Chapter 0 : Introduction to Nutritional Pathology
1. Introduction
Unhealthy dietary pattern
• Processed foods
• High intake
• Less movement
• Higher risk of chronic diseases
Healthy dietary pattern
• More fruits, vegetables and healthier food
• Better nutrient intake
• Better body composition
• More physical activity
2. Terms
2.1 Definitions
Nutrition: the sum of the processes by which food is selected and becomes part of the body.
Does not only depend on physiological activity but also culture and environment.
Food: any substance taken into the body that will help meet the body’s need for energy, growth
and maintenance.
Nutritional status: status of the body resulting from intake and utilization of foods and
nutrients.
2.2 Body composition
Based on the level you can take different measurements
• Atomic level
o Basic elements such as nitrogen, oxygen, etc, which form the fundamental level.
• Molecular level
o Created by combining atoms. These include proteins, fats, carbohydrates, and
other essential compounds.
• Cellular level
o Functional structures built from molecules.
• Tissue level
o Basic building blocks of organs and body systems.
• Whole body level
o At this level, we can measure body composition using methods such as skinfold
measurements or densitometry to estimate fat mass and other components.
1
,3. From undernutrition to overnutrition
In the past, many people died because they had too little access to food. Today, especially in
Western societies, many people suffer because they have too much access to unhealthy food.
So the nutritional problem has shifted from: lack of food → excess of unhealthy food
This causes problems such as:
• obesity
• diabetes risk
• cardiovascular disease
• fatty liver disease
• poor metabolic health
• childhood obesity
from hunter gatherer to industrial revolution we see a big shift in vitamin and fat intake.
3.1 Inuit example
Before the US came the Inuit which lived in Finland mainly consumed meat from fish and seals
for omega 3. They moved from place to place after setting camps.
After the arrival of the USA this lead to settling down and huge health problems
3.2 Marasmus
This is a deficit of both energy and protein. Which leads to severe stunting and irreversible
damage. This leads to sever loss of lean tissue and even death.
Stunting = growth and mental retardation
3.3 Childhood obesity
Obesity is increasingly seen in children and infants.
The problem is not only excess body weight. Childhood obesity can already cause:
• metabolic problems
• organ damage
• higher risk of obesity later in life
• higher risk of chronic diseases
Prevention should start early by reducing fast-acting sugars, limiting fast food and encouraging
children to move more.
4. Nutrients
4.1 Definition
Food consists of water + solid components
Nutrients are components in food that are used by the body to create energy and produce
components required for growth and repair of the body
2
,So nutrients are not just “food”, they are the useful components of food that the body can
metabolize and use.
Non-nutrients are components in food that are not mainly used as energy sources or building
blocks, but can still influence health.
Examples can include: fibers and water.
The important idea is that food contains both useful nutrients and other substances that may
still affect health.
4.2 Macronutrients
These are nutrients which provide energy: calories or kilojoules and are eating in gram
quantities
• Proteins
• Fat
• Carbohydrates
• Alcohol
Fat and carbohydrates have every element (Carbon, Hydrogen, Oxygen) except Nitrogen which is
provided by protein.
4.3 Micronutrients
These are nutrients which do not provide energy and are eating in mg or µg quantities. These are
cofactors for many enzymes.
• Vitamins
o Fat soluble
o Water soluble
• Minerals
o Major minerals
o Trace elements
4.4 Essential vs Non-essential nutrients
Essential nutrients are those that our body cannot produce on its own.
• Vitamins
• Amino acids
• Fatty acids
• Water
3
, Chapter 1 : Concepts for Nutritional Advice
1. Recommended Daily Allowance (RDA)
1.1 Definition
How much of a nutrient does a person need to stay healthy and avoid deficiency or toxicity?
We want our population to be optimally healthy through:
• Disease prevention
• Optimal physiological need
We moved from adequate (to keep alive) to optimum (to be healthy).
Nutrition is essential because the body needs nutrients for normal functioning. If an essential nutrient is
missing, this can cause serious health problem.
1.2 Distribution curve of an individuals requirement
LTI = lowest threshold level = The amount of nutrient required to stay alive.
ERA = estimated average requirement = The amount of a nutrient required to meet the requirement of 50%
of the population.
RDA = recommended dietary/daily allowance = The average daily intake sufficient to meet the nutrient
requirement of nearly all the population (97.5th percentile). RDA = ERA + 2 SD = RNI = reference nutrient
intake.
UL = tolerable upper intake level = The highest intake level of daily nutrient that is likely to pose no risk of
adverse health effects in almost all individuals. This is not the recommended level.
1.3 Disadvantages of the RDA concept
• One cut-off
o It does not take into account variation amongst people meaning it is difficult to translate
to individuals.
• Limited data
o For some nutrients, scientific data are limited. This means recommendations are
sometimes based on incomplete evidence.
• Differences between countries
o Values can differ between countries, for example UK versus USA. This means nutritional
recommendations are not always universal. Different cut-offs for elements.
1
1. Introduction
Unhealthy dietary pattern
• Processed foods
• High intake
• Less movement
• Higher risk of chronic diseases
Healthy dietary pattern
• More fruits, vegetables and healthier food
• Better nutrient intake
• Better body composition
• More physical activity
2. Terms
2.1 Definitions
Nutrition: the sum of the processes by which food is selected and becomes part of the body.
Does not only depend on physiological activity but also culture and environment.
Food: any substance taken into the body that will help meet the body’s need for energy, growth
and maintenance.
Nutritional status: status of the body resulting from intake and utilization of foods and
nutrients.
2.2 Body composition
Based on the level you can take different measurements
• Atomic level
o Basic elements such as nitrogen, oxygen, etc, which form the fundamental level.
• Molecular level
o Created by combining atoms. These include proteins, fats, carbohydrates, and
other essential compounds.
• Cellular level
o Functional structures built from molecules.
• Tissue level
o Basic building blocks of organs and body systems.
• Whole body level
o At this level, we can measure body composition using methods such as skinfold
measurements or densitometry to estimate fat mass and other components.
1
,3. From undernutrition to overnutrition
In the past, many people died because they had too little access to food. Today, especially in
Western societies, many people suffer because they have too much access to unhealthy food.
So the nutritional problem has shifted from: lack of food → excess of unhealthy food
This causes problems such as:
• obesity
• diabetes risk
• cardiovascular disease
• fatty liver disease
• poor metabolic health
• childhood obesity
from hunter gatherer to industrial revolution we see a big shift in vitamin and fat intake.
3.1 Inuit example
Before the US came the Inuit which lived in Finland mainly consumed meat from fish and seals
for omega 3. They moved from place to place after setting camps.
After the arrival of the USA this lead to settling down and huge health problems
3.2 Marasmus
This is a deficit of both energy and protein. Which leads to severe stunting and irreversible
damage. This leads to sever loss of lean tissue and even death.
Stunting = growth and mental retardation
3.3 Childhood obesity
Obesity is increasingly seen in children and infants.
The problem is not only excess body weight. Childhood obesity can already cause:
• metabolic problems
• organ damage
• higher risk of obesity later in life
• higher risk of chronic diseases
Prevention should start early by reducing fast-acting sugars, limiting fast food and encouraging
children to move more.
4. Nutrients
4.1 Definition
Food consists of water + solid components
Nutrients are components in food that are used by the body to create energy and produce
components required for growth and repair of the body
2
,So nutrients are not just “food”, they are the useful components of food that the body can
metabolize and use.
Non-nutrients are components in food that are not mainly used as energy sources or building
blocks, but can still influence health.
Examples can include: fibers and water.
The important idea is that food contains both useful nutrients and other substances that may
still affect health.
4.2 Macronutrients
These are nutrients which provide energy: calories or kilojoules and are eating in gram
quantities
• Proteins
• Fat
• Carbohydrates
• Alcohol
Fat and carbohydrates have every element (Carbon, Hydrogen, Oxygen) except Nitrogen which is
provided by protein.
4.3 Micronutrients
These are nutrients which do not provide energy and are eating in mg or µg quantities. These are
cofactors for many enzymes.
• Vitamins
o Fat soluble
o Water soluble
• Minerals
o Major minerals
o Trace elements
4.4 Essential vs Non-essential nutrients
Essential nutrients are those that our body cannot produce on its own.
• Vitamins
• Amino acids
• Fatty acids
• Water
3
, Chapter 1 : Concepts for Nutritional Advice
1. Recommended Daily Allowance (RDA)
1.1 Definition
How much of a nutrient does a person need to stay healthy and avoid deficiency or toxicity?
We want our population to be optimally healthy through:
• Disease prevention
• Optimal physiological need
We moved from adequate (to keep alive) to optimum (to be healthy).
Nutrition is essential because the body needs nutrients for normal functioning. If an essential nutrient is
missing, this can cause serious health problem.
1.2 Distribution curve of an individuals requirement
LTI = lowest threshold level = The amount of nutrient required to stay alive.
ERA = estimated average requirement = The amount of a nutrient required to meet the requirement of 50%
of the population.
RDA = recommended dietary/daily allowance = The average daily intake sufficient to meet the nutrient
requirement of nearly all the population (97.5th percentile). RDA = ERA + 2 SD = RNI = reference nutrient
intake.
UL = tolerable upper intake level = The highest intake level of daily nutrient that is likely to pose no risk of
adverse health effects in almost all individuals. This is not the recommended level.
1.3 Disadvantages of the RDA concept
• One cut-off
o It does not take into account variation amongst people meaning it is difficult to translate
to individuals.
• Limited data
o For some nutrients, scientific data are limited. This means recommendations are
sometimes based on incomplete evidence.
• Differences between countries
o Values can differ between countries, for example UK versus USA. This means nutritional
recommendations are not always universal. Different cut-offs for elements.
1
