Public Health Nutrition

For General Public Health (MPH)

Credit hr. = 3 hrs

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Mode of delivery
• Lectures

• Reading assignment

• Home take assignments

• Personal reading == adult learning

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Introduction
• Human nutrition is complex, multifaceted scientific
domain indicating how substances in food provide
• Essential nourishment for maintenance of life and
better health

• Public health nutrition

• Deals specifically with the role of nutrition, nutrition
intervention in preventing disease and promoting
wellbeing of community
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 Terms
✓Nutrition is the sum total of the process by which living
things receive and utilize the necessary materials for survival,
growth and maintenance of worn out tissues.
✓Food may be defined as any solid or liquid which when
ingested will enable the body to carry out any of its life
function.
➢ Foods are made up of
▪ Macro and Micronutrients

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 Terms….
❖NUTRIENTS,
✓are substances found in food that gives us nourishment.
We take them from the foods we consume or the
different types of liquid we drink.
❖DIET
✓ what food we eat in the course of a 24-hour, one week,
or one month, etc. period.
✓A pattern of food consumption which is followed by a
population or an individual
✓E.g. Dinner, breakfast, lunch, snacks…

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 Definition of Terms...

✓Food: - is any solid or liquid which when ingested will

enable the body to carry out any of its life function.

✓Food Security: Access at all times to a sufficient supply of

safe and nutritious foods.
✓ Roughage: fiber which enable the body to get rid of waste products,
which would otherwise become poisonous to the body. It add bulk to
feces.

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 Definition of Terms...

Diet: is the sequence of meals in a day (per 24 hours)

Public health nutrition: studies the relationship between

dietary intake and disease at community level

Dietetics: science/art of applying the principles of

nutrition in feeding tailored to individual needs (clinical
nutrition)

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Definition of Terms...

Malnutrition: pathological state resulting from a relative or absolute

deficiency or excess of one or more essential nutrients

Under-nutrition: pathological state resulting from the consumption of an

inadequate quality/quantity over an extended period of time

Over-nutrition: pathological state resulting from the consumption of an

excess quantity of food over an extended period of time

Specific deficiency: pathological state resulting from a relative/absolute

deficiency of an individual nutrient

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 Types of nutrients
• Essential nutrients: those substances absolutely
necessary for growth, development, and maintenance
and are not made in the body either at all or in
sufficient quantity to meet physiological needs

• Nonessential nutrients: those substances that are

either synthesized in the body in adequate
quantity or not necessarily essential for growth,
development and maintenance

• Conditionally indispensable nutrients: these are

required in specific physiological states when the body
can’t synthesize in sufficient amount to meet the
physiological needs.
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Nutrients • Types based on daily requirement
1. Carbohydrates • 1/ Macronutrients
2. Proteins • CHO, fat, lipids and water
3. Lipids/fats • Supply calory except water
• Needed in larger amount by body
4. Vitamins
5. Minerals 2/ Micronutrients
6. Water • Needed in smaller amount (mg, mcgs)
• Minerals and vitamins

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What is Healthy Diet?
Diets: the patterns of food consumption (frequency, mixture,
component,…) that greatly determine health of an individual.

1. Fulfills energy needs (macronutrients)

2. Provides sufficient amounts of essential nutrients (micronutrients)

3. Reduces risk of disease

4. Is safe to consume (low contaminants or potentially harmful added

substances)
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Nutrition and Development
• Nutrition and country development are closely related

• There is mutual relationship between the two.

• The current global initiative of SDG

• Give especial focus on the role of nutrition

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 Sustainable Development Goals
What are the proposed Global Goals?

THE 17 SUSTAINABLE DEVELOPMENT GOALS

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8/25/2024 14
 Source, Nutrition and the Post-2015
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Sustainable Development Goals
 Why nutrition matters?

Nutrition as a promoter of good health

• Nutrition is a major, modifiable, and powerful factor in promoting health,

preventing and treating disease, and improving quality of life.

✓Optimum breast and complementary feedings can prevent 13% and 6%

of deaths among children of under five, respectively.

✓Improving vitamin-A status of vulnerable populations can reduce under-

five mortality rates by at least 23%, saving hundreds of thousands of
children from irreversible blindness.

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Why nutrition matters …

✓Recent research has also demonstrated that vitamin-A supplementation can

mitigate the adverse effects of HIV, malaria, and diarrhea on child growth

✓ Improvements in iron status of affected populations can increase levels of

national productivity by 20%

✓ Iron interventions can also be expected to reduce maternal mortality

considerably

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 Why nutrition matters
2022, global nutrition facts

▪ Nearly half of all deaths in children under 5 are attributable to

undernutrition;

▪ By 2022,

▪ 148 million children were stunted and

▪ 45.5 million were wasted

▪ 6 % children were overweight

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 The impact of malnutrition

Health impact

• Undernutrition affects the body’s immune system.

• Increases the incidence, severity, and duration of common childhood diseases,
such as diarrhea, ARTI, and measles

• People who are malnourished have

• Have weakened defense against disease
• Become ill more easily and more frequently
• Are less able to recover quickly and fully from disease

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 Impact of malnutrition….
• Increases the virulence of infections

• Impaired physical and cognitive development

• Approximately 45-55% of under-five mortality in developing countries is

associated with malnutrition

• The role of obesity and overweight chronic disease.

• Intrauterine malnutrition a predisposition to hypertension, coronary

heart disease, and diabetes later in life.

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 Economic impact
• Economically, the cost of undernutrition and micronutrient deficiencies is estimated
at 2-3 % of global GDP due to its impact on human development, productivity, and
economic growth.
• Ethiopia:16% GDP losses
• Undernutrition is also one of the main pathways by which poverty is perpetuated
through generations.
• Maternal stunting is a strong predictor for giving birth to an underweight child, who will in turn
have a higher risk of physical and cognitive impairment, and will suffer the resulting economic
burdens.

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Impacts
➢ Illness
➢ Intelligence loss
➢ Reduced productivite
➢Short-term adverse effects include recurring illness,
weakness, delayed physical and mental development, irritability, poor
appetite, low weight for age, etc.
➢Long-term adverse effects are stunting or short height for
age, poor learning ability, poor performance at school and poor general
health.
➢All of which reflect in poor working capacity, resulting in low income.
Stunting in girls can have effects on child bearing, resulting in low
birth weight babies.

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 Nutrition and Education

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 Global Trends in Nutrition
• Reduced intake of fruit
and vegetables
• Increase intake of fats
and sugars
• Decrease intake of
fiber

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www.csrees.usda.gov/ree/Presentations/The%20Obesity%20Pandemic%20Aug%2022.ppt
 Stages of the Nutrition Transition
Urbanization, economic growth, technological changes for work, leisure,
& food processing, mass media growth
Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5
Paleolithic man/ Settlements begin/ Industrialization/ Noncommunicable Behavioral Change
Hunter-gathers Monoculture period/ Receding Famine Disease
Famine emerges

Diet
• Wild plants & • Cereals
• Starchy, low variety, • Increased fat, sugar,
• Reduced fat, increased
fruit, veg, CHO, fiber
related
low fat, high fiber processed foods
animals
• water
dominate
• water
• water • caloric beverages
• Increase water, Reduce
caloric beverage intake
NCDs
• Labor-intensive • Shift in technology
• Labor intensive • Labor-intensive • Replace sedentarianism
work job/home of work and leisure
w/ purposeful activity are
increas
Lean & robust,
Nutritional
MCH deficiencies,
ing!
deficiencies Obesity emerges, Reduced body fatness,
high disease weaning disease,
emerge, stature bone density problems improved bone health
rate stunting
declines

Low fertility, High fertility, Slow mortality decline Accelerated life Extended health aging,
Low life expectancy high MCH mortality, expectancy, shift to reduced DR-NCD
low life expectancy increased DR-NCD,
increased disability
period
Source: Popkin 2002 revised 2006.
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 Basics of Nutrients
Macronutrients

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 Energy supply
• While each of these macronutrients provides calories, the amount of calories
that each one provides varies.
✓Carbohydrate provides 4 calories per gram.
✓Protein provides 4 calories per gram .
✓Fat provides 9 calories per gram.

• Besides carbohydrate, protein, and fat the only other substance that provides
calories is alcohol.

• Alcohol provides 7 calories per gram.

• Alcohol, however, is not a macronutrient because we do not need it for

survival.

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 Carbohydrates
• Carbohydrates are made of carbon, hydrogen
and oxygen atoms.
• proportions 6:12:6.
• Two types of carbohydrates are simple
carbohydrates and complex carbohydrates.
• Are main source of energy for most developing
countries(about 80%).
• make up only 45 to 50 percent of the diet of
many people in industrialized countries.

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functions
We need carbohydrate because:
• 45% - 65% of calories should come from carbohydrate
• Carbohydrates are the body’s main source of fuel.
• Sparing Body Protein
• if diet does not provide enough glucose, then other sources of
glucose must be found
• if carbohydrate intake < 50 - 100 g, body protein will be used to make
glucose
• All of the tissues and cells in our body can use glucose for energy.

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Cont…
• Carbohydrates are needed for the central nervous system, the kidneys, the
brain, the muscles (including the heart) to function properly.
• 80 - 120 grams of glucose / day = 480 calories
• Carbohydrates can be stored in the muscles and liver and later used for
energy(glycogen).
• Carbohydrates are important in intestinal health and waste elimination (e.g..
Dietary fiber).
• Preventing Ketosis (Anti-ketogenic)
• incomplete fat metabolism produces KETONES
• an adequate supply of carbohydrate (> 50 – 100 g per day) prevents
KETOSIS

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 Classification of Carbohydrates

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 Food sources
• Free sugars are found from:
• fruits, juices, Soft drinks, , milk, sugar, sugar cane, honey and
yogurt, Cereal grains, Legumes & dried fruits, vegetables,
processed foods (pasta), pastries, breads, candies fruits like
banana, and sweet potato
• Starch is found from:
• starchy foods (like cereals and legumes and potatoes), Other foods
like fruits, vegetables, beans, nuts, seeds
• Oligosaccharides are found from :
• Garlic, onion, Whole grain cereals and legumes (beans and peas)
• Non starch polysaccharides are found from:
• Fruits, vegetables, Whole grain cereals and legumes

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 Simple Carbohydrates
• Monosaccharrides are single sugars.
• These sugars can pass through the wall of the
alimentary tract without being changed by the
digestive enzymes
➢ Glucose serves as the essential energy source, and
is commonly known as blood sugar or dextrose.
➢ Fructose is the sweetest, occurs naturally in honey
and fruits.
➢ Galactose rarely occurs naturally as a single sugar.

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 Cont’d
• Glucose, sometimes also called dextrose,
• is present in fruit, sweet potatoes, onions and other
plant substances.
• It is the end product of other CHO such as
disaccharides and starches.
• It is oxidized to produce energy, heat and carbon
dioxide, which is exhaled in breathing.
• Fructose is present in honey and some fruit juices
• Galactose
• when the milk sugar lactose is broken down by the
digestive enzymes.

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 Disaccharides
• Maltose consists of two glucose units. It is produced during the
germination of seeds and fermentation.
• Maltose=glucose + glucose
• Sucrose is fructose and glucose combined.
• It is refined from sugarcane, tastes sweet, carrot, pineapple and is
readily available.
• sucrose=glucose + fructose
• Lactose is galactose and glucose combined. It is found in milk and
milk products.
• Lactose=glucose + galactose
✓It is much less sweet than sucrose.

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 Oligosaccharides
• Are carbohydrates that contain 3-10 monosaccharide units

• They are present in a number of plant foods including peas,

garlic, onions, lentils and beans.

• Generally, these sugars are considered to be of minor

nutritional significance. However, they serve as dietary fiber.
• E.G. Raffinose, stacchyose, verbacose, fructans, galactans…

• Contribute to flatulence

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 The Complex Carbohydrates
• Few (oligosaccharides) or many (polysaccharides) glucose units
bound/linked together in straight or branched chains.
• Examples ; starch, glycogen and cellulose.
• Glycogen
✓ Storage form of glucose in the body
✓ Provides a rapid release of energy when needed
• Starches
✓ Storage form of glucose in plants
✓ Found in grains, tubers, potatoes, cassava &legumes
✓ Important source of energy for humans.

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 Polysaccharides
• Contains more than 10 monosaccharide units

• Glycogen is made in the human body and is sometimes known as

animal starch.

• Its formed from monosaccharide.

• Surplus glucose is stored as glycogen

• The glycogen in the liver is a reserve fuel; it serves between meals

and over night.

•.
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Other ways classification
1. Glycemic carbohydrates
• Can be digested and utilized by our body
• “Bad”
2. Non glycemic carbohydrates
• Cellulose, hemicelluloses, lignin, pectin and gums are sometimes
called unavailable carbohydrates because humans cannot digest
them
• Resistant starches
• Dietary fibers

• “Good carbs”

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 Dietary fibers
• Dietary fibers provide structure in plants, are very diverse, and cannot be
broken down by human enzymes.
✓ Soluble fibers are viscous and can be digested by intestinal bacteria.
✓ These fibers are found in fruits and vegetables.
✓ Insoluble fibers are non viscous and are not digested by intestinal
bacteria.
✓ These fibers are found in grains.

✓ Diets that are low in fiber have been shown to cause problems such
as constipation and hemorrhoids and to increase the risk for certain
types of cancers such as colon cancer.

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Digestion and Absorption of Carbohydrates
• Carbohydrates are present in three forms:
◼Digestible-most disaccharides
◼Ready-to-absorb- mono saccharides
◼Non-digestible
• Cellulose, hemicellulose, etc
Digestion in the buccal cavity:
• Homogenization occurs with;
• Mastication in the mouth
• Dietary polysaccharides become hydrated

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Cont…
➢ Salivary amylase (ptyalin)  -glycosidase
-Specific for hydrolysis of
-1,4 Internal glycosidic linkages
-Activated by Chloride ions
-Producing maltose, -dextrins & Iso
maltose…….Glucose
➢ Starch digestion by salivary amylase is incomplete

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 Cont….
Digestion in the Stomach:
◼Salivary amylase continues to act for 2 - 3
minutes until acidic pH =1 – 2 destroys the
activity of the enzyme
Digestion in the Small Intestine
◼Two enzymes that digest CHO:
1.Pancreatic enzyme

2.Intestinal mucosal brush border enzymes

• Maltase, lactase and sucrase enzymes

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 1.Pancreatic juice:
Pancreatic amylase -
glycosidase
◼optimum pH= 7.1
◼activated by chloride ion
◼acts exactly as salivary
amylase
Products of hydrolysis of
starch/Glycogen:
▪ Maltose
▪ -Limit dextrin
▪ Glucose

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 2.Intestinal mucosal brush
border:
Disaccharidases
• membrane-bound
❖Carbohydrates are digested
into:
o Glucose
o Galactose
o Fructose

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 Monosaccharides, the end products of carbohydrate digestion, enter
the capillaries of the intestinal villi.

In the liver,
galactose and
fructose are
converted to
glucose.
Small intestine

Monosaccharides travel to the

liver via the portal vein.

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 Cont…..
➢Not all complex carbohydrates are digested at the same
rate;
• Some carbohydrate sources lead to; a near-immediate
rise in blood Glucose levels after ingestion whereas
others slowly raise blood Glucose levels over an
extended period after ingestion.
• Glycemic index of a food is an indication of how
rapidly blood Glucose levels rise after consumption
• The glycemic response to ingested foods depends: not
only on the glycemic index of the foods, but also on:
• The fiber content of the food.
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Dietary fibers
• (14) glucosidic linkage of Cellulose; not hydrolyzed by
human digestive enzymes.
• Dietary fibers passes as it is in stools & beneficial for:
✓ Increasing bulk of intestinal contents by absorbing water
✓ Stimulates peristaltic movements;
◼to reduce stool transit time and prevents constipation
✓ Lower contact with fecal mutagens
✓ Bind & dilute bile acids  Carcinogens
✓ Lower blood glucose and cholesterol
✓ Weight managment
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 Lactose Intolerance
• It refers to a condition of abdominal distension,
severe bowel cramps, and diarrhea, nausea, &
flatulence
✓ After the ingestion of foods containing lactose
✓ Most notably dairy products
• Can be the result of primary deficiency of lactase;
✓ Secondary to an injury to the intestinal
mucosa;
◼ An acquired medical problem due to
intestinal diseases
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 Carbohydrate metabolism
• Once absorbed, carbohydrates have the three fates depending up on the

bodies energy balance:

i. Utilized to produce energy in the form of ATP

ii. Stored in the form of glycogen in the liver and muscles

iii. Stored in the form of fat if the body is plethoric of energy.

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Metabolism overview

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 Cont….
• The Constancy of Blood Glucose
✓ The Regulating Hormones
• Insulin moves glucose into the cells and helps to lower
blood sugar levels.
• Glucagon brings glucose out of storage and raises blood
sugar levels.
• Epinephrine acts quickly to bring glucose out of storage
during times of stress.
✓ Blood glucose can fall outside the normal range with
hypoglycemia or diabetes

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 Recommended Intakes of Sugars

• Recommended Intakes of Sugars

✓Dietary Guidelines state to limit intake of foods and
beverages that are high in added sugars.
✓DRI suggest added sugars should contribute no more
than 25% of a day’s total energy intake (25-38 gram)
✓Overall based on 2000 calorie diet: 225 to 325 gram of

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carbohydrate daily 56
 Lipids: functions, food
sources….

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 Introduction
• The class of nutrients known as lipids includes
triglycerides (fats and oils), phospholipids, and
sterols.

• Triglycerides are lipids with three fatty acids attached

to a glycerol.

• Fatty acids vary in carbon chain lengths, degree of

unsaturation, and number of double bonds.

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Functions of Lipids
• Are the form of stored energy in animals
• Have high energy value 9 kcal/gm of fat
• Act as carriers for fat soluble vitamins
• Are palatable giving good taste and satiety
• Serve as insulator preventing heat loss from the body
• Lubricate the gastrointestinal tract
• Protect the delicate organs such as Kidney, Eyes, heart and
the like.
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 Fatty acids (FA)
• Are composed of straight chain of carbon atoms with hydrogen
atoms attached and an acid group at one end.

• Most fatty acids have even number of carbon atoms, which are 2-
24.

• The two variables which determine the physical property of lipids

are:
• Length of carbon chain and
• Degree of saturation.
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 2. Depending on degree of saturation
• Saturated FA:

✓ If all of the carbon atoms are “saturated” with all hydrogen atoms they can hold,
then No double bond can exist.

✓ Mostly animal foods. E.g. butter(60% ), beef(28%), lamb(46%)

✓ The only plant sources are coconut oil and palm oil/palm kernel.

✓ All short or medium chain fatty acids are saturated.

✓ Long chain fatty acids may be either saturated or unsaturated.

✓ The major saturated fatty acids are palmitic and stearic acids.

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• Unsaturated FA:

• if all of the carbon atoms in a fatty acid are “ not-saturated” with

hydrogen atoms, then Double bond exists.

• Mostly from plant origin. Vegetable oils like olive oil and

safflower oil are rich in unsaturated fatty acids.

• Human breast milk is also rich in polyunsaturated fatty acids.

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✓Monounsaturated FA (MUFA): contain only one double bond between
carbon atoms.
▪ The most prevalent MUFA in the diet is oleic acid.

✓Polyunsaturated FA (PUFA): They have two or more double bonds

between carbon atoms.
• Linoleic acid, an omega-6 FA , is one of the PUFAs commonly found in both animal
and plant foods.

• linolenic acid, the most abundant omega-3 fatty acids, are found in plants and the fish
oils

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 Essential Fatty Acids
• Cannot be synthesized and the two forms of EFAs are:

a. Linoleic Acid (omega 6)

- commonly in animal & plant foods (vegetable oils and meats)

- Immune system

b. Linolenic (omega 3 FA)

• found in plants & the fish oils (dark green leafy vegetables, the two omega-3
fatty acids found in fish, shellfish, and fish oils

• Nervous system

• EFA Deficiencies;- dermatitis, Immune deficiencies, Neurological

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disorders 64
 Omega-3 Fatty Acids (fish oil)

• Health Benefits:

✓Anti-inflammatory Properties

✓Increases HDL (good) Cholesterol

✓Reduces Risk of Blood Clots

✓ Reduces Blood Pressure

✓Reduces Risk of Sudden Cardiac Death

✓Prevention and Rx of heart disease

✓For normal growth and dev’t, especially in the eyes & brain…

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 Triglycerides

• Make up about 95% of dietary lipids.

• Are three fatty acids plus one glycerol molecule

• May be solid (fat) or liquid (oil) at room temperature

• If all the three fatty acids forming the triglyceride are the same it is

called simple triglyceride and

• if they are different it is called mixed triglyceride.

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 Trans Fatty Acids Formed During Partial Hydrogenation

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 Classification of lipids
• Lipids are classified into 3 on the basis of their chemical
structure.
1. Simple lipids = Fats and oils
2. Compound lipid = Phospho-lipids and lipoproteins
3. Derived lipids= fatty acids and sterols
• Human beings cannot synthesize the Poly Unsaturated Fatty
Acids (PUFA), hence they are termed as essential FA.
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 Dietary Cholesterol Is Not Essential
• The liver synthesizes cholesterol needed by the body
• Liver synthesizes ~900 mg/d
• Liver decreases synthesis based on dietary intake to some extent
• Any extra source of calories can be converted to cholesterol by the liver, greatest effect
from
• saturated fatty acids

• trans fatty acids

• meat, eggs, fish, poultry and dairy products (exogenous).

• To reduce the risk of cardiovascular disease, dietary cholesterol intake

should be limited to < 300 mg/day
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Digestion and absorption
• Special arrangements are made in the
digestion of lipids.
• This is due to the hydrophobic nature of lipids.
• Lipids tend to separate from the watery fluids
of digestion.
• Digestive enzymes are hydrophilic.
• Bile from the liver emulsifies lipids.
• Enzymes are then able to break down lipids to
monoglycerides and fatty acids

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 Globules of fat need to be Emulsified before digestion
can take place
Fat globules:
Hydrophobic nature excludes water-
soluble enzymes
Also present limited surface area for
enzyme action
This is why an emulsification process needs to take
place before digestion can begin
Emulsification: Breakdown of large fat globules into
smaller ones;
Mouth  chewing
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 Emulsification of Fat by Bile

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Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Cont….
Dietary fat leaves the stomach and enters the SI,
where it is emulsified by bile salts
The gut hormone cholecystokinin (CCK),
It stimulates: contraction of the gallbladder &
secretion of pancreatic enzymes
The major enzyme that digests dietary TAGs is
pancreatic lipase
Pancreatic lipase is secreted along with:
another protein, colipase, bicarbonate, which
neutralizes the acid that enters the SI

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 Absorption, and Transport of Lipids
• Lipid Absorption
✓ Glycerol and short- and medium-chain fatty acids
diffuse and are absorbed directly into the
bloodstream.
✓ Monoglycerides and long-chain fatty acids form
micelles, are absorbed, and are reformed into new
triglycerides.
✓ With protein they are transported by chylomicrons.
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 Metabolism of Lipids
Triglycerides

Glycerol Fatty acids

Liver (gluconeogenesis)
ß-Oxidation

Brain & other glucose

dependent cells (glycolysis)
Acetyl COA

Pyruvate

Krebs cycle
Co2+H2o+Energy

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 • Lipid transport is made possible by a group of
vehicles known as lipoproteins.
✓Chylomicrons
• Largest of the lipoproteins
• Get smaller as triglyceride portion is
removed by the cells

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 Cont….

✓ VLDL (Very-Low-Density Lipoproteins)

• Composed primarily of triglycerides
• Made by the liver
• Transport lipids to the tissues
✓ LDL (Low-Density Lipoproteins)
• Composed primarily of cholesterol
• Transport lipids to the tissues
✓ HDL (High-Density Lipoproteins)
• Composed primarily of protein
• Transport cholesterol from the cells to the
liver

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Normal Lipid Profile (mg/dl)
• Total Cholesterol < 200
• TG ‘Ugly’ Lipid < 150
• ‘Bad’ Cholesterols LDL < 100
• HDL ‘Good’ cholesterol > 50
• VLDL is Ugly TG ÷ 5 < 30
• Lp(a) ‘Deadly’ cholesterol < 20

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 Health Implications

➢High LDL is associated with higher risk of heart attack and

is known as “bad” cholesterol.
➢High HDL seems to have a protective effect and is known
as “good” cholesterol.
➢These are cholesterol carriers

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 Recommended Intakes of Lipids
• Recommended Intakes of Fat
✓ The DRI and the 2005 Dietary Guidelines recommend fat
at 20-35% of energy intake (400-700 kcalories of a 2,000-
kcalorie diet).

✓ 2005 Dietary Guidelines suggest choosing a diet low in

saturated fat and cholesterol and moderate in total fat.
✓ “Low saturated fats intake also increase
mortality!!... parardox’’

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 Proteins

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 Introduction
• Each protein itself is made up of a variety of smaller
components called amino acids
• Protein is essential for overall health and provides energy.
• Proteins are made from 20 different amino acids, 9 of which
are essential.
• Each amino acid has an amino group, an acid group, a
hydrogen atom, and a side group.
• It is the side group that makes each amino acid unique.
• The sequence of amino acids in each protein determines its
unique shape and function.

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 Functions of proteins
✓ Building Materials for Growth and Maintenance
• A matrix of collagen is filled with minerals to provide strength to
bones and teeth.

• Replaces tissues including the skin, hair, nails, and GI tract lining

✓ Enzymes are proteins that facilitate anabolic (building up) and

catabolic (breaking down) chemical reactions.

✓ Hormones regulate body processes and some hormones are

proteins. An example is insulin.

8/25/2024 85
 Cont….
✓ Regulators of Fluid Balance
• Maintain the volume of body fluids to prevent edema which is
excessive fluid
✓ Acid-Base Regulators
✓ Source of energy and glucose if needed.
• Blood clotting by producing fibrin which forms a solid clot
✓ Amino Acids to Make Other Compounds
• Neurotransmitters are made from the amino acid tyrosine
• Transporter
• Antibodies
8/25/2024 86
 Protein
• There are over 20 amino acids in dietary protein.

• Nine are “essential” amino acids that our bodies cannot

make; we must get these from our diet.

• Eleven amino acids are called “non-essential” because

our bodies are able to make them..

• Dietary proteins from animal sources such as meat, fish

and milk products contain all nine essential amino acids
and are considered complete proteins.
8/25/2024 87
 List of the 20 Amino Acids

8/25/2024 88
 Summary of
amino acid
catabolism.
Amino acids
are grouped
according to
their major
degradative
end product.

8/25/2024 89
 Incomplete proteins
Complete proteins

• Animal source protein • Mostly plant origin

• Contain all essential aas • Lack one or more
essential aas
• High biological value
• Low biological value
• 90-99% absorbed • 70-90% absorbed
• E.g. meat, pork….. • E.g. legumes lack
methionine and cereal
lacks lysine
• Bread plus peanut butter

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 Source of proteins
• Milk and milk products such as cheese, ice cream all derive their
protein from milk.

• Meat, poultry, and fish are all forms of animal tissues

• Eggs are in a class by themselves a protein food of high nutritive

value.

• Vegetables are poor source of protein.

• Legumes provide more than 4 or 6 percent.

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 Digestion and absorption of protein

• The digestion of protein in the alimentary tract is

accomplished by the action of several proteolytic enzymes
in the gastric, pancreatic and intestinal juices.

• Any of these enzymes that have the power to attack active

proteins must be secreted in an inactive form to prevent
damage to the tissues where they are formed.
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 Digestion and Absorption of Protein
• Stomach acid and enzymes facilitate the digestion of
protein.
• It is first denatured, then broken down to polypeptides.
• The small intestine continues to break down protein
into smaller peptides and amino acids so it can be
absorbed.
• No protein digestion in the mouth

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Types of enzymes
• Pepsinogen is secreted by the gastric juice and activated by
the Hydrochloric acid
• Trypsinogen is secreted by pancreatic juice and activated by
entropeptidase
• Chemotrypsinogen is secreted by pancreatic juice and
activated by the active trypsin
• Peptidase intestinal juice

8/25/2024 94
Activation of peptidases

8/25/2024 95
 Summary of protein digestion

8/25/2024 96
8/25/2024 97
 Health Effects and Recommended Intakes of Protein

• Health Effects of Protein

• Heart Disease

• Foods high in animal protein also tend to be high in saturated fat.

• Homocysteine levels increase cardiac risks

• Increase risk of chronic cardiac diseases

• Arginine and taurine may protect against cardiac risks.

• Taurine may have antioxidant properties.

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 Recommended Intakes of Protein
• Recommended Intakes of Protein
✓ 10-35% energy intake
✓ Protein RDA
• 0.8 g/kg/day
• Assumptions
-People are healthy.
-Protein is mixed quality.
-The body will use protein efficiently.
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 Micro-nutrients: Vitamins

8/25/2024 100
 What are micronutrients?
• Micronutrients are nutrients that do not have to be
broken down to smaller units for use by the body.
• Are vitamins and minerals which our body only needs
in small amounts.
• Vitamins are organic and can be affected by extremes
of physical and chemical environment
• Minerals are inorganic.

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 Vitamins
• Are needed for growth, maintenance of health and
reproduction.

• Presently, there are 13 known vitamins

• They are indispensable, non-caloric organic nutrients

needed in tiny amounts in the diet.

• Some vitamins like vitamin A and D are highly stored in

the liver and get released to their functional sites when
needed.
• .

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 Cont…
• Without vitamins thousands of chemical reactions do not
occur.
• Most vitamins cannot be synthesized in the body.
• Vitamins K (Menaquinone) and B12 are synthesized by
intestinal microorganisms though not in adequate
amounts.
• Other vitamins like niacin, vitamin D are synthesized in
the body from their precursors.

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 Group characteristics of vitamins
Characteristics Water soluble Lipid soluble

Vitamin C and B-
Names complexes Vitamins A, D, E and K
(B1,B2,B3,B5,B6,B9,B12)

In organic compounds like chloroform,

Solubility In Water
benzene and ether

Storage Not stored very much Stored in different organs

With lipids through the lymphatic

Absorption Directly
system

Transport in the blood Freely Need to be bound to carrier protein

Apt to develop following Deficiency does not develop following

Deficiency
acute shortages acute shortage of the vitamins

Toxicity upon intake of

mega dose in the Unlikely to occur Likely to occur
form of treatment

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 Water Soluble Vitamins:
Vitamin B group
and Vitamin C

8/25/2024 105
 Thiamine (Vitamin B1)
Functions
• Forms thiamine pyrophosphate (TPP), a combination of two
molecules of phosphoric acid and B1, is the coenzyme form of
this vitamin.

• TPP is critical in several metabolic functions, including the

removal of carbon dioxide reactions, which in turn are
important in the conversion of amino acids, carbohydrates
and fats to energy.

• It is also necessary for the conversion of carbohydrates to fat.

• TPP is needed for the synthesis of acetylcholine, a lack of which
causes inflammation of the nerves and memory loss.

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 Food source
• Plant sources
• whole-wheat, cereals,
• vegetables,
• beans, yeast
• Animal Source
• Salmon steak , Pork meat,
• Beef kidney
• Beef liver, fish
• NB: whole grains contain great amount

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 Deficiency
• causes Beriberi, which literally means “I can’t I
can’t”, indicating the impairment of the Nervous
System and the Cardiovascular System.

• Such a deficiency in alcoholics results in brain

problems known as Wernicke-Korsakoff syndrome.

• This can result in memory impairment, motor

problems, and psychosis.
8/25/2024 108
Cont…
• Vigorous exercise,
excessive
carbohydrates,
alcohol, and diets
high in fat may also
lead to thiamine
deficiency symptoms

8/25/2024 109
 • Risk factors for the deficiency
• Over processing of grains
• Alcoholism
• Inhibit absorption of thiamine
Prevention
• Avoid over milling (over processing) of the
staple cereal
• Fortify staple cereal with Vitamin B1
• Avail adequate amounts of alternative foods
rich in thiamine

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 Riboflavin (Vitamin B2)

Function
❑Maintains healthy mucous membranes lining
respiratory, digestive, circulatory and excretory tracts
when used in conjunction with Vitamin A
❑Preserves integrity of nervous system, skin, eyes.
❑Necessary for the regeneration of glutathione
❑Activates pyridoxine

8/25/2024 111
 Cont…

• Food source
• Dairy products,
• eggs, meat, green leafy vegetables, liver,
• whole-wheat
• cereals, nuts

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 Deficiency
❑Cracks and sores in corners of mouth (angular Stomatitis/
Cheilitis)
❑Inflammation of tongue and lips
❑Eyes too sensitive to light and easily tired
❑Itching, burning and reddening ( Drunkard’s eye)
❑Itching and scaling of skin around nose,
mouth, scrotum, forehead, ears, scalp
❑Dizziness
❑Insomnia
❑Slow learning

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 Niacin (Vitamin B3)
❑ Has two forms namely nicotinic acid and nicotinamide
❑ Functions
❑ participates in more than 50 metabolic functions, all
of which are important in the release of energy from
carbohydrates: NADP/H
❑ Niacin also assists in antioxidant and
detoxification functions
❑ Maintains normal function of skin, nerves, and
digestive system
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 Deficiency (a disease of 4 Ds: Diarrhea, Dematitis, Dementia &
Death)
Early Symptoms:
•Muscle weakness
•General fatigue
•Loss of appetite
•Skin lesions, Nausea and vomiting
•Dermatitis (affecting the sun exposed areas)
Late consequences of severe deficiency called pellagra:
• Diarrhea
• Dementia
• Death

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A pellagra signs: Casals necklace and skin
features

8/25/2024 116
 • Food Sources
• RDA for niacin in food
• Plant
varies from 5 mg to 20 • Brewer's yeast
• Peanuts
mg per day
• Sunflower seeds
• Need varies with age • Animal
• Salmon, Pork
• 6.6mg/1000kcal is • Chicken, white meat
enough for adults. • Beef liver
• Tuna

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 Pyridoxine (Vitamin B6)
• It is particularly indispensable to the action of amino acid
neurotransmitters, like serotonin, dopamine, melatonin,
and norepinephrine, Gama amino butyric acid (GABA)
which effect brain function.
❑ pyridoxal 5'-phosphate (PLP) are essential to over
100 enzymes mostly involved inprotein metabolism.
• Nucleic acid synthesis
❑ Promotes conversion of tryptophan to serotonin
❑ Helps the body to convert tryptophan, an amino acid,
into niacin
❑ Hemoglobin synthesis and function
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Effects
• Several medications, including anti-tuberculosis drugs, anti-
parkinsonians, nonsteroidal anti-inflammatory drugs, and oral
contraceptives, may interfere with vitamin B6metabolism.
• reduce the risk of late-life depression
• Cognitive improvement
• Reduce circulating homocysteine- are associated with an increased
risk of cardiovascular disease
• RDA: 2mg/day
• 1.3 mg/day for adults (19-50 years),
• 1.7 mg/day for men (51+ years), and
• 1.5 mg/day for women (51+ years).
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 Pyridoxine deficiency
❑ Peripheral neuropathy (pins and needles in the
palms and feels)

❑ Weakness, Mental confusion , Irritability,

Nervousness, Insomnia
❑ Poor coordination walking, Hyperactivity,
❑ Muscle twitching
• Convulsion
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 Folic Acid (Vitamin B9)
• FUNCTIONS
❑It is critical to cellular division because it is
necessary for DNA synthesis.
❑Maintains the cell’s genetic code and transfer
inherited traits from one cell to another
❑Promotes normal red blood cell formation.

❑Regulates embryonic and fetal development of

nerve cells.
•.
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 Food sources
• Are called foliages.
• Barley, beans, brewer's yeast
• Calves' liver
• Green, leafy vegetables, Fruits
• Lentils, peas, rice
• wheat and wheat germ
• Orange juice
• Oranges

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Metabolism

8/25/2024 123
 Deficiency
• Without adequate folic acid,
DNA synthesis and repair is
impaired.
• Unrepaired DNA leads to
diseases like cancer
1. Megalobastic anemia
• Impaired cell division and protein
synthesis, which affects rapidly growing
tissues
2. Folic acid deficiency during
pregnancy has been linked to several
birth defects (Neural tube defect)
8/25/2024 124
 Effects
• It prevents neural tube defects,

• So folic acid acid supplementation of high risk women with folate 1

month before and the first 3 months after the onset of pregnancy is
recommended

• Along with vitamins B6 and B12, supplemental folic acid may help those
with inadequate intake to prevent a rise in blood levels of homocysteine
• Believed to be a risk factor for heart disease.

•8/25/2024
Folic acid may counterbalance the effect of alcohol on breast cancer risk.
125
 RDA and prevention methods
• RDA for folic acid varies but pregnant need high amount
about 400microgram

• Prevention methods
• Folic acid supplementation
• Encourage eating folic acid rich foods
• Nutrition education and counseling

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 Cyanocobalamin (Vitamin B12)
❑Parietal cells secrete a special digestive hormone that increases the
absorption of vitamin B-12 in the terminal ileum called intrinsic factor.
❑For this reason vitamin B-12 is called extrinsic factor.
❑Unlike other water-soluble vitamins, this vitamin is stored in the body
tissues, so a deficiency can take years to appear.

8/25/2024 127
 Food sources • FUNCTION

• Vitamin B-12 is found from foods of ❑Conversion of homocysteine to

animal origin which include: methionine (methyl group added to
• Milk, milk products homocysteine)
• Sardines
❑Prevents folate deficiency
• Liver, Beef, Beef liver

• Eggs, Kidney ❑Promotes red blood-cell development,

• NB. Plant products lack vitamin B 12 and DNA synthesis of covering to nerve
cells, maintenance of normal function
8/25/2024 of nervous system. 128
 Deficiency
❑Deficiency is not common
❑Pernicious anemia (megaloblastic anaemia)
❑Impaired brain and nervous system function;
demylination of nerve fibers in Central Nervous System
(Brain and Spinal cord)
❑Numbness and tingling in hands and feet, difficulty
maintaining balance, pale lips, pale tongue, pale gums,
confusion and dementia, headache, poor memory.

8/25/2024 129
Risk factors for B12 deficiency
• RDA for vitamin B12 is about
❑ An inadequate diet as in the case of
vegans (absolute vegetarians) 2.4µg
❑ Disease like infection with fish
tapeworm called Diphyllobothyrium • Prevention methods
latum • Avoid being strict vegetarian
❑ Lack of intrinsic factor in the small
intestine as in the case of surgical • Increased intake of animal source
removal of the parietal cells of the foods
stomach
❑ Surgical removal of the terminal • Nutritional counseling
ileum
❑ Gastrectomy

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 VITAMIN C (ASCORBIC ACID)
❑ Humans are one of a very few species that cannot
manufacture vitamin C and must depend on food
for this vital nutrient.
Functions
❑ Helps to form collagen in connective tissue and tissue
repair.
❑ Increases iron absorption from intestines (converts
non hem iron in to hem iron).
❑ It is antioxidant
❑ Bone density
❑ Wound healing and connective tissue metabolism

8/25/2024 131
 Food Sources:
• Common sources vitamin C are citrus fruits and
green leafy vegetables

• Oranges, papayas

• Potatoes, spinach

• Strawberries

• Sweet and hot peppers

• Cabbage, grapefruit, mangos, lemons

• Tomatoes, broccoli

• Kale, green peppers

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Deficiency
❑ Scurvy: muscle weakness, swollen gums, loss of teeth, tiredness,
depression, bleeding under skin, Spongy bleeding gums
❑ Easy bruising, bleeding tendency
❑ Nose bleeding (epistaxis)
❑ Swollen or painful joints
❑ Anaemia: weakness, tiredness, paleness
❑ Slow healing of wound and reopening of surgical wounds

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 Lipid (fat) Soluble Vitamins

Vitamin A, D, E and K

8/25/2024 135
 Vitamin A (retinol)
❑Beta-carotene is a pro-vitamin A, fat-soluble compound
found in plants,
❑Beta-carotene has the greatest pro-vitamin A activity
❑The body converts beta-carotene to Vitamin A.
❑Retinol is the precursor to active forms of Vitamin A, found
from animals.
❑These forms include retinal, which is used in vision and
reproduction, and retinoic acid, needed in growth and
genetic differentiation.

8/25/2024 136
 Food Sources
Plant sources: Vitamin A is generally found in deep green leafy
vegetables(GLV), yellow orange fruits in the form of B-carotene[
Papaya, Mango, Asparagus , broccoli , Carrots, Kale, fresh Red
palm oil, Pumpkin, Spinach, Orange fleshy Sweet potatoes,
Watermelon)

Animal sources: found in the form of retinole

Liver
Fish liver oil
Milk and milk products
Egg

8/25/2024 137
 Function
• Forms visual pigment : combines with purple
pigment of retina (opsin) form rhodopsin, which is
necessary for sight in partial darkness.
• Necessary for growth of bone, testicular function,
ovarian function
• Embryonic development
• Regulation of growth, differentiation of tissues
• Helps form and maintain healthy skin, hair, and
mucous membranes
• Resistance to infection
• Antioxidant vitamin

8/25/2024 138
 Over dosage toxicity
❑Toxicity occurs if a person takes mega
dose==10XRDA
❑Signs and symptoms
➢Bulging soft spot on head in babies (infants),
sometimes hydrocephaly ("water on brain"),
➢confusion or unusual excitement, diarrhea, dizziness,
➢Double vision, headache, irritability, dry skin,
➢It is teratogen

8/25/2024 139
 Prevention and control of Vitamin A
deficiency
1. High Dose vitamin A Supplementation
a) Universal Supplementation Schedule
• Children 6-11 moths = 100,000 IU every 6 months
• Children 12-59 months 200,000 IU every 6 month
• Lactating women within 6 week after delivery = 200,000IU A
single dose

b) Diseases Targeted Supplementation Schedule

• Measles, diarrhea and xeropthalmia

8/25/2024 140
 2. Breast feeding = Colustrum has high concentration of
vitamin A, it is called the first immunization of the baby
3. Dietary Modification: Fortification of oil, floor ,
sugar
4. Dietary Diversification – Behavior change
communication on the consumption of vitamin A
friendly foods eg. Growing and consuming Orange
fleshy sweet potatoes
5.Nutrition education and counseling

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 Vitamin D (1,25, Dihydroxychole
Calciferol)
The two most important are D-2 and D-3.
•Vitamin D-2 (Ergocalciferol) exists in fungi and yeast
and is the form generally added to milk, food, and
vitamin supplements.
•Vitamin D-3 (Cholecalciferol) is found in fish oils, egg yolks,
and milk.
•The body produces Vitamin D-3 in the presence of ultraviolet
sunlight.
•7-dehydrocholesterol reacts with ultraviolet light of UVB to
produce active Vitamin D
8/25/2024 142
Vitamin D
• Vitamin D is not strictly a vitamin, since it can be synthesized in the
skin, and synthesis into a vitamin.
• it is only when sunlight exposure is inadequate that a dietary source
is required. Its main function is in the regulation of calcium
absorption and homeostasis; most of its actions are mediated by
nuclear receptors that regulate gene expression.
• Deficiency, leading to rickets in children and osteomalacia in adults,
continues to be a problem in countries where sunlight exposure is
poor.

8/25/2024 143
Sources
• Liver, beef, eggs yolk , dairy products , some saltwater fish (salmon, tuna and
sardine).
• Fortified food (milk, yogurt, cheese, margarine, orange juice, breads and
cereals).
• It is stable in cooking and storage.
• Synthesis in skin.

8/25/2024 144
Vitamin D
• The normal dietary form of vitamin D is cholecalciferol (also known as
calciol).
• This is also the compound that is formed in the skin by ultraviolet
(UV) irradiation of 7-dehydrocholesterol.
• Some foods are enriched or fortified with (synthetic) ergocalciferol,
which undergoes the same metabolism as cholecalciferol and has the
same biological activity.

8/25/2024 145
Absorption and metabolism
• Vitamin D is absorbed in lipid micelles and incorporated into
chylomicrons; therefore, people on a low fat diet will absorb little of
such dietary vitamin D as is available.
• Indeed, it is noteworthy that at the time that rickets was a major
public health problem in Scotland, herrings (a rich source) were a
significant part of the diet:
• it can only be assumed that the diet was so low in fat that the
absorption of the vitamin was impaired.

8/25/2024 146
 Functions
❑Regulates growth, hardening and repair of bone by
controlling absorption of calcium and phosphorus from
small intestine.
❑Promotes normal growth and development of infants and
children, particularly bones and teeth.
❑Increases Ca++ uptake from the gut
• Increase transcription and translation of Ca++ transport proteins
in gut epithelium
❑Minor role: also stimulates osteoclasts
• Increase Ca++ resorption from the bone

8/25/2024 147
 Vitamin K
❑Vitamin K is somewhat unique because it has both fat- or
water-soluble forms.
❑K1 (phylloquinone), is found in many plants and animals,
and
❑ K2(menaquinone), is manufactured by microorganisms,
such as bacteria, in the intestinal tract of many animals.
❑K3 (menadione) is a synthetic version with the basic
structure of the naturally occurring vitamins and is twice as
active biologically. This version is soluble in boiling water

❑Fifty percent of the requirement of the vitamin by most

individuals is met by intestinal bacterial synthesis

8/25/2024 148
 Functions
✓ Promotes production of active prothrombin which
are necessary for normal blood clotting.

✓ Prevents hemorrhagic disease of the newborn

✓ Components of bone protein

✓ Osteocalcin and gla protein

8/25/2024 149
 Risk factors
o Newborns (no bacteria in intestinal tract to
synthesize vitamin K
o People on antibiotics (kills intestinal bacteria
o Liver disease ( absorption of vitamin K)
o Fat malabsorption
o Food sources
•Primarily from plants – broccoli, kale,
cabbage, lettuce
•Soy is also rich sources
•Bacteria in the colon provide menaquinone

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 MINERALS

8/25/2024 151
Introduction
❑Minerals are inorganic elements not attached to a
carbon atom.
❑They participate in many biochemical and
physiological processes necessary for optimum growth,
development and health.
❑They constitute 4% of total body weight
❑They are essential structural components of body
tissues and are vital for body processes

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 Minerals are classified into two major groups (macro
minerals and micro minerals).
Macro Minerals (Principal Elements, major
minerals)
These are minerals that are
❑Required in relatively larger amounts > 100 mg/day or
are found in the body in amounts > 5grams.

❑They are: - Calcium (Ca), Phosphorus (P), Sulphur (S),

magnesium (Mg), Sodium (Na), chloride (Cl2), and
Potassium (K).

8/25/2024 153
 Micro Minerals (Trace Elements)

• These are minerals that are:

•
• Required in relatively larger amounts <100 mg/day or are found in the body in
amounts < 5grams.

• They are: - Iodine (I), Iron(Fe), Zinc(Zn), Fluorine(F), Manganes(Mn),

Selenium(S), Cobalt, Nickel

8/25/2024 154
 Iron
• Is one of essential mineral important for health
• Function
• Hemoglobin and myoglobin formation
• Immunity (enhancing neutrophil function)
• Cognitive development
• Metabolic efficiency
• Enhances Physical growth of children

8/25/2024 155
Regulation of Iron absorption
• Regulation of iron uptake by enterocytes and
release of iron stores from macrophages and
hepatocytes is mediated by the hormone
hepcidin.
• Hepcidin decreases serum iron by decreasing
iron absorption and preventing macrophages
from releasing iron (causing iron sequestration).

8/25/2024 156
 Heme and non-Heme
• The iron in meat is about 40 percent heme and 60 percent non-heme.
• Much of the iron in the diet, however, is in the non-heme form.
• This is the form found in plant sources such as fruits, vegetables, grain
products, and in iron fortified foods.
• About 25 – 35 percent of heme iron is absorbed,
• About 3 – 20 percent for non-heme iron.
• For this reason vegetarians, compared to non-vegetarians, require 1.8 times
the amount of iron.
8/25/2024 157
Absorption of iron
• The tannins in both tea and coffee adversely affect iron availability

• Phytates in some legumes and grains, phosphates in cola drinks

• calcium and fiber may also interfere with iron absorption.

• These may be important factors if the diet is already low in iron.

• Vitamin A helps release iron from iron stores

• Iron store of individual is important

8/25/2024 158
 Factors enhancing and inhibiting absorption of
non-hem iron.

Enhancers Inhibitors
Vitamin c Phytates
Amino acids Tanins
High altitude Polyphenoles
Hydrochloric acid Heavy metals
Fermentation Fibers
Alcohol Low altitude
Deficient stores Replete stores
Achlorhydria

8/25/2024 159
Risk factors for anemia
✓Parasitic infection Hook worm, malaria,
Schistosomiasis, heavy load of Trichuriasis or
Ascaris)
✓Cereal based monotonous diet
✓Increase intake of inhibitors
✓Low birth weight infants
✓Children aged 6-59 months
✓Adolescent girls and boys(10-19 years)
✓Pregnant and lactating women
✓ People living with HIV and AIDS
8/25/2024 160
 Food sources of Iron
• Bread, cheese
• Garbanzo beans (chickpeas)
• Lentils, pumpkin seeds
• Seaweed, wheat germ
• Whole-grain products
• Egg yolk, Meat, chicken, fish

8/25/2024 161
 RDA
• Depends on age

8/25/2024 162
Toxicity
• Consuming large quantities of alcohol may increase the absorption of
iron.
• Hemochromatosis,
• absorb too much iron from food that is consumed.
• Once iron is absorbed, it is only excreted through blood loss.
• An overdose of iron supplements can cause toxicity in adults and
children.
• 40 mg/day for children under the age of 14 and
• 45 mg/day for anyone 14 years of age or older.

8/25/2024 163
Iodine
• Functions
• Iodine is a trace element that combines with the amino
acid, tyrosine, to form the thyroid hormone(T3 and
T4) and is necessary for normal thyroid function.
• Thyroid hormone accelerates cellular reactions,
increases oxygen consumption and basal metabolic
rate, influences growth and development, energy
metabolism, differentiation and protein synthesis.
• Ocean water, like seafood, is high in iodine content.
• Goiter is more common in geographic areas that are
inland and where iodine is not added to the soil
through seepage of ocean water and ocean winds.

8/25/2024 164
RDA for Iodine

• 90 µg for preschool children (0 to 59 months);

• 120 µg for schoolchildren (6 to 12 years);

• 150 µg for adolescents (above 12 years) and adults;

• 250 µg for pregnant and lactating women.

8/25/2024 165
• Risk factors for deficiency
• Living in mountainous areas
• Not eating sea foods
• Eating large amounts of raw food that can cause thyroid goiter (goiterogens),
such as spinach, lettuce, beets, cabbage, kale are also at risk of developing iodine
deficiency.
• millet, soy, spinach, sweet potato,

• Goitrogenic substances interfere with iodine uptake in the thyroid

• Goitrins, thiocyanates, and nitriles are all goitrogenic chemicals derived
from natural plant pesticides called glucosinolates.

8/25/2024 166
Food sources
• Drinking water
• Sea foods
• Foods grown on iodine containing soil.
• RDA for iodine is up to 150 µg but requirement for
pregnant mother increases.

8/25/2024 167
zinc
• Zinc is in every cell of the body and is a part of over 300 enzymes.
• Essential for the maintenance of vision, taste and smell, this mineral
is also necessary for immune function, protein synthesis, and cell
growth.
• Zinc has been used successfully in the treatment of rheumatoid
arthritis, acne, and macular (eye) degeneration and wound healing.
• Lean red meat, whole-grain cereals, pulses, and legumes provide the
highest concentrations of zinc
• 25-50 mg/kg

8/25/2024 168
Diet availability of zinc
• diets according to the potential availability of their zinc

• High availability - Refined diets low in cereal fiber

• Mediums availability - Germination of such grains or fermentation
• low availability – high fiber cereals, legumes

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 Functions
• Functions as antioxidant.
• Promotes normal growth and development.
• Immunity (decreases the severity of diarrhea in
children)
• Promotes normal fetal growth.
• Helps synthesize DNA and RNA.
• Promotes cell division, cell repair, cell growth.
• Maintains normal level of vitamin A in blood.

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 Food Sources
▪ Zinc is found in many foods. However the rich sources
are
▪ Red meat- the more dark red the color of the meat
the more the zinc content is.
It is also found in other foods of animal and plant origin.
current WHO recommendation on zinc supplementation

Health workers should provide children

▪ with 20 mg per day of zinc supplementation for 10–14
days during diarrheal attacks.
▪ (10 mg per day for infants under six months old)
during diarrheal attacks.

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 Thank You!

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