Introduction to nutrition

Nutrition is defined as the processes by which an

animal or plant takes in and utilises food
substances. Essential nutrients include protein,
carbohydrate, fat, vitamins, minerals
and electrolytes. Normally, 85% of daily energy
use is from fat and carbohydrates and 15% from
protein. In humans, nutrition is mainly achieved
through the process of putting foods into our
mouths, chewing and swallowing it. The required
amounts of the essential nutrients differ by age and
the state of the body, for example: physical activity,
diseases present (e.g. prostate cancer, breast
cancer or weakened bones – known
as osteoporosis), medications, pregnancy and
lactation.

Why is nutrition important?

Nutrition is essential for growth and development, health and wellbeing.
Eating a healthy diet contributes to preventing future illness and improving
quality and length of life. Your nutritional status is the state of your health as
determined by what you eat. There are several ways of assessing
nutritional status, including anthropometric (i.e. physical body
measurement), food intake and biochemical measurement.
Your body mass index (BMI) is a good indicator of your nutritional status. It
takes into account your weight and height, and correlates well with total
body fat expressed as a percentage of body weight. The correlation
depends on age, with the highest correlation seen in ages 26–55 years and
the lowest in the young and the elderly. If you take your weight in kilograms
and divide it by your height in metres squared, the figure you obtain is your
BMI.
___weight (kg)___
BMI = height x height (m2)
High values indicate excessive fat stores and low values indicate insufficient fat
stores. Your BMI can therefore be used as a diagnostic tool for both over-nutrition
and under-nutrition. If your BMI is between 25.0 and 29.9 you are classisfied as
overweight. If it is above 30.0, you are classified as obese. The healthy BMI range is
18.5–24.9. However, the BMI is best used together with waist circumference.
Body Mass Index (BMI) Calculator
Enter your height and weight below to find out your BMI.
Weight (kg):
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What does this mean?
This information will be collected for educational purposes, however it will remain anonymous.

BMI calculations will overestimate the amount of body fat for:

 Body builders;
 Some high performance athletes;
 Pregnant women.
BMI calculations will underestimate the amount of body fat for:
 The elderly;
 People with a physical disability who are unable to walk and may have
muscle wasting.
BMI is not the best measure of weight and health risk. A person’s waist
circumference is a better predictor of health risk than BMI.

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 BMI and children
The healthy weight range for adults of a BMI of 20 to 25 is not a suitable
measure for children.

For adults who have stopped growing, an increase in BMI is usually caused
by an increase in body fat. But as children grow, their amount of body fat
changes and so will their BMI. For example, BMI usually decreases during
the preschool years and then increases into adulthood.

For this reason, a BMI calculation for a child or an adolescent must be

compared against age and gender percentile charts. These charts should
be used only by health professionals such as your general practitioner, child
health nurse, or dietitian.

Body fat distribution and health risk

A person’s waist circumference is a better
predictor of health risk than BMI. Having fat
around the abdomen or a ‘pot belly’,
regardless of your body size, means you
are more likely to develop certain obesity-
related health conditions. Fat predominantly
deposited around the hips and buttocks
doesn’t appear to have the same risk. Men,
in particular, often deposit weight in the
waist region.

Studies have shown that the distribution of body fat is associated with an
increased prevalence of diabetes, hypertension, high cholesterol and
cardiovascular disease.
Generally, the association between health risks and body fat distribution is
as follows:

 Least risk – slim (no pot belly);

 Moderate risk – overweight with no pot belly;
 Moderate to high risk – slim with pot belly;
 High risk – overweight with pot belly.

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 Waist circumference and health risks
Waist circumference can be used to indicate health risk.

For men:

 94 cm or more – increased risk;

 102 cm or more – substantially increased risk.
For women:

 80 cm or more – increased risk;

 88 cm or more – substantially increased risk.
Being physically active, avoiding smoking and eating unsaturated fat
instead of saturated fat have been shown to decrease the risk of developing
abdominal obesity.
When there is an imbalance between your nutrient requirements and your
intake, malnutrition sets in. There are two forms of malnutrition – under-
nutrition and over-nutrition. Over-nutrition is common in many developed
countries, including Australia.

 .

Associated health conditions

Dietary factors are associated with some leading causes of death, such as:

 Coronary heart disease;

 Some types of cancer;
 Stroke;
 Type 2 diabetes mellitus.

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Essential nutrient requirements
Nutrients can be described as the chemical components of food and can be
classified into six broad groups: carbohydrates, proteins, fats, vitamins,
minerals and water. Water is not technically a nutrient, but it is essential for
the utilisation of nutrients. Nutrients perform various functions in our bodies,
including energy provision and maintaining vital processes such as
digestion, breathing, growth and development.

Energy balance
Your energy requirement depends on your age, size and activity level. If
your energy intake equals the amount of energy you expend, then you are
in energy balance. If your intake exceeds your expenditure, the excess
energy is converted to body fat and you gain weight. On the other hand, if
your intake is less than your expenditure, your body uses up fat stores and
you lose weight. Therefore, for weight to remain stable, the total amount of
calories that are consumed must not exceed the total that is used up
through metabolic processes (e.g. exercising, sweating, breathing). Energy
intake must match energy output. The average energy intake is about 2800
kcal/day for men and 1800 kcal/day for women, although this varies with
body size and activity level.

Carbohydrates
Carbohydrates can be classified as monosaccharide (e.g. glucose, fructose,
galactose), disaccharide (e.g. sucrose, lactose, maltose) and
polysaccharide (e.g. starch, fibre). Carbohydrates must be reduced to the
simplest form of glucose (through digestion) before your body can make
use of them. Carbohydrates should make up at least 55% of your total
energy intake. The brain is a special part of the body that depends primarily
on glucose for its energy and requires about 100 g/day of glucose for fuel.
In some situations, the body can compensate for decreased levels of
carbohydrates by using alternative energy pathways such as burning fatty
acids.

Protein
Protein is important for the production, maintenance and repair of tissues in
the body. When energy intake is insufficient, protein intake must be raised.
This is because ingested proteins are preferentially directed towards
glucose (sugar) synthesis and oxidation. The tissues and organs in the
body are made up of protein and protein compounds. Enzymes (biological
catalysts), antibodies and hormones also consist of protein. The building
blocks of protein are called amino acids. The body can make all of the 20

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amino acids except eight, which are termed essential amino acids. These
are isoleucine, leucine, lysine, methionine, phenylalanine, threonine,
tryptophan and valine. Histidine is essential only for infants. The number
and nature of amino acids present in a particular protein determines that
protein’s characteristics.
For adults, the recommended dietary allowance of protein is about 0.75
g/kg body weight per day. Animal products tend to have the highest amount
of proteins, followed by legumes (beans), cereals (rice, wheat, corn) and
roots. Animal protein (from meat, eggs, fish, milk) contains all the essential
amino acids and is normally referred to as ‘complete’ or ‘high biological
value’ protein. Protein derived from plants lack one or two essential amino
acids. However, a good combination of plant-based protein can be of equal
value to animal protein. For example, legumes lack methionine but have
adequate amounts of lysine. Cereals, on the other hand, lack lysine but
have a lot of methionine. Therefore, a mixture of rice and beans will supply
all the essential amino acids.
Excess protein cannot be stored in the body, so we need to consume
protein daily. Consuming too much protein is not recommended because it
promotes increased calcium excretion through urine, which increases the
risk of developing osteoporosis. Additionally, too much protein intake may
lead to a greater concentration of the amino acid homocysteine in the
blood, and the subsequent conversion to thiolactone. Thiolactone is
associated with increased levels
of atherosclerosis and endothelial damage.

Fats and oils

Most of the fats we consume occur in foods
as triglycerides. A triglyceride is comprised of three
fatty acid molecules attached to a glycerol molecule.
Fatty acids are made up of carbon and hydrogen
atoms and can be either saturated or
unsaturated. Saturated fatty acids (SFA) have the
maximum number of hydrogen atoms attached to
the carbon chain, while unsaturated fatty acids have
less than the required hydrogen atoms. For
example, monounsaturated fatty acids (e.g. oleic
acid) have two hydrogen atoms missing.
Monounsaturated fats are found mainly in nuts,
avocados, olive oil, canola oil, grapeseed oil, peanut
oil, flaxseed oil, sesame oil, corn oil, safflower oil,
sunflower oil, etc.
Polyunsaturated fatty acids (PUFA) have more than two hydrogen atoms
missing (e.g. linoleic acid and linolenic acid). Linoleic and linolenic acids are
regarded as essential fatty acids (EFAs) because the body cannot make
them. There are two categories of EFAs: omega-3 and omega-6. The
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 number that comes after “omega-” represents the position of the first double
bond, counting from the terminal methyl group on the molecule. Omega-3
fatty acids are derived from linolenic acid and omega-6 from linoleic acid.
Alpha linolenic acid (ALA) is converted into eicosapentaenoic acid (EPA),
and later into docosahexaenoic acid (DHA) in the body. Sources  of omega-
3 fats include salmon, mackerel, sardines, anchovies, tuna, flaxseed oil,
walnuts, etc. Sources of omega-6 fats include palm oil, soybean oil, canola
oil, sunflower oil, nuts, etc. Evidence from research indicates that omega-3
fatty acids reduce inflammation and help prevent certain chronic diseases
such as heart disease and arthritis. Omega-3 fatty acids are highly
concentrated in the brain and appear to be crucial to brain function as well
as normal growth and development. Infants who do not get enough omega-
3 fatty acids from their mothers during pregnancy are at risk of mental
impairment.
Generally, saturated fatty acids raise blood cholesterol levels, whereas
unsaturated fatty acids lower them. Saturated fats are found in foods such
as butter, meat and dairy fats. Trans fats are artificially created during food
processing. In the body, trans fats act in a similar way to saturated fats and
may raise cholesterol levels. These fats are considered to be harmful to
your health. Trans fats are found mainly in deep-fried fast foods and
processed foods made with margarine.
Fats are a concentrated and rich source of energy. It is recommended that
your total fat intake is no more than 30% of your energy (calorie/kilojoule)
intake. Polyunsaturated fat should be less than 10% of energy, and
saturated fat and trans fat together should be less than 10%. The rest of
your fat intake should consist of monounsaturated fat.

Vitamins
Vitamins constitute a group of nutrients that are needed in small quantities.
Like amino and fatty acids, most vitamins cannot be made in the body and
must be obtained from dietary sources. Only vitamin D can be
manufactured by the body. Essential vitamins are grouped into two families:
water soluble and fat soluble. Water soluble vitamins can dissolve in water
(thiamine, riboflavin, niacin, vitamin C, folic acid). These cannot be stored
by the body and need to be consumed every day. Fat soluble vitamins can
dissolve in a fat medium (vitamins A, D, E, K). These are taken into our
bodies when we consume fat-containing foods. Vitamins are needed for
various reasons, including the formation of hormones and blood cells. They
generally act as coenzymes. An inadequate supply of vitamins in our diet
leads to the development of diseases.
 Vitamin A: Derived from carotene, vitamin A affects vision, reproduction,
and the formation and maintenance of skin, mucous membranes, bones and teeth.
Deficiency results in night blindness (difficulty in adapting to darkness). The body

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 obtains vitamin A from either carotene (vitamin A precursor) or by absorbing
ready-made vitamin A from plant-eating organisms. Carotene is found in dark
green leafy vegetables and yellow-orange fruit/vegetables. Pre formed vitamin A is
found in milk, butter, cheese, egg yolk, liver, and fish-liver oil.
 Vitamin B complex: The vitamin B complex is a mixture of eight essential
vitamins necessary to enhance immune and nervous system function, and promote
cell growth and division. Pregnant or lactating women, alcoholics and the elderly
are more likely to suffer from vitamin B deficiency.
 Vitamin B1 (thiamine): Thiamine, or vitamin B1, acts as a catalyst in
carbohydrate metabolism. Thiamine deficiency causes beriberi, a vitamin
deficiency disorder characterised by muscular weakness, swelling of the heart
and leg cramps. In severe cases, beriberi may lead to heart failure and death. The
richest dietary sources of thiamine are organ meats (liver, heart, and kidney),
brewer’s yeast, lean meats, eggs, leafy green vegetables, whole or enriched cereals,
wheat germ, berries, nuts, and legumes.
 Vitamin B2 (riboflavin): Riboflavin, or vitamin B2, acts as a coenzyme in
the metabolism of carbohydrates, fats, and respiratory proteins. The best sources of
riboflavin are liver, milk, meat, dark green vegetables, whole grain and enriched
cereals, pasta, bread and mushrooms.
 Vitamin B6 (pyroxidine): Pyridoxine, or vitamin B6, is necessary for the
absorption and metabolism of amino acids. It also plays a role in the body’s use of
fats and in the formation of red blood cells. The best sources of pyridoxine are
whole grains, cereals, bread, liver, avocados, spinach, green beans and bananas.
 Folic acid (vitamin B9 or folacin): Folic acid is a coenzyme needed for
forming body protein and haemoglobin. Folic acid deficiency is associated
with neural tube defects. Dietary sources are organ meats, leafy green vegetables,
legumes, nuts, whole grains and brewer’s yeast. Folic acid is lost in foods stored at
room temperature and during cooking.

Minerals
Minerals are essential, acting as cofactors of enzymes (i.e. enzymes would
not exist or function without minerals). Some of the minerals necessary for
health are:

 Calcium: Calcium is a very important mineral in the diet, especially for

women at menopause. The major function of calcium is to build and help maintain
strong bones. It can stop the onset of osteoporosis and reduce bone loss and
fragility. It is involved in blood clotting. Calcium deficiency can develop when
there is a lack of vitamin D.
 Iron: Iron in food exists as haem and non-haem iron. Haem iron, found in
red meat, is relatively well (20–30%) absorbed. Non-haem iron, found mostly in
cereals, pulses, certain vegetables (e.g. spinach) and eggs, is generally less well
absorbed. Non-haem iron absorption depends on other factors in the diet. For

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 example, vitamin C and animal protein enhance non-haem iron absorption, while
tea, coffee and phytates inhibit it.
 Zinc: Zinc represents only 0.003% of the human body, but is essential for
synthesising protein, DNA and RNA. It is required for growth in all stages of life.
Sources include meats, oysters and other seafood, milk, and egg yolk.

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 Balanced diet
 It is critical that nutrients in our body are available in sufficient
amounts and in the right proportions. This can be achieved by eating
a balanced diet. We must eat a variety of foods, since different foods
contain different nutrients in varying amounts. In stressing the
importance of variety in our diet, Nutrition Australia encourages all
Australians to ensure that their daily diet includes 30 individual foods.
This may appear impossible at first thought, but in reality can easily
be attained by eating typical diets based on carefully selected foods.
Food selection based on the ‘Healthy Eating Pyramid’ can assist you
in planning your meals for a balanced and healthy diet.
 A healthy diet consists mainly of plant foods (e.g. fruits and
vegetables, potatoes, cereals, etc.) and moderate amounts of animal
products (e.g. milk, fish, lean red meat and poultry). Fats and oils
should normally provide less than 30% of our energy, and less than
10% of this should be saturated fat. Lean red meat, poultry and fish,
eggs and dairy foods are rich sources of animal protein. Dairy foods,
apart from supplying quality protein, are good sources of calcium.
Good vegetable sources of protein include legumes (e.g. peanuts,
lentils, kidney beans), soya products (e.g. tofu), grains, nuts and
seeds.

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 Healthy eating pyramid
 The food pyramid is a simple practical guide to selecting varied foods
for meals. The Australian Nutrition Foundation Inc. (Nutrition
Australia) has developed its own food pyramid. The rationale behind
the food pyramid emphasises the need to include generous amounts
of plant-based foods (cereals, legumes, fruits and vegetables) and
moderate amounts of animal products (meat, fish, milk, eggs) in our
diets. Furthermore, our diet should contain only small amounts of
energy-dense foods (e.g. sugar, fats and oils). The base of the
pyramid (plant-based foods) is broad, and the top (animal products) is
narrow. Eating according to the structure of the food pyramid ensures
we consume a healthy diet. With care the food pyramid can also
assist vegetarians and vegans to consume a nutritionally balanced
diet, although some people will require dietary supplements (e.g.
vegans will require vitamin B12).

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 Glycaemic index and glycaemic load
 Carbohydrates should make up at least 55% of our total daily energy
intake. The quality and quantity of these carbohydrates are important
in blood sugar and appetite control. After you consume carbohydrate-
containing foods, your pancreas secretes insulin to break the
carbohydrates down into their building blocks. Insulin acts to lower
blood glucose levels. When your blood glucose levels decrease to a
particular level, your brain is sent a signal and you become hungry
again.
 Even though different foods may contain the same amounts of
carbohydrate, their effects on blood glucose control may be very
different. This has lead to the development of measures such as
the glycaemic index (GI) and glycaemic load (GL) of a food product.
The concept of GI was formulated by Jenkins and colleagues in 1984.
They found that blood glucose response to carbohydrate foods is
independent of the amount of carbohydrates they contain. The
limitation of the GI lies in the difficulty of translating the concept into
practice, since the glycaemic effect of foods is not constant and can
vary depending on the way the food is cooked.
 Low GI and GL foods have been shown to be associated with health
advantages such as decreased blood sugar levels. Foods with a low
GI (less than 55) cause a slower and lower rise in blood glucose
levels. These include breads such as mixed-grain and oat breads,
barley, pasta, noodles, beans, sweet potatoes, green peas and milk.
Foods with a high GI (greater than 70) cause a faster and higher rise
in blood glucose levels. High GI foods include white bread, steamed
white rice and chips.
 By incorporating low GI foods into your diet, you will bring down the
average GI of your meal, have a lower, slower blood sugar response
to the meal and feel ‘full’ for longer.  By consuming low GI foods, you
are more likely to be satisfied and feel full for longer periods of time.
This helps you to maintain a healthy weight and avoid diseases such
as heart disease, diabetes and some cancers.

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