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Nutrition and Diet Therapy - Video Notes (Flashcards)

CHAPTER 1 INTRODUCTION

  • NUTRITION AND DIET THERAPY (First Semester, F.Y. 2025-2026)

    • Course context: foundational study of basic nutrition, concepts, principles, and application; familiarity with different diets for different age groups based on disease; careful selection and preparation essential in hospital and community care.

  • LESSON 1: INTRODUCTION TO NUTRITION, HEALTH AND FOOD

    • NUTRITION: the study of food and how the body makes use of it
    • Involves quantity and quality of food, the process of receiving and utilizing it for growth, renewal of the body, and maintenance of body functions
    • Process of taking in food and using it for growth, metabolism, and repair; nourishing substances can be delivered intravenously (IV) or intradermally (ID) in hospitalized patients
    • Basic function: maintain life, enable growth, and sustain optimum health
    • NUTRIENTS: chemical nutrients present in food and delivered to the body
    • FUNCTION OF NUTRIENTS: provide energy, build and repair tissues, regulate body/life processes
    • FIVE DIMENSIONS OF HEALTH:
    • Physical, Intellectual, Emotional, Social, Spiritual health
    • FOOD: any substance, organic or inorganic, when ingested nourishes the body by building/repairing tissue, supplying heat and energy, and regulating body processes
    • Basic human need alongside clothing and shelter
    • PROCESS OF DIGESTION: breaking down food into substances (carbohydrates, proteins, fats, vitamins) that aid body functions
    • DIGESTIVE SYSTEM FUNCTIONS:
    • Take in food, break down food, absorb digested molecules, provide nutrients, eliminate wastes
    • ORAL CAVITY (Mouth)
    • First part of digestive tract; lips/cheeks aid mastication (chewing)
    • Mechanical digestion begins with mastication
    • SALIVARY GLANDS
    • Produce saliva; keeps oral cavity moist; contains enzymes that begin chemical digestion
    • Saliva produced at ~1 liter/day
    • Salivary amylase begins breakdown of starch to maltose and isomaltose
    • TONGUE
    • Large muscular organ; moves food; aids mastication and swallowing; major sensory organ for taste and important for speech
    • STOMACH
    • Enlarged digestive segment; storage and mixing chamber; forms chyme with stomach secretions
    • Pepsinogen activated to pepsin by HCl; pepsin cleaves protein into smaller peptides
    • Gastrin hormone regulates stomach secretions
    • ~2 L of gastric secretions produced daily
    • SMALL INTESTINE
    • Major site of digestion and absorption due to large surface area
    • Primary absorption in duodenum and jejunum; some in ileum
    • Secretions from intestinal mucosa, liver, and pancreas contribute to digestion
    • Peptidases hydrolyze peptide bonds to amino acids
    • LIVER AND PANCREAS
    • Liver: major digestive/excretory organ; stores/processes nutrients; detoxifies harmful chemicals; synthesizes molecules
    • Pancreas: both endocrine (insulin, glucagon from islets) and exocrine (digestive enzymes from acini); pancreatic amylase and lipase involved in digestion
    • LARGE INTESTINE
    • Contains cecum, colon, rectum, anal canal
    • Transit time ~18-24 hours (vs 3-5 hours in small intestine); chyme becomes feces
    • Water/salt absorption; mucus secretion; microbial activity; some vitamin synthesis (e.g., vitamin K)

  • SELF-DIRECT LEARNING NO.1

    • Prompt to discuss composition of cells, biochemistry, and structure/formula outline

  • CHAPTER 2 MACRONUTRIENTS

  • MACRONUTRIENTS OVERVIEW

    • Needed in large amounts: carbohydrates, proteins, fats
    • Provide energy and building blocks for macronutrients; support growth, maintenance, and metabolism

  • LESSON 3: CARBOHYDRATES

    • MACRO role: main energy source; brain and nerve tissues rely on glucose; carbohydrate reserve fuels fat and protein sparing
    • NOTE: main energy source is carbohydrates; the body uses carbohydrates first; if unavailable, it breaks down fats; if fats are also unavailable, it breaks down protein for energy
    • RDA for CHO: ext{RDA}_{CHO} = 130~ ext{g/day} for adults and children
    • Excess CHO: CHO intake above RDA leads to weight gain/obesity due to increased fat storage in adipose tissue
    • Common carbohydrate sources: sugars, cereals and products (rice, corn, oats, breads, pasta), root crops, starchy vegetables, dried legumes; fruits and milk also contribute

  • CLASSIFICATION OF CARBOHYDRATES

    • MONOSACCHARIDES, DISACCHARIDES, POLYSACCHARIDES

  • MONOSACCHARIDES

    • Fructose (fruit sugar): sweetest sugar; natural in fruits/honey; added as HFCS; also called levulose; hydrolyzed from sucrose/insulin
    • Glucose (Dextrose): also called grape sugar; main energy source; present in fruits, vegetables, corn syrup, honey; all other sugars are converted to glucose for energy
    • Galactose: not free in nature; hydrolyzed from lactose; component of cerebrosides in brain and nerve tissue

  • DISACCHARIDES

    • Sucrose (table sugar): from beets, sugar cane, corn; common table sugar; abundant in molasses, maple syrup, sorghum; widely used in cooking
    • Maltose (Malt sugar): derived from starch digestion with diastase; in intestines not readily fermented (beneficial for infant feeding); often combined with dextrin (dextrimmaltose) in infant formula
    • Lactose (milk sugar): main sugar in milk; lactose intolerance in some individuals; hydrolyzed to glucose and galactose; relatively less sweet

  • POLYSACCHARIDES

    • Not water-soluble compared to mono/disaccharides
    • STARCH: most abundant form; storage form in plants (grains, seeds, tubers, roots, unripe fruits)
    • DEXTRIN: intermediate product of starch digestion; formed by partial hydrolysis or dry heat (toasting bread, browning crust)
    • GLYCOGEN: animal starch; storage form of carbohydrate in liver and muscles

  • FUNCTIONS OF CARBOHYDRATES

    • Chief source of energy; energy production; brain/nerve tissues rely on glucose; glucose is the sole brain energy source
    • Carbohydrates spare protein from being used as energy; prevent unnecessary protein catabolism
    • Regulate fat metabolism; prevent incomplete oxidation of fat
    • Storage form of energy as glycogen; immediate energy source
    • Provide bulk and regulate intestinal peristalsis (dietary fiber/roughage)
    • Dietary fiber (cellulose, hemi-cellulose, pectins, etc.) acts as a broom to regulate peristalsis; reduces constipation; may reduce diverticular disease and colon cancer; can lower cholesterol; reduces mucosal absorption
    • Carbohydrate malnutrition: severe deficiency leads to PEM/CPM; signs include hypoglycemia, weight loss, retarded growth; excess calories from fat/protein can cause obesity; ketosis/acidosis if carbohydrate intake is too low

  • DIETARY FIBER AND SOLUBLE/INSOLUBLE FIBER

    • Dietary fiber (roughage) provides bulk; indigestible polysaccharides like cellulose; hemicellulose; soluble fibers (psyllium, agar-agar, inulin) can form gels and aid laxation
    • CELLULOSE: primary indigestible polysaccharide in plants
    • HEMICELLULOSE: indigestible; present in gums and woody fibers; contains sugars beyond glucose
    • ECTIN/AGAR-AGAR: soluble fibers used as thickeners/binders; in colon absorb water to form bulk and laxative effect
    • PSYLLIUM: soluble; plant (Plantago ovata) seed; ~80% dietary fiber; minor amounts of protein/fat/vitamins/minerals

  • PROTEIN SYNOPSIS (transition to next topic)

  • NOTE: The notes below summarize the subsequent chapters on PROTEIN, FATS, VITAMINS, MINERALS with key data, formulas, sources, and deficiency/toxicity signs.

  • CHAPTER 2 MACRONUTRIENTS (CONTINUED)

  • LESSON 4: PROTEIN AND AMINO ACIDS

    • PROTEIN OVERVIEW
    • Key roles: repair/build tissues; drive metabolic reactions; maintain pH and fluid balance; immune support; transport/stores nutrients; can serve as energy source
    • Origin of term: from Greek proteios meaning “to hold first place” (prime importance)
    • SOURCES: Meat, poultry, fish, milk, wheat, corn, beans, nuts
    • RDA (general): weight (kg) × 0.8 g/day
      • Normal adults: 0.8~ ext{g/kg/day}
      • Athletes: 1.0~ ext{g/kg/day}
      • Pregnancy/Lactation: up to 30 g/day (specific needs vary by weight and stage)
      • Children: up to 2.0 g/kg/day (example for growth)
    • AMINO ACIDS
    • 22 amino acids; building blocks of proteins; CHON elements (carbon, hydrogen, oxygen, nitrogen)
    • If excess protein is consumed: can be used for energy or converted to acetyl-CoA for fat synthesis; excess protein can be stored as fat
    • PROTEIN FUNCTIONS
    • Build/repair cells and tissues; structural role
    • Source of energy when needed
    • Regulate body processes (e.g., osmotic and acid-base balance)
    • PROTEIN CLASSIFICATION
    • Essential amino acids: must be supplied in diet (PVT TIM HALL)
      • PVT TIM HALL: Phenylalanine, Valine, Tryptophan, Threonine, Isoleucine, Methionine, Histidine, Arginine, Lysine, Leucine, Methionine, etc. ( memorize )
    • Non-essential (dispensable): body can synthesize; examples include glutamic acid, aspartic acid, alanine, proline, norleucine, citrulline, hydroxyglycine, hydroxyproline
    • SPECIFIC AMINO ACID ROLES
    • Methionine: methylating agent; helps form heme and choline
    • Phenylalanine: precursor to tyrosine; involved in thyroxine and epinephrine synthesis
    • Tryptophan: precursor for niacin (vitamin B3)
    • PROTEIN QUALITY IMPROVEMENT
    • Fortification: add essential amino acids into foods (e.g., lysine to bread)
    • Enrichment: restore nutrients lost during milling (e.g., lysine in Cerelac)
    • Supplementation: add protein-rich foods to diet
    • Complementation: combine proteins to supply missing essential amino acids (e.g., rice + munggo; soybean + wheat; soybean + nuts; soybean + corn; soybean + kidney bean)
    • PROTEIN STRUCTURE
    • Fibrous proteins: keratin, collagen, fibrin, myosin, elastin (insoluble; provide structural support)
    • Globular proteins: soluble in water (e.g., casein, albumin, globulin)
    • AMINO ACID CONTENT OF PROTEINS
    • Complete proteins: contain all essential amino acids in adequate amounts; typically animal proteins with high BV (e.g., milk casein, egg white albumin)
    • Partially complete proteins: support life but not growth (e.g., gliadin in wheat, legumin in legumes)
    • Incomplete proteins: cannot support life/growth (e.g., zein in corn, gelatin, most plant proteins)
    • PROTEIN-ENERGY MALNUTRITION (PEM)
    • Types: Marasmus (energy and protein deficiency; emaciated, hair dull, skin thin) and Kwashiorkor (protein deficiency with edema; fatty liver; high mortality)
    • PEM/CPM can result from inadequate total intake or imbalanced caloric/protein intake
    • CRITICAL THINKING 1 (exam-style prompts):
    • Discuss at least 2 protein-related diseases; health effects of protein; differentiate acute vs chronic PEM

  • LESSON 5: FATS AND OTHER LIPIDS

    • ENERGY DENSITY: fats provide 9 kcal/g; high-energy source
    • RDA/INTAKE: total fats ~65 g/day; saturated fats ~20 g/day (values vary by source)
    • IMPORTANCE OF FATS
    • Provide essential fatty acids (EFAs): linoleic, linolenic, arachidonic acids
    • Phospholipids for membrane function
    • Fat-soluble vitamins A, D, E, K and their absorption
    • EFAs AND FATTY ACIDS
    • EFAs: long-chain polyunsaturated fatty acids from linoleic, linolenic, and oleic acids; two families: Omega-3 and Omega-6
    • Nonessential fats: Omega-9 fatty acids can be synthesized if EFAs are present
    • CHEMICAL STRUCTURE
    • Fats: carbon, hydrogen, oxygen; glyceride linkage; fats are solids at room temperature; oils are liquids
    • CLASSIFICATION OF LIPIDS
    • Simple lipids (neutral fats): triglycerides (three fatty acids plus glycerol); ~95% of body fats are triglycerides
    • Compound lipids: phospholipids, glycolipids, lipoproteins; derived lipids
    • VISIBLE vs INVISIBLE FATS
    • Visible: butter, margarine, lard, oils
    • Invisible: fats in meats, dairy, eggs, baked goods, avocados, nuts, etc.
    • THREE TYPES OF COMPOUND LIPIDS
    • PHOSPHOLIPIDS: lecithins (emulsification), cephalins (blood clotting), sphingomyelins (myelin)
    • GLYCOLIPIDS: cerebrosides (nerve tissue), gangliosides (complex sugars)
    • LIPOPROTEINS
    • Lipids bound to proteins; lipids require carriers for transport in blood
    • Chylomicrons: largest/lowest density; 80–90% triglycerides; intestinal lipoprotein lipase hydrolyzes triglycerides to FFAs and glycerol
    • VLDLs: liver-produced; 55–65% triglycerides; become LDLs as triglycerides drop
    • LDLs: ~45% cholesterol; carries cholesterol to cells; elevated LDL > 130~ ext{mg/dL} linked to atherosclerosis; “Bad cholesterol”
    • HDLs: carry cholesterol from cells to liver for excretion; HDL ≥ 60~ ext{mg/dL} protective; “Good cholesterol”
    • DIGESTION AND ABSORPTION OF FATS
    • Majority of fat digestion occurs in the small intestine; 95% of ingested fats are digested
    • Minor digestion in the mouth and limited in the stomach via gastric lipase
    • Bile emulsifies fats; pancreatic lipase yields fatty acids and glycerol for absorption via villi
    • OXIDATION AND METABOLISM OF FATS
    • Fat metabolism occurs in cells; fatty acids produce energy (CO2 + H2O)
    • Excess fat stored as adipose tissue
    • CHOLESTEROL
    • Not a true fat but fat-like; present in animal foods; endogenous (liver) and exogenous (diet)
    • Essential for bile acids, vitamin D, steroid hormones; total daily dietary cholesterol recommended ≤ 300~ ext{mg/day}
    • LDL = bad cholesterol; HDL = good cholesterol
    • NEWER FAT-RELATED TERMS
    • Omega-3 fatty acids from fish oils lower triglycerides; may reduce platelet aggregation and blood pressure; EPA/DHA important
    • Omega-6 fatty acids (linoleic acid) lower cholesterol when replacing saturated fats; found in vegetable oils
    • Trans fatty acids (TFAs): produced by hydrogenation; raise LDL and total cholesterol; limit intake
    • FAT FUNCTIONS SUMMARY
    • Concentrated energy source; energy storage (adipose tissue)
    • Structural component; protects organs; insulation; padding
    • Carrier for fat-soluble vitamins; helps with absorption
    • EFAs as essential nutrients; role in prostaglandin formation and physiological regulation (blood pressure, etc.)
    • Flavor, palatability, satiety, and moisture retention in foods
    • DEFICIENCY AND EXCESS OF FATS
    • Fat malnutrition reduces caloric intake and can promote protein catabolism
    • EFA deficiency causes retarded growth and dermatitis in infants
    • Excess fat intake leads to obesity; recommended fat energy contribution ~20–30% of total daily calories (context-specific)
    • FOOD SOURCES OF FATS
    • Visible fats: butter, margarine, lard, cooking oils, fish liver oil, etc.; nuts and seeds; olives; avocado
    • Plant sources: corn/cottonseed/sesame/sunflower/soybean oils; fatty fish; flax; coconut oil high in saturated fats
    • SODIUM GUIDELINES AND SALT REDUCTION TIPS
    • Government guidance: limit salt; sodium intake ~6 g salt per day
    • Practical tips: read labels, rinse canned vegetables, choose fresh/frozen over canned, limit sauces, use herbs/spices, taste before salting

  • CHAPTER 3 MICRONUTRIENTS

  • LESSON 6: VITAMINS

    • VITAMINS: organic compounds needed in small quantities; essential; non-caloric; mostly act as coenzymes; growth and health maintenance

    • CLASSIFICATION BY SOLUBILITY

    • FAT-SOLUBLE: Vitamins A, D, E, K; stored in the body; ADEK

    • WATER-SOLUBLE: Vitamin C, B-complex vitamins (B1, B2, B3, B6, B12, pantothenic acid, biotin, folate, choline considered a pseudo-vitamin by some)

    • VITAMIN A (Retinol)

    • Forms: Preformed vitamin A (retinol) and Provitamin A (carotenoids, e.g., beta-carotene)

    • FUNCTIONS: vision, bone growth, reproduction, cell division; immune function; antioxidant properties

    • DIETARY REQUIREMENTS: Retinol Equivalents (RE): RE = 1~ ext{µg retinol} ext{ or } 6~ ext{µg beta-carotene}

    • SUPPLY: retinol from animal foods (liver, butter, cream, whole milk, egg yolk) and fortified foods; carotenoids from colorful fruits/veggies (beta-carotene best converted to retinol)

    • DEFICIENCY: night blindness, xerophthalmia, keratomalacia, rough skin; increased infection risk

    • HYPERVITAMINOSIS: birth defects, hair loss, dry skin, liver damage, bone/joint pain

    • OPTIMUM STORAGE: men 900 µg RE/day, women 700 µg RE/day

    • VITAMIN D

    • Forms: D2 (ergocalciferol) and D3 (cholecalciferol); formed from provitamin via UV light; considered a prohormone

    • FUNCTIONS: promotes Ca and P absorption; supports normal bone/mineralization; prevents tetany

    • SOURCES: sunlight; fortified foods; milk, fish, liver oils, egg yolk, butter, fortified margarine

    • DIETARY REQUIREMENTS: AI ~ 5~ ext{µg/day}; by age groups (e.g., 2 cups fortified milk/day for 0–50 years; increased AI with age)

    • DEFICIENCY: rickets in children; osteomalacia in adults; osteoporosis risk increases with deficiency

    • HYPERVITAMINOSIS: hypercalcemia; tissue calcification

    • VITAMIN E

    • FORMS: tocopherols (α, β, γ, δ); α-tocopherol most active biologically

    • FUNCTIONS: antioxidant; supports immune function; prevents hemolytic anemia in premature infants

    • SOURCES: vegetable oils (corn, soybean, safflower, cottonseed), margarine, wheat germ, nuts, leafy greens

    • DIETARY REQUIREMENTS: α-tocopherol equivalents (ATE) or TE; RDA ~ 15 mg TE/day

    • DEFICIENCY: hemorrhagic disease in newborns; delayed blood clotting in adults; fat malabsorption conditions

    • VITAMIN K

    • FORMS: K1 (phylloquinone) from green leafy vegetables; K2 (menaquinone) synthesized by gut bacteria; synthetic form is menadione

    • FUNCTIONS: essential for prothrombin formation; blood clotting; treated after antibiotic use or fat absorption issues; antidote for anticoagulants

    • SOURCES: leafy greens (broccoli, cabbage, spinach, kale); dairy, meats, eggs, cereals

    • DIETARY REQUIREMENTS: men 120 µg/day, women 90 µg/day; infants require 2.0 µg (0–6 months) and 2.5 µg (6–12 months)

    • DEFICIENCY/Toxicity: defective coagulation; hyperbilirubinemia risk with fat malabsorption

    • WATER-SOLUBLE VITAMINS (B COMPLEX and C)

    • GENERAL: dissolve in water; not stored extensively; heat/light sensitive; excreted in urine; require regular intake

    • VITAMIN B1 (THIAMINE)

    • FUNCTION: coenzyme in carbohydrate and some amino acid metabolism; essential for nerve/muscle action

    • DIETARY SOURCES: cereals (unrefined/enriched), legumes, yeast, wheat germ, lean pork, organ meats

    • REQUIREMENTS: ~ 1.1-1.2~ ext{mg/day (female/male)}

    • DEFICIENCY: Beriberi (dry and wet); Wernicke-Korsakoff syndrome with chronic alcohol use

    • VITAMIN B2 (RIBOFLAVIN)

    • FUNCTION: coenzyme in metabolism of carbs, fats, proteins; energy release; tissue maintenance (especially oral/macial tissues)

    • SOURCES: both plant and animal foods; leafy greens, whole grains, enriched breads/cereals, dairy/meat/eggs

    • DEFICIENCY: Ariboflavinosis; cheilosis; glossitis; seborrheic dermatitis

    • VITAMIN B3 (NIACIN)

    • FORMS: Nicotinic acid and Niacinamide; coenzyme in energy metabolism; essential to glycolysis and TCA cycle

    • SOURCES: animal/plant proteins; meats, poultry, fish, legumes, enriched cereals; tryptophan can be converted to niacin (NE concept)

    • DIETARY REQUIREMENTS: Niacin equivalents (NE); 1 NE = 1 mg niacin or 60 mg tryptophan

    • GENERAL RECOMMENDATION: ~ 14 mg NE/day (women) or 16 mg NE/day (men)

    • DEFICIENCY: Pellagra (3 D’s: diarrhea, dermatitis, dementia); GI and skin symptoms; glossitis

    • VITAMIN B6 (PYRIDOXINE)

    • FORMS: Pyridoxine, Pyridoxal, Pyridoxamine; PLP is the active coenzyme

    • FUNCTIONS: coenzyme in amino acid/protein metabolism; neurotransmitter synthesis; hemoglobin synthesis; conversion of tryptophan to niacin; metabolizes fatty acids and carbohydrates

    • SOURCES: animal (poultry, fish, liver, eggs); plant (spinach, oats, potatoes, bananas); broad dietary distribution

    • REQUIREMENTS: depends on protein intake; ~ 1.3-1.7~ ext{mg/day} (adult males/females)

    • DEFICIENCY: irritability, depression, dermatitis, nerve issues, growth retardation; microcytic anemia; toxicity mainly in animals

    • PANTOTHENIC ACID (VITAMIN B5)

    • FUNCTION: essential for carbohydrate, protein, and fat metabolism; part of coenzyme A; supports growth and skin integrity; broad metabolic roles

    • SOURCES: liver, other glandular organs, meat, eggs, milk, cheese, legumes

    • DEFICIENCY: natural deficiencies not known in humans; toxicity not established; high doses can cause diarrhea or water retention

    • LIPOIC ACID (not a true vitamin; synthesis in body; cofactor)

    • SOURCES: yeast, liver

    • BIOTIN (VITAMIN B7, Vitamin H)

    • FUNCTION: coenzyme in synthesis of fatty acids and amino acids; synthesized by intestinal bacteria; essential for energy production; supports hair/skin/nails health

    • DIETARY REQUIREMENTS: AI ~ 30 µg/day

    • SOURCES: liver, egg yolk, peanut butter, soy flour, cereals, yeast

    • DEFICIENCY: nausea, anorexia, dermatitis, alopecia; elevated serum cholesterol

    • FOLATE (FOLACIN, FOLIC ACID)

    • FUNCTIONS: DNA synthesis; amino acid/protein metabolism; heme synthesis

    • SOURCES: fortified cereals, sunflower seeds, leafy greens, citrus fruits, legumes

    • DIETARY REQUIREMENTS: micrograms; adult female 400 µg/day; pregnancy 600 µg/day (preconception through early pregnancy: 600 µg)

    • DEFICIENCY: neural tube defects (NTDs) risk; megaloblastic anemia; glossitis; GIT disturbances; impaired absorption

    • COBALAMIN (VITAMIN B12)

    • FORM: cyanocobalamin (common supplement name); contains cobalt

    • FUNCTIONS: folate metabolism; maintenance of myelin; healthy RBCs; GI/bone marrow/nervous tissue

    • ABSORPTION NOTE: requires intrinsic factor; absorption involves gastric secretion, pancreatic proteases, ileal receptors; pernicious anemia occurs with loss of intrinsic factor

    • SOURCES: animal products (organ meats, lean meats, seafood, eggs, dairy)

    • DIETARY REQUIREMENTS: measured in µg; adult needs 2–4 µg/day; increases during pregnancy/lactation

    • DEFICIENCY: megaloblastic anemia; neuropathy; anorexia; glossitis; anorexia; neurologic symptoms

    • CHOLINE (PSEUDO-VITAMIN)

    • ROLE: precursor for acetylcholine and lecithin; essential nutrient (body makes some, but dietary intake is needed)

    • AI: ~550 mg/day (men) and ~425 mg/day (women); UL ~ 3500 mg/day

    • SOURCES: milk, eggs, peanuts

    • DEFICIENCY: rare; toxicity may cause sweating, fishy odor, vomiting, liver damage, hypotension

    • IODINE (TRACE MINERAL)

    • FUNCTION: synthesis of thyroid hormones T3 and T4; regulates broad metabolic functions

    • SOURCES: iodized salt (main source), seafood, kelp, dairy products; plants from iodine-rich soils

    • DEFICIENCY: goiter, cretinism, impaired mental development; pregnancy-related risks

    • RECOMMENDED INTAKE (ages):

      • Infants 0–6 months: 110 µg/day
      • 7–12 months: 130 µg/day
      • Children 1–3 years: 90 µg/day
      • 4–8 years: 90 µg/day
      • 9–13 years: 120 µg/day
      • Adolescents/Adults: 150 µg/day
      • Pregnant: 220 µg/day; Lactating: 290 µg/day

    • ZINC

    • FUNCTION: vision maintenance; potential antiviral effects; supports immune function

    • SOURCES: red meat, poultry, fish

    • DEFICIENCY: growth retardation, reduced appetite, impaired immune function, hair loss, diarrhea, delayed sexual maturation, dermatitis, taste abnormalities

    • FLUORIDE (FLOURINE)

    • NOTE: essential trace element; chronic excess causes dental/bony changes (fluorosis)

  • LESSON 7: MINERALS

    • MINERALS: micronutrients; no calories; not destroyed by heat; remain as ash when food is burned
    • MULTITASKING MINERALS: parts of cells; regulate chemical reactions; maintain water balance; nerve function; blood clotting; energy release
    • MAJOR MINERALS
    • CALCIUM
      • DISTRIBUTION: 1.5–2.2% of body weight; 99% in bones/teeth; ~1% in soft tissues/fluids
      • FUNCTIONS: calcium phosphate formation for bones/teeth; blood clotting; muscle contraction/relaxation; promotes blood circulation
      • SOURCES: dairy; fortified white bread; oily fish; green vegetables; nuts/seeds
      • DEFICIENCY/EXCESS RISKS: stunted growth; rickets; osteomalacia; hypercalcemia
    • PHOSPHORUS
      • DISTRIBUTION: ~85% in bone/teeth with calcium; ~1% in body fluids
      • FUNCTIONS: bone/teeth structure; component of every cell; muscle contraction
      • SOURCES: dairy; fortified cereals; meat; fish; eggs; legumes
      • NOTES: balance with calcium for bone health
    • POTASSIUM
      • DISTRIBUTION: intracellular cation; ~2.6 g/kg fat-free body weight
      • FUNCTIONS: fluid/electrolyte balance; skeletal and cardiac muscle activity; carbohydrate/protein metabolism
      • SOURCES: meat, legumes, milk, fruits, fruit juice, leafy greens, unrefined cereals
      • DEFICIENCY/EXCESS RISKS: hypokalemia (low serum potassium), hyperkalemia (poor kidney excretion); weakness; confusion; distention
    • MAGNESIUM
      • DISTRIBUTION: ~50% in bones; remainder inside cells; ~1% in extracellular fluid
      • FUNCTIONS: supports energy production; protein synthesis; nerve/muscle function; blood glucose and pressure regulation; calcium/potassium transport
      • SOURCES: nuts, soybeans, meat, milk, cocoa, seafood, whole grains, dried beans, peas, leafy greens
      • DEFICIENCY: hypomagnesemia; tetany in kwashiorkor; GI issues; malabsorption; alcoholism
    • SODIUM
      • NA as primary extracellular cation; electrolytes regulate electrical currents; majority outside cells but significant in fluid balance
      • FUNCTIONS: fluid balance; acid-base balance; glucose transport; normal muscle contraction/excitability
      • SOURCES: table salt, processed foods; many vegetables and condiments
      • DEFICIENCY/EXCESS: hyponatremia (dehydration), hypernatremia (edema, hypertension)
      • TIPS FOR LOWERING SODIUM: read labels, rinse canned vegetables, choose low-sodium options, use spices instead of salt
    • CHLORINE
      • FUNCTIONS: maintains fluid/electrolyte & acid-base balance; contributes to stomach acidity (HCl)
      • SOURCE: table salt (NaCl)
    • SULFUR
      • FUNCTIONS: maintains protein structure via disulfide bonds; activates enzymes; detoxification via sulfate conjugation
      • SOURCE: protein-containing foods; ~1% sulfur in protein
      • DEFICIENCY: rare; specific hereditary cystinuria risk
    • TRACE MINERALS
    • IRON
      • FORMS: Heme iron (animal products, more easily absorbed) and Non-heme iron (plants, less absorbed)
      • SOURCES: fish, legumes, meat, liver, poultry, eggs, leafy greens, fortified cereals
      • RDA: Women 19–50 years ~ 18 mg/day; Men 19+ ~ 8 mg/day
      • DEFICIENCY: iron-deficiency anemia; reduced oxygen transport; symptoms include fatigue, pallor
      • ENHANCERS/INHIBITORS: vitamin C enhances non-heme iron absorption; meat enhances heme iron absorption; tannins, calcium can inhibit absorption
      • NOTES: iron overload risk (hemochromatosis) and poisoning risk from excess supplements in children
    • IODINE (covered above in MICRONUTRIENTS section but reiterated here for minerals): deficiency and toxicity risks; recommended intakes per age/gender
    • ZINC (covered above): deficiency signs and sources
    • SUMMARY ON NUTRITION IMPACTS
    • Dietary patterns influence energy balance, tissue synthesis, metabolism, and protection against deficiency diseases
    • Balance among macronutrients and micronutrients is essential for growth, development, and disease prevention

  • ADDITIONAL NOTES & PRACTICAL GUIDANCE

    • A well-balanced diet is the preferred method to meet vitamin A requirements; retinol equivalents are used to compare retinol and beta-carotene intake
    • Vitamin D optimization relies heavily on sunlight exposure; dietary sources supplement the AI recommendations
    • Choline is essential even though it is not a classic vitamin; ensure adequate intake to support neural function and liver health
    • Regularly reference the recommended dietary allowances (RDAs) and adequate intakes (AIs) for age/sex groups; pregnancy and lactation increase some micronutrient needs
    • Be mindful of toxicity thresholds for fat-soluble vitamins (A, D, E, K) and minerals (e.g., calcium, iron, fluoride) to avoid adverse effects

  • KEY FORMULAS AND NUMERICAL REFERENCES

    • CHO RDA: 130~ ext{g/day}
    • Protein requirement (adult): ext{protein}_{req} = ext{body weight (kg)} imes 0.8~ ext{g/day}
    • Retinol Equivalents: RE = 1~ ext{µg retinol} ext{ or } 6~ ext{µg beta-carotene}
    • Fat energy density: 9~ ext{kcal/g}
    • LDL threshold: ext{LDL} > 130~ ext{mg/dL} ext{ (increased risk)}
    • HDL protective level: ext{HDL}
      ightarrow ext{≥} 60~ ext{mg/dL}
    • Vitamin C AI: 75~ ext{mg/day (women)}, 90~ ext{mg/day (men)}
    • Iodine AI by age: see table; e.g., adults 150 µg/day; pregnancy 220 µg/day; lactation 290 µg/day
    • Iron RDAs: Women 18–50: 18~ ext{mg/day}; Men 19+: 8~ ext{mg/day}

  • IMPORTANT CONNECTIONS AND REAL-WORLD RELEVANCE

    • The balance of macronutrients informs energy balance and body composition; insufficient CHO can lead to ketosis and wasting; excess fats can contribute to cardiovascular risk without attention to EFAs
    • Adequate protein intake ensures tissue repair and immune competence; PEM conditions illustrate consequences of malnutrition in children
    • Fat intake influences satiety, vitamin absorption, and cholesterol profiles; choosing unsaturated fats over saturated/trans fats supports cardiovascular health
    • Vitamins and minerals drive enzymatic reactions, DNA synthesis, hormonal regulation, and immune function; deficiencies have wide-ranging effects (e.g., iron-anemia, iodine-goiter, vitamin C-scurvy)

  • ETHICAL, PHILOSOPHICAL, PRACTICAL IMPLICATIONS

    • Nutrition policy (e.g., iodized salt, fortification) aims to prevent deficiency across populations; balancing public health measures with individual dietary choices is essential
    • Accessibility and cultural food practices impact diet planning for therapeutic diets in hospital/community settings
    • Ethical considerations in supplementation: avoiding over-supplementation and potential toxicity; prioritizing food-first strategies when possible

  • CONNECTIONS TO FOUNDATIONAL PRINCIPLES

    • Nutrient classification aligns with thermodynamics of energy and macronutrient metabolism
    • Digestive system anatomy/function underpins nutrient availability for absorption and utilization
    • Hormonal regulation (e.g., insulin, glucagon, thyroid hormones) interacts with nutrient intake to maintain homeostasis

  • REAL-WORLD APPLICATIONS

    • Diet planning for pregnancy, lactation, infancy, childhood, adolescence, adults, and elderly based on disease states
    • Hospital diet therapy and community nutrition programs emphasize therapeutic diets, caloric calculation, and nutrient adequacy

  • SUMMARY OF KEY DEFINITIONS AND TERMS (glossary-style)

    • Nutrients, macronutrients, micronutrients, essential vs nonessential amino acids, RDA, AI, UL, REM, RE, NE, FA, EFAs, lipoproteins, chylomicrons, VLDL, LDL, HDL, PEM, PEM-CPM, marasmus, kwashiorkor, xerophthalmia, rickets, osteomalacia, osteoporosis, scurvy, goiter, cretinism, hemochromatosis, hemoglobin, intrinsic factor, pernicious anemia, beta-carotene, carotenoids, trans fats, essential fatty acids, prostaglandins, bile acids, emulsification, lipoprotein lipase, glycolysis, TCA cycle, ubiquity of trace minerals, and the caloric values of macronutrients (CHO, protein, fat)