1. Introduction to Applied Nutrition
Unit One
Prepared By Muhammad Azhar
Bsc Biochem, MSc Micro, BSN,MSN*
Oxford College Of Nursing & Allied Science Karachi
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2. Objectives
At the end of this session students will be able to:
i. Know history of nutrition.
ii. Learn terminologies related to nutrition.
iii. Discuss role of food and its medicinal value.
iv. Classify food based on their functions.
v. List down some nutritional disorders.
vi. Know role of nurse in nutrition.
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3. History of Nutrition
Nutrition discoveries from ancient days and the continuous research in its effect on health
have positive effect on health and well being.
Some important dates in the history of nutrition are listed below:
i. 400 BC: Hippocrates said, Let food be thy medicine and medicine be thy food’.
ii. 1500 AD: Leonardo da Vinci, an artist and a scientist compared the metabolism of the
body to the burning of the candle
iii. 1747 AD: Dr James Lind, a physician in the British Navy, performed the first
experiment on nutrition.
He gave some lime, sea water and vinegar to British sailors as they were only on a diet of
dried meat and bread during long voyages. During these voyages, they developed scurvy, a
painful bleeding disorder of the gums.
When they were given foods rich in vitamin C, they did not develop this disorder. Although
vitamin C was not discovered till 1930s
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4. Conti...
iv. 1770 AD: Antoine Lavoisier, the father of nutrition, discovered the process of
metabolism and demonstrated where the animal heat comes from.
v. Early 1880s: Important discoveries were made that foods are composed of carbon,
hydrogen nitrogen and oxygen.
vi. 1840 AD: Justus Liebig of Germany declared that carbohydrates were composed of
sugars, fats of fatty acids and proteins or amino acids.
vii. 1897 AD: Christiaan Eijkman, a Dutch physician, discovered that brown rice when
given to natives of Java (Island of Indonesia) were cured of beriberi. Nutritionists
later discovered that unpolished rice, which contains bran is rich in vitamin
B1(thiamine).
viii. 1912 AD: E.V. McCollum discovered the first fat-soluble vitamin, vitamin A.
ix. 1912 AD: Dr Casmir Funk was the first to coin the term vitamin.
x. 1930s: William Rose discovered essential amino acids, the building blocks of
protein.
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5. xi. The next nutrition breakthrough was the discovery of vitamins –
• Vitamin C in 1919,
• Vitamin D in 1925,
• Vitamin K in 1935,
• Vitamin E in 1936,
• Vitamin B1 Thiamine in 1936,
• Vitamin B2 riboflavin in 1935,
• Vitamin B6 pyridoxine in 1936, Vitamin B9 in 1948 and so on.
Nutrition was officially recognized as an independent field of study only in
1928
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6. Basic Terminologies:
Nutrition is defined as the science of food and its relationship to health. It is the branch of
science that studies the process by which living organisms take and use food for the
maintenance of life, growth, reproduction, the functioning of organs and tissues, and the
production of energy.’
A NUTRITIONIST is a person who advises others on matters of food and nutrition and
their impacts on health. The title ‘nutritionist’ has no legal standing and no educational
requirements are necessary for a person to be called ‘nutritionist’.
Nutrients “Nutrients are the compounds in food that provide us energy that help repair
and growth and helps to carry out different life processes. "Human beings require more
than 45 different nutrients for their well being. Nutrients include:
1. Carbohydrates
2. Lipids
3. Proteins
4. Water, Minerals and Vitamins
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7. Malnutrition is a serious condition that happens when diet does not contain the right
amount of nutrients.
It means "poor nutrition" and can refer to:
i. Undernutrition – Not getting enough nutrients
ii. Overnutrition – Getting more nutrients than needed
Classification Of Nutrients
a. Major nutrients (macronutrients): “Nutrients are the compounds in
food that provide us with energy that facilitates repair and growth and helps to carry
out different life processes.” Carbohydrates, lipids, proteins and water.
i. Utilized for energy converted to structural components of cells
ii. Stored as fat, depending on their level of supply
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8. b. Minor nutrients (micronutrients); Micronutrients, which are
c. Required by the body in small amounts. Vitamins and minerals.
i. They regulate the metabolism
ii. They act as biological catalyst and speed up metabolism
Dietitians are qualified and regulated health professionals that assess, diagnose and
treat dietary and nutritional problems at an individual and wider public-health level.
Diet is what a person habitually eats and drinks. Vegetarian diet
A balanced diet is one that contains all of the essential elements/ Nutrients in right
amount, that the human body needs. Carbohydrates, lipids, vitamins, minerals, proteins
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9. A therapeutic diet is a meal plan that controls /meet the special nutritional need of
a individual’s during the treatment or management of certain diseases, illnesses or
medical conditions. KYB diet
Food: Any nourishing substance that is eaten, drunk, or otherwise taken into the
body to sustain life, provide energy, promote growth, etc.
A meal is an occasion when people sit down and eat, usually at a regular time such
as breakfast, lunch, dinner, etc.,
Snacks: are foods that are not eaten as part of meals. The place of snacks in
peoples’ diets and their contribution to overall dietary intake are variable.
Energy Balance is the difference between energy intake, which can be
metabolized, and total energy expenditure.
It could be said that the human body’s energy state is balanced when its energy
expenditure is equal to its energy intake.
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10. Nutrition screening Is a quick look at a few variables to identify individuals who are
malnourished or who are at risk for malnutrition, e.g. screening a pregnant women
Screens are often the responsibility of staff nurses because they can be completed
during a history and physical examination upon admission
Nutritional status Is the state of our body as the results of the foods consumed and
their use by the body. Nutritional status can be good, fair or poor.
Nutritional Assessment: An in-depth analysis of a person’s nutritional status usually
performed in the clinical setting
Body Mass Index: An index of weight in relation to height that is calculated
mathematically by dividing weight in kilograms by the square of height in meters.
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11. Nutritional Security: It is the physical, economic and social access to and a utilization
of an appropriate balanced diet, safe drinking water, environmental hygiene and
primary health care for all.
Food Security: Food security is defined as the availability and the access of food to
all people; whereas nutrition security demands the intake of a wide range of foods
which provides the essential needed nutrients.
Antioxidant: A substance that protects cells from the damage caused by free radicals
Examples of antioxidants include vitamins C and Selenium, and carotenoids, such as
beta-carotene, lycopene, lutein etc.
Free Radicals: It is an unstable molecule that attacks other molecules and plays a
major role in the ageing
Free radicals may play a part in cancer, heart disease, stroke, and other diseases of
aging. e.g. Hydroxyl (OH∙), oxygen super oxide O2
•−
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12. Calorie
The qualitative food requirements are estimated in term of energy is calories.
Physiologic calorie or kilocalorie is the unit of energy, which is the amount of heat
necessary to raise the temperature of one kilogram of water by 1ºC, from 14.5ºC to
15.5ºC. This is 1000 times the physical calorie unit. The international unit of energy
is Joule. 1 kilocalorie = 42 kilojoules
Calorie Value of Food
(kilocalories/gm)
i. Carbohydrates 4
ii. Fat 9
iii. Proteins 4
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13. Respiratory Quotient (RQ) for Foodstuff
i. It is the ratio of the volume of CO2 produced to the volume of O2 consumed,
ii. when a particular food is oxidized in the body.
RQ = Volume of CO2 produced
______________________________
Volume of O2 consumed
iii. RQ for carbohydrate = 1
iv. Lipids = 0.7
v. Proteins = 0.8
vi. On a mixed diet RQ = 0.85
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14. Significance of RQ
i. It indicates the type of food that is being principally metabolized in the body.
ii. In diabetes mellitus and starvation RQ decreases.
Example: If RQ is nearer to 1, then it means more of carbohydrates are metabolized.
Energy Requirements of an Individual
Energy requirement of an individual is made up of several components.
They are:
i. Basal metabolic rate
ii. Specific dynamic action of food
iii. Various activities. However, for women, pregnancy and lactation are additional
components of energy requirement
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15. Factors Influencing Food Habits And Selection Of Food Stuffs
1. Superstitions
2. Social and cultural factors
3. Religions factors
4. Income
5. Geography/availability
6. Advertising and media
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16. Functions of Food
1. Provide energy
2. Body building
3. Regulating the activities of the body including
a. Beating of the heart
b. Maintenance of body temperature
c. Muscle contraction
d. Clotting of blood
e. Control of water balance
f. Elimination of the waste products of the body
4. Provide resistance to diseases
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17. 5. Social function: Feasts are served on specific stages of life—birth, naming
ceremonies, birth days, marriages etc.
6. Psychological functions of food: Breastfeeding provides closeness and security to
the child. Food also satisfy some emotional needs like security, attention and
friendship and acceptance.
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18. Role of Food and its Medicinal Value
i. Curd or Yogurt: Curd contains probiotic or friendly bacteria that thrive in our
intestine and protect us against intestinal infections. It helps in digestion.
ii. Fiber: The indigestible portion of plant foods is referred to as fiber; this plays
important role in lowering cholesterol and preventing constipation and several
degenerative diseases.
iii. Garlic: Allicin in garlic is considered as a remedy for heart disease and stroke. It
also relieve flatulence and has antibacterial properties.
iv. Ginger: It has been used for centuries in the treatment of stomach disorders, like
indigestion, nausea and vomiting and hepatic disorders. It has anti- inflammatory
property as well.
v. Green Tea: Green tea protect us from digestive and respiratory tract infections. It
is also believed to have anticarcinogenic properties and prevent against colon and
stomach cancers.
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19. vi. Pepper: It has been in use for centuries. It has anti- inflammatory properties and
relive respiratory tract infections.
vii. Soya Bean: This is a high protein plant food and is high in solubilities also. It is
effective in reducing bad cholesterol in the body. It also reduces the menopausal
symptoms of hot flashes and reduces the risk of uterine cancer.
Role of Nurse in Nutrition
i. Screen & Assess the nutritional status of the individual, family and community.
ii. Analyze the nutritional demands of the individuals.
iii. Determine the factors that influence the nutritional status like BMI, age, sex,
education, socio economic status, culture, availability of nutrient rich foods while
planning the meal.
iv. Conduct a nutritional surveillance of the community to know the health status of
the community.
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20. v. Plan and provide a nutritional health education programs.
vi. Encourage the health professionals to participate actively in the nutritional
programs.
vii. Create awareness among the public about nutritional supplementation
programs.
CLASSIFICATION OF FOOD
1. Based on its origin
a. Foods of animal origin
b. Foods of vegetable origin
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21. CLASSIFICATION OF FOOD
2. Based on Chemical Composition
a. Proteins
b. Fats
c. Carbohydrates
d. Minerals
e. Vitamins
3. Based on its Function
a. Body building foods – amino acids, proteins
b. Energy giving foods – carbohydrates (wheat, rice)
c. Protective foods – vitamins and minerals (vegetables)
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22. Nutritional Assessment is an extremely useful tool for the application of
nutritional therapy. It is related to the individual’s
i. Food and nutrient intake(diet history)
ii. Lifestyle
iii. Medication intake
iv. Social and medical history
v. Anthropometric, (body composition and biochemical measurements) .It includes
both the screening and assessment of the person’s nutritional status, the collection
of data through the use of interviews, questionnaires and specially designed forms
and the scientific analysis of the information obtained.
vi. These data are used in order to identify the nutritional status of the individual, to
design the appropriate nutritional therapy and to investigate the need for greater
nutritional support.
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23. One of the most helpful, easy to use diet planning tools is the food guide pyramid
which separates foods into specific groups and then specifies the number of
servings form each group to each day
i. The placement of this five food groups on then pyramid emphasizes their role in the diet.
ii. The grains that form the base should serve as the foundation of a healthy diet because
breads, cereals, rice and wheat are high in carbohydrates and low in fat.
iii. The grains are followed by fruits and vegetables which supply the vitamins, minerals and
fiber.
iv. The next level suggests eating smaller amounts of dairy products as well as meat, poultry,
fish, beans, eggs and nuts.
v. While foods from these group provides proteins, calcium, iron, zinc and other nutrients,
they often contain large amount of fat and should be chosen carefully.
vi. The tip of the pyramid consists of fats, oils and sweets. They supply lot of fat and/or
calories and few nutrients.
vii.These items should be added to diet carefully.
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Diet Planning:

24. Food Guide Pyramid—A Guide to Daily Food Choices
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26. References:
• The Atlas of Food by Erik Millstone; Tim Lang; Marion Nestle (Foreword by)
• Dietary Reference Intakes by Jennifer J. Otten (Editor); Jennifer Pitzi Hellwig (Editor); Linda
Meyers
• Handbook of Nutrition and Food, Third Edition by Carolyn D. Berdanier (Editor); Johanna T.
Dwyer (Editor); David Heber
• Manual of Nutritional Therapeutics by David H. Alpers; William F. Stenson; Dennis M. Bier; Beth
E. Taylor
• A dictionary of food and nutrition by David A. Bender
• Food Cultures of the World Encyclopedia by Ken Albala
• Nutrition Essentials for Nursing Practice Dudek, Susan
• Nutrition and Diagnosis-Related Care (Nutrition and Diagnosis-Related Care ( Escott-Stump))
• Introduction to Human Nutrition 2nd Edition by Michael J Gibney
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27. References:
• Academy of Nutrition and Dietetics. (2012). Nutrition Care Manual. Available at http://www.nutritioncaremanual.org.
Accessed on 8/15/12.
• Banh, L. (2006). Serum proteins as markers of nutrition: What are we treating? Practical Gastroenterology, 30, 46–64.
• Fessler, T. (2008). Malnutrition: A serious concern for hospitalized patients. Today’s Dietitian, 10,44–48. White, J., Guenter,
P., Jensen, G., Malone, A., Schofield, M., Academy Malnutrition Work Group, . . . ASPEN Board of Directors. (2012).
Consensus statement of the Academy of
• Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: Characteristics recommended for the
identification and documentation of adults malnutrition (undernutrition).
• Journal of the Academy of Nutrition and Dietetics, 112, 730–738.
• Biochemistry and Nutrition for BSc (Nursing) Manjula Shantaram MSc, PhD, FAGE, FABMS
• Nutrition Essentials for Nursing Practice Susan G. Dudek, RD, CDN, BS Nutrition Instructor, Dietetic Technology Program
Erie Community College Williamsville, New York
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