Module 1: BASIC NUTRITION by Alma M. Jose, RND, MCN Objectives: 1. To define basic nutrition concepts such as nutrition, health, wellness and nutrients. 2. To learn how nutrients are absorbed and pass along the body. 3. To define macronutrients and micronutrients and provide examples of each class. 4. To cite the functions and recommended amounts of the macronutrients and micronutrients 5. To list the food sources for each nutrient. 6. To describe the health effects of each nutrient Lessons: 1. Topics include basic concepts and definition of: •
Nutrition
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Health
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Wellness
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Nutrients and their functions in the body
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Basic guidelines in nutrition (food exchange list, food guides/pyramids, NGF, RENI)
2. Description, classification, digestion and metabolism, functions and recommended amounts, sources and health effects of: •
Macronutrients
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Micronutrients
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Water
Keywords: monosaccharides • sugar • sucrose • disaccharides • gluconeogenesis • lactose • polysaccharides • protein-sparing action • maltose • glucose • homeostasis • starch • fructose • hypoglycemia • glycogen • galactose • glycemic effect • fiber/dietary fiber • grains • insoluble fiber • pectins • soluble fiber • lignin • roughage • pentosan • bulk • diverticulosis • cellulose • hemorrhoids • hemi-cellulose • Amino acids - essential/non-essential • extracellular fluid • intracellular fluid • fluid and electrolyte balance • acid-base balance • buffers • dehydration • water intoxication • water balance • complete protein • incomplete protein • enzyme • pepsin • trypsin • peptidases • denaturation
Lesson 1. Basic Concepts and Definition
Optimal health and well-being require that the body be supplied with food in adequate and balanced amounts to provide the nutrients vital for normal organ development and functioning; for cell reproduction, growth, and maintenance; for high energy and working efficiency; for resistance to infection and disease; and for the ability to repair tissue damage or injury. No one nutrient works alone; each nutrient is dependent on the presence of others to bring desired results. Although everyone needs the same nutrients, each individual requires different amount of each nutrient depending on the age, gender, physiological make-up and physical activity. Knowledge about good nutrition is important because the quality of people’s lives and health depend on it. Objective • To define basic nutrition concepts such as nutrition, health, wellness and nutrients and principles. Lessons •
What is Nutrition
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What is Health
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What is Wellness
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What are nutrients and their functions
1. Nutrition – is the process by which food is converted by the body into simple substances
needed to build and repair tissues, supply energy for physical activity and to support various body functions such as respiration, digestion and elimination. Adequate nutrition is essential for good health. 2. Health - is “a state of complete physical, mental, and social well-being and not merely
the absence of disease and infirmity” according to the World Health organization (1947). A more recent definition states that health is the dynamic, ever-changing process of achieving potential in the physical, social, emotional, mental, spiritual, and environmental dimensions. 3. Wellness – involves the satisfaction of a wide array of factors that lead to positive health.
It is defined as “the achievement of the highest level of health possible in each of several dimensions. To achieve high-level wellness, a person needs to move progressively on a continuum of positive health indicators. 4. Food - refers to any edible material which when taken into the body can provide nutrients
needed to support the various body functions. 5. Nutrients - are chemical substances derived from food which the body uses to build and
repair tissues, generate energy and regulate body processes.
Food provides two different and distinct groups of nutrients: Macronutrients (macro = big) - are nutrients which the body needs in amounts of one gram or more per day and include protein, fat, carbohydrate and water. Micronutrients (micro = small) - are nutrients which the body needs in smaller amounts (less than 1 gram) and include vitamins and minerals. 6. Calorie - is the amount of heat produced or released when food is burned by the body
cells. Calorie also refers to the amount of energy required to “do work” or to perform certain physical activities. 7. Fuel or energy values of foods - Energy is the ability to do work and is measured in
terms of calories. Foods containing carbohydrate, protein and fat provide the body with energy. A gram of either carbohydrate or protein gives approximately four calories, whereas a gram of fat yields nine calories. Fat is a concentrated source of energy. Keywords: Nutrition • Health • Wellness • Food • Nutrients • Calorie • Fuel or energy value of foods
Lesson 2. Basic Guidelines in Promoting Good Nutrition Objectives: •
To identify the basic guidelines in promoting good nutrition.
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To discuss the principles of moderation, balance and variety in the Food Guide Pyramid.
Lessons: •
Food Guide Pyramid
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Nutritional Guidelines for Filipinos (NGF)
How does one know what and how much food to eat? A helpful tool in choosing the foods and the amounts needed for healthy diet is the Food Guide Pyramid. The Food Guide Pyramid (FGP) is a simple graphic presentation of foods grouped according to nutrient contribution. The FGP was developed to help individuals select a well-balanced diet to promote good health. It shows the five food groups arranged in a pyramid. The pyramidal shape indicates the relative amounts or proportions of each food group that should be eaten everyday. Foods at the base should be eaten most of, and those at the tip should be eaten the least. Foods at the middle levels should be eaten in moderation. At the base of the pyramid are carbohydraterich foods such as rice and other cereals, bread and root crops. These foods provide the bulk of the Filipino diet. Vegetables and fruits provide not only vitamins and minerals but also fiber and should be eaten more of. Meat, fish, poultry and dairy products provide good quality protein but are also sources of fat and therefore should be eaten in moderation. Sugar and fat which provide calories mainly are recommended to be eaten the least..
The Pyramid also points to exercise, personal and environmental hygiene as essential for the child’s health and suggests for physical activity to substitute television watching or playing computer games. The Food Guide Pyramid shows how the principles of variety, moderation and balance can be applied in the selection and consumption of foods. A picture of the Food Guide Pyramid and the recommended number of servings for healthy adults is shown in Figure 1.
The Nutritional Guidelines for Filipinos (NGF) is a set of ten messages of simple recommendations that give advice about proper diet and wholesome practices to promote good health for each individual and family members. The NGF was developed in 2000 by the Technical Working Group on the Nutritional Guidelines for Filipinos led by the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST). The NGF messages were based on the nutritional status data of Filipinos and the current dietary habits and food patterns, taking into consideration the country’s food availability and supply, as well as socio-economic condition and cultural practices of the population. The following are the 10 recommended messages in the NGF: 1. Eat a variety of foods everyday.
2. Breastfeed infants exclusively from birth up to 6 months, and then, give appropriate foods while continuing breastfeeding.
3. Maintain children’s normal growth through proper diet and monitor their growth regularly. 4. Consume fish, lean meat, poultry or dried beans. 5. Eat more vegetables, fruits and rootcrops.
6. Eat foods cooked in edible/cooking oil daily. 7. Consume milk, milk products, and other calcium-rich foods such as small fish and dark
green leafy vegetables everyday. 8. Use iodized salt, but avoid excessive intake of salty foods. 9. Eat clean and safe foods. 10. For a healthy lifestyle and good nutrition, exercise regularly, do not smoke and avoid drinking alcoholic beverages. To better understand these messages, the aims and rationale for each message are described as follows: Guideline No. 1 – intends to emphasize the message that no single food provides all the nutrients the body needs. Choosing different kinds of foods from all food groups is the first step to obtain a well balanced diet. This will help correct the common practice of confining food choice to a few kinds of foods, resulting in an unbalanced diet. Guideline No. 2 – intends to promote exclusive breastfeeding from birth up to 6 months and to encourage the continuation of breastfeeding for as long as two years or longer. This is to ensure a complete and safe food for the newborn and the growing infant besides imparting the other benefits of breastfeeding. The Guideline also strongly advocates the giving of appropriate complementary food in addition to breast milk once the infant is ready for solid foods about 6 months to 2 years. Feeding the child properly during this critical period should be given close attention. Guideline No. 3 – gives advice on proper feeding of children. The Guideline also promotes regular monthly weighing to monitor the growth of children, as it is a simple way to assess nutritional status. Guidelines Nos. 4, 5, 6, & 7 – intends to correct the deficiencies in the current dietary pattern of Filipinos. Including fish, lean meat, poultry or dried beans will provide good quality protein and energy, as well as iron and zinc, key nutrients lacking in the diet of Filipinos as a whole. Eating more vegetables, fruits and root crops will supply the much-needed vitamins, minerals and dietary fiber that are deficient in the diet. In addition, it provides defense against chronic degenerative diseases. Including foods cooked in edible oils will provide dietary energy as a partial remedy to energy deficiency of the average Filipino especially children, and better utilization of fat- soluble vitamins A, D, E, and K. Including milk and other calcium-rich foods in the diet will serve not only to supply calcium for healthy bones but also provide high quality protein and other nutrients for growth. Guideline No. 8 – promotes the use of iodized salt to prevent iodine deficiency, which is a major cause of mental and physical underdevelopment in the country. At the same time, the Guideline warns excessive intake of salty foods as a hedge against hypertension, particularly among high-risk individuals.
Guideline No. 9 – intends to prevent food borne-diseases. It explains the various sources of contamination of food and simple ways to prevent from occurring. Guideline No. 10 – aims to promote a healthy lifestyle through regular exercise, abstinence from smoking, and avoiding alcohol consumption. If alcohol is consumed, it must be done in moderation. All these lifestyle practices are directly or indirectly related to nutrition. Keywords: Moderation • Balance • Variety • Nutritional Guidelines for Filipinos Lesson 3. What Happens to the Food We Eat (The Digestive Process) The food eaten undergo digestion, absorption and utilization. Metabolism refers to the chemical processes that occur inside the cells as they transform nutrients into energy and body tissues. The transformation of foods into various nutrients like carbohydrates, fats, and protein and other physiological processes are parts of the metabolic processes. Objectives 1. To describe how foods are digested and transformed through the body 2. To identify the roles of the various digestive organs 3. To discuss how nutrients are utilized in the body Lessons 1. The digestive organs 2. How food moves through the body 3. How nutrients are absorbed and pass along the body The appetizing sight and smell of food stimulate the digestive organs into action. The mouth waters. The stomach contracts. Intestinal glands begin to secrete the chemicals that will act on food and break them into simple substances. The digestive system has the ability to turn complex food into basic nutrients. This requires a group of digestive organs, each designed specifically to perform one role in the process. The digestive system is a long tube that starts at the mouth, continuous down through the throat, to the stomach, and then to the small and large intestine and past the rectum to end at the anus. In between, with the help of the liver, pancreas, and gallbladder, the digestible parts of everything eaten are converted to simple substances that the body can easily absorb to burn for energy or build new tissue form. The indigestible residue is bundled off and eliminated as waste. Digestion is a two-part process – half mechanical, half chemical. • Mechanical digestion takes place in the mouth and the stomach. The teeth break food into small pieces that can be swallowed without choking. In the stomach, a churning action continues to breakdown food into smaller particles.
• Chemical digestion occurs at every point in the digestive tract where enzymes and other substances such as hydrochloric acid (from stomach glands) and bile (from the gallbladder) dissolve food, releasing the nutrients contained. How the Body Digests Food Each organ in the digestive system plays a specific role in the digestive process. The first act occurs in two places that are never listed as part of the digestive tract: the eyes and nose. The Mouth Food is lifted and put into the mouth and the teeth and salivary glands swing into action. The teeth chew, grinding the food, breaking it into small, manageable pieces. As a result: •
The food can be swallowed without choking.
•
The indigestible sheath of fiber surrounding the edible parts of some foods is broken down so that the digestive enzymes can get to the nutrients inside.
At the same time the salivary glands under the tongue and in the back of the tongue secrete the watery liquid called saliva, which performs two important functions: •
Moistens and compacts food so that the tongue can push it to the back of the mouth sending the food down into the esophagus and into the stomach.
•
Provides amylases, enzymes that start the digestion of complex carbohydrates, breaking the starch molecules into simple sugars. No protein or fat digestion occurs in the mouth.
The Stomach The stomach is pouchy part just below the esophagus that holds the chewed food. Like most of the digestive tube, the stomach is circled with strong muscles whose rhythmic contractions - called peristalsis – move food along and turn the stomach into a sort of food processor that mechanically breaks pieces of food into even smaller particles. While this is going on, glands in the stomach wall are secreting stomach juices – a potent blend of enzymes, hydrochloric acid and mucus. Other enzymes, plus stomach juices, begin the digestion of protein and fats, separating these into its basic components – amino acids and fatty acids. The Small Intestine Open the hand and put it flat against the belly button, with the thumb pointing up to the waist and the pinkie pointing down. The hand is now covering most of the relatively small space into which the 20-foot long small intestine is neatly coiled. When chyme spills from the stomach into this part of the digestive tube, a whole new set of gastric juices are released. These include: •
Pancreatic and intestinal enzymes that finish the digestion of protein into amino acids
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Bile, a greenish liquid (made in the liver and stored in the gallbladder) that enables fats to mix with water;
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Alkaline pancreatic juices that make the chyme less acidic so that amylases (the enzymes that break down carbohydrates) can go back to work separating complex carbohydrates into simple sugars
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Intestinal alcohol dehydrogenase that digests alcohol not previously absorbed into the bloodstream
Inside the cells, nutrients are metabolized: burned for heat and energy or used to build new tissues The Large Intestine After every useful, digestible ingredient other than water has been wrung out of the food, the rest – indigestible waste such as fiber – moves to the top of the large intestine, the area known as the colon. The colon’s primary job is to absorb water from this mixture and then to squeeze the remaining matter into the compact bundle known as feces. Feces (whose brown color comes from leftover bile pigments) are made up of indigestible material from food, plus cells that have sloughed off the intestinal lining and bacteria. In fact, about 30 percent of the entire weight of the feces is bacteria. Keywords: Digestion • Absorption • Metabolism • Excretion
TAKE A QUIZ Number the following organs according to proper sequence of the digestion process. 1. Small intestine 2. Stomach 3. Esophagus 4. Mouth 5. Large intestine
Multiple Choice: Select the one choice that best answers the question. 6. These proteins come from foods whose amino acid content is incapable either of
maintaining life or of supporting growth.
Complete protein Incomplete protein Nonessential protein Essential protein 7. Vitamin needed to help prevent macrocytic anemia.
Vitamin B1 Vitamin B3 Vitamin B2 Vitamin B9 8. This provides the medium for transport, chemical reactions, protection, lubrication, and
temperature regulation in the human body. Water Electrolytes Saliva Fluid 9. The process of breaking down food in the body so that it can be absorbed through the
lining of the intestinal tract and other nutritious materials by the body. Absorption Metabolism Digestion Excretion
10. Deficiency in this vitamin may lead to neural tube defects.
Vitamin B1 Vitamin B3 Vitamin B2 Vitamin B9 11. Major concern for humans because it provides bulk and is related to the formation of
feces. Monosaccharides Disaccharides Polysaccharides Fiber 12. This can also be called the “sunshine” vitamin since the body can manufacture this
nutrient when sunshine activates the cholesterol in the skin. Vitamin A Vitamin C Vitamin K Vitamin D 13. Minerals that the body needs in minimal amounts.
Macrominerals Trace minerals Iron
Sodium 14. Vitamin which is water-soluble and has a characteristic red color.
Vitamin C Vitamin B6 Vitamin B12 Vitamin B3 15. Protein energy deficiency wherein the child looks apathetic, new hair grows without the
protein pigment that gave it color, is anemic, and has bloated belly and legs. Marasmus Kwashiorkor Undernutrition Malnutrition 16. Mineral needed for formation of bone and teeth; protects against tooth decay.
Iron Fluorine Copper Iodine 17. Abnormal deposits of hemosiderin in the liver, spleen and other tissues due to abnormal
activity of the iron absorption – storage mechanism as a result of too much or excess iron intake. Hemochromatosis
Hemosiderosis Fatty liver Cirrhosis of the liver 18. Inorganic, indestructible elements that aid physiological processes within the body.
Vitamins Minerals Carbohydrates Fats 19. Excessive amounts of this vitamin may cause a rise in calcium and phosphorus in the
blood and excessive excretion of calcium on the urine. This may lead to calcification of soft tissues and of the walls of the blood vessels and kidney tubules, a condition called hypercalcemia. Vitamin A Vitamin C Vitamin K Vitamin D 20. Chemical substances present in foods which the body uses to build, maintain, and repair
tissues. Nutrients Vitamins Minerals Electrolytes
