NCM 105 - Prelim Notes - Nutrition and Diet Therapy

bs nursing (Southwestern University PHINMA)

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 Absorption - process where nutrients from
Nutrition - process of taking in food and foods are absorbed by the body into the
using it for growth, metabolism and repair. bloodstream
- Nourishing substances such
as nutritional solutions delivered to Nutritional Status - condition of the body
hospitalized patients via IV and ID resulting from the utilization of essential
tube nutrients.

Nutritionist - person who specializes in the Malnutrition - the condition of the body
study of nutrition specifically in the resulting from a lack of one or more
applications of principles of nutrition in the essential nutrients or due to excessive
maintenance of health and prevention and nutrients supply
treatment of diseases
Calorie - fuel potential in a food
Nutrients - chemical nutrients that is - 1 calorie represents the amount of
present in food and delivered in body heat required to take 1 liter of water

Functions: Kcal - the word calorie with the number of

● Provide energy calories
● Build and repair tissues
● To regulate life processes The recommended daily calorie per day:
● Women - 2000 kcal
Macronutrients - nutrients body needs in ● Men - 2,500 kcal
larger amounts (e.g. carbohydrates, protein
& fat) Enzymes - organic catalyst that are protein
in nature and produced by living cells
Micronutrients - nutrients body needs in
smaller amount Catalyst - builds up or slows down chemical
reaction
Food - any substance organic or inorganic,
when ingested or eaten nourishes the body
by: Organ functions:
1. Building and repairing tissues 1. LUNGS - provide oxygen to blood
2. Supplying Heat and Energy 2. STOMACH - helps digest food
3. Regulating body processes 3. HEART - circulates blood through
the body
Metabolism - a chemical process of 4. INTESTINE - absorb nutrients from
transforming foods into substances to the body
sustain life. 5. LIVER - removes toxins from blood
- Chemical process of food and processes nutrients from food.
conversion 6. KIDNEYS - it filters blood and extra
fluid
Digestion - mechanical and chemical
breakdown of food into smaller components

Body system

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● CARDIOVASCULAR SYSTEM - it 2. Prepared under sanitary condition
transports nutrients, gases, waste 3. It is nourishing or nutritious
products and also regulates body 4. Its palatability factor (color, aroma,
temperature. flavor, texture) should satisfy the
● DIGESTIVE SYSTEM - digest and customer
absorbs nutrients and also eliminates 5. It offers variety and planned within
waste products the socioeconomic context
● ENDOCRINE SYSTEM - helps regulate 6. It is free from toxic agents or does
metabolism reproduction and water not contain substances with
balance deleterious to health
● IMMUNE SYSTEM - WBC, lymph
nodes, spleen, thymus gland
- Provides defense against 1. Ingestion
foreign substance 2. Digestion
● INTEGUMENTARY SYSTEM 3. Absorption
- skin, hair, nails, sweat glands 4. Transport
- protects the body 5. Assimilation
- regulates temperature 6. Excretion
- aids in acid-base and water
balance MASTIFICATION - food is crushed and
- Vitamin D mixed with saliva to formed a bolus for
● LYMPHATIC SYSTEM - lymph vessels swallowing.
& nodes
- Helps with fluid balance and PROPULSION - movement of food through
fat absorption the digestive tract
- Removes foreign substance
from food MECHANICAL DIGESTION - mechanical
● MUSCULAR SYSTEM - skeletal, churning of food into the stomach. Serves to
cardiac and smooth muscle further break it apart, and expose more of
- Maintains posture its surface area to digestive juices. Creating
- Directs bodily movements an acidic soup called CHYNE
- Produces body weight
● NERVOUS SYSTEM - brain, spinal CHEMICAL DIGESTION - food by enzymes
cord, nerve, sensory organs present in secretions, produced by glands
- it controls intellectual functions and accessory organs of digestive system.
- it detects sensations and control
movements. ABSORPTION - process by which digested
food substances passed through the walls
Nutrition is how food affects the body. of some organs of the eliminary canal.
Food is essential, it provides vital nutrients for ELIMINATION - food substances that have
survival. been eaten but cannot be digested and
It helps the body function and stays healthy absorbed excreted by the bowel.
NUTRITIONAL PROBLEMS

Food Qualities Nutrition is the selection of foods and

1. Safe to eat preparation of foods, and their ingestion to

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be assimilated by the body. By practicing a ❖ PREGNANT WOMEN
healthy diet, many of the known health ❖ LACTATING WOMEN
issues can be avoided. The diet of an ❖ INFANTS .
organism is what it eats, which is largely
❖ PRESCHOOL CHILDREN
determined by the perceived palatability of
❖ ADOLESCENT GIRLS
foods.
❖ ELDERLY

• HEALTH – It is the state of complete PROTEIN ENERGY MALNUTRITION

physical, mental and emotional wellbeing • Protein–energy malnutrition (or
and not merely the absence of disease or protein–calorie malnutrition) refers to a
infirmity. form of malnutrition where there is
• NUTRIENTS – These are the components inadequate protein and calorie intake
of food that help to nourish the body. The • It is considered as the primary
basic nutrients are CHO, proteins, vitamins, nutritional problem in India
lipids (fats), minerals and water. • PEM is due to the “food gap”
• NUTRITIONAL STATUS – It is the between the intake and requirement
condition of the body as it relates to • Causes childhood morbidity and
consumption and utilization of food. Mortality
• Malnutrition – defined as a pathological
state resulting from a relative or absolute ● KWASHIORKOR
deficiency or excess of one or more ● MARASMUS
essential nutrients ● MARASMIC - KWASHIORKOR
• Undernutrition - condition that results
when insufficient food is consumed over an CAUSES AND RISK FACTORS
extended period of time ✓ Inadequate intake of food
• Overnutrition – pathological state ✓ Diarrhea
resulting from the consumption of excessive ✓ Respiratory infections
quantity of food over an extended time
✓ Measles
• Imbalance – pathological state resulting
✓ Intestinal worms
from disproportion among essential
nutrients with or without the absolute ✓ Infants and preschoolers
deficiency of any nutrient
• Specific deficiency – pathological state CONTRIBUTORY FACTORS
resulting from a relative or absolute lack of ✓ Poor envt. Hygiene
specific nutrients ✓ Large family size
✓ Poor maternal health
✓ Failure of lactation
NUTRITIONAL PROBLEMS ✓ Premature termination of breast
● PROTEIN ENERGY feeding
MALNUTRITION (PEM) ✓ Delayed supplementary feeding
● MICRONUTRIENT DEFICIENCY
✓ Use of over diluted cow’s milk
● CHRONIC DISEASES
● EATING DISORDERS
KWASHIORKOR
Kwashiorkor is the most common and
NUTRITION PROBLEMS IN INDIA
widespread nutritional disorder in a
WHO IS AT RISK??
developing countries. It is a form of

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malnutrition caused by not getting growth retardation
enough protein in the diet.

KWASHIORKOR AND MARASMUS – A

COMPARATIVE CHART

MARASMUS KWASHIORKOR
• Marasmus is a severe form of malnutrition ✓ Acute illness/infections, measles,
that consists of the chronic wasting away of AGE, trauma, sepsis are some causes
fat, muscle, and other tissues in the body. ✓ Protein is principal nutrient
• Malnutrition occurs when the body does ✓ 18 months to 3 years
not get enough protein and calories. ✓ Rapid, acute onset
• This lack of nutrition can range from a ✓ Some weight loss
shortage of certain vitamins to complete ✓ High mortality
starvation.
• Marasmus is one of the most serious MARASMUS
forms of protein-energy malnutrition (PEM) ✓ Severe prolonged starvation,
in the world. chronic/recurring infections
✓ Calories and protein are principal
nutrients
✓ 6 months to 2 years
✓ Chronic, slow onset
✓ Severe weight loss
✓ Low mortality unless related to
underlying disease condition

COMPARISON OF CLINICAL FEATURES

KWASHIORKOR
MARASMIC KWASHIORKOR ➢ Edema, pot belly, swollen legs
A malnutrition disease, primarily of children, ➢ Mild to moderate growth retardation
resulting from the deficiency of both calories ➢ Weight masked by edema
and protein. The condition is characterized ➢ Low subcutaneous fat
by severe tissue wasting, dehydration, ➢ Muscle atrophy
loss of subcutaneous fat, lethargy, and ➢ Round face (moon face)
➢ Dry, flaky peeling skin
➢ Thin dry easily plucked hair

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➢ Enlarged liver • Exclusive breast feeding for 6 months
➢ Xerophthalmia there after supplementary foods may be
➢ Anemia, diarrhea, infection introduced along with breast feeds
• Immunization for infants and children
MARASMUS • Nutritional supplements
No edema • Early diagnosis and treatment
• Promotion and correction of feeding
➢ Weight loss upto 40%
practices
➢ Severe growth failure
• Family planning and spacing of birth
➢ Severe emaciation • Periodic surveillance
➢ Severe loss of subcut fat • Nutritional rehabilitation
➢ Severe muscle atrophy
➢ Wrinkled face (old man’s face) LOW BIRTH WEIGHT
➢ Rare skin changes An LBW newborn is any newborn with a
➢ Common hair changes birth weight of less than 2.5kg (including
➢ Mildly enlarged liver 2.499kg) regardless of gestational
age.
➢ Anemia, diarrhea, infection
RISK FACTORS
o Maternal malnutrition o Anemia
ASSESSMENT OF PEM
CAUSES
Gomez Classification
o Illness/infections o Short maternal stature
o Very young age
o High parity
o Close birth intervals o IUGR
o Hard physical labor during pregnancy
o Smoking

Between 90 – 110% Normal Nutritional

Status
Between 75 – 89% Mild malnutrition (1st
degree)
Between 60 – 74% Moderate Malnutrition
(2nd degree)
Under 60% Severe Malnutrition (3rd
degree)

WEIGH CALCULATION FORMULA

PREVENTION
• Identification of mothers at risk –
malnutrition, heavy workload, infections,
PREVENTION disease, and high BP
• Oral rehydration therapy helps to prevent • Increasing food intake of mother,
dehydration caused by diarrhea

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supplementary feeding, distribution of iron ✓ 1-3 years
and folic acid tablets
• Avoidance if smoking CLINICAL FEATURES
• Improved sanitation methods ✓ Corneal ulcers
• Improving health and nutrition of young ✓ Softening of
girls
cornea
• Early detection and treatment of medical
✓ Keratomalacia
disorders – DM HTN
✓ Bitot spot
• Controlling infections – UTI, rubella,
syphilis, malaria

MICRONUTRIENT DEFICIENCY

VITAMIN A DEFICIENCY
Overweight and obesity are defined as PREVENTION AND CONTROL
abnormal or excessive fat accumulation that ✓ Administering large doses of vitamin
presents a risk to health. A crude population A orally on a periodic basis
measure of obesity is the body mass index ✓ Regular and adequate intake of
(BMI), a person’s weight (in kilograms) vitamin A ✓Fortification of certain food
divided by the square of his or her height (in with vitamin A – sugar, salt, tea and
meters). A person with a BMI of 30 or more skimmed milk
is generally considered obese. A person
with a BMI equal to or more than 25 is NUTRITIONAL ANEMIA
considered overweight. Nutritional anemia is a condition where the
hemoglobin content of blood is lower than
XEROPHTHALMIA normal as a result of a deficiency of one or
Xerophthalmia i.e., dry eyes refers to all the more essential nutrients, regardless of the
ocular manifestations of vitamin A deficiency cause of such deficiency.
in man It is the most widespread
and serious nutritional disorder leading to
blindness

RISK FACTORS
✓ Poor SE status
✓ Faulty feeding practices
✓ Weaning
✓ PEM
✓ Infections

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 anemia (<8g/dL)
✓ Iron and folic acid supplements
✓ Food fortification with iron
✓ Changing dietary habits
✓ Control of parasites
✓ Nutritional education and awareness

IODINE DEFICIENCY DISORDERS (IDD)

RISK FACTORS IDD leads to a much wider spectrum of
▪ Infants and children disorders commencing with the intrauterine
▪ Pregnant women life and extending through childhood to
▪ Pre menopausal women adult life with serious health and social
▪ Adolescent girls implications
▪ Older adults
▪ Alcoholism
▪ Chronic/ critically ill ▪ Excessive exercise

CAUSES
▪ Inadequate diet
▪ Insufficient intake of iron
▪ Iron malabsorption ▪ Pregnancy
▪ Excessive menstrual bleeding
▪ Hook worm infestation ▪ Malaria
▪ Close birth intervals ▪ GI bleed
DISORDERS
CLINICAL MANIFESTATIONS ➢ Goiter
➢ Hypothyroidism
➢ Subnormal intelligence
➢ Delayed motor milestones
➢ Mental deficiency
➢ Hearing defects
➢ Speech defects
➢ Mental retardation
➢ Neuromuscular weakness
EFFECTS OF ANEMIA PREGNANCY
• Increases risk of maternal and fetal ➢ Endemic cretinism
morbidity and mortality ➢ Intrauterine death
• Abortions, premature births, PPH, low birth
weight are associated with anemia during PREVENTION
pregnancy • Iodized salt
• Iodine monitoring
PREVENTION • Public awareness and education
✓ Estimation of Hb to assess degree of
anemia COMPLICATIONS
✓ Blood transfusion in severe cases of • Thyrotoxicosis
• Iodide goiter
• Iodinism

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• Lymphocytic thyroiditis • Preventing use of fluoridated toothpaste
• Fluoride supplements not prescribed for
ENDEMIC FLUOROSIS children consuming fluoridated water
In many parts of the world where drinking
water contains excessive amounts of LATHYRISM
fluorine (3- 5mg/L), endemic fluorosis has • It is a paralyzing disease of human and
been observed. animals
• Also referred to as Neurolathyrism as it
DENTAL FLUOROSIS affects the nervous system
• It occurs when excess fluoride is ingested
during the years of tooth calcification – first
7 years of life
• Characterized by molting of dental enamel
which has been reported above 1.5mg/L
intake
• Fluorosis seen on the incisors of upper jaw

• Lathyrus Sativus is commonly known as

‘khesari dhal’, a good source of protein but
SKELETAL FLUOROSIS its toxins affects the nerves
• Associated with life time daily intake of 3- • The toxin present in lathyrus seed has
6mg/L or more been identified as BETA OXALYL AMINO
• Heavy deposition of fluoride ALANINE (BOAA) which has blood brain
in skeleton barrier
• Crippling occurs leading to disability
STAGES OF LATHYRISM
• Latent stage
• No stick stage
• One stick stage
• Two stick stage
• Crawlerstage

INTERVENTIONS
• Vitamin C prophylaxis
• Banning the crop
• Removal of toxin
• Education and awareness
• Genetic approach – producing low toxin
variety of crop
• Socio economic changes
PREVENTION
• Changing the water sources NUTRITIONAL PROGRAMS
• Chemical defluorination • Vitamin A Prophylaxis Program

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• Prophylaxis against Nutritional Anemia as a distorted body self-perception.
• IDD Control Program
• Specific Nutrition Program BULIMIA NERVOSA
• Balwadi Nutrition Program • Bulimia nervosa is an eating disorder
• Integrated Child Development Scheme characterized by binge eating and purging,
• Mid – day Meal Program or consuming a large amount of food in a
• Mid – day Meal Scheme short amount of time followed by an
attempt to rid oneself of the food consumed
CHRONIC DISEASES OBESITY (purging), typically by vomiting, taking
Obesity is an epidemic diseases, which a laxative, diuretic, or stimulant, and/or
consists of body weight that is in excess of excessive exercise, because of an
that appropriate for a person’s height and extensive concern for body weight.
age standardized to account for differences,
leading to an increased risk to health related CLINICAL MANIFESTATIONS
problems • Amenorrhea
• Obvious, rapid, dramatic weight loss at
Overweight and obesity are defined as least 15% under normal body weight[
abnormal or excessive fat accumulation that • May engage in frequent, strenuous, or
presents a risk to health. A crude population compulsive exercise
measure of obesity is the body mass index • Perception of self as overweight despite
(BMI), a person’s weight (in kilograms) being told by others they are too thin
divided by the square of his or her height (in • Intolerance to cold and frequent
metres). A person with a BMI of 30 or more complaints of being cold body
is generally considered obese. A person • Bradycardia or tachycardia
with a BMI equal to or more than 25 is • Depression: may be in a sad, lethargic
considered overweight. state
• Solitude: may avoid friends and family;
becomes withdrawn and secretive
• Swollen joints
• Abdominal distension
• Halitosis (from vomiting starvation-induced
ketosis)
• Dry hair and skin, as well as hair thinning
• Fatigue
• Rapid mood swings

EATING DISORDERS

ANOREXIA NERVOSA
• Anorexia nervosa is an eating Nutrients are defined as the substances
disorder characterized by immoderate food found in food that keep your body
restriction, inappropriate eating habits or functioning.
rituals, obsession with having a thin figure,
and an irrational fear of weight gain, as well Body needs nutrients to:

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 ● Fuel your energy. ● Lubricates joints.
● Help you grow.
● Repair itself. Sources:
● Maintain basic bodily functions. ● These adequate intakes include all
fluids, but it’s preferable that the
Framework of the Food Guide Pyramid majority of intake is from plain water
(except for infants where fluid intake
● Balance - Eat foods from all groups is met by breastmilk or infant
of the Food Guide Pyramid. formula).
● Variety - Eat different foods from
each food group. Deficiency/ Toxicity
● Moderation - Eat more foods from ● Dehydration - loss of water from
the bottom of the pyramid, and the body
fewer and smaller portions of foods
from the top of the pyramid.

- The body’s main source of energy

and provide the body’s need for dietary
fiber.

Food Sources:
● Pasta, breads, cereals, grains, rice,
fruits,milk, yogurt and sweets.

Two types of Carbohydrates:

● Starches or Complex Carbohydrates
● Simple Carbohydrates
● Water
● Carbohydrates Starches or Complex Carbohydrates
● Protein Food Sources:
● Fat ● Whole grain breads and cereals,
● Vitamins pasta, vegetables, rice, tortilla
● Minerals and legumes.
Function in the Body:
● An excellent source of fuel (energy)
for the body.
● Rich in vitamins, minerals and fiber.
- 1/2 to 3/4 of the human body
consists of water. Starches

Functions in the Body:

● Water carries nutrients to your cells
and carries waste from your body.
● Regulates body temperature.
● Dissolves vitamins, minerals, amino
acids and other nutrients.

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 ● Helps promote regularity

Required Intake
● Total dietary fiber intake
should be 25 to 30 grams a
day from food, not
supplements.

Deficiency/Toxicity
● Constipation/Bloating
● Hunger after meals
Simple Carbohydrates ● Lack of energy
● High cholesterol levels
Food Sources: ● Blood sugar fluctuation
● Fruits, juices, milk, and yogurt.
● Candy, soda, and jelly. These uncomfortable side effects of
excessive fiber can occur when someone
- These simple carbohydrates have a eats more than 70 grams (g) of fiber a
bad reputation because they are day.
high in calories and low in nutritional
value.

Deficiency: Food Sources:

● Lack of Energy ● Meat, fish,eggs, poultry, dairy
● Constipation products, legumes, nuts and seeds.
● Nausea, (Breads, cereals and vegetables
● Headache also contain small amounts of
● Bad Breath protein.)

Function in the Body:

- is the plant material that doesn’t ● Provides energy.
break down when you digest food. ● Help to build, maintain, and repair
Many, but not all, complex body tissues.
carbohydrates contain fiber. - Proteins are made up of chemical
Food Sources: compounds called amino
● Oatmeal, fruits, vegetables, acids.There are 20 amino acids.
whole grains and legumes.

Function in the Body:

● Aids in digestion. - Of the 20 amino acids, the human
● May reduce the risk of body is capable of producing 11 of
developing some diseases them. The other 9 called, “Essential
like heart disease, diabetes Amino Acids” must be supplied by
and obesity, and certain food sources.
types of cancer.

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Two types of Protein: .8. Lysine:
● Complete Proteins: - important for energy production,
○ Contain all 9 essential amino immune function and the production of
acids. They are found in animal collagen and elastin
Sources.
● Incomplete Proteins: 9. Histidine:
○ Lack one or more of the - critical for maintaining the myelin
essential amino acids. They sheath, a protective barrier that
are found in plant sources. surrounds your nerve cells

ESSENTIAL AMINO ACIDS Protein deficiency

● Muscle wasting
1. Phenylalanine: ● Risk of bone fractures
- plays an integral role in the structure ● Skin,hair and nail problems
and function of proteins and ● Stunted chidren growth
enzymes and the production of other
amino acids Kwashiorkor
- The most severe form of protein
2. Valine: deficiency.
- helps stimulate muscle growth and - It is a form of malnutrition caused by
regeneration and is involved in energy a lack of protein in the diet.
production

3. Threonine:
- plays a role in fat metabolism and
immune function

4. Tryptophan:
- regulates your appetite, sleep and
mood

5. Methionine:
- necessary for tissue growth and the
absorption of zinc and selenium, Kwashiorkor
minerals that are vital to your health 8). - also known as “edematous
malnutrition” because of its association with
6. Leucine: edema (fluid retention).
- helps regulate blood sugar levels,
stimulates wound healing and Kwashiorkor is caused by a lack
produces growth hormones of protein in the diet.

7. Isoleucine:
- important for immune function,
- The most concentrated form of food
hemoglobin production and energy
energy (calories).
Regulation

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Food Sources: ● beneficial fats
● Butter, vegetable oils, salad ● improve blood cholesterol levels,
dressings, nuts and seeds, dairy ● ease inflammation,
products made with whole milk or ● stabilize heart rhythms
cream, and meats.
1. Monounsaturated fats
Function in the Body: - are found in high concentrations in:
● Provide substances needed for • Olive, peanut, and canola
growth and healthy skin. oils
● Enhance the taste and texture of • Avocados
food. • Nuts such as almonds,
● Required to carry “fat-soluble” hazelnuts, and pecans
vitamins throughout the body. • Seeds such as pumpkin
● Provide energy. and sesame seeds

Types of Fat 2. Polyunsaturated fats

- are found in high concentrations in
● Saturated Fat: ● Sunflower, corn, soybean, and
- Fats that are usually solid at flaxseed oils
room temperature. ● Walnuts
● Flax seeds
Food Sources: Animal foods and ● Fish
tropical oils. ● Canola oil – though higher in
● The type of fat most strongly monounsaturated fat, it’s also a
linked to high cholesterol and good source of polyunsaturated fat.
increased risk of heart
disease. Fatty acids
- are the building blocks of the fat in
● Unsaturated Fat: our bodies and in the food we eat.
- Fats that are liquid at room During digestion, the body breaks down fats
temperature. into fatty acids, which can then be absorbed
into the blood. Fatty acid molecules are
Polyunsaturated Fat usually joined together in groups of three,
Food Sources: forming a molecule called a triglyceride.
● Vegetables and fish oils.
● Provide two essential fatty acids Omega-3 fats
necessary for bodily functions. ● An important type of
polyunsaturated fat. The body
Monounsaturated Fat can’t make these, so they must
Food Sources: come from food.
● Olive oil, canola oil, nuts, seeds. ● An excellent way to get omega-3
● May play a role in reducing the risk fats is by eating fish 2-3 times a
of heart week.
● Good plant sources of omega-3 fats
Unsaturated fats include flax seeds, walnuts, and
● liquid at room temperature, canola or soybean oil.

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 ● Vitamins are separated into two
Saturated fat types: Fat Soluble & Water Soluble
- is mainly found in animal foods, but Vitamins.
a few plant foods are also high in
saturated fats, such as coconut, coconut oil, Fat/Water Soluble Vitamins
palm oil, and palm kernel oil.
Fat Soluble Vitamins
Trans fats ● Vitamins A, D, E, K
- are made when liquid oils get turned ○ Require fat for the stomach
into solid fats. This process is called to allow them to be carried
hydrogenation. Trans fats are found in a lot into the blood stream for use
of processed foods. (absorption).
○ Can be stored in the body for
later use.
Water Soluble Vitamins
- A fat-like substance that is part of every ● Vitamins C and B-complex
cell of the body. ● Require water for absorption.
● Easily absorbed and passed through
Function in the Body: the body as waste.
● Helps the body make necessary
cells including skin, and hormones. Vitamin A
● Aids in digestion. Food Sources:
● The human body manufactures all ● Dark green, leafy vegetables, deep
the cholesterol it needs. You also get yellow and orange fruits and
cholesterol from animal food vegetables, liver, milk, cheese, and
products you eat. eggs.
When cholesterol levels are high there is Function in the Body:
a greater risk for heart disease. ● Helps keep skin and hair healthy.
● Aids in night vision.
● Plays a role in developing strong
bones
Food Sources:
Vitamin D
● Fruits, vegetables, milk, whole-grain
Food Sources:
breads, cereals and legumes.
● Vitamin D fortified milk, egg yolk,
salmon, and liver.
- Unlike carbohydrates, fats, and
● Nonfood Source: the sun.
proteins, vitamins DO NOT provide
Function in the Body:
energy (calories).
● Helps the body use calcium and
phosphorus.
Function in the Body:
● Plays a role in building strong bones
● Help regulate the many chemical
and teeth.
processes in the body.
● There are 13 different vitamins
Vitamin E
known to be required each day for
Food Sources:
good health.
● Whole-grain breads and cereals;

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 dark green, leafy vegetables; dry Functions in the Body:
beans and peas; nuts and seeds; ● The body depends on minerals for
vegetable oils; margarine; liver. practically every process necessary
Function in the Body: for life.
● Helps form red blood cells, muscles, ● Minerals actually become part of the
and other tissues. body.
● The body requires 16 minerals daily.
Vitamin K
Food Sources: Minerals
● Dark green and leafy vegetables ● Calcium
(such as spinach, lettuce, kale, ● Phosphorus
collard greens), and cabbage. ● Magnesium
Function in the Body: ● Sodium
● Helps blood to clot. ● Potassium
● Iron
Vitamin B-complex ● Others include:
Food Sources: Iodine, Zinc, Copper, Sulfur,
● Whole grain and enriched breads Chloride, etc.
and cereals; dry bean and peas;
peanut butter; nuts; meat; poultry;
fish; eggs; milk. Calcium & Phosphorus
Food Sources:
Function in the Body: ● Dairy Products: milk,
● Helps the body use the energy from cheese, ice cream, green
the foods we eat. leafy vegetables, canned
● Helps brain, nerves, and muscles sardines and other
function. processed fish eaten with
bones.
Vitamin C Function in the Body:
Food Sources: ● Helps build and maintain
● Citrus fruits, strawberries, kiwi, healthy bones and teeth.
broccoli, tomatoes, and potatoes. ● Helps heart, nerves, and muscles
work properly.
Function in the Body:
● Helps heal wounds. Deficiency (lack) of calcium
● Helps maintain healthy bones, &phosphorus leads to osteoporosis.
● teeth, and blood vessels.
● Helps body fight infection. Iron
Food sources
● Liver, kidney, heart, meat, egg yolk,
dried beans and peas, spinach,
dried fruit, whole-grain & enriched
Food Sources: breads & cereals, nuts.
● Meats, beans, nuts, fruits, Function in the Body:
vegetables, dairy products, and ● Helps make hemoglobin in red blood
grains. cells.

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 ● Helps cells used oxygen. The best way to avoid a nutrient
Deficiency (lack) of iron leads to anemia. deficiency is to eat a well balanced diet.

Sodium Body mass index (BMI) is a tool that

Food sources healthcare providers use to estimate the
● Processed & prepared foods. amount of body fat by using your height and
Canned vegetables, soups, pickles, weight measurements. It can help assess
lunch meats, ham, bacon, sausage, risk factors for certain health conditions. The
hotdogs, and frozen Foods. BMI is not always an accurate
Salt/sodium is used to preserve food and representation of body fatness
improve the taste and texture of food.
● Condiments. Table salt, soy sauce, What is body mass index (BMI)?
ketchup, mustard, BBQ sauce, steak sauce Body mass index (BMI) is a medical
● Natural sources. Some meats, screening tool that measures the ratio of
poultry, dairy products (esp. your height to your weight to estimate the
cheeses) and vegetables. amount of body fat you have. Healthcare
providers calculate BMI by using weight in
Sodium kilograms (kg) divided by the square of
Function in the Body: height in meters (m2).
● Helps maintain the right In most people, BMI correlates to body fat
balance of fluids in your — the higher the number, the more body fat
body. you may have — but it’s not accurate in
● Helps transmit nerve some cases. BMI alone does not diagnose
impulses. health. Healthcare providers use BMI and
● Influences the contraction other tools and tests to assess someone’s
and relaxation of muscles. health status and risks.
Excess sodium can lead to
hypertension (high blood ● High body fat may lead to heart
pressure), a condition that can disease, stroke and Type 2 diabetes.
lead to cardiovascular and kidney ● Low body fat may be
diseases. related to malnutrition. Just the right amount
of body fat helps vitamins and minerals get
Nutrient Deficiency into your body. It also provides a source of
- A nutritional deficiency occurs when energy for your body, helps maintain body
your body doesn’t get enough temperature and protects your organs.
nutrients. ● You should not use the standard
Symptoms: BMI chart to evaluate a child’s or
● At first the symptoms may not seem teenager’s weight. Talk to your
serious. They may include: child’s healthcare provider about the
tiredness, difficulty sleeping or optimum weight range for their age
concentrating, frequent colds, and and height.
weight loss or gains.
● However, if the deficiency is not What is BMI used for?
corrected the symptoms may get
more serious and effect the skin, Healthcare providers use BMI to help
eyes, and bones. diagnose weight types and as a screening

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tool for certain health conditions. If you have underweight, your healthcare
provider will likely order certain blood tests
Diagnosing weight types with BMI and other tests to check your overall health
and to see if you’re malnourished.
In general, the following BMI ranges (in
kg/m2) classify different weight types: In general, the higher your BMI, the higher
your risk for the following conditions:

● Underweight: Less than 18.5.

● Heart disease.
● Optimum range: 18.5 to 24.9.
● High blood pressure (hypertension).
● Overweight: 25 to 29.9.
● Type 2 diabetes.
● Class I obesity: 30 to 34.9.
● Gallstones.
● Class II obesity: 35 to 39.9.
● Osteoarthritis.
● Class III obesity: More than 40.
● Sleep apnea.
BMI isn’t the only tool providers use to ● Certain cancers,
classify weight types. Other tools include:
including colon, breast, endometrial
and gallbladder.
● Measuring waist circumference.
● Depression and other mental health
● Measuring skin thickness using conditions.
skinfold calipers in certain areas of
your body, such as the back of your It’s important to remember that you could
upper arms and under your shoulder have any of the above health conditions
blades. without having a high BMI. Similarly, you
could have a high BMI without having any of
● DEXA scan and air displacement these conditions. Genetics and other
plethysmography (ADP) — these are factors, such as smoking cigarettes, play a
used less often. large role in the development of these
conditions.
Screening for health risks with BMI
If your BMI reveals you may have obesity,
If you have a BMI less than 18.5 your provider will likely order certain blood
(underweight), you may be at higher risk for tests to check your general health, such as
developing the following conditions: a comprehensive metabolic panel and lipid
panel.

● Malnutrition. How do I calculate my BMI?

● Anemia.
You can calculate BMI yourself with these
● Weakened immune system, which steps:
could lead to more frequent
infections and illnesses. ● Multiply your weight in pounds by
● Osteoporosis. 703.

● Infertility. ● Divide that answer by your height in

inches (there are 12 inches in 1

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 foot). lean body mass (the weight of
everything in your body except fat)
● Divide that answer by your height in
and fat mass. Because of this, a
inches again. person can have a high BMI (by
being muscular) but still have a very
For example, a person who weighs 180 lbs. low fat mass and vice versa.
and is 5 feet and 5 inches tall (65 inches
total) would calculate their BMI in the ● The same BMI chart is used for
following way: adults assigned male at birth
(AMAB) and adults assigned female
1. 180 x 703 = 126,540. at birth (AFAB) even though adults
2. 126,540 / 65 = 1,946.769. AFAB typically have more body fat
3. 1,946.769 / 65 = 29.95. than adults AMAB.
● The BMI chart hasn’t been adjusted
Their BMI would be 29.9.
for the increasing average adult
height over the years.
What is a healthy BMI?
You shouldn’t use the standard BMI chart to
The optimum range for a healthy BMI is assess the amount of body fat of the
considered to be 18.5 to 24.9. following populations:
It’s important to remember that body fatness
isn’t the only determiner of overall health. ● Athletes and bodybuilders.
Several other factors, such as genetics,
activity level, smoking cigarettes or using ● Children and teenagers.
tobacco, drinking alcohol and mental health
conditions all affect your overall health and ● Pregnant people.
your likelihood of developing certain medical ● People over the age of 65.
conditions.
● People who have muscle
What are the limitations of BMI? atrophy (wasting) due to medical
conditions.
The standard BMI chart has limitations for
various reasons. Because of this, it’s Limitations of using BMI as a screening
important to not put too much emphasis on tool for health conditions
your BMI.
The BMI as a screening tool for assessing
Even though the BMI chart can be the risk of certain health conditions, such as
inaccurate for certain people, healthcare Type 2 diabetes and heart disease, has
providers still use it because it’s the some limitations, including:
quickest tool for assessing a person’s
estimated body fat amount.
● The BMI doesn’t measure the
Limitations of using BMI to help location or distribution of body fat.
diagnose weight types This is an issue because excess fat
accumulation in certain areas of your
The standard BMI has limitations in regards body, such as in your belly
to diagnosing weight types, including: (abdomen), is associated with a
higher risk of health conditions than
excess fat accumulation in other
● BMI doesn’t differentiate between
areas of your body, such as in your

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 thighs. diabetes, high blood pressure,
cardiovascular disease and high
● The relationship between BMI and
cholesterol (dyslipidemia); familial
rate of death often doesn’t account longevity (average lifespan); or
for such factors as family history of family history of cancer.

A note from Cleveland Clinic

Body mass index (BMI) is a quick tool that healthcare providers can use to assess your risk for
certain health conditions. However, BMI is not always an accurate measurement of body fatness
and is not the sole determiner of your general health. If you have any questions or concerns
about your weight or your risk for developing certain health conditions, such as heart disease,
talk to your healthcare provider. They’re available to help.

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Downloaded by SHERYNE JOEL LABITA (s.labita.sherynejoel@cmu.edu.ph)