:Presented By

Dr.Eglal Hakeim &Dr.Hoda Syaed

 Nutrition
-:Definition of Nutrition
* Nutrition is a basic human needs for the body &the
mind.
Nutrition refers to the food (nutrients) that we eat *
Definition of Nutrients:-
Nutrients are the elements necessary for body processes &
function as (cellular metabolism& repair ,organ function
,growth & body movement).
Essential Nutrients:-
The six classes of nutrients are: carbohydrate, fat,
protein, water, minerals, and vitamins.
 Carbohydrates (carbo.) -1

Function Source RDA

Major source of - .Bread and cereal - *45-55%

.energy (glucose) .Pasta, potatoes -
.dried beans, lentils - of
Provides fiber which - .fruits as dates - total
. stimulates peristalsis .dried fruits, cakes - .calories
,sugar, syrup, jelly -
.Excess is stored as fat - jam, honey, molasses about *
.100mg
 Fat -2

Function Source RDA

- Supply large amount of -Animal sources: * less than
energy. full cream milk & its 30% of
.Excess stored as fat - products, butter, cream, total
.Conserves body heat - egg yolk, fatty meat. calories.
.Keep skin healthy - Plant sources: sesame,-
.Carries vitamins A, D,E,K - olives, nuts, seeds of about *
Important in structure of nerve - cotton, sun flower oil, 15-20gm
. tissue margarine
.Protect body part - )‫(الزيوت المهدرجة‬
Makes processed food more - .Fried foods -
.palatable .Cooking and table fats -
.Salad oils -
 Protein -3

Function Source RDA

- Builds and repairs all
tissues.
Build blood and form-
. antibodies
.Supplies energy -
Assist in acid-base and -
.fluid balance
,Formation of hormones -
.enzymes, immunoglobulin
.Assist in blood clotting -
- Animal protein: * 44-56
milk and its products, gm for
eggs, lean meat (red adult.
& white), organ meat *60gm for
(liver, heart, kidney) ,
and fish. pregnant.
Plant protein: dried - 65gm for*
beans and peas, .lactating
peanut butter, nuts,
fortified bread,
cereals, pulses
 Vitamins -4
Fat
soluble Vit Function Source Deficiency
Vitamin A ,Necessary for skin- Liver, milk, butter, Night*
,mucous membranes cheese, cream, egg blindness;
.and night vision yolk, fortified milk, dry skin,
Growth &development -
.of bones & teeth
-7
.margarine
Spinach, broccoli,
disorders of
mucous
Important role in - carrots, red peppers, membranes
immune function .sweet potatoes

Vitamin D Necessary for the- Sun light on the skin, Rickets in*
calciferol( absorption of calcium liver, fatty fish, egg children;
) and phosphorus yolks, fortified milk, osteomalacia
ready-to-eat cereals, in adults
and margarine
Vitamin E Necessary for health- Vegetable oils, *Increase
(tocopherol) of cell membrane margarine, salad RBC
dressing, other hemolysis
foods made with in adults;
vegetable oil, nuts. anemia,
edema, and
skin lesion
in infants

Vitamin k Needed for the- green leafy Bleeding

)menadione( synthesis of vegetables, liver,
prothrombin and milk, vegetables of
other clotting factors cabbage family
Water-soluble
Vitamins Function Source Deficiency
Thiamine -Release energy Whole grain Beriberi;
)Vitamin B1( from carbohydrates and enriched anorexia,
and amino acids breads and edema,
-Needed for growth cereals; liver, enlarged
-Promote normal legumes, nuts heart, sudden
appetite and nervous death from
system functioning heart failure
Riboflavin -Essential for growth Milk and its Skin and
)Vitamin B2( products, whole tongue
grain and disorders;
enriched breads dermatitis,
and cereals, photophobia
eggs, meat,
green leafy
vegetables
 Niacin -Helps release energy All protein Pellagra with
)Vitamin B3( from nutrients foods, whole dermatitis,
-promote nervous grain and diarrhea,
system functioning enriched breads mental disorder
and cereals,
Pyridoxine -Participates in the Meats, fish, Nervous
)Vitamin B6( metabolism of amino poultry, legumes, system and
acids and proteins fruits, green skin disorders
leafy vegetables,
whole grain and
nuts.
Vitamin B12 -Helps form red blood Animal products: Anemia,
cells and DNA meat, fish, gastrointestinal
-Maintain nerve cells poultry, disorders,
-Helps in metabolize shellfish, milk, neurologic
some fatty acids and diary products, disorders
amino acids eggs; some
 Folic acid -Help in the formation Leafy vegetables, Anemea;
)vitamin B9 ( legumes, seeds, neuraltube
of hemoglobin and liver, orange juice, defects in
DNA. fruits, breads, embryo
-vital for new cell cereals, and other
synthesis grains are fortified
with folic acid
Ascorbic acid -Necessary for Citrus fruits and Scurvy, poor
)Vitamin C( synthesis of collagen juices, peppers, bone and
-Maintain capillaries broccoli, wound
-Aids in the cauliflower, healing,
absorption of iron, cantaloupe, bleeding
thyroxin synthesis, kiwifruit, gums,skin
immune system strawberries, change,
functioning tomatoes anemia,
increase
susceptability
to infection
 Minerals -5
Selected
Mineral Function Source Deficiency
Potassium(K) -Help in nerve Fruits and Nerve and
and muscle activity. vegetables, muscle
-fluid and electrolyte legumes, disorder
balance, acid-base whole grains,
balance milk, meats,
coffee
Sodium(Na) -Fluid and electrolyte Processed Weakness,
balance, acid-base foods: canned cramps,
balance soups, meats, diarrhea,
-Nerve impulse vegetables; dehydration,
conduction, regulate pizza confusion
cell membrane
Iodine (I) -Necessary for Iodized salt, Hypothyroidism;
synthesis of seafood, bread, iodine-deficient
thyroid hormones dairy products goiter

that regulate
growth,
development, and
metabolic rate
Magnesium -Component of Green leafy Muscle spasm,
)Mg( some enzymes; vegetables, dysrhythmias,
important in nuts, legumes, vasodilatation,
carbohydrate whole grains, growth failure in
metabolism, bone seafood, children.
formation, nerve chocolate,
transmission, cocoa
smooth muscle
relaxation
 Calcium -Component of Milk and milk Rickets,
)Ca( bones and teeth, products, fortified tetany, bone
nerve conduction, orange juice, softening
muscle contraction,green leafy
blood clotting vegetables, sweet
potatoes, small
fish with bones,
legumes
Phosphorus -Component of All animal Bone
)P( bones and teeth, products( meat, demineraliz
acid-base balance, poultry, eggs, ation
energy metabolism, milk), bread,
cell membranes ready-to-eat
structure, regulation cereal
of hormones
 Iron(Fe) -Component of Beef liver, red Anemia, dry
hemoglobin ( red meats, legumes, skin,
blood cells) fortified cereals, lowered
-Maintain enzyme bread. immunity,
systems weakness,
fatigue,
impaired
wound
healing
Fluorine(F) -Component of bones Fluoridated water, Dental
and teeth, promotes tea caries
resistance to dental
decay
 Water – 6

Function Source RDA

-Water composes 60% potable water ,and adult fluids
water content of intake is
to 70% of total body ingested foods as about 2.5
fresh fruits& liters/day.
weight. vegetables and
- It is a necessity of fluids.
life, being a
component of all body
cells, that is needed
for body functioning.
 Body Energy
Definition of energy :
It is the fuel to do work.
Need for energy:
Energy is essential for tow reasons:
1- It provides the body the power to do its work as:
contraction of skeletal muscle for movement require
energy.

2- Energy is the source of heat for body temperature.

Measurement of energy:
Energy is measured in units called kilocalories.
-One calorie is the amount of energy required to
raise the temperature of one liter of water by 1C°.

-The energy yield of the three food groups:

*Carbohydrate yields 4 Cal/gm.
*Protein yields 4 Cal/gm.
*Fat yields 9 Cal/gm.
Energy Balance Scale
‫‪1- Weight maintenance‬‬ ‫‪when food intake =out put‬‬

‫مثال( ‪:)1‬‬
‫األشخاص الذين ال يبذلون جهد عضلي قليل مثل(الموظفين اإلداريين ‪)....................‬‬
‫يحتاجون إلى تقليل معدل الطاقة في الغذاء حتى يتناسب مع معدل الحركة التي‬
‫يبذلونها حتى يحدث توازن بين الداخل من الطعام و الخارج من الطاقة‪.‬‬

‫مثال ( ‪:)2‬‬
‫األشخاص الذين يبذلون جهد عضلي كبير مثل( الرياضيين‪ -‬عمال البناء‪ -‬عمال‬
‫الحفر‪ ).............‬و األشخاص الذين يبذلون جهد عضلي و ذهنا كبير مثل( الطلبة‪-‬‬
‫المهندسين‪ -‬الممرضين‪ )..............‬كل هؤالء يحتاجون إلى زيادة معدل الطاقة في‬
‫الغذاء حتى يتناسب مع معدل الحركة التي يبذلونها حتى يحدث توازن بين الداخل‬
‫من الطعام و الخارج من الطاقة‪.‬‬
‫)‪Weight gain (over weight or obesity‬‬ ‫‪food intake‬‬ ‫‪-2‬‬
‫‪:than out put‬‬

‫إذا لم يتم التوازن في المثال (‪ , )1‬وأصبح معدل الطاقة ( من الغذاء) اكبر من معدل‬
‫الحركة ‪ ,‬سوف يؤدى إلى زيادة إلى الوزن و مرض السمنة‪.‬‬

‫)‪Weight loss (mal nourished‬‬ ‫‪food intake than out -3‬‬

‫‪:put‬‬
‫لذا لم يتم التوازن في المثال (‪, )2‬و أصبح معدل الطاقة( من الغذاء) اقل من معدل الحركة‬
‫‪ ,‬سوف يؤدى إلى انخفاض في الوزن و سوء تغذية‪.‬‬
:Energy Expenditure
Energy expenditure differs depending on whether the -
.body is in a resting or non resting state

-The basal metabolic rate (BMR) is the amount of

energy the body requires per unit time to perform
essential activities at rest.(include breathing, kidney
function, cardiac muscle contraction
Factors affecting metabolic rat :
Food Guide Pyramid
Carbohydrate metabolism:
Glucose converted to glycogen in the presence of insulin and stored in the
liver and skeletal muscles and excess of it transform to adipose tissue.
1gm carbo 4kcal of energy.

Fat metabolism:
Fats are converted into glycerol and fatty aids and stored in the body’s fat
deposits
1gm fat 9kcal of energy.

Protein metabolism:
Protein converted into amino acids and stored in the liver and
skeletal muscle and excesses of it converted to fat
1gm protein 4kcal of energy
:Metabolism of carbohydrates
The liver plays an important role in the regulation of blood
.glucose levels

:Metabolism of protein
.The liver can make a variety of different amino acids

:Metabolism of fats
The liver can break down fatty acids, synthesize cholesterol
and phospholipids, and convert excess dietary protein
.and carbohydrates to fat

:Phagocytosis
The kupffer cells can phagocytose bacteria and other
.substances
 Nutrition for patient with special cases
•Diet in liver diseases:-
Hepatitis:
•High-protein : 75 to 100 gm. Of high-quality protein
daily, it is essential for building new liver cells and
tissues.
•High-carbohydrate : 300 to 400 gm of carbohydrate
daily, that help meet the energy demands of the
disease process.
•Moderate fat : to encourage poor appetite.
Liver Cirrhosis:
•Low protein intake: in the absence of hepatic
coma, about 80 to 100 gm of protein/day. If signs of

coma begin, the protein will have to be restricted.

•Low sodium: to prevent( ascites ).

•Soft texture: if the esophageal varices develop.

•High carbohydrate.

•Moderate fat is used.

•Adequate vitamins intake, especially B- complex

vitamins including thiamin and folate, are important
•Diet in cardiac diseases & hypertension:-
-Low fat to prevent atherosclerosis.
- Low sodium & avoid salty foods (‫رنجة‬-‫سيخ‬RRR‫ف‬-‫)مخلل‬

to reduce fluid retention (edema) & over loading on the

heart.

- Increase calcium & potassium intake to replace loss

with diuretic use.

-Increase vegetables & fruits intake.

-Restricted calories
-:Diet in renal diseases
- Low protein in diet.
- Low sodium in diet to prevent edema & hypertension.
-Low fat intake.
-Phosphate restriction.
-Calcium, iron& vitamin supplementation.

- Adequate potassium intake.

- Adequate carbohydrate to provide energy.
- Adequate fluid intake to maintain adequate urine
volume , if there is no restriction.
Diet in diabetes mellitus:-
•Decrease carbohydrates intake.

•Decrease food containing sugar.

•Decrease protein intake.

•Low fat intake.

•Increase fibers intake to improve blood sugar level.

•Increase vegetables and fruits.

Diet in burns:-
•Increase intake of calories, protein, vitamin C, and
the B-complex vitamins.

•Respiratory disease:
Soft, high-calorie, high-protein diet.

Tuberculosis:
Increase intake of protein, calories, calcium, and vitamin
A