5. This
can be availed on (-Date-) at (-
time-)
Always check your Google
classroom for messages and
announcements.
 REFERENCES / RESOURCES

• Nix, S. Williams Basic Nutrition and

Diet Therapy. 14th Ed.
• Available:
https://evolve.Elsevier.com/Williams/
basic/