Energy balance in children Protein balance in children

Assprof Luchyshyn NYu

bull Energy is used continuously in the body and is fundamental to physiologic processes

bull Requirements of individuals vary in relation to a wide variety of factors making energy metabolism an issue of great importance to the pediatrician

3

Metabolism

Metabolism all chemical reactions occurring in an organism

Anabolism chemical reactions that expend energy to make new chemical bonds

Catabolism chemical reactions that harvest energy when bonds are broken

Nutrition is a science that deals with the relation of food substance to living things In the study of nutrition the following items must be considered

a) bodily requirement for various substances

b) function in body

c) amount needed

d) level below which poor health results

Feeding a Healthy Young Child

Planning Childrenrsquos

Meals

bull A complete diet must supply the elements carbon hydrogen oxygen nitrogen phosphorus sulfur

bull and at least 18 other inorganic elements

bull The major elements are supplied in carbohydrates lipids and protein

bull In addition at least 17 vitamins and water are necessary

bull If an essential nutrient is omitted from the diet certain deficiency symptoms appear

bull Children normally need a certain number of calories each day (energy allowance) that their bodies use as energy for normal daily activities (walking breathing etc)

bull This ranges for boys from 2000 calories for a 7-10 year old

bull 2500 calories for an 11-14 year old

bull 3000 calories for a 15-18 year old

For girls

bull the ranges are from 2000 calories for a 7-10 year old

bull to 2200 calories for an 11-18 year old

bull These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities

bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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bull Energy is used continuously in the body and is fundamental to physiologic processes

bull Requirements of individuals vary in relation to a wide variety of factors making energy metabolism an issue of great importance to the pediatrician

3

Metabolism

Metabolism all chemical reactions occurring in an organism

Anabolism chemical reactions that expend energy to make new chemical bonds

Catabolism chemical reactions that harvest energy when bonds are broken

Nutrition is a science that deals with the relation of food substance to living things In the study of nutrition the following items must be considered

a) bodily requirement for various substances

b) function in body

c) amount needed

d) level below which poor health results

Feeding a Healthy Young Child

Planning Childrenrsquos

Meals

bull A complete diet must supply the elements carbon hydrogen oxygen nitrogen phosphorus sulfur

bull and at least 18 other inorganic elements

bull The major elements are supplied in carbohydrates lipids and protein

bull In addition at least 17 vitamins and water are necessary

bull If an essential nutrient is omitted from the diet certain deficiency symptoms appear

bull Children normally need a certain number of calories each day (energy allowance) that their bodies use as energy for normal daily activities (walking breathing etc)

bull This ranges for boys from 2000 calories for a 7-10 year old

bull 2500 calories for an 11-14 year old

bull 3000 calories for a 15-18 year old

For girls

bull the ranges are from 2000 calories for a 7-10 year old

bull to 2200 calories for an 11-18 year old

bull These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities

bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
• Slide 2
• Slide 3
• Slide 4
• Slide 5
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3

Metabolism

Metabolism all chemical reactions occurring in an organism

Anabolism chemical reactions that expend energy to make new chemical bonds

Catabolism chemical reactions that harvest energy when bonds are broken

Nutrition is a science that deals with the relation of food substance to living things In the study of nutrition the following items must be considered

a) bodily requirement for various substances

b) function in body

c) amount needed

d) level below which poor health results

Feeding a Healthy Young Child

Planning Childrenrsquos

Meals

bull A complete diet must supply the elements carbon hydrogen oxygen nitrogen phosphorus sulfur

bull and at least 18 other inorganic elements

bull The major elements are supplied in carbohydrates lipids and protein

bull In addition at least 17 vitamins and water are necessary

bull If an essential nutrient is omitted from the diet certain deficiency symptoms appear

bull Children normally need a certain number of calories each day (energy allowance) that their bodies use as energy for normal daily activities (walking breathing etc)

bull This ranges for boys from 2000 calories for a 7-10 year old

bull 2500 calories for an 11-14 year old

bull 3000 calories for a 15-18 year old

For girls

bull the ranges are from 2000 calories for a 7-10 year old

bull to 2200 calories for an 11-18 year old

bull These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities

bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
• Slide 2
• Slide 3
• Slide 4
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• Slide 45

Nutrition is a science that deals with the relation of food substance to living things In the study of nutrition the following items must be considered

a) bodily requirement for various substances

b) function in body

c) amount needed

d) level below which poor health results

Feeding a Healthy Young Child

Planning Childrenrsquos

Meals

bull A complete diet must supply the elements carbon hydrogen oxygen nitrogen phosphorus sulfur

bull and at least 18 other inorganic elements

bull The major elements are supplied in carbohydrates lipids and protein

bull In addition at least 17 vitamins and water are necessary

bull If an essential nutrient is omitted from the diet certain deficiency symptoms appear

bull Children normally need a certain number of calories each day (energy allowance) that their bodies use as energy for normal daily activities (walking breathing etc)

bull This ranges for boys from 2000 calories for a 7-10 year old

bull 2500 calories for an 11-14 year old

bull 3000 calories for a 15-18 year old

For girls

bull the ranges are from 2000 calories for a 7-10 year old

bull to 2200 calories for an 11-18 year old

bull These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities

bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Feeding a Healthy Young Child

Planning Childrenrsquos

Meals

bull A complete diet must supply the elements carbon hydrogen oxygen nitrogen phosphorus sulfur

bull and at least 18 other inorganic elements

bull The major elements are supplied in carbohydrates lipids and protein

bull In addition at least 17 vitamins and water are necessary

bull If an essential nutrient is omitted from the diet certain deficiency symptoms appear

bull Children normally need a certain number of calories each day (energy allowance) that their bodies use as energy for normal daily activities (walking breathing etc)

bull This ranges for boys from 2000 calories for a 7-10 year old

bull 2500 calories for an 11-14 year old

bull 3000 calories for a 15-18 year old

For girls

bull the ranges are from 2000 calories for a 7-10 year old

bull to 2200 calories for an 11-18 year old

bull These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities

bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
• Slide 2
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
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Planning Childrenrsquos

Meals

bull A complete diet must supply the elements carbon hydrogen oxygen nitrogen phosphorus sulfur

bull and at least 18 other inorganic elements

bull The major elements are supplied in carbohydrates lipids and protein

bull In addition at least 17 vitamins and water are necessary

bull If an essential nutrient is omitted from the diet certain deficiency symptoms appear

bull Children normally need a certain number of calories each day (energy allowance) that their bodies use as energy for normal daily activities (walking breathing etc)

bull This ranges for boys from 2000 calories for a 7-10 year old

bull 2500 calories for an 11-14 year old

bull 3000 calories for a 15-18 year old

For girls

bull the ranges are from 2000 calories for a 7-10 year old

bull to 2200 calories for an 11-18 year old

bull These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities

bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
• Slide 2
• Slide 3
• Slide 4
• Slide 5
• Slide 6
• Slide 7
• Slide 8
• Slide 9
• Slide 10
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• Slide 40
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45

bull A complete diet must supply the elements carbon hydrogen oxygen nitrogen phosphorus sulfur

bull and at least 18 other inorganic elements

bull The major elements are supplied in carbohydrates lipids and protein

bull In addition at least 17 vitamins and water are necessary

bull If an essential nutrient is omitted from the diet certain deficiency symptoms appear

bull Children normally need a certain number of calories each day (energy allowance) that their bodies use as energy for normal daily activities (walking breathing etc)

bull This ranges for boys from 2000 calories for a 7-10 year old

bull 2500 calories for an 11-14 year old

bull 3000 calories for a 15-18 year old

For girls

bull the ranges are from 2000 calories for a 7-10 year old

bull to 2200 calories for an 11-18 year old

bull These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities

bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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bull Children normally need a certain number of calories each day (energy allowance) that their bodies use as energy for normal daily activities (walking breathing etc)

bull This ranges for boys from 2000 calories for a 7-10 year old

bull 2500 calories for an 11-14 year old

bull 3000 calories for a 15-18 year old

For girls

bull the ranges are from 2000 calories for a 7-10 year old

bull to 2200 calories for an 11-18 year old

bull These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities

bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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For girls

bull the ranges are from 2000 calories for a 7-10 year old

bull to 2200 calories for an 11-18 year old

bull These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities

bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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bull Metabolism will be studied in various parts Interrelationships will be pointed out as they are encountered Just as there are three basic biomolecules - carbohydrates lipids and proteins the metabolism of each of these will be studied individually

bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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bull Techniques are available for short- and long-term measurements of energy expenditure which serve different purposes

bull The principal techniques are suitable for the age range from birth to adolescence

bull The theory of energy metabolism is briefly discussed including a summary of the different working definitions

bull The principles and practicalities of classical indirect calorimetry the doubly labeled water method the bicarbonate method and heart rate monitoring are then described

Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Proteinbull A protein is a complex high molecular

weight organic compound consists of amino acids joined by peptide bonds

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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• Slide 45

Protein

bull 1048714 Makes up cell structurebull 1048714 Helps develop repair and maintain tissuesbull 1048714 Produces hemoglobin enzymes and many

hormonesbull 1048714Maintains normal blood osmotic pressurebull 1048714 Forms antibodiesbull 1048714 Can be energy sourcebull 1048714 Breaks down into amino acids to be usedbull by the body

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
• Slide 2
• Slide 3
• Slide 4
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• Slide 37
• Slide 38
• Slide 39
• Slide 40
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45

In human nutritional needsproteins come in two forms

complete proteins contain all eight of EAA that humans cannot produce themselves all meat and other animal products are sources include beef lamb pork poultry fish shellfish eggs milk and milk products

complete proteins

incomplete proteins

incomplete proteins lack or contain only a very small proportion of one or more EAAProtein in foods (such as grains fruits and vegetables) are either low are considered incomplete proteins

HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
• Slide 2
• Slide 3
• Slide 4
• Slide 5
• Slide 6
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HEMOGOLBIN

bull The hemoglobin molecule consists of

bull the protein globin which is composed of

bull four subunit polypeptide chains (2 alpha

bull and 2 beta) each of which contains a

bull single heme group with its single iron

bull atom for the transport of oxygen

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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• Slide 43
• Slide 44
• Slide 45

MYOGLOBIN

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
• Slide 2
• Slide 3
• Slide 4
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• Slide 38
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• Slide 43
• Slide 44
• Slide 45

20 AMINO ACIDS

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
• Slide 2
• Slide 3
• Slide 4
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• Slide 38
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• Slide 41
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• Slide 43
• Slide 44
• Slide 45

PROTEIN METABOLISM

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
• Slide 2
• Slide 3
• Slide 4
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• Slide 42
• Slide 43
• Slide 44
• Slide 45

Proteins have a variety of structures so have a variety of functions in the body

bull enzymes many hormones antibodies hemoglobin cytochromes support (collagen) movement (actinmyosin)

bull Amino acids form hormones neurotransmitters

bull Thyroxine epinephrine dopamine (from tyrosine)

Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Amino acids can be a source of energy

bull bull Dietary proteins contain about the same amount of energy per gram as carbohydrates

bull bull the non-nitrogen part of amino acids can be oxidised directly in cell respiration or after conversion to ketone bodies

bull bull Normally about 12 of our daily energy needs come from amino acids

bull bull Excessive use of amino acids for energy causes a deficiency of tissue proteins and an excess of ketone bodies

Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Dietary Protein Amino Acid Pool ampMetabolic Pathways

bull Unlike carbohydrate or fat there is no specific storage depot for proteins or amino acids

bull Instead the amino acid pool of the blood plasma acts as a reservoir which each tissue can draw upon

bull bullEach tissue makes those specific proteins which it needs controlled by the active genes in that tissue

bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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bull The liver is the major organ involved in protein metabolism especially for deamination urea synthesis and gluconeogenesis

bull A normal diet should contain sufficient protein for metabolic needs

bull Complete proteins with 9 essential amino acids which the body cannot synthesize eg phenylalanine Most plant proteins are incomplete

Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Metabolic Pathways of Proteins amp Amino Acids

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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• Slide 45

Protein amp Amino Acid Anabolism

bull bull PROTEIN SYNTHESIS occurs on ribosomes in every cell and is stimulated by Anabolic Hormones

bull - Insulin-like Growth Factor(IGF)bull - Thyroxine (in growing children) bull - Insulinbull - Estrogen amp Testosteronebull bull Weight-bearing exercise causesbull anabolism amp growth of musclebull Non essential amino acids can be synthesized by

TRANSAMINATION (transfer of an amino group to a keto acid to create an amino acid)

Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Answers for Metabolic Pathways

bull 1 GLYCOLYSISbull 2 KREBS (TCA) CYCLEbull 3 OXIDATIVE PHOSPHORYLATIONbull 4 GLYCOGENOLYSISbull 5 GLYCOGENESISbull 6 GLUCONEOGENESISbull 7 LIPOLYSIS (LIPID MOBILISATION)bull 8 LIPOGENESISbull 9 PROTEIN HYDROLYSIS (PROTEIN MOBILISATION)bull 10 PROTEIN SYNTHESISbull 11 BETA OXIDATIONbull 12 KETOGENESISbull 13 DEAMINATION

RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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RECOMMENDED NUTRITIONAL INTAKECOMPOSITION

bull 55 to 65 Carbohydrate

bull 25 to 30 Fat

bull 10 to 15 Protein

SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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SOME CONCLUSIONS ABOUT PROTEIN

bull Dietary supplementation of protein beyond that necessary to maintain nitrogen balance does not provide additional ergogenic benefit

bull Ingesting carbohydrateprotein prior to exercise may reduce catabolism whereas ingesting carbohydrate protein following exercise may promote glycogen resynthesis a more anabolic hormonal environment and recovery

bull The extent to which these strategies affect training adaptations is unknown

Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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• Slide 3
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Ergogenic Properties of Protein

bull 1048714 Builds fat-free muscle massbull 1048714 Strength athletes need 14 to 18 g per

kg body weightbull 1048714 Endurance athletes need 12 to 14 g

per kg body weightbull 1048714 Diets exceeding 18 to 20 g per kg body

weight per day have not been proven to provide additional benefits and may damage kidney function

Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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• Slide 3
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Protein deficiency can lead to

symptoms such as fatigue insulin

resistance hair loss loss of hair

pigment loss of muscle mass low

body temperature and hormonal

irregularities

Severe protein deficiency is fatal

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

• Slide 1
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• Slide 3
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• Slide 43
• Slide 44
• Slide 45

Protein-energy malnutrition (PEM) contains 3 forms

kwashiorkor (KW) marasmus

marasmic KW

PEM represent a group of pathologic conditions

associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning frequently associated with infections mainly gastrointestinal infections

Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Kwashiorkor occurs in areas of famine limited food supply and low levels of education lead to inadequate knowledge of proper dietEarly symptoms are fatigue irritability and lethargy As protein deprivation continues growth failure loss of muscle mass generalized swelling (edema) decreased immunity occur A large protuberant belly is common Skin conditions (such as dermatitis changes in pigmentation thinning of hair and vitiligo) are seen frequently Shock and coma precede death

protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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protuberant belly

loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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loss of hair pigment

swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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swelling (edema)

6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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6 个月大 出生时有 8 斤半由于母乳少出生几天就给孩子冲奶粉食用两个月后体重是 14 斤 现在却仅有 12 斤乌黑的头发也渐渐稀疏变黄再变白

Skin pigmentation

Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Marasmus resulting from an insufficient nutritional intake

associated with acute conditions (gastroenteritis)

or chronic conditions (eg tuberculosis HIV infection)

Marasmus results from a negative energy balance a decreased energy intake increased energy expenditure or both Children adapt to an energy deficit with a decrease in physical activity lethargy a decrease in basal energy metabolism slowing of growth and finally weight loss Pathophysiological changes associated with nutritional and energy deficits can be described as (1) body composition changes (2) metabolic changes and (3) anatomic changes

Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Body composition

Body mass Body mass is significantly decreased

Fat stores can decrease to as low as 5 of the body

weight and be macroscopically undetectable

The remaining fat is usually stored in the liver

body water The proportion of water increases

proportion of extracellular water also increases

resulting in edema

protein mass can decrease up to 30

The muscle fibers are thin Muscle cells are atrophic

Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Other organ mass

The brain skeleton and kidney are

preserved whereas the liver heart

pancreas and digestive tract are first

affected

bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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bull This is typically a disease of impoverished

countries because of drought or political

turmoil bull Improving calorie and protein intake will

correct it treatment is not started too late bull Full height and growth potential will never be

achieved in children bull Severe kwashiorkor may leave a child with

permanent mental and physical disabilities

Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Monkey face

Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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Excess protein can cause problems as well

such as causing the immune system to overreact

liver dysfunction from increased toxic residues

bone loss due to increased acidity in the blood

diet high in meat could lead to high cholesterol or

other diseases such as gout

Another potential problem is that may put a strain on

the kidneys

Side Effects

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