Fundamentals of Nutrition — Page 1 Outline
I. Fundamentals of nutritional concepts
Scope and focus: Delving into the foundational principles of nutrition, including definitions of key terms, nutrient classifications, and their roles in human health.
Functions and Roles:
Defining Nutrition: Understanding the comprehensive process by which organisms ingest, digest, absorb, transport, utilize, and excrete food substances, converting them into energy and raw materials for growth, metabolism (anabolism and catabolism), and repair of cells and tissues. This involves the study of food, its components, and their interaction with the body.
Energy Metabolism: Exploring how the body converts the chemical energy stored in food (macronutrients) into a usable form, primarily adenosine triphosphate (ATP), through complex metabolic pathways such as glycolysis, the Krebs cycle, and oxidative phosphorylation. This process fuels all cellular activities, from muscle contraction to nerve impulse transmission.
Nutrient Requirements: Basics of recommended daily allowances (RDAs), adequate intakes (AIs), tolerable upper intake levels (ULs), and estimated average requirements (EARs) for different populations. These guidelines are set by health organizations to ensure adequate intake for most healthy individuals and to prevent both deficiencies and toxicities, considering factors like age, gender, activity level, and physiological state.
No. of hours: 3
II. Principles of anatomy and physiology, biochemistry, health assessment, and health education in nutrition and diet therapy
Scope and focus: Integrating the understanding of body structures and functions, chemical processes, health status evaluation, and educational strategies into nutritional practices.
Functions and Roles:
Anatomy and Physiology: Understanding how different organ systems (e.g., digestive, endocrine, circulatory, renal) influence nutrient absorption, metabolism, and excretion. This includes processes like peristalsis in the gastrointestinal tract, hormonal regulation of blood glucose, and renal filtration of waste products. Role in identifying physiological responses to diet and understanding how diet impacts organ function and overall homeostasis.
Biochemistry: Studying the intricate chemical reactions and molecules (e.g., enzymes, hormones, neurotransmitters) involved in nutrient utilization, energy production, metabolic regulation, and cellular signaling. This includes understanding the structure and function of carbohydrates, lipids, proteins, vitamins, and minerals at a molecular level, and their roles in pathways like gluconeogenesis, fatty acid synthesis, and amino acid catabolism. Role in understanding nutrient-gene interactions (nutrigenomics) and the effects of metabolic dysregulation.
Health Assessment: Learning comprehensive methods to evaluate an individual's nutritional status, including detailed anthropometric measurements (e.g., BMI, skinfold thickness, waist circumference), biochemical tests (e.g., blood glucose, lipid panel, serum albumin, vitamin D levels), clinical signs (e.g., hair, skin, nail changes), and dietary intake analysis (e.g., 24-hour recall, food frequency questionnaires, food diaries). Role in identifying nutritional deficiencies, excesses, and risk factors for chronic diseases.
Health Education: Developing effective, culturally sensitive strategies to communicate accurate nutritional information to individuals and communities, promoting sustainable behavioral changes for healthier eating habits. This involves applying educational theories and models (e.g., Health Belief Model, Transtheoretical Model) to empower individuals to make informed dietary choices, understand food labels, and prepare nutritious meals. Role in public health campaigns, patient counseling, and community-based interventions.
No. of hours: 5
III. Nutritional importance of dietary macronutrients and micronutrients
Scope and focus: Detailed examination of the major classes of nutrients required in varying quantities for human health, energy, and bodily functions.
Learning Outcome (LO): LO: 5 (Understanding the critical roles of these nutrients in maintaining health and preventing disease).
Functions and Roles:
Macronutrients (Energy-providing nutrients):
Carbohydrates: Primary and most readily available source of energy for the body, especially the brain and muscles. Classified into monosaccharides (glucose, fructose, galactose), disaccharides (sucrose, lactose, maltose), and polysaccharides (starch, glycogen, fiber). Functions include glucose supply for cellular respiration, energy storage (glycogen in liver and muscles), and providing dietary fiber for digestive health, bowel regularity, and cholesterol reduction. Roles in glucose regulation and sparing protein for tissue repair.
Proteins: Essential for tissue growth, repair, and maintenance throughout the lifespan. Composed of amino acids, categorized as essential (must be obtained from diet) and non-essential. Functions include enzyme production (catalyzing biochemical reactions), hormone synthesis (e.g., insulin, growth hormone), immune function (antibodies), fluid balance (albumin), and acid-base balance. Roles as building blocks for muscles, skin, hair, nails, and blood components (e.g., hemoglobin). Protein quality (e.g., PDCAAS) and nitrogen balance are also key considerations.
Fats (Lipids): Concentrated source of energy (providing 9 kcal/gram), essential for hormone production (steroid hormones), absorption of fat-soluble vitamins (A, D, E, K), and insulation to maintain body temperature. Composed of fatty acids (saturated, monounsaturated, polyunsaturated – including essential omega-3 and omega-6 fatty acids), triglycerides, phospholipids, and cholesterol. Functions include protecting vital organs, maintaining cell membrane integrity, and providing structural components. Roles in nerve impulse transmission and eicosanoid production.
Micronutrients (Non-energy-providing nutrients required in smaller amounts):
Vitamins: Organic compounds essential for various metabolic processes, acting primarily as coenzymes or cofactors. Roles in vision (Vitamin A), immune function (Vitamins C, D), bone health (Vitamins D, K), antioxidant protection (Vitamins C, E), and energy release from macronutrients (B-vitamins). Divided into fat-soluble (A, D, E, K, stored in body fat) and water-soluble (B-vitamins, C, generally not stored). Deficiencies or toxicities can lead to specific health issues.
Minerals: Inorganic elements crucial for bone and teeth formation (calcium, phosphorus), fluid and electrolyte balance (sodium, potassium, chloride), nerve function (potassium, sodium), muscle contraction (calcium, magnesium), and as components of enzymes and hormones (e.g., iron in hemoglobin, iodine in thyroid hormones, zinc in immune function). Categorized as major minerals (e.g., calcium, phosphorus, magnesium, sodium, potassium, chloride) and trace minerals (e.g., iron, zinc, copper, selenium, iodine). Essential for numerous physiological processes, with imbalances causing a range of health problems.
No. of hours: 4
IV. Dietary guidelines, understanding nutritional needs, and promoting healthy eating habits
Scope and focus: Exploration of evidence-based recommendations for healthy eating, methods for assessing individual and population-level nutritional requirements, and practical strategies for encouraging healthier food choices.
Functions and Roles:
Dietary Guidelines: Providing evidence-based public health recommendations on food intake and physical activity to promote health, prevent chronic diseases (e.g., heart disease, type 2 diabetes, certain cancers), and reduce the risk of nutrient deficiencies. Examples include the Dietary Guidelines for Americans (e.g., MyPlate), the UK's Eatwell Guide, and WHO guidelines. Roles in policy making for food programs, public health education, and food product development.
Understanding Nutritional Needs: Assessing individual requirements based on a comprehensive set of factors including age, gender, activity level, physiological state (e.g., pregnancy, lactation, growth in childhood), specific health status (e.g., chronic diseases, allergies, intolerances), genetic predispositions, and cultural practices. This involves calculating Basal Metabolic Rate (BMR) and Total Daily Energy Expenditure (TDEE) and adjusting macronutrient and micronutrient intake accordingly. Roles in personalized nutrition planning, medical nutrition therapy, and athletic performance optimization.
Promoting Healthy Eating Habits: Implementing diverse educational programs, individualized nutrition counseling, and creating supportive environmental changes to facilitate the adoption and long-term maintenance of healthy diets. This includes strategies like motivational interviewing, cognitive behavioral therapy, community garden initiatives, school nutrition programs, workplace wellness programs, and advocating for clear food labeling regulations. Roles in behavior modification, public health campaigns, and addressing food insecurity.
No. of hours: 2
V. Diet Therapy is used to manage various health conditions
Scope and focus: Application of nutritional principles to prevent, manage, and treat diseases and health conditions through specific dietary modifications. This includes Medical Nutrition Therapy (MNT), which is an evidence-based approach provided by a registered dietitian nutritionist.
Functions and Roles:
Disease Prevention and Management: Utilizing specific dietary patterns, nutrient adjustments, and therapeutic diets to address underlying pathological processes, mitigate symptoms, and improve quality of life. This includes managing inflammation, optimizing immune response, and supporting organ function.
Cardiovascular Diseases (CVDs): Diet therapy focuses on lowering sodium intake to manage hypertension, reducing saturated and trans fats and dietary cholesterol to improve lipid profiles, and increasing fiber and plant-based foods to promote heart health. Examples include the DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean diet.
Diabetes Mellitus: Strategies involve glycemic control through consistent carbohydrate intake, emphasis on complex carbohydrates, balanced macronutrient distribution, and portion control. Education on carbohydrate counting and understanding the glycemic index is crucial for managing blood glucose levels.
Gastrointestinal Disorders: Dietary modifications for conditions like Irritable Bowel Syndrome (IBS), Crohn's disease, Ulcerative Colitis, and Celiac disease. This may include low FODMAP diets for IBS, fiber adjustments, gluten-free diets for celiac disease, and nutrient-dense, easily digestible foods during flares of inflammatory bowel diseases.
Renal Diseases: Diet therapy involves restricting protein, sodium, potassium, and phosphorus intake to reduce the burden on impaired kidneys and prevent complications like fluid overload, hyperkalemia, and hyperphosphatemia. Fluid restriction may also be necessary.
Malnutrition and Weight Management: For malnutrition, strategies include increasing energy-dense and protein-rich foods, oral nutritional supplements, and enteral or parenteral nutrition if necessary. For weight management, approaches focus on creating a sustainable caloric deficit, promoting balanced macronutrient intake, and encouraging physical activity, often tailored for individuals considering or post-bariatric surgery.
Food Allergies and Intolerances: Strict avoidance of specific allergens (e.g., peanuts, tree nuts, milk, eggs, soy, wheat, fish, shellfish, sesame) to prevent adverse immune reactions. For intolerances (e.g., lactose intolerance, gluten sensitivity not celiac), management involves limiting or avoiding problematic foods based on individual tolerance levels, often with guidance on finding suitable substitutes to ensure nutritional adequacy.