energy metabolism

AP Dr Nugroho Abikusno
medical nutrition
Trisakti university
energy metabolism
series of processes in energy production
released by macronutrients such as
carbohydrates, fats, protein and in certain
cases alcohol
ATP releases energy in the form of ADP
and P
glycolysis
piruvate
mitochondria
acetyl CoA
citric acid cycle
ATP
electron transport chain
ADP + P, ATP and water
gluconeogenesis
deamination
acetyl CoA or pyruvate
fatty acids
Acetyl CoA
beta-oxidation
ketone bodies in access
regulating metabolism
liver
enzymes
ATP
minerals

micronutrients
thiamin
niacin
riboflavin
biotin
pantothenic acid
vitamin B6
magnesium
iron
copper
preserving energy
slowing metabolic rate
reduction in energy requirement
slowing gluconeogenesis
nervous system uses less glucose and
more ketone bodies
accumulation of body fat
metabolic disorders
PKU
galactosemia
glycogen storage disease
carbohydrates
table sugar
jam
jelly
fruits
soft drink
rice
pasta
cereal
bread
beans
lentils
corn
peas
dairy products
dietary fiber
grains
legumes
tuber
sweeteners
Nutritive:
energy
alcohol
sorbitol
mannitol
xylitol
Non nutritive:
no energy
artificial
non or low calorie
glucose
primary energy source
protein sparring
prevents ketosis

Fiber:
constipation
diverticular disease
body weight, blood glucose and
cholesterol
protein
Requirements: Valine Lysine Glycine
Leucine Threonine Glutamine Isoleucine
Cysteine Alanine Phenylalanine Arginine
Glutamic acid Tryptophan Proline
Methionine Histidine
Uses
Glutamic acid - Neurotransmitter
Tyrosine - Catecholamines
Tryptophan - Serotonin, Niacin
Glycine - Purines, Pyrimidines
Cysteine - Glutathion, Taurine
Methionine - Choline, Creatine
food proteins (MW)
Casein Milk 34 000
-lactoglobulin Milk 35 000
Ovalbumin Eggs 44 000
Gluten Wheat 39 000
Myosin Meat 850 000
nitrogen balance
Humans cannot store excess amino acids
not used for protein synthesis; they must
be degraded and the N eliminated in the
urine
In adults, dietary N requirements are
determined by the need to replace
obligatory losses
Once the true requirement is met, the
N balance will tend to remain close to zero
protein quality
Quality
Digestibility
Biological value
protein quality
QualityContent of essential amino acids
relative to a reference protein
DigestibilityPercent of ingested protein
that is absorbed
Biological valuePercent of absorbed
dietary protein that is retained in the body;
also, rate of growth per g of protein
consumed
example
Egg 97 100
Milk 95 100
Meat 94 100
Maize 85 89
Rice (polished) 88 93
Beans 78 82
protein content (g/100g)
Cassava1.5
Potato 2.0
Cows milk 3.3
Rice 7.0
Eggs 13.0
Lean beef 19.0
key lipid molecules
Chylomicrons
Formed in the intestine to carry fatty
acids into the circulation after a meal is
consumed
Disappear from the blood in the fasting
state, degraded in the liver
VLD
TG-rich lipoprotein made in the liver
Releases TG to tissues and give origin to
LDL
Lipids: functions
Energy storage, mobilization, and
utilization
Prostaglandin, cytokine synthesis
Cell differentiation and growth
Cell membrane structure, myelination
Signal transmission
Hormone synthesis
Bile acid synthesis
Blood lipids
LDL
Cholesterol-rich lipoprotein made from
remnant VLDL, carries about 70% of blood
cholesterol
HDL
Made both in liver and intestine, carries
cholesterol from the periphery to the liver
All lipoproteins are eventually captured
and degraded in the liver via a receptor
system
in adults
From 20% to 35% of total calories can be
derived from fat
Lower limit is set by altered blood lipids
( TG, LDL)
Upper limit is determined by increasing
risk of excess energy intake and obesity
fat in human diet
Fat is an efficient way to pack more
calories in less volume and, thus, fat is
important for feeding infants and young
children
After the first year of life, there is no
particular advantage in using fat to provide
calories
However, flavor and texture of foods are
highly dependent on their fat content
total fat
Infants fed breast milk consume 50% fat
After weaning, they should progressively
reach the recommended fat intake level for
adults, by age 8 -10
recommended intake
There is no physiological need for
saturated fat; however, it is virtually
impossible to create a healthy saturated
fat-free diet
Thus, the recommendation is to consume
no more than 10% of total calories from
saturated fat
Also, some fat in the diet is needed to
allow absorption of fat-soluble vitamins
recommended intake
Essential Fatty Acids
Linoleic acid5-10% of total calories
Alpha-Linolenic acid0.2-1.2% of total
calories
Diet should contain certain amount of
preformed PUFAs (DHA, EPA)
This can be achieved by consuming fatty
fish twice a week
EPA deficiency
Clinical
Dermatitis
Thrombocytopenia
Increased susceptibility to infections
Failure to thrive
History of low fat intake
Laboratory
Serum Triene:Tetraene ratio > 0.4