Nutrition

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Nutrition is the science that interprets the interaction of nutrients and other substances in food (e.g. phytonutrients, anthocyanins, tannins, etc.) in relation to maintenance, growth, reproduction, health and disease of an organism. It includes food intake, absorption, assimilation, biosynthesis, catabolism and excretion.[1]

The diet of an organism is what it eats, which is largely determined by the availability, the processing and palatability of foods. A healthy diet includes preparation of food and storage methods that preserve nutrients from oxidation, heat or leaching, and that reduce risk of food-born illnesses.

Registered dietitian nutritionists (RDs or RDNs)[2] are health professionals qualified to provide safe, evidence-based dietary advice which includes a review of what is eaten, a thorough review of nutritional health, and a personalized nutritional treatment plan. They also provide preventive and therapeutic programs at work places, schools and similar institutions. Certified Clinical Nutritionists or CCNs, are trained health professionals who also offer dietary advice on the role of nutrition in chronic disease, including possible prevention or remediation by addressing nutritional deficiencies before resorting to drugs.[3] Government regulation especially in terms of licensing, is currently less universal for the CCN than that of RD or RDN. Another advanced Nutrition Professional is a Certified Nutrition Specialist or CNS. These Board Certified Nutritionists typically specialize in obesity and chronic disease. In order to become board certified, potential CNS candidate must pass an examination, much like Registered Dieticians. This exam covers specific domains within the health sphere including; Clinical Intervention and Human Health.[4]

A poor diet may cause health problems, causing deficiency diseases such as blindness, anemia, scurvy, preterm birth, stillbirth and cretinism;[5] health-threatening conditions like obesity[6][7] and metabolic syndrome;[8] and such common chronic systemic diseases as cardiovascular disease,[9] diabetes,[10][11] and osteoporosis.[12][13][14] A poor diet can cause the wasting of kwashiorkor in acute cases, and the stunting of marasmus in chronic cases of malnutrition.[5]

Nutrients[edit]

Text Box: Main article: Nutrient

The list of nutrients that people are known to require is, in the words of Marion Nestle, "almost certainly incomplete".[54] As of 2014, nutrients are thought to be of two types: macro-nutrients which are needed in relatively large amounts, and micronutrients which are needed in smaller quantities.[55] A type of carbohydrate, dietary fiber, i.e. non-digestible material such as cellulose, is required,[56] for both mechanical and biochemical reasons, although the exact reasons remain unclear. Other micronutrients include antioxidants and phytochemicals, which are said to influence (or protect) some body systems. Their necessity is not as well established as in the case of, for instance, vitamins.

Most foods contain a mix of some or all of the nutrient types, together with other substances, such as toxins of various sorts. Some nutrients can be stored internally (e.g., the fat-soluble vitamins), while others are required more or less continuously. Poor health can be caused by a lack of required nutrients or, in extreme cases, too much of a required nutrient. For example, both salt and water (both absolutely required) will cause illness or even death in excessive amounts.[57][58]

Macronutrients[edit]

The macronutrients are carbohydrates, fiber, fats, protein, and water.[55] The macronutrients (excluding fiber and water) provide structural material (amino acids from which proteins are built, and lipids from which cell membranes and some signaling molecules are built) and energy. Some of the structural material can be used to generate energy internally, and in either case it is measured in Joules or kilocalories (often called "Calories" and written with a capital C to distinguish them from little 'c' calories). Carbohydrates and proteins provide 17 kJ approximately (4 kcal) of energy per gram, while fats provide 37 kJ (9 kcal) per gram,[59] though the net energy from either depends on such factors as absorption and digestive effort, which vary substantially from instance to instance. Vitamins, minerals, fiber, and water do not provide energy, but are required for other reasons.

Molecules of carbohydrates and fats consist of carbon, hydrogen, and oxygen atoms. Carbohydrates range from simple monosaccharides (glucose, fructose, galactose) to complex polysaccharides (starch). Fats are triglycerides, made of assorted fatty acid monomers bound to a glycerol backbone. Some fatty acids, but not all, are essential in the diet: they cannot be synthesized in the body. Protein molecules contain nitrogen atoms in addition to carbon, oxygen, and hydrogen. The fundamental components of protein are nitrogen-containing amino acids, some of which are essential in the sense that humans cannot make them internally. Some of the amino acids are convertible (with the expenditure of energy) to glucose and can be used for energy production, just as ordinary glucose, in a process known as gluconeogenesis. By breaking down existing protein, the carbon skeleton of the various amino acids can be metabolized to intermediates in cellular respiration; the remaining ammonia is discarded primarily as urea in urine. This occurs normally only during prolonged starvation.

Carbohydrates[edit]

Text Box: Main article: Carbohydrate

Carbohydrates may be classified as monosaccharides, disaccharides, or polysaccharides depending on the number of monomer (sugar) units they contain. They constitute a large part of foods such as rice, noodles, bread, and other grain-based products. Monosaccharides, disaccharides, and polysaccharides contain one, two, and three or more sugar units, respectively. Polysaccharides are often referred to as complex carbohydrates because they are typically long, multiple branched chains of sugar units.

Traditionally, simple carbohydrates are believed to be absorbed quickly, and therefore to raise blood-glucose levels more rapidly than complex carbohydrates. This, however, is not accurate.[60][61][62][63] Some simple carbohydrates (e.g., fructose) follow different metabolic pathways (e.g., fructolysis) that result in only a partial catabolism to glucose, while, in essence, many complex carbohydrates may be digested at the same rate as simple carbohydrates.[64] Glucose stimulates the production of insulin through food entering the bloodstream, which is grasped by the beta cells in the pancreas.

Fiber[edit]

Text Box: Main article: Dietary fiber

Dietary fiber is a carbohydrate that is incompletely absorbed in humans and in some animals. Like all carbohydrates, when it is metabolized it can produce four Calories (kilocalories) of energy per gram. However, in most circumstances it accounts for less than that because of its limited absorption and digestibility. Dietary fiber consists mainly of cellulose, a large carbohydrate polymer which is indigestible as humans do not have the required enzymes to disassemble it. There are two subcategories: soluble and insoluble fiber. Whole grains, fruits (especially plums, prunes, and figs), and vegetables are good sources of dietary fiber. There are many health benefits of a high-fiber diet. Dietary fiber helps reduce the chance of gastrointestinal problems such as constipation and diarrhea by increasing the weight and size of stool and softening it. Insoluble fiber, found in whole wheat flour, nuts and vegetables, especially stimulates peristalsis – the rhythmic muscular contractions of the intestines, which move digesta along the digestive tract. Soluble fiber, found in oats, peas, beans, and many fruits, dissolves in water in the intestinal tract to produce a gel that slows the movement of food through the intestines. This may help lower blood glucose levels because it can slow the absorption of sugar. Additionally, fiber, perhaps especially that from whole grains, is thought to possibly help lessen insulin spikes, and therefore reduce the risk of type 2 diabetes. The link between increased fiber consumption and a decreased risk of colorectal cancer is still uncertain.

Fat[edit]

Text Box: Main article: Fat

A molecule of dietary fat typically consists of several fatty acids (containing long chains of carbon and hydrogen atoms), bonded to a glycerol. They are typically found as triglycerides (three fatty acids attached to one glycerol backbone). Fats may be classified as saturated or unsaturated depending on the detailed structure of the fatty acids involved. Saturated fats have all of the carbon atoms in their fatty acid chains bonded to hydrogen atoms, whereas unsaturated fats have some of these carbon atoms double-bonded, so their molecules have relatively fewer hydrogen atoms than a saturated fatty acid of the same length. Unsaturated fats may be further classified as monounsaturated (one double-bond) or polyunsaturated (many double-bonds). Furthermore, depending on the location of the double-bond in the fatty acid chain, unsaturated fatty acids are classified as omega-3 or omega-6 fatty acids. Trans fats are a type of unsaturated fat with trans-isomer bonds; these are rare in nature and in foods from natural sources; they are typically created in an industrial process called (partial) hydrogenation. There are nine kilocalories in each gram of fat. Fatty acids such as conjugated linoleic acid, catalpic acid, eleostearic acid and punicic acid, in addition to providing energy, represent potent immune modulatory molecules.

Saturated fats (typically from animal sources) have been a staple in many world cultures for millennia. Unsaturated fats (e. g., vegetable oil) are considered healthier, while trans fats are to be avoided. Saturated and some trans fats are typically solid at room temperature (such as butter or lard), while unsaturated fats are typically liquids (such as olive oil or flaxseed oil). Trans fats are very rare in nature, and have been shown to be highly detrimental to human health, but have properties useful in the food processing industry, such as rancidity resistance.[citation needed]

Essential fatty acids[edit]

Text Box: Main article: Essential fatty acids

Most fatty acids are non-essential, meaning the body can produce them as needed, generally from other fatty acids and always by expending energy to do so. However, in humans, at least two fatty acids are essential and must be included in the diet. An appropriate balance of essential fatty acids—omega-3 and omega-6 fatty acids—seems also important for health, although definitive experimental demonstration has been elusive. Both of these "omega" long-chain polyunsaturated fatty acids are substrates for a class of eicosanoids known as prostaglandins, which have roles throughout the human body. They are hormones, in some respects. The omega-3 eicosapentaenoic acid (EPA), which can be made in the human body from the omega-3 essential fatty acid alpha-linolenic acid (ALA), or taken in through marine food sources, serves as a building block for series 3 prostaglandins (e.g., weakly inflammatory PGE3). The omega-6 dihomo-gamma-linolenic acid (DGLA) serves as a building block for series 1 prostaglandins (e.g. anti-inflammatory PGE1), whereas arachidonic acid (AA) serves as a building block for series 2 prostaglandins (e.g. pro-inflammatory PGE 2). Both DGLA and AA can be made from the omega-6 linoleic acid (LA) in the human body, or can be taken in directly through food. An appropriately balanced intake of omega-3 and omega-6 partly determines the relative production of different prostaglandins, which is one reason why a balance between omega-3 and omega-6 is believed important for cardiovascular health. In industrialized societies, people typically consume large amounts of processed vegetable oils, which have reduced amounts of the essential fatty acids along with too much of omega-6 fatty acids relative to omega-3 fatty acids.

The conversion rate of omega-6 DGLA to AA largely determines the production of the prostaglandins PGE1 and PGE2. Omega-3 EPA prevents AA from being released from membranes, thereby skewing prostaglandin balance away from pro-inflammatory PGE2 (made from AA) toward anti-inflammatory PGE1 (made from DGLA). Moreover, the conversion (desaturation) of DGLA to AA is controlled by the enzyme delta-5-desaturase, which in turn is controlled by hormones such as insulin (up-regulation) and glucagon (down-regulation). The amount and type of carbohydrates consumed, along with some types of amino acid, can influence processes involving insulin, glucagon, and other hormones; therefore, the ratio of omega-3 versus omega-6 has wide effects on general health, and specific effects on immune function and inflammation, and mitosis (i.e., cell division).

Protein[edit]

 

Proteins are structural materials in much of the animal body (e.g. muscles, skin, and hair). They also form the enzymes that control chemical reactions throughout the body. Each protein molecule is composed of amino acids, which are characterized by inclusion of nitrogen and sometimes sulphur (these components are responsible for the distinctive smell of burning protein, such as the keratin in hair). The body requires amino acids to produce new proteins (protein retention) and to replace damaged proteins (maintenance). As there is no protein or amino acid storage provision, amino acids must be present in the diet. Excess amino acids are discarded, typically in the urine. For all animals, some amino acids are essential (an animal cannot produce them internally) and some are non-essential (the animal can produce them from other nitrogen-containing compounds). About twenty amino acids are found in the human body, and about ten of these are essential and, therefore, must be included in the diet. A diet that contains adequate amounts of amino acids (especially those that are essential) is particularly important in some situations: during early development and maturation, pregnancy, lactation, or injury (a burn, for instance). A complete protein source contains all the essential amino acids; an incomplete protein source lacks one or more of the essential amino acids.

It is possible with protein combinations of two incomplete protein sources (e.g., rice and beans) to make a complete protein source, and characteristic combinations are the basis of distinct cultural cooking traditions. However, complementary sources of protein do not need to be eaten at the same meal to be used together by the body.[65] Excess amino acids from protein can be converted into glucose and used for fuel through a process called gluconeogenesis. The amino acids remaining after such conversion are discarded.

Water[edit]

 

Water is excreted from the body in multiple forms; including urine and feces, sweating, and by water vapour in the exhaled breath. Therefore, it is necessary to adequately rehydrate to replace lost fluids.

Early recommendations for the quantity of water required for maintenance of good health suggested that 6–8 glasses of water daily is the minimum to maintain proper hydration.[66] However the notion that a person should consume eight glasses of water per day cannot be traced to a credible scientific source.[67] The original water intake recommendation in 1945 by the Food and Nutrition Board of the National Research Council read: "An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods."[68] More recent comparisons of well-known recommendations on fluid intake have revealed large discrepancies in the volumes of water we need to consume for good health.[69] Therefore, to help standardize guidelines, recommendations for water consumption are included in two recent European Food Safety Authority (EFSA) documents (2010): (i) Food-based dietary guidelines and (ii) Dietary reference values for water or adequate daily intakes (ADI).[70] These specifications were provided by calculating adequate intakes from measured intakes in populations of individuals with “desirable osmolarity values of urine and desirable water volumes per energy unit consumed.”[70] For healthful hydration, the current EFSA guidelines recommend total water intakes of 2.0 L/day for adult females and 2.5 L/day for adult males. These reference values include water from drinking water, other beverages, and from food. About 80% of our daily water requirement comes from the beverages we drink, with the remaining 20% coming from food.[71] Water content varies depending on the type of food consumed, with fruit and vegetables containing more than cereals, for example.[72] These values are estimated using country-specific food balance sheets published by the Food and Agriculture Organisation of the United Nations.[72] Other guidelines for nutrition also have implications for the beverages we consume for healthy hydration- for example, the World Health Organization (WHO) recommend that added sugars should represent no more than 10% of total energy intake.[73]

The EFSA panel also determined intakes for different populations. Recommended intake volumes in the elderly are the same as for adults as despite lower energy consumption, the water requirement of this group is increased due to a reduction in renal concentrating capacity.[70] Pregnant and breastfeeding women require additional fluids to stay hydrated. The EFSA panel proposes that pregnant women should consume the same volume of water as non-pregnant women, plus an increase in proportion to the higher energy requirement, equal to 300 mL/day.[70] To compensate for additional fluid output, breastfeeding women require an additional 700 mL/day above the recommended intake values for non-lactating women.[70]

For those who have healthy kidneys, it is somewhat difficult to drink too much water,[70] but (especially in warm humid weather and while exercising) it is dangerous to drink too little. While overhydration is much less common than dehydration, it is also possible to drink far more water than necessary, which can result in water intoxication, a serious and potentially fatal condition.[74] In particular, large amounts of de-ionized water are dangerous.[70]

Micronutrients[edit]

The micronutrients are minerals, vitamins, and others.[55]

Minerals[edit]

Text Box: Main articles: Dietary mineral and Composition of the human body

Dietary minerals are inorganic chemical elements required by living organisms,[75] other than the four elements carbon, hydrogen, nitrogen, and oxygen that are present in nearly all organic molecules. The term "mineral" is archaic, since the intent is to describe simply the less common elements in the diet. Some are heavier than the four just mentioned, including several metals, which often occur as ions in the body. Some dietitians recommend that these be supplied from foods in which they occur naturally, or at least as complex compounds, or sometimes even from natural inorganic sources (such as calcium carbonate from ground oyster shells). Some minerals are absorbed much more readily in the ionic forms found in such sources. On the other hand, minerals are often artificially added to the diet as supplements; the most famous is likely iodine in iodized salt which prevents goiter.

Macrominerals[edit]

Many elements are essential in relative quantity; they are usually called "bulk minerals". Some are structural, but many play a role as electrolytes.[76] Elements with recommended dietary allowance (RDA) greater than 150  mg/day are, in alphabetical order (with informal or folk-medicine perspectives in parentheses):

Calcium, a common electrolyte, but also needed structurally (for muscle and digestive system health, bone strength, some forms neutralize acidity, may help clear toxins, provides signaling ions for nerve and membrane functions)

Chlorine as chloride ions; very common electrolyte; see sodium, below

Magnesium, required for processing ATP and related reactions (builds bone, causes strong peristalsis, increases flexibility, increases alkalinity)

Phosphorus, required component of bones; essential for energy processing[77]

Potassium, a very common electrolyte (heart and nerve health)

Sodium, a very common electrolyte; in general not found in dietary supplements, despite being needed in large quantities, because the ion is very common in food: typically as sodium chloride, or common salt. Excessive sodium consumption can deplete calcium and magnesium,[verification needed] leading to high blood pressure and osteoporosis.

Sulfur, for three essential amino acids and therefore many proteins (skin, hair, nails, liver, and pancreas). Sulfur is not consumed alone, but in the form of sulfur-containing amino acids
Trace minerals[edit]

Many elements are required in trace amounts, usually because they play a catalytic role in enzymes.[78] Some trace mineral elements (RDA < 200 mg/day) are, in alphabetical order:

Cobalt required for biosynthesis of vitamin B12 family of coenzymes. Animals cannot biosynthesize B12, and must obtain this cobalt-containing vitamin in their diet.