Question

Three or four sentences for each bullet point.

• Guideline recommendations, both for nutrients to include in our diets, and those to limit or eliminate altogether.
• Proportionality of the macronutrients: what does the term mean and why is it an important part of a healthy eating pattern
• Nutrient density vs, energy density: implications for healthy weight management
• Supplementation: vitamins, minerals, and protein: indications and contraindications
• Obesity, metabolic syndrome, benefits of exercise
• Dietary changes recommended to ensure a healthy blood lipid profile, avoid obesity throughout the life cycle, and decrease risk of chronic diseases associated with dietary intake

Answer 1

• 1.Guideline recommendations, both for nutrients to include in our diets, and those to limit or eliminate altogether.
• Answer 1:
• The guideline recommendations for the dietary nutrients are the inclusion of the macronutrients[fats20-35% of daily calories ,carbohydrates 45-65%of daily calories,proteins 10-35%of daily calories, and water] and micronutrients[vitamins,minerals] in the diet in the recommended daily allowance with the consumption of calories which are appropriate for the age,sex and the activity of the person.
• The guideline recommendations for the nutrients which should be included in the diet are macronutrients like carbohydrates, proteins and unsaturated fats and essential fatty acids with micronutrients like zinc, calcium, magnesium, selenium, iodine,magnesium,manganese,water soluble and fat soluble vitamins A,D,E,K,, which are present in foods like whole grains, legumes ,fresh fruits and vegetables, dairy products, fish like salmon and tuna ,walnuts and olive oil.The consumption of fibre in the food should be increased as this helps to prevent constipation, decreases the body fat and and helps in weight management.
• The nutrients which must be limited or eliminated in the diet altogether are saturated fats and trans fats, which can increase the level of the low density cholesterol in the body and cause hyperlipidemias, hypercholesterolemias and increase the risk of atherosclerosis,chronic heart disease and stroke.
• The consumption of nutrients like excess sodium and excess added sugars[low glycemic index] which are present in the packaged and processed foods like candies,colas,sweets,chocolates should also be decreased /eliminated as this leads to diseases like hypertension and diabetes mellitus.

• 2.Proportionality of the macronutrients: what does the term mean and why is it an important part of a healthy eating pattern
• answer 2:
• Proportionality of the macronutrients refers to the proportions of the fats, carbohydrates and proteins in the diet consumed by an individual .The acceptable micronutrient proportions in a healthy diet are: 45 - 65 % of the daily calories from carbohydrates, 20- 35% of the daily calories from fats and 10- 35% of the daily calories from proteins
• Maintaining the proportionality of the macronutrients provides the body with the necessary nutrition as per our body needs to maintain the body functions and maintains normal body weight. Carbohydrates and fats  provide the energy to work while proteins provide the building blocks for the body cells and immune function of the body.
• Healthy eating pattern refers to eating the macronutrients and micronutrients in the food in proper proportion as per the recommended daily allowance and the consumption of the macronutrients as per the above expressed proportionality contributes to the healthy eating pattern.
• Any deviation from the proportionality of the macronutrients in the diet contributes to poor eating habits, leads to diseases and makes us unhealthy. For example, the consumption of fat macronutrient in large proportions than advised leads to obesity, hypercholesterolemia, hypertriglyceridemia ,chronic heart diseases and stroke ;The consumption of refined sugars carbohydrate  macronutrient in large proportions than prescribed leads to obesity,diabetes mellitus.

• 3.Nutrient density vs, energy density: implications for healthy weight management
• answer 3:
• Nutrient density refers to consumption of foods which are high in essential nutrients but less in volume/ weight thereby providing more nutrients than calories.For healthy weight management, the consumption of nutrient dense foods should be more than the consumption of energy dense foods as it provides more nutrients with less calories thereby helping in maintaining the body weight.
• Energy density refers to the consumption of foods which are high in energy, provide more calories and are less in volume or weight. The energy density of food is expressed as Kilocalories per gram of the food.The energy dense foods are generally rich in fats and sugars,low in water and fibre content and include foods such as cheese,peanuts, butter,biscuits and so on.
• The consumption of energy dense foods helps to provide the body with extra energy for periods of stress but it has the risk of increasing the body weight by providing calories more than the need of the body and may contribute to weight gain. These may be advised in patients who are suffering from low weight, malnutrition or low appetite states but should be avoided in obese individuals.
• The consumption of nutrient dense foods provides the nutrition for the body at the same time restricting the calories intake thereby helping to maintain the normal body weight and are advised in normal healthy individuals, overweight and obese individuals for healthy weight management. Whole grains, fruits ,vegetables, beans, seeds, pulses and lean protein when consumed boiled without additional fats, salt or sugar are nutrient dense foods providing the body with all the nutrients with the limited calories .

• 4.Supplementation: vitamins, minerals, and protein: indications and contraindications
• answer 4:
• The supplementation of vitamins ,minerals and proteins is required in conditions of excess need of vitamins, minerals and proteins and in conditions of decrease in the dietary intake of vitamins, minerals and proteins.The indications of supplementation of the diet with vitamins, minerals and proteins are In pregnant and breastfeeding women, persons with chronic diseases with weight loss ,crash dieters, drug abusers, alcoholics, elderly individuals,individuals with the malabsorption problems like diarrhoea, celiac disease and cystic fibrosis, pancreatitis and deficiency states.
• The large doses of vitamins and minerals are harmful for the body and can cause body toxicity. The high dose supplements of vitamins and minerals are contraindicated and should not be taken unless advised.
• The contraindications for protein supplement intake include inherited defects of amino acid metabolism like phenylketonuria, metabolic diseases like gout, presence of protein allergy like peanut allergy or egg allergy.
• The contraindications to mineral supplementation include presence of kidney renal dysfunction,renal stones{ calcium should be avoided}, vascular disease ,stroke[high dose calcium is contraindicated], active peptic ulcer disease[ zinc ,copper ,potassium and vitamin C supplementation should be restricted
• The contraindications to vitamin supplementation are present in specific states of the vitamin supplement interacting with the patients regular medications.For example;avoiding pyridoxine supplementation{decreases the drugs effects] in patients taking phenytoin and levodopa, avoiding vitamin E supplementation[increases the risk of bleeding ]in patients on warfarin therapy. Avoiding niacin supplementation [risk of myopathies/rhabdomyolysis] in patients with HMG COA reductase inhibitor drugs commonly known as statins.

• 5.Obesity, metabolic syndrome, benefits of exercise
• answer 5:
• Obesity is defined as a abnormal excessive accumulation of body fat/adipose tissue resulting in the increase in body mass index greater than 30,
• The metabolic syndrome is defined as abnormal biochemical, metabolic processes in the body which increase the risk of diseases like heart disease, stroke, hypertension, diabetes mellitus and obesity characterized by three of the five components including increased waist circumference, increased triglyceride levels in blood, elevated blood pressure, low levels of HDL cholesterol and elevated fasting glucose level.
• In patients with obesity and metabolic disease, exercise helps in the lipid metabolism thereby decreasing the body fat ,the body weight,the elevated blood pressure and decreases the risk of chronic diseases. Besides this, exercise also improves insulin resistance thereby improving glucose tolerance and decreasing the blood glucose levels.
• Exercise and physical activity helps to burn the extra calories and improves the body metabolic rate which helps in the weight management and control of obesity and metabolic syndrome.

• 6.Dietary changes recommended to ensure a healthy blood lipid profile, avoid obesity throughout the life cycle, and decrease risk of chronic diseases associated with dietary intake
• answer 6:
• The dietary changes recommended to ensure healthy blood lipid profile, avoid obesity throughout the life cycle and decrease the risk of chronic diseases associated with dietary intake are to restrict the daily calorie intake as per the recommended daily allowance, avoid calorie excess, use large amounts of fresh fruits and vegetables in the diet. limit added sugars and extra calories.
• The dietary changes recommended are to avoid the consumption of fast food, junk food and replace the saturated fats and trans fats in the diet with unsaturated fats like olive oil, walnut oil, fish oils which can decrease triglycerides and LDL cholesterol, increase the levels of HDL cholesterol and decrease the risk of chronic heart diseases and stroke.
• Consumption of adequate amounts of fibre in the diet with the maintenance of proper proportion of the macronutrients and micronutrients in the food avoiding hydrogenated fats are the dietary changes recommended.
• Restricting the consumption of excess salt[to decrease risk of hypertension] ,excess sugars[to decrease risk of diabetes mellitus}, excess fat{[to decrease risk of obesity,heart disease stroke],excess calories[to decrease risk of obesity,metabolic syndrome] and excess fried foods in the diet and increasing the consumption of whole grains ,legumes, fruits vegetables, green leafy vegetables salads and essential fatty acids like omega 3 fatty acids in the diet are the dietary changes recommended.
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