Assignment Code: MFN-004/AST-1/TMA-1/2022-23

Course Code: MFN-004

Assignment Name: Advance Nutrition

Year: 2022-2023

Verification Status: Verified by Professor

Maximum Marks: 100

This assignment is based on Units 1 -19 of the MFN-004 Course.

Section A - Descriptive Questions

There are eight questions in this part. Answer all questions. (80marks)

1. a) Enumerate the components affecting energy requirement. (5)

Ans) The components affecting energy requirement are:

Factors Affecting the BMR:

Body size and composition

1. Age

2. Gender

3. Hormonal status

4. Environmental conditions

5. Pregnancy and lactation

6. Fever/illness/infections/injury

7. Nutritional status

Factors Affecting the Thermic Effect of Food:

1.  Age

2. Physical activity

3. Meal size

4. Meal composition

5. Meal frequency

6. Processing

Factors Affecting the Energy Expended in Physical Activity:

1. Sedentary or light activity lifestyles

2. Active or moderately active lifestyles

3. Vigorous or vigorously active lifestyles

b) Briefly explain the concept of Recommended Dietary Allowances (RDA) and Estimated Average Requirement (EAR) (3)

Ans) The Recommended Dietary Allowances (RDA) are the amounts of essential nutrients that are thought to be enough to meet the nutrient needs of nearly all healthy people (97 to 98 percent) in a certain age and gender group. RDAs help us plan well-balanced diets that include a wide range of foods from different food groups that help us meet our nutrient needs.

Estimated Average Requirement is a value for the amount of nutrients that is thought to meet the needs of 50% of healthy people in a group. EAR is a standard amount of nutrients that a person needs for good health and well-being as a whole. It is used to find out how much of each nutrient a person gets and how common it is for a person to not get enough of a certain nutrient. So, it helps figure out if each person is getting enough of the nutrients they need.

c) What are the goals behind estimating RDAs? (2)

Ans) The goals behind estimating RDAs are:

1. Plan for food supplies for the whole country.

2. Making plans for emergency food supplies.

3. Giving information on adding vitamins and minerals to food.

4. Evaluation of the right amount of nutrients for each person and each group.

5. Changing the nutrients needed to treat diseases in the clinic.

2. a) What do you understand by amino acid score and biological value of protein? How are these used to know the quality of protein in the diet? (4)

Ans) Amino acid score, in combination with protein digestibility, is the method used to determine if a protein is complete. PDCAAS and DIAAS are the two major protein standards which determine the completeness of proteins by their unique composition of essential amino acids.

Using the PDCAAS method, the protein quality rankings are determined by comparing the amino acid profile of the specific food protein against a standard amino acid profile with the highest possible score being a 1.0.

Biological value is a measure of the proportion of absorbed protein from a food which becomes incorporated into the proteins of the organism's body. It captures how readily the digested protein can be used in protein synthesis in the cells of the organism.

It measures protein quality by calculating the nitrogen used for tissue formation divided by the nitrogen absorbed from food. This product is multiplied by 100 and expressed as a percentage of nitrogen utilized.

b) Discuss briefly the methods to improve the quality of protein in the diet, giving suitable examples. (4)

Ans) The methods to improve the quality of protein in the diet are:

Mutual supplementation

1. Improvements to cereal proteins: Cereals don't have a lot of lysine and threonine, but legumes, milk, meat, and fish do. So, the proteins in legumes, milk, meat, and fish work well to add to the proteins in cereal.

2. Soybean proteins and sesame proteins are both good sources of lysine but not enough methionine. Sesame proteins, on the other hand, are good sources of methionine but not enough lysine. So, the proteins in sesame add to those in soyabean in a good way.

Supplementation with individual amino acids

1. Adding lysine and threonine to cereal diets makes them better. Adding lysine alone or a mixture of lysine and threonine to cereal diets significantly raises the PER of cereal proteins or proteins from poor cereal diets.

2. Methionine can make the proteins in soy and cow's milk better. Soy and cow's milk proteins don't have enough methionine. When methionine is added to the diet, the PER goes up from 2.0 to 2.9 for soy proteins and from 3.0 to 4.0 for milk proteins.

c) Enlist the clinical and biochemical features of PEM. (2)

Ans) The clinical and biochemical features of PEM are:

1. Reduced body weight

2. Muscle wasting and decreased strength

3. Reduced respiratory and cardiac muscular capacity

4. Skin thinning

5. Decreased metabolic rate

6. Hypothermia

7. Apathy

8. Oedema

9. Immunodeficiency

3. a) Briefly discuss the digestion, absorption and transportation of carbohydrates and fats. (6)

Ans) The digestion, absorption and transportation of carbohydrates:

During digestion, the body breaks down starches and sugars both mechanically and into single units of glucose, fructose, and/or galactose. These single units are then absorbed into the bloodstream and sent to different parts of the body to be used as energy. Starches are broken down into glucose molecules in the mouth, but most of the work is done in the small intestine by specific enzymes made by the pancreas. In the same way, certain enzymes break down the disaccharides sucrose, lactose, and maltose into single sugar units. When sugars and starches are broken down, glucose, fructose, and galactose are the end products. Glucose, fructose, and galactose are taken in through the small intestine's membrane and sent to the liver, where they are either used by the liver or sent to other parts of the body.

The digestion, absorption and transportation of fats:

Fat and other parts of food are separated in the stomach. In the small intestines, enzymes and bile work together to break down fats. The fats are taken in by the cells in the gut. Long-chain fatty acids come together to make chylomicrons, which are large lipoprotein structures that move fats through the lymph system. Chylomicrons are made in the cells of the intestine. They move lipids from the intestine into the bloodstream. Because they dissolve in water, short and medium fatty chains can go straight from the intestinal microvillus into the bloodstream. Fiber-rich foods make it harder for the body to take in cholesterol. When there isn't enough energy, the body uses the fat it has stored as energy.

b) Classify dietary fibre on the basis of solubility and give examples of foods high in these fibres. Enumerate the properties of dietary fiber that make it beneficial to the body. (2+2)

Ans) The classification of dietary fibre on the basis of solubility are:

Insoluble DF

1. Cellulose

2. Some hemi-celluloses

3. Lignin

Soluble DF

1. Pectin

2. Gums

3. Mucilage

4. Some hemi-celluloses

The properties of dietary fiber that make it beneficial to the body are:

1.  It doesn't dissolve in water, but it can be changed chemically to dissolve more easily. Poorly fermented by bacteria in the colon.

2. Hemicelluloses with acids in their side chains have a small electric charge and dissolve in water. Others can't be solved. Fermentability by intestinal flora depends on the sugars and where they are in the molecule. For example, hexose and uronic acids are easier for bacterial enzymes to get to.

3. Pectin can dissolve in water and turn into a gel. They have the ability to bind ions. They are completely broken down by bacteria in the colon.

4. a) Describe briefly the regulation of water balance in the human body. Explain the conditions that can be caused by disturbances in fluid balance in the body. (4)

Ans) The amount of water you take in and how much you lose can vary a lot depending on your habits and the environment. Despite this, your total body water needs to stay the same so that your osmolality is normal, and your body can work properly. The number of osmoles of solute per kilogramme of solvent is used to measure the osmolality. In chemistry, an osmole is a unit of measurement that tells how many moles of a chemical compound add to the osmotic pressure of a solution. Even though the ways the body gets water and the ways it loses water are in balance, the fluid exchanges that happen in a 24-hour period are incredibly large and well-controlled. Water intake is controlled by thirst, and urine output is controlled by the kidneys. Water loss from diarrhoea, feeling sick, sweating too much, or her can cause dehydration and changes in how fluids are distributed in the body.

b) What are polyphenols? Enumerate briefly the health benefits of polyphenols. (2)

Ans) Compounds that have a -ON group attached to the benzene ring are called polyphenols. Flavonoids, phenolic acids, and polyphenols are the three main groups (tannins). They both come from phenylalanine or shikin1ic acid, which is a common intermediate. There are many different kinds of natural phenolic compounds, from simple ones like hydroxybenzoic acid to ones that are very complex, like tannins. They have one or more sugar residues that make them sticky. The OH groups that are linked can be glucose, galactose, rhamnose, xylose, arabinose, glucuronic or galacturonic acids.

Health Benefits of Polyphenols

1. Anti-microbial

2. Anti-viral

3. Antioxidant

4. Hypotensive

5. Hypoglycaemic

6. Anti-carcinogenic

7. Anti-mutagenic

8. Oestrogenic

9. Anti-ulcer

10. Anti-inflammatory

11. Prevent expression of adhesion molecule

12. Inhibit replication of HIV

c) What are antinutritional factors? Give examples. (2)

Ans) Anti-nutritional factors, like trypsin inhibitor, phytic acid, and cyanogen, are just as important as a plant part's nutritional value. The anti-nutritional factors can be thought of as substances that are made in natural foods by the normal metabolism of a species and by different mechanisms (such as the inactivation of some nutrients, a slowing of the digestive process, or the metabolic use of feed) that work against good nutrition. So, the methods in the chapter would help with trypsin inhibitor, phytic acid, and cyanogen in food.

d) Discuss the nutritional requirements of people living in cold climate (2)

Ans) The nutritional requirements of people living in cold climate are:

1. Depending on how much you move and how cold it is, you may need anywhere from 3,632 to 4,317 kcal/d, or 46 to 57 kcal per kg of body weight per day.

2. In colder, more difficult conditions, you may need 4,200 to around 5,000 kcal/d, or 54 to 62 kcal per kg of body weight per day.

5. a) Explain the term calcium homeostasis. (4)

Ans) Calcium homeostasis refers to the maintenance of a constant concentration of calcium ions in the extracellular fluid. It includes all of the processes that contribute to maintaining calcium at its “set point.” Because plasma rapidly equilibrates with the extracellular fluid, ECF is kept constant by keeping the plasma constant.

Maintaining a constant plasma is important for:

1. Nerve transmission

2. Nerve conduction

3. Muscle contraction

4. Cardiac contractility

5. Blood clotting

6. Bone formation

7. Excitation–secretion coupling

8. Cell-to-cell adhesion

9. Cell-to-cell communication.

b) How tryptophan is converted to niacin? Explain with the help of flow chart. (3)

Ans) For the body to turn tryptophan from food into niacin, it needs enough iron, riboflavin, and vitamin B6.

c) Briefly describe the role of vitamin E and selenium in lipid peroxidation. (3)

Ans) Vitamin E is important because it is a physiologically essential antioxidant that stops uncontrolled lipid peroxidation by scavenging lipid peroxyl radicals to stop chain propagation, no matter what kind of free radicals start the chain. The main thing that stops in vivo lipid peroxidation is the antioxidant vitamin E, which breaks chains. Selenium in the diet helps make glutathione peroxidase, so it also acts as a hydroperoxide reducer, which is another way it fights free radicals.

6. a) Mention any two tests each that can measure the following: (3)

i) Cardiovascular endurance

Ans) The two tests that can measure Cardiovascular endurance are Astrand Cycle Test and Cooper's Run.

ii) Muscular strength and endurance

Ans) The two tests that can measure Muscular strength and endurance are Flexed-arm Hang and Push-ups.

iii)Flexibility

Ans) The two tests that can measure Flexibility are Sit-and-Reach Flexibility and Calf muscle flexibility test.

b) What are ergogenic aids? Enlist the categories of nutritional ergogenic aids. Discuss in brief the side effects of these aids to the body. (1+3+1)

Ans) Ergogenic aids are substances, tools, or actions that make it easier to use, make, or recover energy. Anabolic steroids, human growth hormone, caffeine, and creatine are the ergogenic aids that people talk about and use the most.

The nutritional ergogenic aids are categorized as follows:

1. Water and Electrolytes

2. Carbohydrates

3. Proteins

4. Vitamins

5. Antioxidants

6. Minerals

7. Caffeine

8. Intermediary metabolites

9. Creatine

The side effects of these aids to the body:

1. Hyperhydration

2. Muscle stiffness

3. Diarrhoea

4. Chest Pain

5. Depression

6. Lethargy

7. Nausea

8. Impair training and performance.

9. Flushing

10. Muscle cramp

c) Write short note on nutritional requirements in hot environment.

Ans) Drinking enough water at regular intervals keeps you from getting dehydrated, sick, or too hot. It also keeps your work performance up. Heat acclimatisation doesn't really change how much water is needed. Thirst is not a good way to tell how well you are hydrated. Hypohydration usually makes people feel very thirsty when they lose 5 to 6 percent of their body weight (removal of water). At this point, the physical performance isn't as good as it could be.

7. a) Briefly discuss the physiology of lactation and enumerate the importance of human milk for infant growth and development. (4)

Ans) The normal physiology of breastfeeding is a process that starts to happen long before the baby's first latch. It means that the breast has to change in size, shape, and what it is made of at each stage of a woman's development. The stages of development are puberty, pregnancy, and breastfeeding.

Between 6 and 12 months, it can give a child half or more of the energy they need. Between 12 and 24 months, it can give them a third of the energy they need. Breast milk is also an important source of energy and nutrients when someone is sick, and it helps keep malnourished children from dying. Human milk provides healthy GIT mucosal stimuli, changes the composition of gut microbiota, and likely helps the developing immune system of an infant (i.e., HMOs, milk microbiota, miRNA, antibodies, lactoferrin, immunoglobulins, cytokines, and hormones).

b) Write the food sources, functions and RDA for adult man and woman for the following nutrients: (2+2+2)

i) Zinc

Ans) Food sources:

1. Sea Food

2. Oysters

3. Shrimp

4. Meat and Poultry

5. Liver

6. Chicken

7. Eggs

Functions:

1. Zinc is an important part of many enzymes that help make and break down carbohydrates, lipids, proteins, and nucleic acids, as well as help the body use other micronutrients.

2. Zinc helps maintain the integrity of cells and organs by stabilising the molecular structure of cellular components and membranes.

RDA for adult man: 11 mg a day

RDA for adult woman: 8 mg a day

ii) Vitamin C

Ans) Food sources:

1. Rich sources: Amla and guava.

2. Good sources: Drumstick leaves, other leafy vegetables and fruits such as cashew fruit melons, berries, pineapple and tomatoes.

3. Fair sources: Apples, banana, grapes.

Functions:

1. It is a strong antioxidant because it can give up a hydrogen atom to make an ascorbyl free radical that is pretty stable.

2. It gets rid of reactive nitrogen oxide species to keep target molecules from becoming nitrosated.

3. It helps the body absorb soluble iron that isn't in haem by chelation or just by keeping the iron in its reduced form.

4. It helps prevent or treat diseases caused by atherosclerosis because of how it affects the way cholesterol is used in the body.

5. It keeps low density lipoproteins from becoming oxidised.

RDA for adult man: 90 mg a day.

RDA for adult woman: 75 milligrams (mg) a day.

iii) Copper

Ans) Food sources:

1. Egg, whole

2. Milk, whole

3. Yoghurt, low fat, plain

4. Cheese, Cheddar

5. Meat, Fish, Poultry

6. Liver, beef

7. Chicken

8. Pork

9. Tuna, canned

Functions:

1. Amine oxidases are found in all of the body's tissues and break down amines that are physiologically active.

2. Serotonin, norepinephrine, tyramine, and dopamine are all changed by monoamine oxidase.

3. Diamine oxidase inactivates histamine. Also turns off polyamines that are needed for cell growth, so it may help stop cells from growing too fast. High activity in the intestine, the kidney, and the blood inside the body.

4. Lysyloxidase determines the lysine of newly formed immature elastin and collagen. After this, crosslinks are made.

RDA for adult man and woman: for 19+ years is 900 micrograms daily for both.

8. a) Briefly discuss the following: (2.5+2.5)

i) Nutrient needs and dietary management for pregnant women

Ans) In addition to energy and protein, the body needs more folic acid, iron, zinc, calcium, vitamin C, and vitamin D. These are the main micronutrients for which the body has a physiological need. About 300 extra calories are needed each day to keep a healthy pregnancy going. These calories should come from a well-balanced diet of protein, fruits, vegetables, and whole grains. As little as possible, you should eat sweets and fats.

ii) Dietary modification for the elderly male

Ans) The Dietary modification for the elderly male:

1. Because calories are limited, nutrient-dense foods should be on the menu to meet nutrient needs.

2. Small meals should be given often and should be easy to make and digest.

3. There is less saliva production, which makes it hard to swallow. Soups, vegetables with sauces, curds or raitas, and dals should be part of the meals, and meals that are too dry should be avoided.

4. Elderly people need to eat protective foods like fruits and vegetables. Every effort should be made to get these into the daily diet.

5. When planning meals for older people, you should think about what they like, don't like, and prefer to eat.

6. When it comes to older people who have long-term diseases like diabetes, high blood pressure, or heart disease, their diets may need to be changed even more.

7. People should not drink alcohol or smoke cigarettes.

b) Briefly explain the measures to avoid macro and micronutrient deficiency during emergencies. (2.5)

Ans) The measures to avoid macro and micronutrient deficiency during emergencies are:

1. Increasing the daily ration will make it possible to sell extra food to buy things like fruits and vegetables.

2. Putting different things in food baskets, like pulses, groundnuts, fresh fruits and vegetables, and red palm oil. Fruits and vegetables that are grown in home gardens are a better alternative.

3. Including foods with added micronutrients in the ration, such as cereals and pulses, iodized salt, vitamin A-fortified skim milk, or vegetable oils.

4. Providing supplements when a diet assessment and obvious signs and symptoms point to a specific deficiency.

c) Write short notes on space foods. (2.5)

Ans) Space food is a type of food product created and processed for consumption by astronauts during missions to outer space. The food has specific requirements of providing balanced nutrition for individuals working in space while being easy and safe to store, prepare and consume in the machinery-filled weightless environments of crewed spacecraft. Most space food is freeze-dried to ensure long shelf life. In recent years, space food has been used by various nations engaging in space programs as a way to share and show off their cultural identity and facilitate intercultural communication.

Section B - OTQ (Objective Type Questions) (20 marks)

1. Briefly explain the following terms giving examples: (10)

i) Ketosis

Ans) Ketosis is a metabolic state that occurs when your body burns fat for energy instead of glucose. The keto diet has many possible benefits including potential weight loss, increased energy and treating chronic illness. However, the diet can produce side effects including “keto” breath and constipation

ii) Resistant starch

Ans) Resistant starch type 2 (RS2). This type of starch is naturally resistant because of the nature of the starch granule. RS2 occurs in foods where the starch is eaten raw (e.g., unripe bananas) or where the granules do not gelatinize during cooking (e.g., high-amylose corn starch). Resistant starch type 3 (RS3).

iii) Indirect calorimetry

Ans) Indirect Calorimetry—The “Energy Equivalent” of Oxygen: When 1 litre of oxygen is metabolized with glucose, 5.01 Calories of energy are released; when metabolized with starches, 5.06 Calories are released; with fat, 4.70 Calories; and with protein, 4.60 Calories.

iv) Pre-eclampsia

Ans) With preeclampsia, we might have high blood pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of organ damage. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range.

v) Functional foods

Ans) Functional foods are foods that contain, in addition to nutrients, other components that may be beneficial to health. Some examples include foods fortified with vitamins, minerals, probiotics, or fiber. Nutrient-rich ingredients like fruits, vegetables, nuts, seeds, and grains are often considered functional foods as well.

vi) Essential fatty acids

Ans) Essential fatty acids include linoleic acid (LA), an omega-6 fatty acid, and alpha-linolenic acid (ALA), an omega-3 fatty acid. These fatty acids make hormones that regulate the immune system and central nervous system

vii) Amylase Inhibitors

Ans) Amylase inhibitors are substances that reduce the activity of amylase, the digestive enzyme required to break down dietary starches into absorbable glucose. Many plants and plant foods, including vegetables and legumes, contain amylase-inhibiting compounds that may be useful in preventing and treating type 2 diabetes.

viii) Growth monitoring

Ans) Growth monitoring consists of routine measurements to detect abnormal growth, combined with some action when this is detected. As primary care workers worldwide invest time in this activity, we sought evidence of its benefits and harms.

ix) SAM

Ans) S-Adenosylmethionine (SAMe) is a naturally occurring compound found in almost every tissue and fluid in the body. It is involved in many important processes. SAMe plays a role in the immune system, maintains cell membranes, and helps produce and break down brain chemicals, such as serotonin, melatonin, and dopamine.

x) Phytoestrogens

Ans) Phytoestrogens is an oestrogen-like substance found in some plants and plant products. Phytoestrogens may have anticancer effects. The source of phytoestrogens are nuts, seeds, fruits and vegetables. Food sources include soybeans, garlic, celery, carrots, potatoes, rice, wheat, red clover, sweet potatoes, fruits (apples, pomegranates and chaste berries) and coffee. Isoflavones are found in legumes, especially soybeans.

2. Ram is a 42 year old sedentary male having body weight of 65 kg. Calculate the energy requirement using the factorial estimation of total energy expenditure. (5)

Note: Refer Unit 2, MFN-004 for the necessary calculations.

Ans) Factorial estimates of energy use add up all the expected parts of energy use, like BMR, and take into account how much energy different activities cost and how long they take.

Energy requirement for Ram can be calculated as:

BMR calculated from the predictive equation is: 6.29 MJ/day (1619 Kcal/day) (i.e., 0.048 x 55 + 3.653 = 6.293 MJ/day or 11.472 x 65 + 873.1= 1,618.78 Kcal/day)

PAL from mid-point of the moderately active lifestyle is: 1.85

TEE or Energy requirement: 6.29 x 1.85 = 11.63 MJ/day (2777.78 Kcal/day), or 11.63/65 = 178 KJ/kg/day (43 Kcal/kg/day)

3. Tabulate the ICMR (2020) recommended dietary allowances for energy, protein, vitamin A, iron, calcium for the following: (5)

i) 27 yrs lactating mother of 50kg doing sedentary work

ii) 9 months infant

iii) 70 years man of 60 kg

iv) 14 years girl

v) 11 years boy