INTRODUCTION TO NUTRITION

Food is a basic need for all living beings. Food gives us energy to carry out
our day-to-day activities and keeps all the system in our body functioning well.
Food supplies the nourishing substances needed by our body to build and repair
tissues and to regulate various function.

DEFINITIONS

Food: Food can be defined as any substance which nourishes the body and is fit
to eat. It may be solid or liquid. Food provides the body with materials for
providing energy, growth and maintenance, and regulating various processes in
the body. These materials of which food is made up of are termed nutrients.

Nutrients: Nutrients are the chemical substances present in food, which the
body needs to carry out its functions. There are six major groups of nutrients,
namely, proteins, carbohydrates, fats, vitamins, minerals, and water.

Nutrition: Nutrition is the science of nourishing the body. It includes much more
than just consuming a balanced diet. Nutrition is a study of various nutrients,
their characteristics, functions, requirement, and sources. The effect of
deficiency, excessive intake, digestion, absorption, and utilization in the body as
well as the interrelationships that occur among some nutrients is an important
part of nutrition.

RELATION OF FOOD AND HEALTH

Malnutrition: Malnutrition is an impairment of health resulting from a

deficiency, excess, or imbalance of nutrients in the diet. It includes both
undernutrition or deficiency and over nutrition or excessive consumption.

Undernutrition: It refers to a deficiency of calories and/or one or more nutrients

in the diet. An undernourished person is underweight.

Over nutrition: It refers to an excess of calories and/or one or more nutrients in

the diet. An excessive intake of calories results in overweight which can lead to
obesity. An excessive intake of fat soluble vitamins can cause hypervitaminosis or
vitamin toxicity.

Diet: A diet means the kinds and amounts of food and beverage consumed every
day. A diet may be normal diet or it may be a modified diet which is used in the
treatment of specific disease or condition.
Health: The World Health Organization defines health as a state of complete
physical, mental and social well being and not merely the absence of disease or
infirmity.

NUTRITIONAL STATUS

The nutritional status of an individual is defined as the condition of health

as influenced by the utilization of nutrients in the body. The nutritional status of
an individual or a community can be assessed by surveying the kind and amount
of food being consumed, signs of ill health or deficiency symptoms if present,
height, weight, and other measurements as well as level of nutrients in the blood
and excreted in the urine.

FOOD AND ITS FUNCTIONS

Physical functions

Each nutrient in food has specific functions to perform in the body. The
physiological functions performed by food are as follows:

Providing energy: The body needs energy to carry out voluntary and involuntary
work. Involuntary work includes all process which is not under the control of our
will such as digestion, respiration, and circulation and goes on continuously
irrespective of whether we are asleep or awake. Voluntary activities or activities
which we wish to do such as walking, playing games, and working require energy,
and the amount of energy required will depend on the nature of activity. The
energy needed for these activities in supplied by oxidation of the foods we eat
mainly carbohydrates and fats.

Body building or growth: It is one of the most important functions of food. An

infant grows into a healthy adult by consuming the right kinds and amount of
food year after year. Our body is made up of millions of cells and when growth
takes place, new cells are added to the existing cells and cells increase size.

Maintenance or repair: In the adult body, worn out cells are continuously being
replaced by new ones. The daily wear and tear of cells needs to be maintained.
Proteins, minerals, and water are the main nutrients required for growth as well
as maintenance of all cells and tissues in the body.

Regulation of body processes: Food also regulates numerous activities in the

body such as the beating of the heart, maintenance of body temperature, clotting
of blood, and excretion of wastes. Each of these processes is controlled and
carried out by specific nutrients for example vitamin K and calcium is necessary
for clotting of blood.

Protective function: Nutrients keep body cells in a healthy condition to ward off
infection, they help in building up the bodys resistance to disease and help the
body recover rapidly from any infection. These functions are performed by
vitamins and proteins.3

Psychological function

We all have emotional needs such as need for love, attention, and security. Food
can play an important role in fulfilling these needs. Mother can express her love
for her child by preparing the childs favourite meal. Food can be given as a
reward for good behavior or deprived as a punishment for bad behavior. People
feel comfortable and secure when they are served food they have been used to
consuming. Many people eat to relieve anxiety and frustration, while some may
eat less or refuse food when they are depressed and lonely. Food is therefore
strongly associated with ones emotions and feelings.

Social function

Food carries a lot of social significance. Warmth and friendship are

expressed through sharing ones food or inviting people to dine. Preparing special
foods or ones favourite food is a way of showing respect or affection.

Food is a significant part of celebrations for occasions such as birthdays,

weddings, and other joyous occasions. Festivals such as Diwali, Dussehra,
Christmas and Id have special menus prescribed for the occasions.

Food also has religious significance. Some foods can be offered to god,
while other are avoided on certain days for religious reasons. The type of food
prepared and served is a status symbol. Even today, in some communities, adult
males are given more and better quality food than females because of their higher
social status.

CLASSIFICATION OF NUTRIENTS

Nutrients are the essential constituents of food that are required by the
body in suitable amounts. There are approximately fifty nutrients which are
placed in six categories, namely, proteins, carbohydrates, fats, vitamins,
minerals, and water. The requirement for macronutrients is in grams, while the
requirement for micronutrients is in milligrams and micrograms.1

CARBOHYDRATES
 Carbohydrates are a major source of energy for humans, providing
approximately 45% to 80% of the total caloric intake in different income
groups. They are mainly present in food in the form of sugars, starches and
fibers.

CLASSIFICATION OF CARBOHYDRATES

S.No Category Name of carbohydrate Sources

Simple Carbohydrates or Sugars
1. Monosaccharides Glucose (dextrose) Fruits, vegetables, honey
(single sugar Fructose (levulose)
unit) Galactose On hydrolysis of lactose
2. Disaccharides Sucrose (glucose+fructose) Sugar cane, sugar beet.
(two sugar units) Maltose (glucose+glucose) Sprouted and malted
grains, acid hydrolysis of
starch.
Lactose (glucose+galactose) Milk is the only sources
Complex Carbohydrates or Polysaccharides
1. Available Starch Cereals, pulses, roots,
tubers, vegetables and
under-ripe fruits.
Glycogen (animal starch) Liver and muscle of
freshly slaughtered
animals.
Dextrin Partial breakdown of
starch by dry heat or
digestion.
2. Unavailable or dietary fibres
a) Water insoluble Cellulose Structural fibre in whole
Hemicellulose grain cereals, nuts,
wheat bran, figs,
vegetables etc.
b) Water soluble Pectins Non-structural fibres in
Gums apples, citrus fruits,
Mucilages guava, oats, barley,
pulses, seaweeds etc.
FUNCTIONS

1. The chief function of carbohydrate is to provide energy to the body so that

it can carry out day-to-day work and maintain body temperature. All
carbohydrate except fiber provides 4 kcal/g of energy. It is the cheapest
source of energy available.
2. Glucose is the only form of energy used by the central nervous system.
When blood glucose levels fall, the brain does not receive energy and
convulsions may occur.
3. Carbohydrates can be converted into non-essential amino acids, provided a
source of nitrogen is available.
4. The sugar lactose helps in the absorption of the minerals calcium and
phosphorus.
5. Lactose helps certain bacteria to grow in the intestine. This bacterial flora
is capable of synthesizing B-complex vitamins in the gut.
6. Dietary fibre plays an important role of increasing faecal mass by
absorbing and holding water, stimulating peristalsis, and eliminating
faecal waste.
7. Fibre also helps in lowering blood cholesterol levels by binding bile acids
and cholesterol.

ROLE OF DIETARY FIBRE IN PREVENTION AND TREATMENT OF DISEASE

Dietary fibre refers to the total amount of naturally occurring material in

plant foods, which is not digested. The terms roughage, bulk, and unavailable
polysaccharides are synonymous with fibre. Fibres cannot be digested by human
enzymes.

Dietary fibre or roughage does not provide humans with but performs
many important functions in the body. Fibre can absorb and hold water thereby
increasing faecal bulk. This acts as a laxative and reduces intraluminal pressure
in the colon preventing diverticulosis. Insoluble fibre prevents constipation by
stimulating peristalsis in the large intestine. The contraction of muscular walls of
the digestive tract is stimulated by fibre. Fibre increases water absorption,
forming a larger, softer stool that rapidly passes through the colon. Soluble fibre
binds bile acids and cholesterol and is beneficial to people suffering from
coronary heart disease. Fibre reduces the triglyceride and cholesterol levels in
blood.

Functions and sources of dietary fibre

a) Insoluble Fibres
S.No Type Functions Food source

1 Cellulose 1. Insoluble fibre Bran whole grain

2. Holds water cereals, especially
3. Increases stool bulk wheat, rye, apples,
4. Reduces intraluminal cabbage, beans.
colonic pressure
2. Hemicellulose 5. Prevents constipation Bran, whole grain
6. Binds minerals such as cereals, especially
Ca and Fe millets-jowar, bajra,
7. Binds bile acids ragi.
3. Lignin(non 8. Reduces transit time Whole grain cereals
carbohydrate pears, peaches,
source) plums mature
vegetables

b) Soluble fibres

S.No Type Functions Food source

1. Pectins 1. Soluble fibre Guava, apple, citrus

2. Binds cholesterol and fruits, wood apple,
bile acids berries, carrots and
3. Holds water green beans.
2. Gums 4. Fermented in the colon to Oatmeal, pulses and
volatile fatty acids and beans, processed
gas by the normal foods.
3. Mucilages, bacteria flora of the colon Thickener in food
seaweeds and products, stabilizer,
algae gelling agent in
puddings.

Fibre is beneficial to people on weight reduction regime. It helps in

lowering blood sugar levels in diabetic individuals by slowing down
carbohydrate absorption and lowers the insulin requirement. Regular intake of
fibre may prevent cancers of the colon and rectum. Food such as whole grain
cereals, fruits, and vegetables, especially when the peel and seeds are edible,
are rich sources of fibre. The fibre content of the daily diet should be
approximately 30-40 g/day.
4

SOURCES
Cereals Pulses Fruits and Nuts and Miscellane
 ous
Vegetables Oilseeds
Wheat All whole grains and Mango Cashewnuts Sugar
Rice dehusked pulses Chikoo Coconut Jaggery
Jowar and their by- Jackfruit (dry) Honey
Bajra products. Custard apple Groundnuts Sago
Ragi e.g., rajma, bengal Banana Gingelly Tapioca
Oats gram, whole green Beans seeds Dates
Barley gram, lentils, and Potato Raisins
Corn besan. Yam
Colocasia

LIPIDS

Fats and oils belong to a group of compounds called lipids, which are
insoluble in water butoluble in fat solvents. Like carbohydrates they are
mainly made up of carbon, hydrogen, and oxygen. They contain much
smaller proportions of oxygen than carbohydrates and larger proportions of
carbon and hydrogen. Hence, they are a more concentrated source of
energy.
The lipids of importance to our health are fatty acids, fats, oils,
phospholipids, lipoproteins, and sterols.

FATTY ACIDS

Fatty acids consist of chains of carbon atoms with a methyl (CH 3)

group at one end and a carboxyl (COOH) group at the other end. Fatty
acids may have short chains or they may have long chains (12-22 carbon
chains). They may be saturated or unsaturated. Saturated fats have single
bonds between carbon atoms, while unsaturated fats have one or more
double bonds between the carbon atoms. Fatty acids with two or more
double bonds are called polyunsaturated.

Unsaturated fatty acids

Unsaturated fatty acids are two types monounsaturated fatty acids

(MUFA) and polyunsaturated fatty acids (PUFA).

Monounsaturated fatty acids

Oleic acid is a monounsaturated fatty acid and has one double bond.
It is found in groundnut, olive oil, corn oil, etc. They may help lower blood
cholesterol levels.

Polyunsaturated fatty acids

The polyunsaturated fatty acids are those with two or more double
bonds. They include linoleic acid (two double bonds) linolenic acid (three
double bonds) and arachidonic acid (four double bonds). They help in lowering
blood cholesterol levels and prevent atherosclerosis and coronary heart
disease.

Some unsaturated fatty acids present in food

Fatty acid Food source

Oleic acid Groundnuts, sesame, olives, butter, cocoa butter,
cashew nuts, avocado
Linoleic acid Safflower, sunflower, cottonseed, corn, soyabean,
groundnut, salmon, tuna
Linolenic acid Soya bean, rape seed, sesame, butter
Arachidonic acid Animal fats, groundnut
Erucic acid Rape seeds oil/mustard oil
Eicosapentaenoic acid Fish oils

Essential fatty acids

Two of the polyunsaturated fatty acids (PUFA) cannot be synthesized

by the body. They have to be provided in the required amount by our diet
and are called essential fatty acids. They are linoleic acid, an omega6 fatty
acid, and linolenic acid, an omega-3 fatty acid.

Saturated fatty acids

These are found in animal foods such as meat, butter, cheese, and
egg yolk and in plant foods such as coconut oil, palm oil, and cocoa butter.
Hydrogenated fats used in bakery products and confections have a high
percentage of saturated fatty acids. Stearic acid, palmitic acid, myristic
acid, and butyric acid are some of the saturated fatty acid. A maximum of
10% of our total calories should come from saturated fats.

Some saturated fatty acids present in food

Fatty acid Food source

Acetic acid Vinegar
Butyric acid Butter
Caproic acid Butter
 Caprylic acid Coconut, palm kernel
Lauric acid Palm kernel, coconut
Myristic acid Coconut, butter
Palmitic acid Palm, soya, sesame, butter, lard, cotton seed
Stearic acid Beef tallow, cocoa butter, lard

PHOSPHOLIPIDS

They are composed of fats, phosphoric acid, and a nitrogenous base,

e.g., lecithins and cephalins. They are required for cell permeability and for
the formation of brain and nervous tissue. They help in transporting fats
throughout the body as they form a part of lipoproteins.

LIPOPROTEINS

They include chlyomicrons, very low-density lipoproteins (VLDL),

low-density lipoproteins (LDL), and high-density lipoprotein (HDL). They
are composed of lipids (triglycerides, cholesterol, and phospholipids) and
proteins in varying proportions with percentage of protein being least in
chylomicrons and more in HDL. Lipoproteins are required for transporting
triglycerides to various tissues in the body via blood circulation. Since LDL
is the main carriers of cholesterol, an increase in LDL increases the risk of
heart disease. HDL helps in lowering blood cholesterol. An LDL/HDL ratio
of less than 3 is desirable.

GLYCOLIPIDS

They contain glucose or galactose in place of one of the fatty acids in the
triglyceride molecule.

CHOLESTEROL

It is a fat like substance present in food. It is different in structure from

triglycerides, as it has a ring structure. It is present in all cells of the body and in
large amounts in brain and nerve tissue. Cholesterol if consumed in excess is
responsible for diseases of the cardiovascular system. The normal blood
cholesterol level for adults should be below 200mg/100ml blood. The human
body gets cholesterol from two sources:

1. Synthesis in the liver

2. Food rich in cholesterol
 If the diet is deficient in cholesterol, the body can synthesize the required
cholesterol. The functions of cholesterol are listed below:

1. Cholesterol is a precursor of all steroid hormones e.g. sex hormones.

2. A precursor of vitamin D, 7-dehydrocholesterol is present in the skin which
is irradiated by UV rays of sunlight to form vitamin D.
3. It is required for formation of bile.
4. It is an essential constituent of cell membranes.

Cholesterol is present in animal foods only. Whole milk, butter, ghee,

cream, egg yolk, organ meats, and shellfish are rich sources.
It is also synthesized by the body independent of the dietary intake.

FUNCTIONS OF FATS

Energy: Fats are a concentrated source of energy in our diet. One gram of fat/oil
gives nine kilocalories when it is oxidized in the body.

Protein sparing action: The kilocalories from fat spare dietary proteins from being
oxidized for energy. An adequate intake of fat in the diet allows proteins to
perform their main functions of growth and maintenance.

Thermal insulation: Subcutaneous fat act as insulation and helps in retaining

body heat.

Protection of vital organs: Fat provides protective padding to vital organs from
mechanical shock and keeps them in place.

Absorption of fat soluble vitamins: Fat is necessary for the absorption of fat
soluble vitamins A, D, E, and K.

Essential fatty acids: An adequate intake of fats and oils is necessary to meet the
bodys requirements for linoleic and linolenic acids.

Satiety value: Fats slow down the secretion of gastric juice and speed of digestion.

Synthesis of cell membranes: Fats are an important constituent of all cell

membranes.

Synthesis of hormones: The lipid cholesterol is necessary for the synthesis of

some hormones, e.g., sex hormones.

FOOD SOURCES
 Most foods except the bread cereal group and the vegetable fruit group
(except olives and avocado) contain varying percentages of lipids. Some fats are
visible such as fats and oils added to food or used for frying. Many sources are
hidden or invisible such as the fats and oils naturally present in the food, e.g.,
milk, egg yolk, oily fish, and meat. Both visible and invisible sources must be
taken into account while calculating the fat content of a meal.

Plant sources

All oils and oilseeds like groundnut, sesame, soya bean, rice bran, coconut,
almond, cashew nut, corn, safflower, sunflower, and all hydrogenated fats and
margarine are sources of lipids.

Animal sources

Mutton, pork, fish, poultry, milk, and milk products such as butter, cream,
yoghurt, cheese, eggs and organ meats.

Invisible sources

Invisible sources of fats are nuts, salad dressings, flesh food, desserts,
cookies, cakes, milk, eggs, milk based sweetmeats, etc., which are rich in fat, but
the fat is not visible.

WATER

Water is the most essential constituent of our body. It accounts for 55-70%
of our total body weight. Men have a higher proportion of water in their body as
compared to women. Lean individuals have more water than the obese, and
infants and children have a greater proportion of water than adults.

The total body fluid is distributed among two major compartments.

1. The extracellular fluid or water present outside the cells in the interstitial
spaces and blood plasma.
2. The intracellular fluid or the water present inside the cells.

Functions

1. Water quenches thirst and is the most refreshing and cooling of all
liquids.
2. It is a structural component of all cells. In the bone, water is tightly
 bound, but in most tissues, a constant interchange takes place between
the body compartments of water.
3. Water is the medium in which all chemical reactions take place.
4. It is an essential component of all body fluids such as blood, lymph,
cerebrospinal fluid, bile, digestive juices, and urine.
5. It acts as a lubricant and helps food to be swallowed and digested food
to pass through the gastro intestinal tract.
6. It acts as a solvent for the products of digestion and helps in
transporting these products to different tissues.
7. Water regulates body temperature by taking up and distribution of heat
produced in cells when metabolic reactions take place.
8. It helps in excreting waste products of metabolic reaction.
9. Water is essential to maintain the turgidity of cells.

Daily intake of water

Apart from the water we drink during the day to relieve thirst between and
during meals, there are three major sources of water.

Beverages and liquid foods: Hot and cold beverages such as tea, coffee, milk
shakes, fruit juices, and soups are largely made up of water.

Water content of solid foods: Another important source of water is fruits,

vegetables, and the water used for cooking food. Solid foods contain varying
percentages of water. The water consumed from beverages and solid food
amounts to 2,100 ml/day approximately.

Metabolic water: It is synthesized in the body as a result of oxidation of fats,

proteins and carbohydrates, adding to about 200ml/day.

Oxidation of 100g of fat 107 ml water

Oxidation of 100g of protein 41 ml water

Oxidation of 100g of carbohydrate 56 ml water

Daily loss of body water

Water loss through sweat: The extent of water loss through perspiration or
sweat largely depends on physical activity ad environmental temperature. The
volume of sweat secreted is normally about 100 ml/day but could increase to a
few litres in very hot weather or during heavy exercise.

Water loss in urine: This is the most important mechanism by which the body
maintains a balance between fluid intake and output as well as electrolyte
homeostasis. Urine volume can be as low as 0.5 litres/day in a dehydrated
person or as high as 20 litres/day in a person who has been drinking
tremendous amount of fluid. The rate of filtration of water in the normal kidney
is about 125 ml/minute or approximately 180 litres daily for an adult. About
99% of the water filtered is absorbed into the blood while 500-2000 ml is excreted
as urine.

Water loss in faeces: Only a small amount of water (100ml/day) is normally lost
in faeces. The saliva, gastrointestinal secretion, and bile may together add to 8
litres or more fluid per day. If there is diarrhea or vomiting, fluid losses may be
large and cause dehydration.

Insensible water loss: It is the loss of water we are not consciously aware of even
though it occurs continuously in all living beings. It includes loss of fluid by
evaporation from the skin and through respiratory tract which is greater in cold
weather.

Water balance

Daily intake and output of water

Intake Output

Fluids ingested 2,200 Insensible-skin 350

From metabolism 200 Insensible-lungs 350
Sweat 100
Faeces 100
Urine 1,500
Total 2,400 2,400
3

Deficiency of water

Excessive loss of water could take place due to diarrhea, vomiting, fever,
excessive perspiration, strenuous exercise, and uncontrolled diabetes mellitus.
It can result in dehydration. Dehydration can be classified as

Mild <5% fluid loss

Moderate 5-15% fluid loss
Severe 15-20% fluid loss

A 20% loss of fluid from the body can be fatal.

 A dehydrated person feels thirsty, has a dry mouth, sunken and dry eyes,
and may feel restless, irritable or even lethargic or unconscious in severe cases.
The skin when pinched does not go back quickly. A dehydrated person is
usually managed by oral rehydration therapy (ORT). The WHO recommends
oral rehydration salts (ORS) that are to be dissolved in 1 litre of water. This is
to be sipped till hydration returns to normal.

ORS Formula
Ingredients Amount in grams
Sodium chloride (NaCl) 3.5
Disodium citrate dehydrate 2.9
Potassium chloride 1.5
Glucose anhydrous 20
Water 1 litre

Oral rehydration salts are most often prescribed in cases of diarrhoea.

Glucose present in ORS enhances the absorption of salt.

Apart from ORS, ORT also includes any of the following.

1.Sugar and salt solution.

40g sucrose + 4 g NaCl in 1 litre of water.
2.Rice water with salt.
50g rice + salt in 1 litre water.
3.Dilute salted lassi.
4.Plain water, lemon water, coconut water, thin soups, or dal water may also
be given along with ORT.

If vomiting is severe, intravenous fluids such as normal saline (0.9%

NaCl) and dextrose need to be administered. When the body loses fluids, it
loses both water and electrolytes, hence ORS or Dextrose Normal Saline (DNS)
is given. Dehydration cannot be treated by giving pure water only.

ENERGY

Energy is defined as the ability to do work. Energy exists in several forms. The
forms of energy important in nutrition are:
1. Chemical energy in food.
2. Light or solar energy for synthesis of vitamin D in the skin and for
photosynthesis is plants.
3. Mechanical energy for movement of muscles.
4. Electrical energy for functioning of the brain and verve cells.
 5. Heat energy, generally produced when energy is converted from one form to
another. They energy from food is finally converted into heat energy.

UNITS OF MEASUREMENT

The energy present in food or the energy needed by the body is measured
in units called joules or calories. The calorie in nutrition is the large calorie or
kilocalorie. The kilocalorie is defined as the amount of heat required to raise the
o
temperature of 1 kg (1000g) of water by 1 C. This calorie is 1000 times bigger
than the calorie used in physics. The international unit for energy is the joule (J)
and it is the energy expended when 1 kilogram (kg) is moved 1 metre
(m) by a force of 1 newton (N).
Scientists and nutritionists are concerned with large amounts of energy, so
3 6
they use the units kilocalorie, kilojoules (kJ= 10 J), or megajoule (MJ=10 J) to
express energy.
1 kilocalorie = 4.184 kilojoules
1 megajoule = 239 kilocalories

ENERGY VALUE OF FOOD

The energy content of various foods can be measured in two ways: by

calorimetry or by proximate composition.

Calorimetry

The bomb calorimeter is based on the principle of calorimetry. It measures

the heat produced when the food sample is ignited by an electric spark in the
presence of oxygen and platinum which acts as a catalyst. The bomb calorimeter
is made of two main parts an inner part in which a measured quantity of food
sample to be tested is placed and an outer portion which contains a known
volume of water. When the food sample is electrically ignited, the surrounding
water absorbs the heat produced. The energy value of the food is calculated by
measuring the rise in temperature of water, based on the definition of the term
calorie.

Proximate Composition

This is a simpler and faster way of determining the calorie content of food.
The approximate carbohydrate, fat and protein content of a food given in the food
composition tables is multiplied by their fuel factor, i.e., calories provided by 1 g
of the nutrient and this total gives the energy value of the food.

Carbohydrates 4 kcal
Proteins 4 kcal
Fats 9 kcal

ENERGY NEEDS OF THE BODY

The energy requirement for an average healthy person is based on the

energy required to carry out basal processes as well as the energy cost of
activities one indulges in. The allowances are suggested for a reference man
weighing 60kg and a reference woman weighing 50 kg in the 20-39 year age
group.

Reference Man: The reference man is between 20-39 years of age and
weighs 60kg. He is in a state of good health, free from disease, and
physically fit for active work. He is moderately active and is employed for
8 hours in moderate work. He spends 8 hours in bed, 4-6 hours sitting or
engaged in light work, and 2 hours in walking, active recreation, or
household chores. On an average his energy requirement is 2875 kcal.

Reference Woman: the reference woman is between 20-39 years of age and
weighs 50kg. She is moderately active and spends 8 hours in routine
household work. She spends 8 hours in bed, 4-6 hours sitting or moving
around and performing light activity, and 2 hours in walking, active
recreation, or household chores. On an average her energy requirement is
2225 kcal.

BASAL METABOLIC RATE

The amount of energy required by the body for carrying out involuntary
work and maintaining the body temperature is known as the basal metabolic rate
(BMR). The involuntary work includes the functioning of various organs and
system which work continuously to keep the body processes going such as the
heart and blood circulation, the kidneys and excretion. Approximately one third
of this energy is needed for these processes while the remaining two thirds is
utilized for maintenance of muscle tone.
Factors affecting the BMR

Many factors influence the BMR.

Body size: Heat is continuously lost through the skin. A tall well built person
has a greater skin surface area than shorter or smaller person and loses more
heat through the skin and hence has a higher BMR.

Body composition: The amount of muscle tissue and adipose or fatty tissue in
the body affects the BMR. An athlete with well built muscles and little body fat
has a higher BMR than a non athlete with more body fat of the same weight. The
metabolic activity in muscle tissue or lean tissue is much more as compared to
adipose or fatty tissue.

Age: During periods of rapid growth, the BMR increases by 15-20% because the
growth hormone stimulates cell metabolism and new cells are formed. It is high
during infancy, pre-school years, and puberty. During pregnancy and location it
rapidly increases once again. The BMR gradually decline with age at the rate of
2% for each decade after the age of 21 years.

Sex: The BMR is 10% higher is male as compared to female. The difference in
BMR is attributed to a higher proportion of adipose tissue in females and
hormonal variations between the sexes.

Fever: Fever increases the BMR by 7% for each degree Fahrenheit rise in body
temperature. This is one of the reasons for loss of weight during fever.

State of health: The BMR is low during starvation and malnutrition because of
reduction in muscle tissue. In diseases and conditions where catabolic processes
are high such as cancers, tuberculosis, and burns, BMR is high.

Hormones: Disorders of the thyroid gland markedly influence the BMR.

Hyperthyroidism, a condition of excessive production of thyroid hormone
increases BMR, and hypothyroidism or decreased production of thyroid hormone
decreases BMR.

Climate: BMR rises when the climate is cold in order to maintain normal body
temperature. In very warm climates leading to profuse sweating, BMR may
increase by trying to reduce body temperature.

Psychological tension: Worry and anxiety increases BMR.

SPECIFIC DYNAMIC ACTION

 Specific dynamic action (SDA) is a term used to describe the effect food has
in increasing the metabolic rate above the level found when fasting. Energy

is needed to digest, absorb, and metabolize the food we eat. Food intake
stimulates the metabolism process leading to an increase in energy expenditure.
This is known as the thermogenic effect of food or the specific dynamic effect.
Proteins have maximum effects on SDA, increasing the BMR by about 30% when
eaten alone, while carbohydrates and fats show smaller increases. When eaten
together in a normal mixed diet, the increase is about 5-10% of basal
metabolism.

PHYSICAL ACTIVITY

Physical activity increases the energy requirement above the basal metabolism.
There is a wide variation in the energy required for physical activity among
individuals. Physical activity includes energy needed for work, recreation, and
mental activity, i.e., all voluntary activities. Some people use up more energy for
physical activity than for basal metabolism. On the basis of occupation, activities
are grouped under three heads.
Sedentary work teaching, office work, executive, housewife, tailoring.
Moderate work farming, industrial labour, driver, maidservant.
Heavy work stone cutter, miner, wood cutter.

ENERGY BALANCE

The human body is constantly using energy which needs to be replaced.

For this a constant supply of energy is required. Energy is used for basal
metabolism, specific dynamic action, and physical activity. The energy from the
food we eat, mainly carbohydrates and fats, is used to meet the energy demands
of the body. When food is not available during fasting or starvation, the body
draws upon its own stores to meet the energy needs of the body. The body has
three types of energy store.

Glycogen: The form is which carbohydrate is stored in the muscle and liver is
adequate to last for 12-48 hours. Approximately 300g glycogen is stored in the
muscle and 100g in the liver.

Muscle: Protein is stored in limited amounts in the muscle.

Adipose tissue: Fat is stored in the adipose tissue and the amount stored varies
vastly from one person to another.
 A person in energy balance neither gains weight nor loses weight.
Excessive consumption of calories as compared to the output or activity leads to
a condition called over weight, which in severe cases is called obesity. A deficient
intake of carbohydrates and fats in the diet leads to underweight or under
nutrition. Both underweight and obesity are undesirable conditions which need
timely correction.5

Definition: Energy balance is a condition in which the energy provided by food is

nearly equal to the total energy expended by the body resulting in steady body
weight.
Energy balance: Energy output = Energy input

OVERWEIGHT

Overweight and obesity affect over 25% adults in developed countries and can
lead to serious health consequences if not treated early. When an individuals
energy intake consistently exceeds energy expenditure, weight gain occurs
initially, leading to obesity. Since energy can neither be created nor destroyed but
can be changed from one form to another, the excess chemical energy from food
is converted into fat and stored as potential energy in the adipose tissues.

Overweight: A person whose body weight is 10% more than the prescribed
height for weight standards for his age and sex.

Obese: A person whose body weight is 20% or more than that of the prescribed
standards.

Grossly obese: A person who weighs 45kg or 100% more than accepted
standards.

Causes of obesity

Family food habits rich high calorie foods

Ignorant of calorific value of food
Skips breakfast, gobbles high calorie snacks
Sedentary lifestyle
Lower metabolism with increasing age but failure to reduce intake
Emotional outlet- eats more to overcome worry, stress, etc.
Attend many social events
Distress eating ( to avoid wastage)
 All obese people should lose one to two pounds per week. Physical activity
should be increased for faster weight loss and better muscle tone.

UNDERWEIGHT

Underweight is caused due to under nutrition which is the result of

ingesting insufficient quantity of food. An energy intake less than the need are
the most common cause. Other causes for underweight are poor assimilation of
food due to digestive disorders, faulty absorption, intestinal infections, poor food
habits, stress and tension, poverty and lack of nutrition knowledge.

Under nutrition affects ones growth, health, behavior, and brain

structure and function. Such individuals should be prescribed a high calorie,
high protein, and moderate fat diet for gaining weight. An excess of 500
kcal/day will help in gaining 1 lb/week.

BODY MASS INDEX

The concept of ideal or desirable body weight has been changing from
time to time and ideal weight for different body frames was initially computed.
Today the weight of an individual is assessed on a more scientific basis known
as the body mass index (BMI).

2 2
Body mass index= weight in kilograms / (height in metres) = W/H

On the basis of BMI, obesity is graded follows:

Obesity BMI
Grade 1 25-29
Grade 2 30-40
Grade 3 >40

DIETARY SOURCES

All foods provide energy. While selecting food one must consider the other
nutrients such as proteins, vitamins, minerals, and fibre present in the food
and make a wise choice.
The nutrients carbohydrates and fats are consumed mainly as a source
of energy. All refined carbohydrates i.e., sugars and starch and all foods rich in
fats are rich sources of energy.
The cereal group is another excellent source of energy and supplies the
highest percentage of calories.
 Hollow calorie foods Nutrient dense foods
Aerated soft drinks Milk, cheese, yoghurt
Synthetic syrups Green leafy vegetables
Candy and candy floss Pulses, sprouts
Chocolates Soya beans, peanuts
Iced cakes and fresh Guava, amla
Cream pastries Liver, fish, meat
Ice lolly Eggs
Puffy pastry Flax seeds

PROTEINS

Protein is the basic material of every living cell. It is the only nutrient that
can make new cells and rebuild tissues. Therefore, an adequate amount of
protein in the diet is essential for normal growth and development and for the
maintenance of health.

Definition

Proteins are large, complex, organic compounds made up of carbon,

hydrogen, oxygen, and nitrogen. The presence of nitrogen distinguishes proteins
from carbohydrates and fats. Apart from nitrogen, elements such as sulphur,
phosphorus, copper, and iron are also found in some proteins.

The basic units from which proteins are built are the amino acids. Each
amino acid contains a carboxyl groups (COOH) or acid group and an amino
group (NH2).

Essential amino acids

Those amino acids which cannot be synthesized in sufficient amounts by

the body and must be provided by the diet are called essential amino acids. The
human adult requires eight essential amino acids, while growing children require
ten essential amino acids. Essential amino acids are indispensable to life.

Non essential amino acids

Non-essential amino acids do not mean that these amino acids are not
required by the body. They are termed non-essential because they are not dietary
essentials. If they are lacking in the diet, they can be synthesized by the body
from other amino acids.

The twenty-two amino acids presents in proteins could be compared with

the letters of the Roman alphabet and the innumerable words present in our
dictionary. Similarly, innumerable proteins can be formed by using the twenty
two amino acids in varying sequences and quantities.

Classification of amino acids

Essential amino acids Non essential amino acids

Adults Additional for children
Isoleucine Histidine Alanine
Leucine Arginine Aspargine
Lysine Aspartic acid
Methionine Cysteine
Phenylalanine Glutamine
Threonine Glycine
Tryptophan Hydroxylysine
Valine Hydroxyproline
Proline
Serine
Tyrosine

Classification of proteins

Proteins may be classified on

(1) The basis of their structure

(2) The basis of their quality, i.e., the amino acids present in them.

Classification by structure

Simple proteins: These proteins are made up of amino acids only, e.g., zein in
corn, albumin in egg white, and gliadin in wheat consist of amino acids only.

Conjugated proteins: These proteins have a non protein molecule attached to

the protein, e.g., blood protein haemoglobin, which contains a haeme (iron)
group attached to protein and milk protein casein, which has a phosphate
group attached.
 Derived proteins: These result from a partial breakdown of a native protein.
Proteoses, peptones, and polypeptides are formed when digestive enzymes
begin their action on proteins.

From the nutritional point of view, classification of proteins on the basis

of their quality is more relevant than classification by structure.

Classification by quality

Proteins are classified into three groups on the basis of their quality.

Complete proteins: These proteins contain all amino acids in sufficient

proportions and amounts to meet the bodys need for growth and repair of

tissue cells. A complete protein food has high B.V. Eggs, milk, meat, fish, and
poultry are complete protein foods. They are found in animal foods.

Partially complete proteins: These are proteins in which one or more essential
amino acids are present in inadequate amounts. They cannot synthesize tissues
without the help of the other proteins. The value of each is increased when it is
consumed in combination with other incomplete protein foods. Cereals contain
inadequate amounts of essential amino acids lysine, and pulses are deficient in
essential amino acid methionine.

Incomplete proteins: These proteins are incapable of growth and repair of body
cells, they cannot maintain life. One or more essential amino acids may be
completely lacking in these proteins, e.g., gelatin and zein in corn. Gelatin lacks
three essential amino acids and is the only animal protein which is incomplete.

Function in the human body

Proteins perform three main functions

1. Structural function
2. Regulatory function
3. Energy

Structural function:

Growth: The primary function of food protein is the synthesis of body cells.
Proteins are the major constituent of muscles, organs, endocrine glands, and
collagen. Collagen is the main structural protein of bones, tendons, ligaments,
skin, blood vessels, and connective tissue. All enzymes and some hormones, e.g.,
insulin are made up of proteins. Proteins are required for the formation and
growth of all these substances. During periods of rapid growth, additional
proteins are needed for synthesis of body components.

Maintenance or wear and tear: Protein is required by all age groups for
continuous maintenance of all the cells in the body. Cells have a varying life span
and proteins are needed to replace the old or worn out cells.

Regulatory function: All amino acids from food protein are used for growth and
maintenance. Certain amino acids and proteins have highly specialized functions
in the regulation of body process and protection against disease. Some of the
regulatory functions are as follows.

1. Haemoglobin, an iron containing protein in the red blood cells, performs an

important role by transporting oxygen to the tissue cells.
2. Plasma proteins maintain water balance and regulate the osmotic pressure
in the body.

3. Antibodies that are protein in nature perform a protective function by

increasing the bodys resistance to disease.
4. All enzymes and some hormones, e.g. insulin are made up of protein. The
hormone insulin regulates blood sugar levels. Enzymes act as specific
catalysts to metabolic process in the body.
5. Some amino acids have specific functions, e.g. tryptophan serves as a
precursor for niacin, a complex vitamin. The amino acid tyrosine in
combination with iodine forms the hormone thyroxine.

Energy: like carbohydrates, proteins too provide 4 kcal/g when broken down in
the body. If the diet does not supply adequate calories from carbohydrates and
fats, the proteins from the diet will be oxidized to meet the energy needs of the
body. Protein is used by the body as a source of energy only when no other
source of energy is available.

Methods of improving protein quality

Animal protein contains all essential amino acids in correct proportions

and amounts and is good quality proteins. Four essential amino acids are in
short supply in plant proteins. They are lysine, methionine, threonine, and
tryptophan. Proteins in plant foods are generally deficient in one or two essential
amino acids. Cereals are poor in lysine and pulses are poor in methionine.

Protein will be synthesized only when all amino acids, which form the
protein, are present simultaneously. Vegetable proteins are partially complete
proteins. These two points should be kept in mind while improving the protein
quality of a meal.

The protein quality of a mainly vegetarian diet can be improved in the

following ways.

1. By including a small quantity of complete protein food in every meal.

Complete protein foods such as milk, curds, paneer, cheese, buttermilk,
and eggs could be used in small quantities in various preparations instead
of including it in one meal only, e.g. cereal and milk, egg or cheese
sandwiches, french toast, raitha, curd rice, or buttermilk at all meals in
place of bowl of curd in one meal.
2. Correct mixtures of plant foods could provide all essential amino acids in
suitable proportions and amounts. Cereal and pulse combinations will
complement each other as cereals provide methionine, which is lacking in
pulses, and pulses provide lysine, which is lacking in cereals, when cereal
and pulses are consumed together in the same meal, e.g. missie roti,
thalipeeth, puran poli, idli, and rajmah chawal. This is possible because
the same amino acids are not missing from all plant foods.
3. Synthetic amino acids may be added to processed foods to compensate for
the amino acid deficient in them, e.g., lysine enriched bread. Textured

vegetable proteins are used successfully to improve the protein quality and
reduce the cost of protein rich foods.

When plant proteins are consumed with a small quantity of animal protein,
the quality of the mixture is likely to be as effective as if only animal protein has
been consumed. A good rule while planning menus would be to include some
animal proteins at each meal instead of concentrating it all in one meal.

Dietary sources

Proteins are present in both plant and animal foods.

Animal food sources

Animal food sources provide the highest quality or complete proteins such as
eggs, milk and milk products (cheese, paneer, mawa, milk powder, curds,
condensed milk), meat, fish, shell fish, poultry and organ meats.

Plant food sources

Pulses, especially soya bean (43% protein) and its products such as soya milk,
tofu, textured vegetables proteins; nuts, and oilseeds - groundnut and gingelly
seeds are important sources of protein in the Indian diet
MICRONUTRIENTS
MINERAL
S
(Inorganic substances found in body tissues
and fluids and occur in foods
as salts)

As components of organic compounds

(e.g., haemoglobin contains iron,
thyroxine contains iodine).

As inorganic compounds (e.g., calcium

phosphate in the bones).
As free ions in every cell in the body.

In all body fluids.

DEFINITI
ON
Minerals
are
inorganic
elements
required by
the body
in varying
amounts
to carry
out
various
body
functions.
They
remain
largely as
ash when
plant and
animal
tissues are
ignited.
CLASSIFICAT
ION

Major
minerals: 7
minerals are
required over
100mg/day
(calcium,
phosphorus,
sodium,
chlorine,
potassium,
 magnesium,
sulphur).
Minor
minerals:
Less than
100mg/day
(iron and
manganese).
Trace
elements:
Few
microgra
ms to few
milligrams
/day
(iodine,
fluorine,
zinc,
molybden
um).
 FUNCTIONS
Form the structural components of
bones, teeth, soft tissues, blood &
muscles.
Regulate activity of the nerves and
contraction of muscles.
Maintains acidbase balance of the body
fluids.
Control water balance.
Activate enzymes.
Regulate cellular oxidation.
 Necessary for clotting of blood.
Form part of molecules of hormones and
enzymes (iodine in thyroxine, zinc in
insulin).
Constituents of vitamins (thiamine contains
sulphur).
CALCIUM
FUNCTIONS
Calcium is in the form of Calcium Phosphate
to give hardness to bones.
Calcium acts as a catalyst in clotting of
blood.
Calcium regulates contraction & relaxation
of muscles.
Calcium activates a number of enzymes such
as pancreatic lipase.
DEFICIEN
CY
RICKETS
RICKETS
DEFICIEN
CY
OSTEOPOROSIS
OSTEOPOROSIS
DEFICIEN
CY
TETANY
TETANY
 SOURCES
Milk & milk products excluding butter,
ghee, cream.
Ragi, green leafy vegetables.
Small dried fish.
Nuts and oilseeds such as gingelly
seeds.
Betel leaf with slaked lime.
IRO
N
 FUNCTIONS
Component of haemoglobin necessary for
carrying oxygen.
Helps in brain functions such as good
attention span and capacity to learn.
Essential part of several oxidative enzymes.
Facilitates the oxidation of CHO, proteins, and
fats within the cell and release of energy for
physical work.
 FORMS
Haeme iron
Iron associated to protein, globin, to
form haemoglobin. Haeme is found in
flesh food only.
About 23% is rapidly absorbed and
transported.
Nonhaeme iron
Iron present in all plant sources plus 60% of
animal sources.
Tightly bound to organic molecules as ferric
iron.
 In acidic medium of stomach, it is reduced
to ferrous form.
About 8% is absorbed.
Vit C and HCl in gastric juice help in
conversion from ferric to ferrous form.
 DEFICIENCY
Hypochromic anaemia.
General fatigue.
Breathlessness on exertion.
Headache.
Oedema.
Pallor.
Haemoglobin 59g/100 ml.
Spoon shaped nails.
DEFICIEN
CY
PALLOR
SPOON
SHAPED NAILS
 SOURCES
Liver, organ meat, shell fish, lean
meat, egg yolk.
Peaches, apricots.
Green leafy vegetables.
Wholegrain and enriched cereals.
Jaggery.
Pressed rice.
Iron cooking utensils.
IODI
NE
 FUNCTIONS
Constituent of thyroxine.
Thyroid hormone regulates the rate of
oxidation in the cells and rate of
metabolism.
 DEFICIENCY
Goitre an enlargement of the thyroid
gland.
Cretinism in infants born to thyroxine
deficient women.
Low BMR, muscular flabbiness, dry skin,
thick lips, mental and skeletal
retardation.
Deficiency is more in females.
DEFICIEN
CY
GOITRE
CRETINISM
 SOURCES
Saltwater fish, shell fish.
Iodine content of eggs.
Meat, dairy products depending on iodine
content of diet of the animal.
Fortification of salt with potassium iodate.
SODIU
M
 FUNCTIONS
Maintains fluid balance between ICF and
ECF.
Helps in muscle contraction.
Regulates the alkalinity and acidity of body
fluids along with the mineral chloride.
Regulates cell permeability or passage of
substances into and out of the cell.
 DEFICIENCY
Seen in farm & mine workers.
Occurs during severe vomiting and
diarrhoea.
Symptoms are weakness, giddiness,
nausea, and muscle cramps.
 SOURCES
Milk, meat, poultry.
Egg white.
Green leafy vegetables.
Bengal gram dhal.
Beetroot.
Sodium from additives.
FLUORI
NE
 FUNCTIONS
Fluoride along with calcium forms tooth
enamel which is more resistant to decay.
Maintains bone structure.
 DEFICIENCY
Dental Caries is
seen in areas
where drinking
water contains
less than 0.5
ppm of
fluorine.
 EXCESS
Dental Fluorosis
Mottled teeth,
teeth are
discoloured,
have a chalky
white
appearance.
Enamel
becomes dull &
unglazed, pitted
giving a
corroded
appearance.
 EXCESS
Skeletal fluorosis
Hypercalcificati
on of bones.
Mottled areas
get yellow
brown stains
or discoloured.
 SOURCES
Fluoridated water. (1ppm or 1mg / litre is the
ideal level of fluoride in drinking water).
Milk, eggs and fish.
Topical appliactions of stannous fluoride by
dentists.