Introduction to Nutrition

By: Berhe Gebremichael (MPH, Assistant Professor)

Haramaya University, Ethiopia

July 2023

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Outline
• Definition of terms
• Brief historical development of nutrition
• Classification of nutrients
• Testing for the presence of some nutrients
• Food/nutrient digestion and absorption
• Nutrition and health
• Nutrition and development
• Nutrition transition

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Definition of terms (terminology)

• How do you define nutrition?

– Science of food, the nutrients and other substances therein, their action, interaction
and balance in relation to health and disease

– The process by which the organism ingests, digests, absorbs, transports, utilizes
and excretes food substances

– It also deals with social, cultural, psychological and physiological implications of

food and eating

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 Food

Nutrients
Other compounds
1-Macronutrients -Fibers
2-Micronutrients -Phytochemicals
-Pigments
-Additives
Functions of nutrients -Alcohols
1-Provide energy -Others
2-Build tissues
3-Regulate metabolic processes
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 Definition of terms…cont’d)

Human nutrition: scientific discipline concerned with access and utilization of food
and nutrients for life, health, growth, development and well-being

Public health nutrition: art and science of promoting population health status via
sustainable and equitable improvements in the food and nutrition system

Community nutrition: group of activities linked to applied nutrition with in the

context of public health

Dietetics/clinical nutrition: science/art of applying the principles of nutrition in

feeding tailored to individual needs

What is the difference between public health nutrition and community nutrition?
What about dietetics versus clinical nutrition?
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 Definition of terms…cont’d)

Food: is anything edible (defined by culture/religion)

Diet: is the sequence of meals we consume in a specified period; e.g. per 24 hrs, week)
– It is a pattern of food consumption which is followed by a population or an
individual

Roughage: is the portion of plant food that our body cannot digest
– It enables the body to get rid of waste products
– What are the benefits of roughage/fiber?

Nutrient: is an active ingredient in the food that play specific structural or functional
role in the body’s lively activity.
More than 50 nutrients are currently identified
Are oxygen, nitrogen, hydrogen and alcohol nutrients?
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 Definition of terms…cont’d)

Macronutrients: nutrients required by our body in larger quantities and need to be

transformed in to smaller units by the body (carbohydrates, lipids and proteins)

Micronutrients: nutrients required in smaller quantities by the body (vitamins and

minerals)

Nutritional Assessment: interpretation of the anthropometric, biochemical, clinical

and dietary data in order to determine whether a person is well nourished or
malnourished

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 Definition of terms…cont’d)

Malnutrition: pathological state resulting from a relative or absolute deficiency or

excess of one or more essential nutrients (primary vs. secondary malnutrition)

Under-nutrition: pathological state resulting from the consumption of an inadequate

quality/quantity of food over an extended period of time

Over-nutrition: pathological state resulting from the consumption of an excess

quantity of food over an extended period of time

Specific deficiency: pathological state resulting from a relative/absolute deficiency of

an individual nutrient

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Historical development of nutrition

• It started in the ancient time (prior to 476 A.D.)

 Hippocrates (460-359 BC) stated that “Persons who are naturally very fat are apt
to die earlier than those who are slender.”

• After the middle ages (476-1453), i.e. Italian renaissance

 Leonardo daVinci (1452-1519) stated that “If you do not supply nourishment
equal to the nourishment departed, life will fail in vigour; and if you take away
this nourishment, life is absolutely destroyed.”

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 Historical development of nutrition…cont’d

Many others made contributions in 19th centuries:

 1857: Claude Bernard isolated glycogen

 1899: Emil Fisher began classic studies of protein composition

 1883/87: energy studies in small animals and farm animals were initiated

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 Historical development of nutrition…cont’d

Spectacular advances have been made in the 20th century

• Vitamins were discovered, essential amino acids identified

• Certain minerals found to be essential

• The electron microscope (1933) made the study of nutrition at cellular level
possible

• The one-world concept emerged in the 20th century

 Hunger anywhere in the world is of concern to us

 Nutrition education and founding of the ‘Nutrition Education Society’ in 1971

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 Historical development of nutrition…cont’d

Gained emphasis in the international agenda:

 World food & Nutrition summits, UN declarations & commitments

 International agencies working on food and nutrition

 Nations with food & nutrition policies

 The end of the 20th century gave priority for the role of nutrition through the MDGs
and SDGs

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Classification of nutrients

There are six classes of nutrients:

 Carbohydrates, lipids, proteins, vitamins, minerals and water

There are several ways to classify the six classes of nutrients:

 Essential or conditionally essential or non-essential
 Organic or inorganic
 Macronutrient or micronutrient
 Energy yielding or body building or disease prevention
 Animal source or plant source

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Test for the presence of some nutrients

• Test for starch: adding weak iodine solution in a test tube containing potato or wheat
flour turns to blue black colour

• Test for sugar: Adding benedict’s solution into a test tube containing crushed pieces of
bananas, grapes or apple, and heating it forms red precipitate

• Test of fats: wrap the food item in a piece of paper and crush it. After straightening the
paper, an oily patch appears

• Test of proteins: Add copper sulphate and caustic soda to test-tube containing food
sample. Appearance of a violet colour indicates presence of protein

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Food/nutrient digestion and absorption

• The body’s machinery to process food and turn it into nutrients takes place in the
digestive system in two stages; digestion and absorption

• Most of the digestion and absorption processes occur in the small intestine

• Digestion—is the breakdown of food into smaller units and finally into absorbable
nutrients that involves both physical and chemical processes

• Physical digestion includes chewing of food, churning/mixing food with gastric juice
to form chyme, segmentation, and transportation by peristalsis

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 Food/nutrient digestion and absorption…cont’d

• Chemical digestion is the action of enzymes that break nutrients into absorbable
compounds

• In addition to enzymes, other chemicals support the digestion process, including;

– Acid in stomach (HCl)

– Neutralizing base in the small intestine
– Bile for emulsification of fats
– Mucus (lubricates and protects the GI lumen)

• Many of the nutrients (vitamins, minerals and water) do not need to be digested

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 Food/nutrient digestion and absorption…cont’d

• Absorption—is the movement of nutrients from the gut into the bloodstream or
lymphatic system for circulation

• There are four processes by which nutrients are absorbed:

– Passive diffusion (across concentration gradient): e.g. water, small lipids and water
soluble substances such as glycerol and urea
– Facilitated diffusion (concentration gradient + trans-membrane protein carrier): e.g.
fructose
– Active transport (against concentration gradient and needs ATP): e.g. minerals,
glucose, galactose, amino acids
– Endocytosis (cell membrane engulfs nutrients)

• Salivary gland, liver, gallbladder and pancreas are assisting organs of the GIT for
digestion and absorption of foods/nutrients
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Nutrition and health

• Individuals can be categorized into:

 Optimally nourished
 Under-nourished
 Over-nourished
 Malnourished

• Optimum breast and complementary feedings can prevent 13% and 6% of deaths
among children of under five, respectively

• Improving vitamin-A status of vulnerable populations can reduce under-five mortality

rates by at least 23%

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 Nutrition and health…cont’d

• Improvements in iron status of affected populations can increase levels of national

productivity by 20%

• Iron interventions can also reduce maternal mortality considerably

• Currently, both communicable and non-communicable diseases are directly or

indirectly associated with the effect of nutritional problems:

 Tuberculosis, measles, diarrheal, malaria, HIV/AIDS

 Diabetes mellitus, hypertension, ischemic heart disease, colon cancer

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Nutrition and development

• There is bidirectional relationship between nutrition and country development

 How?

• The current global initiative of SDG gives special focus on the role of nutrition

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Nutrition transition

 What are the three transitions that determine global health?

• Demographic transition

 From high birth and death rates to low birth and death rates

• Epidemiological transition

 Omran’s stages: epidemics, receding pandemics, NCDs

• Nutritional transition

 Processed foods with added sugar, saturated fats and sodium

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 Demographic transition Epidemiologic transition Nutrition transition

High fertility/mortality High prevalence of infectious disease High prevalence under-nutrition

Reduced mortality, changing age Receding pestilence,

Receding famine
structure poor environmental conditions

Focus on family planning, Focus on famine

infectious disease control alleviation/prevention

Diet-related non-communicable
Reduced fertility, aging Chronic diseases predominate diseases predominate

Focus on healthy aging Focus on medical intervention,

spatial redistribution policy initiatives, behavioral change

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 Stages of the nutrition transition
Urbanization, economic growth, technological changes for work, leisure,
& food processing, mass media growth
Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5
Paleolithic man/ Settlements begin/ Industrialization/ Non-communicable Behavioral Change
Hunter-gathers Monoculture period/ Receding Famine Disease
Famine emerges

• Reduce fat, increased

• Starchy, low variety, • Increased fat, sugar,
• Wild plants & • Cereals fruit, veg, CHO, fiber
low fat, high fiber processed foods
animals dominate • Increase water, reduce
• Water • Water • Water • caloric beverages
caloric beverage intake
• Labor intensive • Labor-intensive • Labor-intensive • Shift in technology
• Replace sedentariness
work job/home of work and leisure
with purposeful activity

Nutritional
Lean & robust, MCH deficiencies,
deficiencies Obesity emerges, Reduced body fatness,
high disease weaning disease,
emerge, stature bone density problems improved bone health
rate stunting
declines

Low fertility, High fertility, Slow mortality decline Accelerated life Extended health aging,
Low life expectancy high MCH mortality, expectancy, shift to reduced DR-NCD
low life expectancy increased DR-NCD,
increased disability
period

02/18/2024 Source: Popkin 2002 revised 2006. 27

Reading assignments;

– Nutrition and agriculture

– Nutrition and gender
– Nutrition and population
– Nutrition and education

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 Thank you!

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