Option A: Human Nutrition and Health Summary Notes

A1: Components of the Human Diet

A.1.1 Define nutrient.
A nutrient is a chemical substance found in foods that is used in the body.

A.1.2 List the types of nutrient that are essential in the human diet
Essential nutrients
(cannot be synthsesised in the body from other
nutrients, so must be included in the diet)

Non-Essential Nutrients
(Can be synthesized in the body or found from
alternative sources. Dietary intake of these nutrients
reduces the need for biosynthesis)
Carbohydrates (energy can come from other
sources, such as lipids and proteins)
Other lipids and fatty acids
Other vitamins
Other minerals
Other amino acids

Water
Some fatty acids (including omega-3 linolenic
acid and omega-6 linoleic acid)
Some Vitamins (including A, some B vitamins,
C, D, folate)
Dietary minerals (including iron, potassium,
sodium, calcium, phosphorous and iodine)
Some amino acids (including phenylalanine
and methionine)

A.1.3 State that non-essential amino acids can be synthesized in the body from other nutrients
Biosynthesis is the production of non-essential nutrients in the body from components of essential nutrients. If
these nutrients are present in the diet, the body does not need to expend the energy on biosynthesis. Sources: (4)
(3) (2)

Option A: Human Nutrition and Health Summary Notes

A.1.4 Outline the consequences of protein deficiency malnutrition
If intake of protein is too low, it could lead to protein deficiency malnutrition - a lack of essential amino acids.
These amino acids are required for production of proteins, such as plasma proteins, extracellular proteins, DNA
and plasma membranes in the body.
Protein deficiency malnutrition is a key factor in kwashiorkor. Symptoms include:
-

Stunted growth
Muscle and skin problems
Impaired mental development
Immune system impairment
Edema (swelling in the abdomen and legs as plasma proteins responsible for balancing tissue fluids are
not produced, so fluid builds up)

A.1.5 Explain the causes and consequences of phenylketonuria (PKU) and how early diagnosis and a
special diet can reduce the consequences
PKU is the result of a mis-sense mutation in the PAH gene. It is autosomal and recessive. The PAH gene codes
for the enzyme tyrosine hydroxylase .The essential amino acid phenylalanine cannot be converted to tyrosine, so
builds up to dangerous levels.
This disorder is cumulative and degenerative: its effects build up over time and lead to ongoing deterioration.
Symptoms: skin disorders and intellectual disability. Heart problems and microcephaly can also develop in
severe cases.

Diagnosis: a blood test at birth will detect the presence of absence of the enzyme. As this is a cumulative
disorder, the earlier it is diagnosed and the diet is started, the less chance there is of severe complications.
Treatment: a phenylalanine-controlled diet from birth is essential. Foods containing phenylalanine are
minimised, including dairy, aspartame sweeteners, breastmilk, nuts and meat. Tyrosine supplementation may be
used.
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Option A: Human Nutrition and Health Summary Notes

A.1.6 Outline the variation in the molecular structure of fatty acids, cis- and trans- unsaturated fatty
acids, monounsaturated and polyunsaturated fatty acids.
Fatty acids have the same general structure, but there is variation in the bonds between carbon atoms. Saturated
fats have no double bonds: all possible valences have been occupied. A mono-unsaturated fatty acid has C=C
double bond, whereas as polyunsaturated fatty acid has two or more C=C double bonds.

There is also variation in the structure of unsaturated fatty acids. cis- isomers have the hydrogen atoms on the
same side of the C=C double bond, whereas trans- isomers have the hydrogen atoms on opposite sides. Most
trans- fats are created artificially.
In unsaturated fatty acids, the omega-number indicates the position of the first double bond, from the CH 3 group.
An omega-3 fatty acid has the C=C double bond at the third bond along the chain.

Hydrogenation is a process which is used to create trans- fatty acids from cis- fatty acids. Hydrogen is used to
saturate some of the double bonds in an oil, making solid fats from liquid oils: making margarine from vegetable
oil. Although this has benefits with regard to storage and mass-production, it has health effects.
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Option A: Human Nutrition and Health Summary Notes

Oleic acid (CH3(CH2)7CH=CH(CH2)7COOH) is an omega-9 fatty acid. It is a component of olive oil in its cisform. Its isomer, elaidic acid (trans-oleic acid) is found in hydrogenated vegetable oil.

A.1.6 Evaluate the health consequences of diets rich in the various types of fatty acid
Saturated Fats
Cis- fatty acids
Trans- fatty acids
Sources:
Sources:
Sources:
Animal fats butter, milk, cheese, Vegetable oils, such as olive oil, Hydrogenated
vegetable
oils,
red and white meat, eggs, palm oil
fish oils
margarine, some natural sources
All contribute to dietary intake and excess consumption is related to weight gain and coronary heart disease. Fat
contains more energy per gram than carbohydrates or proteins.
-Can raise harmful LDL cholesterol -May promote beneficial HDL -may have a greater negative effect
-Lead to atherosclerosis and cholesterol and inhibit harmful on LDL cholesterol and increased
coronorary heart disease
LDL.
risk of atherosclerosis and CHD
-omega 3 fatty acids linked to brain than saturated fats
development
-some natural trans- fats may have
less harmful impacts
Dietary studies are difficult to control sufficiently to gain really reliable data. Where data are produced it may
not be possible to conclude causal relationships from correlation. Care must be taken to think critically about
nutrition-based news stories and articles.

A.1.8 Distinguish between vitamins in minerals in terms of their chemical structure

Vitamins are organic compounds made by plants or animals, whereas minerals are inorganic ions. Minerals can
be found in water, soil and many organic food types as a result of uptake.

Option A: Human Nutrition and Health Summary Notes

A.1.9 Outline two of the methods that have been used to determine the recommended daily
intake of vitamin C
Vitamin C (ascorbic acid) is essential in the human diet. It maintains mucus membranes as a component of
collagen, and promoted healing and skin growth. Deficiency of vitamin C can lead to scurvy, characterized by
bleeding hair follicles, gums and liver spots on the skin. In extreme cases it can be fatal.
Recommended Daily Intakes (RDI) of vitamin C have been set at 45-60mg day -1. These levels were determined
based on a number of experiments into levels of vitamin C that gave optimum benefit.
Humans and guinea pigs cannot synthesise vitamin C, so it is possible to measure the effects of varying vitamin
C doses in carefully controlled experiments.
Human trials: observe the symptomatic effects of varying doses of vitamin C supplementation
Conscientious objectors from WWII volunteered to take part in a series of medical trials in Sheffield over a fouryear period. In one of these, 20 volunteers were used to measure the effects of varying vitamin C concentrations.
Weeks 1-6: No vitamin C in foods, but all given 70mg supplement
Weeks 7-end (8 months):
Dose:
Measurements:
Effects:

0 mg per day
10mg per day
70 mg per day
-Blood and urine vitamin C.
-3cm incisions made on thighs, stitched. Observed healing time and strength of scar tissue.
Repeated periodically
-Scurvy in all cases within 6-8 months.
No evidence of scurvy or other ill effects.
-One patient experienced severe heart
complications (rectified after being given
vitamin C)

Outcome: recommendation set at 30mg day-1

Another example of a human trial took place in a prison in Iowa, and the outcome was similar, with a
recommended intake of around 30mg day-1.

Guinea pig trials: observe the effect of vitamin C concentration on collagen structure
After periods of varying vitamin C supplementation and measurement of blood and urine vitamin C levels,
guinea pigs were sacrificed and the structure of collagen fibres observed. Guinea pigs with restricted vitamin C
showed weaker collagen.

Option A: Human Nutrition and Health Summary Notes

A.1.10 Discuss the amount of vitamin C that an adult should consume per day, including the level needed
to prevent scurvy, claims that higher intakes protect against upper respiratory tract infections, and
danger of rebound malnutrition.
Recommended Daily Intakes (RDI) of vitamin C have been set at 45-60mg day -1. These are based on controlled
experiments using human and animal subjects.
There is some debate on whether the RDI should be higher, with experts such as Nobel-winner Linus Pauling
suggesting that megadoses (1000mg or more) are required per day. The Vitamin C Foundation recommend 3
doses of 1000mg per day.
The evidence for the efficacy of these recommendations is not strong, yet some have suggested it can boost the
immune system, prevent upper respiratory tract infections, decrease susceptibility to cancer and speed healing
and recovery from illness. Large-scale, randomized and controlled trials of these claims have not taken place.
Some adverse effects of high dose vitamin C regimes can include instestinal problems and acidosis, but there is
little data to suggest long-term harm. It has also been suggested that rebound malnutrition can occur as a result
of systemic conditioning during long periods of high-dose supplementation: the body is accustomed to excreting
large amounts of vitamin C and this continues once supplementation stops, leading to deficiency. The evidence
for these claims is also weak.

A.1.11 List the sources of vitamin D in human diets.

Vitamin D can be produced by skin as a response to sunlight. It also can be found (in a slightly different form) in
foods: fatty fish, fish oils, liver, eggs and some mushrooms. In some countries, milk is supplemented with
vitamin D.

A.1.12 Discuss how the risk of vitamin D deficiency from insufficient exposure to sunlight can be balanced
against the risk of contracting malignant melanoma.
Vitamin D is required to allow uptake of calcium, which is then used to produce bone matrix. Rickets, vitamin D
deficiency, results from low levels of vitamin D, calcium or both. Symptoms of vitamin D deficiency include
bow legs and stunted growth.
There is a strong negative correlation between increasing darkness of skin colour and vitamin D synthesis.
Historically, darker-skinned populations were exposed to stronger sunlight for longer periods of time. Darker
skin produces vitamin D more slowly, but offers protection against skin cancer (malignant melanoma). Pale
skinned people are more able to produce vitamin D, yet more susceptible to skin cancer.
Risks of vitamin D deficiency can be negated with supplementation or attention to dietary sources, whereas the
risk of skin cancer can be reduced by covering pale skin, staying indoors or using sunblocks.

Option A: Human Nutrition and Health Summary Notes

A.1.13 Explain the benefits of artificial dietary supplementation as a means of preventing malnutrition,
using iodine as an example.
Artificial supplementation can be used to ensure that a population has adequate access to essential nutrients,
even if the supply of naturally-containing foods is limited. Some examples include adding fluoride to drinking
water to prevent tooth decay, vitamin D supplementation of milk to prevent rickets or iodine supplementation of
salt to prevent thyroid problems (hypothyroidism).
Iodine is essential in production of thyroxine, a hormone responsible for regulating metabolic rate in the body
and therefore body temperature. Patients suffering from hypothyroidism are at risk of mental retardation and
goiter, an extreme swelling of the thyroid glands in the neck. It can cause birth defects and miscarriages.
Worldwide supplementation of edible salt with iodine has greatly reduced incidence of iodine deficiency
disorders, at very low cost and with minimal objection.
Genetic engineering is also being used to produce enhanced crops, such as beta-carotene rich golden rice, though
there is more ethical debate concerning these methods.

A.1.14 Outline the importance of fibre as a component of a balanced diet

Dietary fibre includes the components of foods which cannot be digested by the human body. This is largely
cellulose, a structural component of the plant cell wall. Although it cannot be digested an absorbed into the
blood, dietary fibre plays an important role in human health.
-

Provides bulk in food, allowing one to feel full when eating

Helps regulate blood sugar
Reduces blood cholesterol
Strengthens action of peristalisis in the intestine
Reduces constipation

Dietary fibre is sourced from vegetables, nuts, wholegrains and some fruits.

A2: Energy in Human Diets

A.2.1 Compare the energy content per 100g fat, carbohydrate and protein.
Various units of energy can be used on food labels, but we use the unit kJ (kilojoules).
Comparative energy contents (approximate), kJ per 100g:
Fats
Carbohydrates
Proteins
4000
1760
1720
Notice that fats contain more than double the energy per unit mass than carbohydrates or proteins.

Option A: Human Nutrition and Health Summary Notes

Some food labels use Calories, which is the more common term in public science. One calorie is the energy
required to raise the temperature of 1kg water by 1 oC. One food Calorie is actually 1000 calories (1kcal). One
food Calorie is equivalent to 4.18kJ.
Question: what is the link between the energy content of fats and their metabolism in respiration? Refer to the
role of CoA.

A.2.2 Compare the main dietary sources of energy in different ethnic groups.
Dietary energy can come from various sources, carbohydrates, proteins or fats, depending on the foods available
to a population. These staples make up the bulk of a populations diet, and are generally crops.
Region/ group
Continental Europeans, USA
UK & Northern Europe
Central Africa and Brazil
Americas and Africa
Asia
Eskimo tribes
Isolated island populations

Main food energy source

Wheat (as bread or pasta)
Potatoes, wheat (bread) or rye
Cassava (sweet potato)
Maize (corn)
Rice
Whale and fish meat
Fish

A.2.3 Explain the possible health consequences of diets rich in carbohydrates, fats and proteins.
Carbohydrates
Proteins
Fats
As all macronutrients contain energy, high intake can lead to storage of excess energy as fat, therefore weight
gain, possible obesity and coronary heart disease. The ideal is a balance of all three to ensure sufficient intake of
all essential nutrients.
-Carbohydrates are digested to -Sufficient protein intake is - strong correlation between high
monosaccharides (sugars) which required to provide essential amino fat intake and obesity, as well as
are absorbed into the blood. acids.
coronary heart disease
Prolonged high intake can lead to -There is minimal risk in a diet high - saturated and trans- unsaturated
diabetes as the liver become less in protein, though some kidney fats pose a higher risk than cissensitive to insulin.
problems may be reported.
unsaturated fats
-Carbohydrates which cannot be -Some weight-loss diets promote - some positive effects of diets rich
digested (such as cellulose) count replacing
carbohydrates
with in cis- fats, with regard to reducing
as fibre, which has health benefits.
proteins. These may result in long- harmful cholesterol
term malnutrition as nutrient rich
foods are avoided.
A.2.4 Outline the function of the appetite control centre of the brain.
Appetite is controlled in the hypothalamus of the brain. Control is both nervous and hormonal: some hormones
trigger appetite-stimulating neurons, others trigger appetite-inhibiting neurons.
An empty stomach releases the hormone gherin, which triggers appetite-stimulating hormones, leading to
hunger. When food enters the stomach, gherin production is stopped, reducing hunger.
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Option A: Human Nutrition and Health Summary Notes

Appetite is also inhibited when:
1. Food entering the intestine stimulates release of PYY3-36 hormone.
2. Carbohydrate and protein digestion stimulate release of insulin hormone from the pancreas.
3. Fat storage stimulates release of leptin hormone from the pancreas. This is enhanced by insulin.
These three hormones trigger appetite-inhibiting neurons in the appetite control centre.
There are strong links to malfunction of any of these pathways and obesity, as the individual eats more than is
required.

A.2.5 Calculate body mass index (BMI) from the body mass and height of a person.

e.g. 1: 70kg man, 1.8m tall. BMI = 70 / 1.82 = 21.6

A.2.6 Distinguish, using the body mass index, between being underweight, normal weight, overweight and
obese.
BMI
Below 18.5
Category
Underweight
Limitations of the BMI using this table:
-

18.5-24.9
Normal

25.0-29.9
Overweight

Race, gender and age are not considered

No distinction is made on body fat/water/muscle composition

Examples:
9

30.0 and above

Obese

Option A: Human Nutrition and Health Summary Notes

e.g.
1

Height (m)
1.8

Body Mass (kg)

70

BMI
21.6

2
3

1.9
1.9

70
120

19.4
33.2

Category
Overweight
Normal
Obese

A.2.7 Outline reasons for increasing rates of clinical obesity in some countries, including availability of
cheap high-energy foods, large portion sizes, increasing use of vehicles for transport, and a change from
active to sedentary occupations.
Clinical obesity is an excess of body fat. Generally it is caused by consuming more energy than is used in
activity, with the excess stored as body fat. Obesity carries a reduced life expectancy, high risks of CHD,
diabetes, heart attacks and strokes.
The obesity epidemic is on the increase globally, in developed nations in particular. There are many contributing
factors:
Food availability
Portion sizes
Transportation
Sedentary lifestyles
Poverty
Genetic factors

Packaged, sugary or fatty foods are energy-dense they contain a lot of energy per
unit mass. A large mass is consumed to feel full, but an excess of energy is also
consumed.
A trend to supersizing meals and overeating contributes to intake of excess energy.
Increasing use of vehicles as transport means less energy is burned off than if one
walked or used pedal-power.
Professions are increasingly information-based and office-centred, so workers are
less active. Engagement in TV, video games and other passive hobbies reduces
exercise in children and adults.
Linked to food availability. Often the cheapest option for the poor in developed
nations is the packaged, processed, high-energy alternative. Whole foods and fresh
ingredients tend to be more expensive.
Genetic factors are strongly linked to addiction, compulsive eating, susceptibility to
weight gain, heart disease or diabetes or to problems with appetite control
mechanisms.

A.2.8 Outline the consequences of anorexia nervosa.

Anorexia nervosa is an eating disorder in which the patient severely limits food intake. It is a medical condition
with mental and physiological causes. It is closely associated with body image and meeting aesthetic standards
imposed by culture. It is most common in females, but does occur in males.
Health consequences include:
Malnutrition
Hormone imbalance
Mental health
Blood
Muscle and bone
Immunity and healing
Skin problems

Deficiency in some or all essential nutrients as a result of not eating can lead to any
of the effects below.
Periods stop, problems in pregnancy, growth and development
Mood swings, poor concentration, phobias and paranoia
Anemia and circulatory problems, including heart weakness
Loss of muscle mass, lack of strength, osteoporosis, more easily injured
Susceptible to infections, recovery and healing are impaired
Dry, easily damaged, discoloration
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Option A: Human Nutrition and Health Summary Notes

Death

As a result of prolonged, severe starvation

A3: Special Issues in Human Nutrition

A.3.1 Distinguish between the composition of human milk and artificial milk used for bottle-feeding
babies.
Colostrum
Antibodies
Protein
Carbohydrates
Fatty acids
Vitamins and minerals

Breastmilk
Present in first feeds. Stimulates newborn
digestion.
Present in colostrums in high doses, and
subsequent milk.
Lower, but more easily digested and
absorbed. Human.
Higher in lactose, linked to brain
development.
Human fatty acids.
May be lower, but easier to absorb.

Formula
Not present
Not present
Higher, but harder to digest and absorb.
Bovine sources.
Lower in lactose. May come from
glucose.
Palm oil or alternatives .
Higher, but harder to absorb.

A.3.2 Discuss the benefits of breastfeeding.

Benefit
Immunity
Digestive function
Cost
Bonding
Nutrition
Mothers health

Effect
Colostrum and early breastmilk contain high concentrations of antibodies, protecting
the infant from infections.
Colostrum stimulates digestive tract function and eases defecation. Easier to digest
than formula milk.
Breastmilk is free and readily available as long as the mother remains healthy
Aids in mother-child bonding and communication
More complete than formula and changes in composition to match the needs of the
infant
Aids in weight-loss, reduces risk of breast cancer, type II diabetes and post-partum
depression.

A.3.3 Outline the causes and symptoms of type II diabetes.

Diabetes mellitus (type II diabetes) is also known as adult-onset diabetes as it generally manifests in adulthood.
Receptors on the liver become resistant to insulin produced by the pancreas, leading to complications with blood
sugar control.

Causes:

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Option A: Human Nutrition and Health Summary Notes

Obesity, and prolonged intake of high-energy foods can cause the receptors in the liver to wear
out or become resistant to insulin. There is a very strong link with obesity. As the obesity epidemic
increases, the age of adult-onset diabetes is also decreasing.
Genetics also plays a role. Some people are genetically more susceptible to developing type II diabetes and
should use their family history as an indicator and take preventative measures largely a balanced diet and
exercise.
Symptoms:
Glucose in the urine as the kidney is unable to reabsorb all of the glucose back into the blood. Deyhdration as
water-balance is disrupted, coupled with excessive urination. Weight loss as insulin is less able to store fat. Sleep
loss and tiredness are also symptoms. Blurred vision and potential blindness.

A.3.4 Explain the dietary advice that should be given to a patient who has developed type II diabetes.
Type II diabetes can be controlled through careful diet and healthy lifestyle. An obese or overweight patient
would be advised to reduce their weight and exercise more.
Dietary advice:
Eat low GI foods.

Explanation:
Some foods release energy more slowly - they have a lower glyceimic index.
Eating these reduces spikes in blood sugar.
Cut out sugars and refined These are high GI foods they are broken down into sugars and absorbed quickly,
carbohydrates
causing blood sugar to rise quickly. They include sugary snacks, white bread and
pasta.
Eat high fibre foods
High fibre makes one feel without providing too much energy. High fibre diets
can also help reduce the effects of diabetes.
Small, regular meals
Smaller releases of energy more frequently result in less dramatic blood sugar
changes than large, infrequent meals.
Choose
diabetic Some packaged foods may be labeled to show that they have reduced sugars or
alternatives
carbohydrates, suitable for diabetics.
Read the food labels
Learn how to read and interpret food labels to avoid eating unsuitable foods.

A.3.5 Discuss the ethical issues concerning the eating of animal food products, including honey, eggs, milk
and meat.
Animal products are a major component of the human diet, though they are not without their ethical concerns.
As populations grow, demand for food increases, including meat and animal products. Concerns arise with
regard to ethical treatment of animals and environmental sustainability.
Food product
Meat

Advantages
Source of proteins, some
vitamins and minerals.

Ethical concerns
-Animal welfare issues in intensively-farmed cattle, poultry.
Pain and suffering in slaughter.
-Growth of antibiotic-resistant bacteria and new strains of
viruses as a result of overuse of medication. Use of growth
hormones may affect human health, such as earlier onset of
puberty.
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Option A: Human Nutrition and Health Summary Notes

Fish

Source of proteins
helpful fatty acids.

and

Milk

Source of energy, protein,

calcium

Eggs

Source of protein and fats, a

meat alternative in some
cultures

Honey

Honey
is
a
natural
sweetener. Bees pollinate
many flower species.

-Huge demand for land and water to grow crops

to feed animals is no longer sustainable and
results in clearing of rainforests and habitat destruction.
Methane and other emissions from farming livestock
contribute to global warming.
-Many fish species are endangered due to overfishing.
-Concerns of biomagnification of toxins in the food chain and
risks to human health.
-Animal welfare issues in intensively-farmed cattle, poultry.
-Growth of antibiotic-resistant bacteria and new strains of
viruses as a result of overuse of medication.
-Huge demand for land and water to grow crops to feed
animals is no longer sustainable and results in clearing of
rainforests and habitat destruction. Methane and other
emissions from farming livestock contribute to global
warming.
- Cholesterol health risks associated with too much egg yolk
consumption.
-Battery-farmed chickens fed hormones, in cramped
conditions and can be treated inhumanely. Living spaces can
be dirty and encourage spread of illness.
-Male chicks are routinely culled as they cannot produce
eggs.
-Farmed bees compete with local insect and bee populations
for nectar. Artificial selection of bees will result in a genetic
shift in bee populations.

A.3.6 Evaluate the benefits of reducing dietary cholesterol in lowering the risk of coronary heart disease.
Cholesterol is needed in small amounts in the body to produce hormones and plasma membranes. In excess it is
thought to contribute to atherosclerosis by forming deposits in the arteries. Rupture of plaques can cause clots, or
CHD. However, this is a paradigm that is being challenged and it highlight the correlation-cause argument.
In a review of studies, it has been suggested that the link between dietary cholesterol intake and CHD is not
logical, and that the more likely cause of CHD is a diet high in saturated fats. Diets high in saturated fats tend to
be high in cholesterol, so there is a correlation without necessarily causation.
With moderate cholesterol intake, the body is able to remove excess with no harmful effect dietary cholesterol
is not necessarily converted into plasma cholesterol. Plasma cholesterol can be HDL (not harmful), or LDL
(plaque-forming).
Extreme intakes may lead to a greater buildup of LDL in atherosclerosis. Although there is a small risk of
cholesterol leading to CHD, the risks of smoking, inactivity and heredity are much stronger and more closely
related to CHD.
Although a cholesterol-controlled diet may slow or reduce the risk of atherosclerosis, it must be combined with a
healthy diet and lifestyle if it is to have a significant effect on reducing the risk of CHD.
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Option A: Human Nutrition and Health Summary Notes

A.3.7 Discuss the concept of food miles and the reasons for consumers choosing foods to minimize food
miles.
Food miles are a measure of the distance a food product travels from plough to plate. It is an indicator of the
environmental impact of the foods we eat, as this travel involves costs in fuel, emissions, packaging and time:
the further a product travels, the less sustainable it is. Some imported foods cost more in energy per gram for
their transport than they provide for the consumer.
Some consumers prefer to choose locally grown or farmed food products to reduce the costs, use of packaging
and preservatives, use of oil/fuel and emissions. They may also hope to encourage outlets to use local providers
of produce rather than imported goods.

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