D.

Excess fiber can cause altered

elimination patterns such as
constipation if fluid intake is not
adequate.

E. Increased intake of sugars in the diet

can lead to hyperactivity, CHO craving,
obesity, elevated triglycerides, and
dental caries.

F. Decreased levels of CHOs in the diet

can lead to tissue breakdown leading to
ketosis and metabolic acidosis.
 PROTEIN

vital part of every body cell muscle,

bone, blood, and organs.
 PROTEIN

A. Function

Repair and Maintenance

. Protein is termed the building block of the
body. It is called this because protein is vital
in the maintenance of body tissue, including
development and repair. Hair, skin, eyes,
muscles and organs are all made from
protein.
. This is why children need more protein per
pound of body weight than adults; they are
growing and developing new protein tissue.
 PROTEIN

A. Function

Energy
. Protein is a major source of energy. If you
consume more protein than you need for
body tissue maintenance and other
necessary functions, your body will use it
for energy. If it is not needed due to
sufficient intake of other energy sources
such as carbohydrates, the protein will be
used to create fat and becomes part of fat
cells.
 PROTEIN

A. Function

Hormones
. Protein is involved in the creation of some
hormones. These substances help control body
functions that involve the interaction of several
organs. Insulin, a small protein, is an example of
a hormone that regulates blood sugar. It involves
the interaction of organs such as the pancreas
and the liver. Secretin, is another example of a
protein hormone. This substance assists in the
digestive process by stimulating the pancreas and
the intestine to create necessary digestive juices.
 PROTEIN

A. Function

Enzymes
. Enzymes are proteins that increase the rate of
chemical reactions in the body. In fact, most of
the necessary chemical reactions in the body
would not efficiently proceed without enzymes.
A. Participates in chemical reactions throughout
the body in the form of nucleoproteins( DNA/
RNA).
B. Participates in digestive enzymes.
C. Participates in contraction of
muscles(actin/myosin).
 PROTEIN

A. Function

Transportation and Storage of

Molecules
. Protein is a major element in
transportation of certain molecules.
. Hemoglobin is a protein that has
oxygen- carrying capacity.
. Albumin is a major protein in plasma
that helps to transport free fatty
 PROTEIN

A. Function

o.Myoglobin is a protein carrier found in

muscle cells
o.Lipoproteins help to carry cholesterol &
fat- soluble vitamins in the body.
o.Protein binding in the body can affect
serum concentrations of calcium as well
as certain medications.
 PROTEIN
A. Function

Antibodies
. Protein forms antibodies that help
prevent infection, illness and
disease. These proteins identify
and assist in destroying antigens
such as bacteria and viruses.
They often work in conjunction
with the other immune system
cells. For example, these
 PROTEIN
B. Building blocks
Amino Acids
The body needs 22 amino acids in
order to grow and develop properly.
The body can produce most of these
amino acids itself.
A. Essential Amino acids- body cant
produce
9 amino acids must be received through
the food you eat
 PROTEIN
B. Building blocks
Amino Acids

Foods that contain all 9 essential

amino acids are complete proteins.
(histidine, isoleucine, leucine, lysine,
methionine, phenylalanine,
threonine, tryptophan, and valine.)
 PROTEIN
B. Building blocks
Amino Acids

All animal products are complete

proteins meat, milk ,poultry, cheese,
fish , & eggs
 PROTEIN
B. Building blocks
Amino Acids

B. Nonessential Amino acids- body can

synthesize
(plants may be rich in protein but are
incomplete).
 PROTEIN
B. Building blocks
Amino Acids

It is possible to combine 2 incomplete

proteins to make a complete protein.
a. Wheat bread and peanut butter
 PROTEIN
B. Building blocks
Amino Acids

It is possible to combine 2 incomplete

proteins to make a complete protein.
b. Legumes and seeds
 PROTEIN
B. Building blocks
Amino Acids

It is possible to combine 2 incomplete

proteins to make a complete protein.
c. Legumes and grains
Essential Nonessenti Conditional
Amino al Amino ly Essential
Acids Acids Amino
Acids
Histidine Alanine Arginine
Isoleucine Asparagine Carnitine
Leucine Aspartic Acid Cysteine
Lysine Glutamic Citrulline
Methionine Acid Taurine
Phenylalanin Glycine Tyrosine
e Proline
Threonine Serine
Tryptophan
Valine
 PROTEIN

Excess protein cannot be stored in the

body.
1. The body will only use as much protein
as it needs.
2. The excess is converted into glucose
and burned as energy or stored as fat.
3. The body needs a daily supply of
protein.
4. Small amounts of protein at each meal
is better than one large serving.
 PROTEIN

Excess protein causes:

1. Dehydration, because more water is
needed to flush protein out of the
system.
2. Strain on liver and kidneys.
3. A need for more calcium which results
in a calcium deficiency.
 PROTEIN

C. Recommendations for CHON intake

in the diet
1. percent in the diet ( 10- 20%
recommended)
A. A healthy adult requires 0.8 g/kg of
BW

B. Special group concerns are noted

for clients with devtl considerations,
clients with new tissue/ repair concerns
and those with increased metabolic
 PROTEIN
D. Food Sources
1. Animal sources & eggs
 PROTEIN
D. Food Sources
2. soy proteins
 PROTEIN
D. Food Sources
3. Added CHONs to processed
foods( casein & gelatin)
 PROTEIN
D. Food Sources
4. Amino acids to foods
A. Aspartame( Phenylalanine & aspartic
acid)
an artificial, non-saccharidesweetener
used as asugar substitute in some foods
and beverages
B. MSG(Monosodium glutamate)
E. Health Concerns
1. Protein Energy
Malnutrition( PEM)
A. Kwashiorkor-deficiency
state of CHON leading to
edematous
presentation( hepatomegaly)
E. Health Concerns
1. Protein Energy
Malnutrition( PEM)
B. Marasmus- deficiency
state to both CHON &/or energy
leading to malabsorption, & a
thin, matchstick appearance.
E. Health Concerns
1. Protein Energy
Malnutrition( PEM)

C. Protein deficiencies can result

in anemia, wt loss due to tissue
wasting, & edema formation
due to decreased colloid
osmotic pressure.
2. High Protein Diets
A. Increased CHON in the diet
may lead to exclusion of other
needed nutrients & cause other
deficiencies.
B. Increased CHON in the diet can
place more stress on the kidneys
C. Can lead to heart diseases and
osteoporosis.
3. Nitrogen Balance
is a measure ofnitrogeninput minus
nitrogen output
( Nitrogen Balance = Nitrogen intake
- Nitrogen loss)
Sources of nitrogen intake include
meat, dairy, eggs, nuts and legumes,
and grains and cereals.
Examples of nitrogen losses include
urine, feces, sweat, hair, and skin.
3. Nitrogen Balance
A. client consumes less than
excreted indicating CHON
deficiency & tissue breakdown
B. Client consumes more than
excreted indicating building up
of tissue( growth periods).
 FATS
Fats contain about 9 calories per gram twice as many
carbohydrates or protein.

A. Function
1.Structural Component
A. Found in all cell membranes & participates
in cell metabolism.
B. Is stored as adipose tissue in the body.
C. Provides cushioning and protection for vital
organs.
D. Provides skin lubrication in the form of
secretions of sebaceous glands.
E. Provides insulation( subcutaneous fat) to
regulate body temperature & aids in nerve
impulse transmission.
2. Transport Component: Lipoproteins
TRIGLYCERIDES-Too much of this type of fat may raise
the risk of coronary artery disease
CHOLESTEROL: A fat related substance found in all
animal fats and some vegetable fats that may form
fat deposits on the wall of the arteries. A condition
called atherosclerosis.
In order to carry fat in the bloodstream the body
coats it with a water soluble protein called a
lipoprotein.

Two types of cholesterol

a.Low Density Lipoproteins
LDL bad cholesterol
1. Fat in the blood stream that
is on its way to cell for storage.
b.High Density Lipoproteins
HDL good cholesterol
1. Fat in the bloodstream that is in
route to the liver where it is
processed and excreted from the
body.
2. HDL works to minimize the
harmful effects of LDL by causing
it to be removed from the
bloodstream and excreted.
3. Cannot get HDL from the food
you eat.
 How to lower cholesterol levels
a. Choose more vegetables, fruits, cereal grains and
starches.
b. Choose fish and poultry instead of red meat.
c. Trim fat from meat and skin from chicken before cooking.
d. Eat less or avoid organ meats such as liver, brain or
kidney.
e. Eat less commercial baked goods made with lard,
coconut oil, palm oil or shortening.
f. Eat less sausage, bacon and processed luncheon meats.
g. Use skim or low fat milk.
h. Choose low fat cheeses.
i. Eat less cream, ice cream, and butter.
j. Use low fat yogurt.
k. Eat less food fried in animal fats or shortening.
l. Eat fewer eggs, or fewer egg yolks.
B. Building Blocks
1. Fatty acids

A. Essential fatty acids consist

of linoleic ( omega 6 FA),
arachidonic, & linolenic acids
(omega-3 FA) that must be supplied
in the diet because the body cant
manufacture them.
B. Nonessential fatty acids are
those that can be manufactured in
the body & dont require dietary
ingestion.
 2. fatty acid configuration & types of fats

A. Saturated versus unsaturated

Saturated
Saturated fats are
normally solid at room
temperature.
Most come from
animal sources such
as beef, poultry,
whole-fat milk, cheese
and butter, however
several come from
plant sources, like
coconut, palm and
palm kernel oils.
 2. fatty acid configuration & types of fats

A. Saturated versus unsaturated

Saturated
Saturated fats raise
levels of both total
blood cholesterol and
low-density lipoprotein,
or bad cholesterol.
Elevated low-density
lipoprotein is associated
with an increased risk
for developing
cardiovascular disease.
Limit your saturated fat
intake to no more than
7 percent of daily
calories, recommends
the American Heart
Association.
 2. fatty acid configuration & types of fats

A. Saturated versus unsaturated

Unsaturated
Unsaturated fats come
primarily from plant
foods, such as nuts and
seeds, and are liquid at
room temperature.
Examples include
vegetable oils such as
olive, peanut,
sunflower, soybean and
corn.
Unlike saturated fats,
unsaturated fats do not
raise blood cholesterol
or low-density
lipoprotein levels.
 2. fatty acid configuration & types of fats

B. monounsaturated vs polyunsaturated
Monounsaturated
1. An FA with one carbon-to-
carbon bonds, is usually of
animal origin, & is solid @
room temperature.
a.A fatty acid that has one
hydrogen bond missing.
b.Source mostly from
plants (olive oil & peanut
oil)
c.Slightly lowers LDL
cholesterol, but some
studies show that it may
slightly raise HDL - other
studies show its effect on
HDL is neutral
d.Canola oil had both
 2. fatty acid configuration & types of fats

B. monounsaturated vs polyunsaturated
polyunsaturated
1. An FA with more than one
carbon-to-carbon double
bond is considered to be
polysaturated fatty acids
(PUFA).
a.A fatty acid that has
two or more hydrogen
bonds missing. b.Source
mostly from plants.
c.Lowers cholesterol, but
also slightly lowers HDL
(good cholesterol).
d.They supply essential
fatty acids.
 2. fatty acid configuration & types of fats

C. Omega-3 & Omega-6 fatty acids

Omega-3
1. Omega-
3:linolenic( Ess FA)
has been shown to
have preventive
effects on heart
disease
. decreased blood
clotting tendency,
. decreased blood
pressure
. & decreased cardiac
mortality); found in
salad, cooking oil,
 2. fatty acid configuration & types of fats

C. Omega-3 & Omega-6 fatty acids

Omega-6
Linoleic( Ess FA)
has been shown to
lower serum
cholesterol levels;
prolong clotting
time, help prevent
cardiac dse. & aid
in brain devt.;
found in vegetable
oils, peanuts, &
eggs.
 2. fatty acid configuration & types of fats

D. Trans
change form to Fatty acids
trans configuration
in chemical
structure, are
associated with
increased incidence
of cardiac disease
by increasing LDL
levels and
decreasing HDL
levels.
3. Glycerides
 4. Phospholipids & Sterols

A. Lecithin is a
phospholipids that
act as an emulsifier
in the body & can
be used as an
additive to food
products to
stabilize
consistency; found
in plant & animal
foods.
 4. Phospholipids & Sterols

B. Cholesterol is a sterol
compound that is produced by
the liver & is also found in
dietary sources
1. Functions include:
component of bile salts that
aids digestion, essential
component of cell membranes
required for production of
hormones( cortisone,
adrenaline, estrogens, &
testosterone) & vit D.
2. lipoprotein carriers recognize
cholesterol.
C. Recommendations for lipid
intake in the diet
1. Percent in the diet(< 30% total, <
10% saturated recommended)
A. Healthy adult
1. Not to exceed 30% of total
calories but not less than 105
of daily total Kcalories.
2. Dietary cholesterol intake of ,
300mg per day.
B. Special population groups
1. Clients with diabetes, cardiac
D. Food Sources
1. Natural fat sources are found in many dietary food
sources since most animal and plant contain some
percentage of fat.
2. Added fats found in processed foods are usually due
to the hydrogenation process.
3. Artificial fat products include alternative items that
are specifically produced to replace fat content in the
diet.
4. labeling
a. Fat-free items must contain , 0.5 g of fat per
serving size
b. Low fat items must contain 3 g or less of fat per
serving size
c. Reduced can be further categorized as being
reduced in fat ro cholesterol content.
E. Health Concern
1. EFA can cause growth failure, reproductive failure
2. Lipids and cardiac dse.
a. lipids increase plaque formation
b. HDL and LDL levels
1. HDL is cardioprotective
2. Increased LDL levels are assoc. With heart
dse.
c. Dietary risk factors include excess saturated fat,
increase cholesterol levels and intake of trans fatty
acids in the diet.
d. Omega-3 and omega-6 fatty acids,
monounsaturated fats, fiber, antioxidants are
cardioprotective