Nutrients: are the chemical components of food which are required for tissue
function ( both Cellular metabolism and physical activity) and structure (
growth and repair)
Nourishment: is the process by which organisms obtain, assimilate, and
utilize nutrients
Nutrition: is the science that deals with nutrients and nourishment
Nutrient types:
Macronutrients Micro nutreints
A) Organic macronutrients: A) Organic micronutrients:
Carbohydrates 1-fat soluble vitamins (AKED)
Lipids 2-water soluble vitamins (BC)
proteins
B) Inorganic macronutrients: In oragnic micronutrients
Electrolytes Trace elements
minerals
• Macronutrients are those nutrients required in amounts of a
gram or more per day.
• The organic (carbon containing) macronutrients are primarily
sources of energy.
• An excess of these macronutrients can lead to chronic
disease states such as obesity, while a general deficiency can
lead to starvation.
• The inorganic (non-carbon containing) macronutrients
include major electrolytes and minerals: Na, Cl, K, Ca, MG, P
-excesses or deficiencies of these can lead to alterations of
metabolism, including effects on the metabolism of other
nutrients
• Micronutrients
• required in amounts of < gm/day.
• They are necessary, for example, as cofactors for specific
enzymes in metabolic pathways.
• Excess amounts can lead to toxicity, whereas deficiencies of
individual micronutrients can lead to classical deficiency
diseases such as scurvy.
• inorganic micronutrients :
• are inorganic elements required by the human body in minute
quantities.
• In biology, trace elements are those present at levels of less than
100 ppm in tissue.
• In human nutrition, however, the term essential trace element is
defined as an element required in mg quantities in the diet.
Organic micronutrients:
organic micronutrients include vitamins, which are organic
substances required in small amounts in order to regulate cell
function and maintain life.
In general, vitamins cannot be synthesized endogenously (few exceptions) and
must be provided in the diet.
MACRONUTRIENTS
• Includes carbohydrates (energy),lipids, ethanol (excess causes
hypoglycemia) and proteins
• Albumin and total protein are routinely measured, but concentrations of these
in blood reflect underlying disease
• Blood albumin concentration does not fall even in starving
patients, unless their condition is complicated by, for example,
sepsis.
Q) why albumin concentration does not fall in starvation?
Inorganic mAcronutrient :
Na, Cl,
K, Mg
Ca,P,
Water-soluble vitamins
-include B1, B2, B3, B5, B6, B7, B9, B12, and C.
-are absorbed from the GIT and enter the blood, in
which they are transported to the sites where they
are required.
-Any excess water-soluble vitamins removed from
the body by excretion in the urine.
Vitamin B1 (thiamine)
• The most common cause of vitamin B1 deficiency
globally:
• poor nutrition , eating only white
refined rice
• Alcoholics
Thiamine
• It is a cofactor for a number of metabolic processes
with ATP production , I e thiamine helps energy
production
• It Helps dehydrogenase enzymes
• Most notably the conversion of pyruvate to acetyl
CoA.
• Pyruvate dehydrogenase is B1 dependent
• Thiamine deficiency build up pyruvate , excess
pyruvate converted to lactic acid causing lactic
acidosis
The classical deficiency syndrome is Beri-Beri, which may be either ‘dry’ or ‘wet’
dry Beri-Beri :peripheral neuropathy
painful calf muscles, poor coordination,
tingling and paralysis
wet Beri-Beri: the main finding is heart failure,
leading to the development of oedema and
Unexplianed metabolic acidosis
End stage thiamine deficiency
irreversible neurological damage (Wernicke-Korsakoff syndrome)
can be
Thiamine is also a cofactor for transketolase? Explain and comment
Vitamin B9 folic acid,
The word folic acid is
in the form of tetrahydrofolic acid, is involved derived from latin
in single carbon transfer word Folium means
reactions, including a key role in DNA leaf & it is also
synthesis. isolated from the leafy
vegetable spinach
Folic acid mainly
consists of three
components
Pteridine ring PABA
(p-amino benzoic
acid) Glutamic acid
residue (1 to 7
residues) Hence it is
known as Pteroyl-
glutamic acid
Deficiency of folic acid results in macrocytosis,
and megaloblastic anaemia in severe cases.
Megaloblastic anemia
DNA synthesis is retarded causing
cells to divide slowly
Causing big immature nuclei but
normal cytoplasm
(nuclear/cytoplasmic asynchrony)
The most common cause is vitamin
b12 and folate Deficiency
B9 deficiency in early pregnancy and prior to
conception has been associated with neural tube
defects in the foetus, and so supplementation is often
recommended.
Folate (along with B6 and B12) is also used to help reduce
the homocysteine level in patients with homocystinuria,
and this helps reduce the high rate of vascular disease
*Homocystinuria is a disorder of methionine metabolism, leading to an abnormal
accumulation of homocysteine and its metabolites (homocystine, homocysteine-cysteine
complex, and others) in blood and urine
Vitamin B12 or cobalamin
B12
is only found in foods of animal
origin, and absolute vegetarianism
will lead to deficiency of B12 after
5–10 years.
up to one year’s requirements can be retained in the liver,
B12 is water-soluble and excessive intakes are efficiently
excreted in the urine.
Addisonian ,pernicious anaemia, megaloblastic
refers to a specific autoimmune disease, autoantibodies destroy
parietal cells, causling less IF production
* IF production might be also impaired by;
atrophic gastritis,
Helicobacter pylori infection
bacterial overgrowth.
• severe vitamin B12 deficiency might also cause:
• peripheral neuropathy,
• memory loss, dementia,
• Glossitits
• an irreversible neurological disease called subacute degeneration of the
spinal cord,
• Vitamin B12 deficiency also raises the concentration of homocysteine in
blood.
• the most severe cases, death.
Methyl malonly
CoA mutase Co enzyme
Methionine is needed for myelin
maintenance
Causes of vitamin B12 deficiency :
• Diet very rarely
• Pernicious anemia
• Pancreatic damage lack of pancreatic enzymes /The B12 in the stomach cannot be
liberated, meaning that B12 can not bind to IF
• Illeal disease/resection, without Ileum B12-IF can not be absorbed
• Small intestine : tape worms or bacterial overgrowth can compete for B12
How do you test for vitamin B12 deficiency?
1-schiling test
2-methylmalonic acid is more relabile test for B12 ( B12 deficient have normal levels)
Vitamin B2 riboflavin
required for numerous metabolic redox
reactions.
no specific syndrome described in riboflavin
deficiency,
However, a number of clinical signs may be
present, including angular stomatitis and
glossitis (inflammation of the tongue).
Vitamin B2 riboflavin
Vitamin B3 niacin
• part of nicotinamide adenine
dinucleotide (NAD+) and NADP,
• involved in many redox reactions in
human metabolism
• Pellagra syndrome results from severe deficiency (dermatitis,
diarrhoea, dementia)
• Glossitis milder deficiency
• High does of niacin is used to treat dyslipidemia
Vitamin B5 (pantothenic acid)
• Common in food , so deficiency is rare
• Part of CoA and plays fundamental role in carbohydrate
metabolism
Vitamin B6 (pyroxidine)
• Common in food , so deficiency is rare
• B6 ( in high doses i.e 100 times more than normal dose) is
used with B12, B9 to treat homocysteinuria
• Sometimes deficiency caused sings of glossitis, neuropathy,
and sideroblastic anemia
Vitamin B7 (Biotin) /vitamin H
• Biotin is co-facor in some carboxylase reactions involved with
FA metabolism, and gluconeogensis
• Deficiency is rare
However biotin binds strongly with avidin ,
Avidin is in raw egg white, consumption of significant quantities
of raw egg has been associated with biotin deficiency
