Nutrition plays a crucial role in maintaining optimal health and preventing various diseases. The relationship between nutrition and health is intricate, with dietary choices significantly influencing overall well-being. Here's a comprehensive description of nutrition in health and disease: Nutrition in Health: Essential Nutrients: A balanced diet provides essential nutrients such as carbohydrates, proteins, fats, vitamins, and minerals. These nutrients are vital for the proper functioning of the body, supporting growth, development, and overall maintenance of health. Energy Balance: Nutrition contributes to maintaining an appropriate energy balance. The intake of calories should match the body's energy expenditure, preventing issues like obesity or malnutrition. Disease Prevention: A nutritious diet can help prevent various chronic diseases, including heart disease, diabetes, and certain cancers. Antioxidants from fruits and vegetables, for instance, play a role in protecting cells from damage. Immune System Support: Adequate nutrition supports a robust immune system, helping the body defend itself against infections and illnesses. Nutrients like vitamins A, C, and D, as well as zinc and selenium, are essential for immune function. Healthy Aging: Proper nutrition contributes to healthy aging by maintaining muscle mass, bone density, and cognitive function. Nutrient-rich foods are especially important as individuals age to support overall well-being. Nutrition in Disease: Malnutrition: Inadequate or imbalanced nutrition can lead to malnutrition, which encompasses both undernutrition and overnutrition. Undernutrition can result in stunted growth, weakened immune function, and other health complications, while overnutrition can contribute to obesity and related diseases. Chronic Diseases: Poor dietary choices are linked to the development of chronic diseases such as cardiovascular disease, type 2 diabetes, and certain types of cancers. Diets high in saturated fats, sugars, and salt can contribute to these health issues. Nutritional Deficiencies: Insufficient intake of specific nutrients can lead to deficiencies, causing a range of health problems. For example, vitamin deficiencies may result in conditions like scurvy (vitamin C deficiency) or rickets (vitamin D deficiency). Inflammation: Certain dietary patterns, such as those high in processed foods and low in anti-inflammatory nutrients, may contribute to chronic inflammation, a factor implicated in various diseases, including arthritis and inflammatory bowel diseases. Digestive Health: Nutrition plays a pivotal role in maintaining digestive health. Poor dietary choices can lead to gastrointestinal issues, including irritable bowel syndrome (IBS) and inflammatory bowel diseases (IBD). In summary, nutrition is a cornerstone of health and disease prevention. Making informed and balanced dietary choices is crucial for maintaining overall well-being and reducing the risk of various health

1. NUTRITION IN
HEALTH &
DISEASE
BY: DR. ANOSHA RIAZ

2. What is Nutrition?
• Definition:
“ Nutrition may be defined as the science of food & its
relationship to health”
• It is concerned primarily with the part played by nutrients in body
growth, development & maintenance.
• Good Nutrition means:
“ Maintaining a nutritional status that enables us to grow
well & enjoy good health”
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3. What are Nutrients?
• Definition:
“Nutrients are organic & inorganic complexes
contained in food.”
They are classified as
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Macronutrients Micronutrients

4. Types of Nutrients
Macronutrients
Proteins, fats, carbohydrates
are called as macronutrients
because they form main bulk
of food.
Proteins 7-15%
Fats 10-30%
Carbohydrates 65-80%
Micronutrients
They are required in small
amounts that is why
called as micronutrients
Vitamins
Minerals
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5. Balanced Diet
• Diet consisting of adequate amounts of all the
necessary nutrients recommended for healthy growth
& for efficient daily activities & functions.
• A balanced diet contains the proper quantities &
proportions of the needed nutrients to maintain good
health. It must have balanced amounts in proper
proportions of carbohydrates, fats, proteins, vitamins,
minerals, & water intake.
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6. WHO
Recommended
Dietary Goals
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7. 1. Energy intake (calories) should be
in balance with energy expenditure.
 To avoid unhealthy weight gain, total fat should not exceed
30% of total energy intake.
 Intake of saturated fats should be less than 10% of total
energy intake.
 Intake of trans-fats less than 1% of total energy intake.
 Unsaturated vegetable oils should be substituted for the
remaining fat requirement.
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8. 2. Intake of Free Sugars
 Limiting intake of free sugars to less than 10% of total
energy intake is part of a healthy diet.
 A further reduction to less than 5% of total energy intake is
suggested for additional health benefits
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9. 3. Salt Intake
 Keeping salt intake to less than 5 g per day (equivalent to
sodium intake of less than 2 g per day) helps to prevent
hypertension, & reduces the risk of heart disease & stroke
in the adult population.
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10. 4. Protein Intake
 Protein should account for approximately 10-15% of the
daily intake
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11. 5. Carbohydrates Intake
 Excessive consumption of refined carbohydrates should be
avoided, some amount of carbohydrates rich in natural fibre
should be taken.
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12. 6. Restricted Diet
 Junk foods such as colas, ketchups & other foods that
supply empty calories, should be reduced.
 Sources rich in energy such as fats & alcohol should be
restricted.
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13. PROTEINS
“Proteins are complex
nitrogenous compounds,
composed of carbon,
hydrogen, nitrogen &
sulfur in varying
amounts.”

14. Areas of growth
Composition Proteins are made up of smaller units called AMINO ACIDS
> Essential Amino Acids
> Non-Essential Amino Acids
Sources Animal Sources: Milk, meat, eggs, cheese, fish & fowl
Vegetable Sources: Pulses, cereals, beans, nuts & oil seeds
Functions - Provides amino acids which are the building blocks of body
- Form collagen & have role in repair & maintenance of body tissues
- Maintenance of osmotic pressure, synthesis of certain substances like
antibodies, plasma proteins, hemoglobin & enzymes
- Proteins are also connected with immune mechanism of body
Daily
Requirements
75 gm
Proteins &
Disease
- Kwashiorkor is result of protein deficiency
- Delayed eruption & hypoplasia
- Cementum deposition is retarded
- Resorption of alveolar bone

15. Oral defense system depends on adequate supply of
proteins.
Patients with ill-fitting dentures, edentulousness &
poor oral health status will be unable to consume
enough protein which predisposes such person to
decrease immune function, impaired wound healing &
oral infections
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16. FATS
“Fats are greasy substances
found in the tissues of animals
& some plants. Fats & oils are
concentrated forms of energy.
Fats yield fatty acids & glycerol
on hydrolysis.”

17. Areas of growth
Composition Fats are hydrophobic hydrocarbon molecules consisting of fatty acids
& glycerol. Glycerol has three carbons, each of which is attached to a
hydroxyl group. Most fats are formed through replacement of the
hydrogen of each hydroxyl group by a fatty acid.
Sources Animal Sources: Ghee, Butter, milk, Cheese, Eggs & Fat of meat & fish
Vegetable Sources: Ground nut, mustard, sesasme, coconut.
Functions - They are high energy foods thus provide energy
- Fat beneath skin provides insulation against cold
- Serve as vehicles for fat soluble vitamins
- Fats on the body support viscera such as heart, kidney & intestine
- Essential fatty acids are needed by body for growth, for structural integrity
of cell membrane & decreased platelet adhesiveness
Daily
Requirements
55 gm
Fats & Disease - Obesity
- Phrynoderma
- Coronary Heart Disease
- Cancer

18. Research also indicates that high fat intake
tends to be inhibitory towards dental
caries. Small quantities of nuts & cheese
can be good between meals for patients
concerned with dental caries
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19. Carbohydrates
“A large group of organic
compounds that includes sugars,
starch, & cellulose, containing
hydrogen & oxygen in the same
ratio as water (2:1) & used as
structural materials & for energy
storage within living tissues.”

20. Areas of growth
Composition A carbohydrate is a naturally occurring compound, or a derivative of
such a compound, with the general chemical formula Cx(H2O)y, made
up of molecules of carbon (C), hydrogen (H), & oxygen (O).
Carbohydrates are the most widespread organic substances & play a
vital role in all life.
Sources Bread, beans, milk, popcorn, potatoes, cookies, spaghetti, soft drinks, corn, &
cherry pie. They also come in a variety of forms. The most common &
abundant forms are sugars, fibers, & starches.
Functions - Oxidation of fats
- Synthesis of certain non- essential carbohydrates.
- Synthesis of ground substance of the connective tissues like chondroitin,
keratin & dermatan sulphates
Daily
Requirements
225 – 325 gm
Carbohydrates
& Disease
- Deficiency of carbohydrates is not experienced much as they found
abundantly in most of the foods

21. The type, consistency, time of intake &
frequency of the carbohydrates are the
major factors in causation of dental
caries
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22. Vitamins
“vitamin is an organic molecule
that is an essential micronutrient
that an organism needs in small
quantities for the proper
functioning of its metabolism.”

23. Types of Vitamins
Fat Soluble
Vitamins
• Fat-soluble vitamins are absorbed along with fats in the
diet & are stored in the body's fatty tissue & in the liver.
• They are found in many plant & animal foods & in dietary
supplements. Vitamins A, D, E, & K are fat-soluble.
Water Soluble
Vitamins
• Water-soluble vitamins are carried to the body's tissues but are
not stored in the body. They are found in many plant & animal
foods & in dietary supplements & must be taken in daily.
• Vitamin C & members of the vitamin B complex are water-
soluble.
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24. Fat Soluble Vitamins
Strengthen bones
Calcium absorption
Immune System
Immune System
Flushes Toxins
Blood Clotting
Bone Health
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Vision
Reproduction
Bone Health
Immune system
Skin

25. Deficiencies
• Scurvy
• Poor wound healing
• Bleeding gums
• Degenerative lesions in
skeletal muscles &
heart
• Hemolytic &
hypoplastic anemia
• Anatomic changes in
nervous system
• Failure of bone
calcification, rickets in
children osteomalacia in
adults
• Night Blindness
• Reduced resistance to
infection
A D
K
E

26. Water Soluble Vitamins
Vitamin Actions Sources Deficiency
B1 (Thiamine) Co-enzyme in carbohydrate
metabolism
Enriched breads,
cereals, legumes, seeds,
nuts
Beri-Beri
Wernicke’s Korsakoff
syndrome in alcoholism
B2
(Riboflavin)
Co-enzyme in fat & protein
metabolism
Enriched & whole grains,
meats, liver, eggs, dairy
products, fish, poultry,
dark leafy vegetables
Ariboflavinosis with
glossitis, cheilitis &
seborrheic dermatitis
B3
(Niacin)
Co-factor to enzymes
involved in energy
metabolism glycolysis &
tricarboxylic acid cycle
Meats, poultry, fish,
whole & enriched
breads, cereals, milk
Pellagra, toxicity leads to
vasodilation, liver
damage, gout & arthritic
symptoms
B5
(Pyridoxine)
Coenzyme in energy
metabolism, antibody &
hemoglobin formation
Meat, poultry, fish, whole
& enriched breads, eggs
Altered nerve function

27. Water Soluble Vitamins
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Vitamin Actions Sources Deficiency
B12
(Cobalamin)
Transport/storage of
folate energy metabolism,
blood cell & nerve
formation
Animal foods, fortified
cereals, eggs
Pernicious anemia
Vitamin C
(Ascorbic
Acid)
Essential to collagen
production used in the
structure of bone & CT,
aids wound healing &
iron absorption
Fresh fruits, citrus fruits,
red & green peppers,
broccoli, snow peas,
brussels sprouts
Scurvy
Poor wound healing
Bleeding gums
Folic Acid
(Folate)
Coenzyme metabolism,
fetal neural tube
formation
Green leafy vegetables,
legumes, citrus fruits
Megaloblastic anemia

28. Minerals
“Minerals make up about 4% of
body weight. There are more than
50 chemical elements found in the
human body which are required
for growth, repair & regulation of
vital body function”

29. Minerals
Major Elements
• These are required from dietary sources in amounts greater
than 100mg per day
• Calcium, phosphate, sodium, potassium, magnesium,
Trace Elements
• These are required by the body in quantities of less than a
few milligrams per day
• Iron, iodine, fluorine, zinc, copper, cobalt, chromium,
manganese, molybdenum, selenium, nickel, tin, silicon &
vanadium
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30. Major Elements
Mineral Actions Sources Deficiency
Calcium Bone/tooth formation, blood
clotting & nerve muscle
function
Milk based foods, green
leafy vegetables,
legumes
Reduced bone density
Phosphorus Bone/tooth formation,
metabolism, acid base
balance
Dairy foods, eggs, meat,
fish, poultry, legumes,
whole grain
Rare
Magnesium Bone/tooth formation, nerve
& muscle function, blood
clotting, cofactor in
metabolism
Whole grain, green leafy
vegetables, hard water,
meat, dairy products,
fish
Associated with fluid
volume deficit,
weakness, muscle
twitching, convulsions
Fluoride Bone/tooth formation,
resistance to caries
Natural water,
fluoridated water, tea,
seafood, seaweed
Increased dental caries

31. Trace Elements
Mineral Actions Sources Deficiency
Zinc Required for digestion,
metabolism, wound healing,
tissue growth & repair,
reproduction
Protein foods, meats, fish,
poultry, eggs, legumes
Retarded growth,
taste/smell alterations,
decreased immune
functions & wound
healing
Iron Growth, immune system of
health, hemoglobin &
myoglobin formation, energy
production
Liver & other meats, fish,
eggs, poultry, green
vegetables, legumes,
enriched breads & cereals
Microcytic anemia,
(women & children at
more risk)
Copper Coenzyme in antioxidant
reactions & energy
metabolism, iron use, wound
healing, blood & nerve fibre
production
Organ meats, seafood,
green leafy vegetables,
nuts, seeds, water from
copper pipes
Bone demineralization &
anemia
Iodine Thyroxin synthesis, regulates
metabolism, growth &
development
Iodized salt, seafood Goitre, tiredness, weight
gain

32. NUTRITIONAL
PROBLEMS
IN PUBLIC
HEALTH

33. 1. Low Birth Weight
2. Protein Energy Malnutrition
3. Xerophthalmia
4. Nutritional Anemia
5. Iodine Deficiency Disorders (IDD)
6. Dental Fluorosis
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34. 1. Low Birth Weight
• Low birth weight (i.e. birth weight less than 2500 g) is a major public
health problem.
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Causes of Low Birth Weight
• Maternal malnutrition and anaemia
• Physical labour during pregnancy
• Illness especially infection, etc.
• The proportion of infants born with LBW has been selected as one of
the nutritional indicators for monitoring progress towards “Health
for All” by the year 2000

35. 2. Protein energy Malnutriton
• This condition was recognized in the middle of the last century and attributed to
dietary deficiency of proteins as well as total caloric intake.
• By 1970s it came to be recognized that the disorder is primarily due to deficient caloric
intake, protein intake is usually adequate.
• The current concept of PEM is its clinical forms—kwashiorkor and marasmus.
Causes
• Inadequate intake of food both in quantity and quality.
• Infections notably diarrhea, respiratory infections, measles, etc.
• Other contributory factors are poor environmental conditions, large family size, poor
maternal health, failure of lactation, premature termination of breastfeeding.
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36. KWASHIORKOR
 The most characteristic feature of Kwashiorkor is
edema, giving rise to “MOONFACE” usually
accompanied by skin lesions, irritability and lack of
interest in surroundings.
 Loss of weight may not be apparent because of
edema.
 Kwashiorkor is much less frequently seen than
marasmus, but it is a more serious form of
malnutrition, which may be fatal within days to
weeks.
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37. MARASMUS
 The characteristic features of Marasmus are
marked loss of weight, wasting of muscles and
loss of subcutaneous fat.
 As a result, the child appears to be just skin and
bones with wrinkled face and shining alert eyes
giving the appearance of a “wise old man”.
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38. Classification of Malnutrition
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39. 3. Xerophthalmia
• It refers to all the ocular manifestations of vitamin A
deficiency in man.
• Xerophthalmia is most common in children aged 1–3
years, and is often related to weaning. The younger the
child, the more severe the disease. The victims belong to
the poorest families.
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40. 4. Nutritional Anemia
• It Nutritional anemia is a disease syndrome caused by malnutrition in
its widest sense.
• It has been defined by WHO as “a condition in which the hemoglobin
content of blood is lower than normal as a result of a deficiency of one
or more essential nutrients regardless of the cause of such deficiency.”
Causes
• Iron deficiency
• Frequently folate or vitamin B12 deficiency.
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41. 5. Iodine Deficiency Disorders (IDD)
• Iodine deficiency results in impaired synthesis of
thyroxine.
• This manifests more commonly as GOITER, seen
in the form of a diffuse or nodular enlargement of
the thyroid gland.
• Symptoms and signs of hypothyroidism may also
be present.
• During the last few decades, it is being
increasingly recognized that iodine deficiency
during intrauterine life and childhood has serious
health and psychological implications.
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42. • There is much wider spectrum of disorders such as:
• Iodine deficiency disorder (IDD) refers to all the effects of iodine
deficiency on human growth and development, which can be prevented
by correction of iodine deficiency
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Hypothyroidism.
Retarded physical development.
Impaired mental function
Increased rate of spontaneous abortion.
Neurological cretinism.

43. 6. Dental Fluorosis
• Fluorosis of dental enamel which occurs when excess fluoride is
ingested during the years of tooth calcification is characterized by
“mottling” of dental enamel.
• Teeth lose their shiny appearance and chalky-white patches develop on
them. White patches become yellow and sometimes brown or black.
• In severe cases, loss of enamel gives the tooth a corroded appearance.
• Mottling is best seen on the incisors of the upper jaw.
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44. Nutritional deficiency and its oral clinical
manifestations
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45. DISORDERS OF OVER-NUTRITION
OBESITY
BMI (Body mass index)
Normal: 18.5 - 24.9
Overweight: 25 - 29.9
Obese: 30 and over
HYPERVITAMINOSIS
Due to self-medication, excessive intake
of vitamins is a common occurrence.
Rapid urinary excretion prevents any
toxic effects of water soluble vitamins.
In contrast, fat soluble vitamins tend to
be stored in the liver and adipose tissue
and cannot be excreted.
Hypervitaminosis A and D are well
recognized clinical disorders.
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Thank You!
Any Questions