NutritionNutritionNutritionNutrition

Dr.Khalid Hama salih,

Pediatrics specialist M.B.Ch.; D. C.H

F.I.B.M.S.ped

NutritionNutrition: the study of nutrients in food, how the : the study of nutrients in food, how the body uses nutrients, and the relationship between body uses nutrients, and the relationship between diet, health and disease.diet, health and disease.

Major food manufacturers employ nutritionists and Major food manufacturers employ nutritionists and food The food we eat determines the way we look, food The food we eat determines the way we look, and to some extent the way we feel, think, and and to some extent the way we feel, think, and behave scientists. behave scientists.

Nutritional disorders are not confined to children Nutritional disorders are not confined to children living in areas of famine and starvation , they are living in areas of famine and starvation , they are also found in children living in developed countries also found in children living in developed countries ..

Weight wise:nutritional requirement of Weight wise:nutritional requirement of children are relatively higher than in adult due children are relatively higher than in adult due

to :higher basal metabolic rate active growth to :higher basal metabolic rate active growth

Building of store & more physical activityBuilding of store & more physical activity

Why is Nutrition ImportantWhy is Nutrition Important??

Energy of daily livingEnergy of daily living Maintenance of all body Maintenance of all body

functionsfunctions Vital to growth and Vital to growth and

developmentdevelopment Therapeutic benefitsTherapeutic benefits

HealingHealing PreventionPrevention

Nutritional requirement :Nutritional requirement :

Denote physiological requirement of various Denote physiological requirement of various nutrient to maintain normal metabolism.nutrient to maintain normal metabolism.

Basal metabolic rate(BMR):minimum energy Basal metabolic rate(BMR):minimum energy requirement to maintain essential physiological requirement to maintain essential physiological function f the body at rest, is highest in function f the body at rest, is highest in infancy55cal/kg/day decrease with age infancy55cal/kg/day decrease with age 25-30cal/kg/day in late childhood25-30cal/kg/day in late childhood

Normal child spend:50% of energy requirement Normal child spend:50% of energy requirement for BMR,25%for physical activity,12% for for BMR,25%for physical activity,12% for growth,5% for digestioinof food,8%for fecal growth,5% for digestioinof food,8%for fecal losseslosses

Ideal diet should provide 50-60% as CHO,Ideal diet should provide 50-60% as CHO, 20-30% asfat& 10-15% as protein20-30% asfat& 10-15% as protein Each gram of protein,fat,CHOprovide4,9,4calories Each gram of protein,fat,CHOprovide4,9,4calories

respectively.respectively. Normal energy requirement:Normal energy requirement: 11stst <10kg 100cal/kg <10kg 100cal/kg 2nd10-20kg 1000+50cal/kg2nd10-20kg 1000+50cal/kg 33rdrd >20kg 1500+20cal/kg >20kg 1500+20cal/kg

COMPOSITION OF FOODCOMPOSITION OF FOOD

Food is composed of the same chemicals that Food is composed of the same chemicals that make up our bodies (water, salts, proteins, and make up our bodies (water, salts, proteins, and so on)so on)..

When we talk about diet, foods are classified When we talk about diet, foods are classified according to the kinds of nutrients they provideaccording to the kinds of nutrients they provide..

These nutrients classified as:These nutrients classified as:1.Macronutrient or proximate 1.Macronutrient or proximate

principlese.g:proteins,fat,carbohydrateprinciplese.g:proteins,fat,carbohydrate2.micronutriente.g:vitamine & minerals 2.micronutriente.g:vitamine & minerals

PROTEINSPROTEINSThese are the basic substances of our bodies – These are the basic substances of our bodies – constitute 20% of body wt ,are important source constitute 20% of body wt ,are important source of energy as wellas required forof energy as wellas required for::

A. body building i.e growth of muscle&tissueA. body building i.e growth of muscle&tissue

B. repair &maintains of tissueB. repair &maintains of tissue

C. synthesis of substance C. synthesis of substance e.g:AB,enzyme ,hormoine,HBe.g:AB,enzyme ,hormoine,HB , ,

D.maintaince of osmoticD.maintaince of osmotic

SOURCESSOURCES Milk Dried

peas Pulses Nuts

Soya beans

protein requirement are differ from age to age and protein requirement are differ from age to age and from condition to other .usually:1.8-1.5mg/kgfrom condition to other .usually:1.8-1.5mg/kg

Amino acids are essential nutrients in forming Amino acids are essential nutrients in forming cell protoplasm , there are 9 essential A.A. which cell protoplasm , there are 9 essential A.A. which are essential for the growth .histidine essential are essential for the growth .histidine essential only for infantonly for infant

* Arginine , cystine , taurine are essential for low * Arginine , cystine , taurine are essential for low birth wt infants .birth wt infants .

DeficiencyDeficiency of protein is specially harmful in childhood of protein is specially harmful in childhood..

It can lead to impairment of It can lead to impairment of physicalphysical and and mental mental growthgrowth..

Children with deficiency are more likely to get frequent Children with deficiency are more likely to get frequent infectionsinfections

..

FATSFATS

Fats are very concentrated sources of energyFats are very concentrated sources of energy..

They give twice as much energy as either proteins They give twice as much energy as either proteins or carbohydratesor carbohydrates..

Those fats which exist in Nature in the solid state Those fats which exist in Nature in the solid state are called are called fatsfats..

Those which are liquid by nature are called Those which are liquid by nature are called oilsoils..

a.as vehicle for fat-soluble vita.as vehicle for fat-soluble vit..

b.suorce of essencial fatty acidb.suorce of essencial fatty acid

c.temperature regulationc.temperature regulation. .

d. increase palatability of ffodd. increase palatability of ffod

Some vegetable oils are Some vegetable oils are hydrogenatedhydrogenated..

They are treated with particular temperature and They are treated with particular temperature and pressure in the presence of a chemical.pressure in the presence of a chemical.

After this process they can be kept even in hot After this process they can be kept even in hot climates.climates.

During the process, the vegetable oils lose certain During the process, the vegetable oils lose certain essential components which promote growth essential components which promote growth and keep the skin healthy.and keep the skin healthy.

SOURCESSOURCES(vegetable sources) include :groundnut, (vegetable sources) include :groundnut, gingerly, rape seed, coconut oil). Ghee (animal source)gingerly, rape seed, coconut oil). Ghee (animal source)..

CARBOHYDRATESCARBOHYDRATESCarbohydrates are more commonly known as starches Carbohydrates are more commonly known as starches and sugarsand sugars..

are consumed either as free-are consumed either as free-sugare.g:monosaccharides(glucose,fructose&galactosesugare.g:monosaccharides(glucose,fructose&galactose)&disaccarides(sucrose,maltose,lactose)or as complex-)&disaccarides(sucrose,maltose,lactose)or as complex-sugarei.e polysaccharides e.g starchsugarei.e polysaccharides e.g starch

They provide heat and energyThey provide heat and energy..

Glucose is Glucose is the the fuelfuel for the activity of all the cellsfor the activity of all the cells..

Carbohydrates also provide Carbohydrates also provide bulkbulk or or fiberfiber or or roughageroughage..

This is in the form of cellulose, which is the fibrous This is in the form of cellulose, which is the fibrous material present in many fruit and vegetablematerial present in many fruit and vegetabless..

SOURCES: glycogen,cereals, starchy vegetables such as potatoes

VITAMINSVITAMINS

Vitamins are complex chemical substances Vitamins are complex chemical substances required by the body in very small amountsrequired by the body in very small amounts..

There are about a dozen vitamins which are There are about a dozen vitamins which are essential to good healthessential to good health..

Which act as co-factorsw in many enzyme Which act as co-factorsw in many enzyme system&dividedin to 2 groupssystem&dividedin to 2 groups

11..Fat soluble vit.ADEKFat soluble vit.ADEK

22..Water soluble:B_complex group&vit.cWater soluble:B_complex group&vit.c..

However, a well balanced diet supplies all the However, a well balanced diet supplies all the vitamins, their actions, symptoms of vitamins, their actions, symptoms of deficiency, and sources have been given belowdeficiency, and sources have been given below

Some Vitamins in Relation to ManSome Vitamins in Relation to Man

VitaminsSymptoms of deficiency

Action in bodyGood sources

ANight blindnessNormal vision

Maintaince integrity of epithelial,removal of free-radical

Carrots, mango, papaya

B1•Weakness

•Altered nerve function

•beriberi

Normal nerve function

Whole cereals milk

B2Pellagra (dermatitis, diarrhea, dementia)

Normal metabolism of proteins, fats & carbohydrates

Whole cereals milk,egg

VitaminsSymptoms of deficiency

Action in bodyGood sources

B6•Periphral neuritis ,seizure

Normal CNS function

Widely distributed

Folic acid

AnemiaNormal nucleic acid synthesis

production of red cells

Green leafy vegetables

VitaminsSymptoms of deficiency

Action in bodyGood sources

Ascorbic acid /C

Scurvy – fatigue, hemorrhage, abnormalities of bones

Wound healing increased resistance to infection

Fresh fruit (oranges, lemons, ‘amala’ gooseberry)

DRickets – defective bones and muscles

•Normal growth of bones and teeth.•Normal muscle tone

Milk and milk products

MINERALSMINERALS Minerals required by the body include calcium, Minerals required by the body include calcium, iron, and iodine (though iodine is usually iron, and iodine (though iodine is usually described as a ‘described as a ‘trace elementtrace element.’.’

CalciumCalcium

Is necessary for the maintenance of the teeth and Is necessary for the maintenance of the teeth and bones, for clotting of blood, and for muscular bones, for clotting of blood, and for muscular contractioncontraction..

SourcesSources: milk and mild products, dried fruit : milk and mild products, dried fruit (specially dates), fresh fruit (‘sitaphal’ or (specially dates), fresh fruit (‘sitaphal’ or custard apple), and certain cereals, such as ragicustard apple), and certain cereals, such as ragi..

IronIron

Is a component of hemoglobin (the red coloring Is a component of hemoglobin (the red coloring substance in the blood), and of myoglobin (the substance in the blood), and of myoglobin (the red coloring substance in the muscles)red coloring substance in the muscles)..

It is concerned with oxygen transport and cellular It is concerned with oxygen transport and cellular respirationrespiration..

Deficiency of iron affects the formation of Hb, Deficiency of iron affects the formation of Hb, which is present in lower than normal amounts. which is present in lower than normal amounts. This is called anemiaThis is called anemia..

SourcesSources: dried fruit, nuts, jaggery, dried peas and : dried fruit, nuts, jaggery, dried peas and beans, and green leafy vegetablesbeans, and green leafy vegetables..

IodineIodine

Is important as it is used by the thyroid gland to Is important as it is used by the thyroid gland to synthesize the hormones, thyroxine and synthesize the hormones, thyroxine and triiodothyronine.triiodothyronine.

These two hormones influence the body growth and These two hormones influence the body growth and metabolism.metabolism.

Deficiency of iodine leads to low levels of thyroid Deficiency of iodine leads to low levels of thyroid hormone in the blood.hormone in the blood.

Hence the feedback or check on the anterior pituitary Hence the feedback or check on the anterior pituitary and hypothalamus is removed.and hypothalamus is removed.

Hence the hypothalamus releases the releasing hormone Hence the hypothalamus releases the releasing hormone (RH), which brings about release of the stimulating (RH), which brings about release of the stimulating hormones (SH) of the anterior pituitary.hormones (SH) of the anterior pituitary.

The SH stimulate the thyroid gland, which The SH stimulate the thyroid gland, which increases in size – this is called increases in size – this is called goitergoiter..

Though enlarged, it is unable to produce the Though enlarged, it is unable to produce the hormones, till iodine is providedhormones, till iodine is provided..

SourcesSources: sea salt, sea food, cereals, and : sea salt, sea food, cereals, and nowadays ‘iodized saltnowadays ‘iodized salt’’

Zinc :is essetial component of many Zinc :is essetial component of many enzymee.g:carbonic anhydrase,alkaline enzymee.g:carbonic anhydrase,alkaline phosphatase.widely distributed in tissue phosphatase.widely distributed in tissue :80-:80-

80-90Mg/dl normal plasma80-90Mg/dl normal plasma Zinc is essential for :Zinc is essential for : 1.normal growth1.normal growth 2.normal immunity2.normal immunity 3wound healing3wound healing 4.synthesis of hormone4.synthesis of hormone

Sources:meat,milk,nut,legumeSources:meat,milk,nut,legume

Flourine:is the most abundant element in Flourine:is the most abundant element in nature,about96% of bady flourine is present in nature,about96% of bady flourine is present in bone&teathbone&teath

Flourine is required for mineralization of Flourine is required for mineralization of bone&dental enamelbone&dental enamel

Drinking water is the principle source for itDrinking water is the principle source for it

HEALTHFUL FOODSHEALTHFUL FOODS

UNHEALTHFUL FOODS

Fast foodCanned

food Saturated fat