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M.SC 1st Semester Advance Nutrition-I CARBOHYDRATES –MOST IMPORTANT ORGANIC COMPOUNDS IN THE NATURE CHIEF SOURCE OF ENERGY MADE UP OF CARBON,HYDROGEN AND OXYGEN(1:2:1) BUILDING BLOCKS OF A MOLECULE IMPORTANT SOURCE OF ENERGY REQUIRED FOR METABOLIC ACTIVITIES THESE ARE POLYHYDROXY ALDEHYDES OR KETONES AND THEIR DERIVATIVES MONOSACCHARIDE OLIGOSACCHARIDE POLYSACCHARIDE • GLUCOSE • SUCROSE • STARCH • FRUCTOSE • LACTOSE • GLYCOGEN • GALACTOSE • MALTOSE • CELLULOSE ‘MONO’-ONE & ‘SAKCHARON’-SUGAR SIMPLEST SUGAR-CANT HYDROLYZED FURTHER SMALL CHAINS OF ALDEHYDES AND KETOSE SWEET TASTING AND DISSOLVE IN WATER SUBDIVISON OF MONOSACCHARIDE:- TRIOSE: THREE C- ATOMS EG:-GLYCEROSE TETROSE:FOUR C-ATOMS EG:-ERYTHROSE PENTOSE:FIVE C-ATOMS EG:-RIBOSE HEXOSE:SIX C-ATOMS EG:-GLUCOSE,FRUCTOSE ‘OLIGO’-FEW & SACCHARIDE-SUGAR COMPOUND SUGARS –YIELD 2-10 MOLECULES OF SIMPLE SUGARS LOW GLYCEMIC INDEX CARBOHYDRATES PRIMARLY FOUND IN LEGUMES SUB DIVISION OF OLIGOSACCHARIDE: DISACCHARIDE:YIELDS 2 MOLECULES ON HYDROLYSIS EG:SUCROSE,LACTOSE,MALTOSE TRISACCHARIDES:YIELDS 3 MOLECULES ON HYDROLYSIS EG:RAFFINOSE TETRASACCHARIDE:YIELDS 4 MOLECULES ON HYDROLYSIS EG:STACHYOSE GLYCEMIC INDEX: GLYCEMIC INDEX MEASURES HOW FAST THE FOOD IS LIKELY TO RAISE OUR BLOOD GLUCOSE LEVEL • • Carbohydrate that breakdown rapidly during digestion have the highest glycemic indices. such carbohydrate require less energy to be converted into glucose ,which results in faster digestion and a quicker increase in blood glucose Carbohydrate that breakdown slowly releasing glucose gradually into blood stream,have a low glycemic index BIOCHEMICAL STRUCTURE OF CARBOHYDRATES-FOR EXAMPLE AMYLOPECTIN IS MORE READILY ABSORBED RIPENESS-RIPE FRUITS AND VEGETABLES TEND TO HAVE MORE SUGAR THAN UNRIPE ONES,AND SO TEND TO HAVE A HIGHER GLYCEMIC INDEX TYPE OF STARCH-SOME STARCH ARE EASIER TO BREAK INTO SUGAR MOLECULES THAN OTHERS-EG-STARCH IN POTATOES AND ABSORBED QUICKLY IN BLOOD STREAM FAT CONTENT AND ACID CONTENT-THE MORE FAT OR ACID A FOOD CONTAINS,THE SLOWER ITS CARBOHYDRATE ARE CONVERTED TO SUGAR AND ABSORBED INTO THE BLOOD STREAM PHYSICAL FORM-FINELY GROUND GRAIN IS MORE RAPIDLY DIGESTED AND SO A HIGHER GLYCEMIC INDEX CONTROL YOUR BLOOD GLUCOSE LEVEL CONTROL YOUR CHOLESTROL LEVEL CONTROL YOUR APPETITE LOWE YOUR RISK OF GETTING HEART DISEASE LOWER YOUR RISK OF GETTING TYPE2 DIABETES COMPARISON ‘POLY’-MANY & ‘SACCHARIDE’-SUGAR COMPOUND SUGARS-YIELDS MORE THAN 10 MOLECULES OF SIMPLE SUGARS ON HYDROLYSIS INSOLUBLE IN WATER SUBDIVISON OF POLYSACCHARIDE:- HOMPLOYSACCHARIDE:YIELDS SAME TYPE OF MONOSACCHARIDE UNITS EG:STARCH,GLYCOGEN HETEROPOLYSACCHARIDE:YIELDS DIFFERENT TYPE OF MONOSACCHARIDE UNITS EG:HYALURONIC ACID STARCH STARCH IS STORAGE MOLECULE IN PLANTS MADE UP OF AMYLOSE AND AMYLOPECTIN AMYLOSE LINEAR COMPONENT OF STARCH.THE LINKAGE IN AMYLOSE IS α 1 4 LINKAGE AMYLOPECTIN BRANCH COMPONENT OF STARCH.THE LINKAGE IN AMYLOPECTIN IS α 1 4 AND α1 6 STORAGE MOLECULES IN ANIMALS AND IS OFTEN CALLED ‘ANIMAL STARCH’ STORED IN THE LIVER AND MUSCLES OF ANIMALS GLYCOGEN IS BRANCHED CHAIN POLYSACCHARIDE AND RESEMBLES AMYLOPECTIN IN STRUCTURE IT IS HIGHLY BRANCHED AS COMPARE TO STARCH LINEAR COMPONENT OF STARCH.AMYLOSE CONSIST OF GLUCOSE UNITS LINKED TOGETHER BY α1 4 BONDS THE CHAIN LENGTH OF AMYLOSE VARIES AND IT IS CONSIDERED TO HAVE AMOLECULAR WEIGHT OF1.1 TO 1.9 MILLIONS AMYLOSE IS SOLUBLE IN WATER CEREAL STARCHES USUALLY CONTAIN 25% AMYLOSE AND 75% AMYLOPECTIN IT IS THE STRUCTURE OF AMYLOSE THAT IS RESPONSIBLE FOR THE BLUE COLOUR PRODUCED BY IODINE WITH STARCH THE STRUCTURE OF AMYLOSE CONTRIBUTES TO THE GELLING CHARACTERSTICS OF COOKED AND COOL STARCHES AMYLOPECTIN ALSO HAS THE BACKBONE OF α1 4 LINKAGE BUT IN ADDITION THE MOLECULE IS BRANCHED THROUGH α1 6 THE LENGTH OF THE LINEAR UNIT IN AMYLOPECTIN IS ABOUT 20-25 GLUCOSE UNITS AMYLOPECTIN HAS A BRUSHLIKE STRUCTURE AND ITS MOLECULAR WEIGHT IS OVER 10 MILLION AMYLOPECTIN IS RESPONSIBLE FOR THICKENED PROPERTIES OF STARCH PREPARATION BUT IT DOES NOT CONTRIBUTE TO GEL FORMATION AMYLOSE AMYLOPECTIN AMYLOSE HAS SIMPLER STRUCTURE AND HENCE SOLUBLE IN WATER.WHEN POTATOES ARE BOILED,AMYLOSE EXTRACTED BY HOT WATER TURNING IT MILKY AND OPALESCENT AMYLOPECTIN IS LESS SOLUBLE BECAUSE THE TWO COMPONENTS MAY BE SEPARATED PARTIALLY BY KEEPING STARCH IN WATER FOR PROLONGED PERIOD.THE AMYLOPECTIN LEFT BEHIND ACCOUNTS FOR MOST OF THE STARCH IN BOILED POTATOES IT IS SOLUBLE WITHOUT SWELLING IN HOT WATER AMYLOPECTIN SWELLS IN WATER AMYLOSE IS READILY DISPERSED AMYLOPECTIN FORMS TYPICAL IN WATER BUT DOES NOT FORM STARCH GEL GEL CHARACTERSTICS AMYLOSE PRODUCES A TYPICAL BLUE COLOUR WITH IODINE AMYLOPECTIN GIVES PURPLISH COLOUR WITH IODINE PROVIDING ENERGY AND REGULATION OF BLOOD GLUCOSE:-each gram of carbohydrate when oxidized yields approximately 4kcal of energy SPARE THE USE OF PROTEINS FOR ENERGY:-when carbohydrates are not sufficient in our body to provide energy,protein breakdowwn itself to fullfill the requirement of carbohydrates HELPING IN PREVENTING KETOSIS:-In the absence of adequate cho large amount of ketone bodies are produced.The accumulation of ketone bodies increases the acidity of blood • • • GIVE BULK TO THE DIET:-carbohydrates give bulk to the diet. ACT AS FLAVOURS AND SWEETNERS:-Different sygars vary in sweetness,fructose is twice sweet as sucrose and sucrose is 30% sweet than glucose Carbohydrates are also important for the correct working of our brain, heart and nervous, digestive and immune systems. These act as intermediates in the biosynthesis of other basic biochemical entities ROLE IN MUSCLE: carbohydrates are the major source of energy for muscular work.during muscular contraction,glycogen is broken down to lactic acid through glycolysis ROLE IN LIVER:these include detoxifying action and regulating influence of proteins and fat metabolism.liver is rich in glycogen and is more resistant to certain poisons such as carbon tetrachloride,alcohol ,arsenic and bacteria SOURCE OF ENERGY FOR HEART MUSCLE:the heart muscle mainly uses glucose as source of energy SYNTHESIS OF RIBOSE TO GLUCOSE:it is formed in the body from glucose by hexose mono phosphate pathway CONVERSION TO FAT:excess calories fed in the diet in the form of carbohydrate is stored as fat in adipose tissue LACTOSE Lactose is the main source of energy supplied to new born mammalian in mother’s milk Easily fermented to lactic acid ,by lactic acid bacteria(lactobacillus) ,while preparing curds and cheese Helps in absorption of calcium and phosphorous It triggers production set of genes in some bacteria • STARCH It is also used in the form of flakes, sticks, and pearls (tapioca and sago). Starch in its basic refined form is used in cooking to thicken foods such as sauces, cabbages and many others. In industry, it is used in the manufacturing of adhesives, paper, textiles and as a mold in the manufacture of sweets such as wine gums and jelly beans. Starch is huge part of our diet.our bodies breakdown starch into simple sugars which is then used for energy(ATP) • DIETARY FIBRE(UNAVAILABLE CARBOHYDRATE) Many Foods Contain Non-digestable Carbohydrates.These Non-digestable Carbohydrate Designated As “Dietary Fibre”or Unavailable Carbohydrates It used to be believed that fibres could not be used by the human body, as the digestive juices in the body did not contain enzymes capable of breaking down these compounds. It was overlooked that a part of the fibre is fermented by enzymes found in the microorganisms of the large intestines. SOLUBLE FIBRES INSOLUBLE FIBRES PECTINS GUMS AND MUCILAGES CELLULOSE HEMICELLULOSE LIGNIN SOLUBLE FIBRES ARE SOLUBLE IN WATER AND BECOME STICKY IN CONSISTENCY INSOLUBLE FIBRE DOESN’T DISSOLVE OR ABSORB WATER.IT PASSES THROUGH OUR DIGESTIVE SYSTEM IN CLOSE TO ITS ORIGINAL FORM Helps maintain bowel integrity and health. A highfiber diet may lower your risk of developing hemorrhoids, and small pouches in your colon. Lowers blood cholesterol levels. Soluble fiber found in beans, oats, flaxseed and oat bran may help lower total blood cholesterol levels by lowering low-density lipoprotein, or "bad," cholesterol levels. Helps control blood sugar levels. Fiber, particularly soluble fiber, can slow the absorption of sugar, which for people with diabetes can help improve blood sugar levels Aids in weight loss. High-fiber foods generally require more chewing time, which gives your body time to register when you're no longer hungry, so you're less likely to overeat. SMALL INTESTINE IS UNABLE TO DIGEST,LIMITED DIGESTION IN LARGE INTESTINE PORTION OF STARCH THAT IS NOT BROKEN BY HUMAN ENZYMES CLASSIFICATION:RS 1:TRAPPED IN CELLS(SEEDS & LEGUMES) RS2:NATIVE STARCH(RAW POTATOES,BANANAS) RS3:CRYSTALLINE,NON-GRANULAR STARCH (COOKED POTATOES) RS4:CHEMICALLY MODIFIED 20gms OF RESISTANT STARCH EATEN EVERY DAY BENEFITS TO PEOPLE WHO ARE TRYING TO REDUCE WEIGHT INCREASE STOOL BULK,ACTING AS A MILD LAXATIVE TYPE OF CARBOHYDRATE MONOSACCHAIDE •GLUCOSE(BASIC SUGAR UNIT) •FRUCTOSE(FRUIT SUGAR) •GALACTOSE(DERIVED FROM LACTOSE) DISACCHARIDE •SUCROSE(TABLE SUGAR) •MALTOSE(MALT SUGAR) •LACTOSE(MILK SUGAR) POLYSACCHARIDE MOLECULAR CONTENTS 1MOLECULE OF GLUCOSE 1MOLECULE OF FRUCTOSE 1MOLECULE OF GALACTOSE 1 MOLECULE OF GLUCOSE+1 MOLECULE OF FRUCTOSE 2 MOLECULES OF GLUCOSE 1 MOLECULE OF GALACTOSE+ 1MOLECULE OF GLUCOSE STARCH:AMYLOSE,AMYLOPECTI N NONSTARCH:CELLULOSE,PECTINS DIGESTION ABSORPTION UTILIZATION • • • • DIGESTION IN ORAL CAVITY ACTION OF SALIVA: FOOD MIXES WITH SALIVA SALIVA CONTAINS SALIVARY AMYLASE(PTYALIN) PTYALIN CONVERTS STARCH INTO MALTOSE,ISOMALTOSE AND DEXTRINS 30% STARCH HYDROLYSED HERE STARCH salivary amylas e MALTOSE ISOMALTOSE α-DEXTRINS ACTION OF PANCREATIC JUICE ◦ PANCREATIC JUICE CONTAINS DIGESTIVE ENYME CALLED PANCREATIC α-AMYLASE ◦ α- AMYLASE CONVERTS STARCH INTO MALTOSE,ISOMALTOSE AND DEXTRINS STARCH pancreati c amylase MALTOSE ISOMALTOSE α-DEXTRINS • ACTION OF INTESTINAL JUICE INTESTINAL JUICE CONTAINS MALTASE,ISOMALTASE,SUCRASE,DEXTRINASE, LACTASE WHICH ACT AS FOLLOWS:- MALTOSE MALTASE 2GLUCOSE ISOMALTASE ISOMALTOSE SUCROSE SUCRASE LACTASE LACTOSE 2GLUCOSE GLUCOSE FRUCTOSE GLUCOSE GALACTOSE α- DEXTRINASE α- DEXTRINS GLUCOSE Once digestion is essentially finished, waste products leave the ileum with the help of fiber, and these solids then enter the large intestine (the colon). In the colon, water is reabsorbed; some nutrients are produced by friendly bacteria (vitamin K, biotin, vitamin B 12 ); fibers are digested to various acids and gases; and minerals, such as potassium and sodium, are reabsorbed (when needed). Any fiber that is not broken down—and small amounts of other undigested products—are excreted in the feces. GLYCOLYSIS: SEQUENCE OF REACTION THAT CONVERTS ONE GLUCOSE TO 2 MOLECULES OF PYRUVATE TAKES PLACE IN CYTOPLASM ITS BOTH AEROBIC AND ANAEROBIC ATP YIELD-8ATP FORMED IT HAS 2 PHASE PREPARATORY AND PAY OFF OCCURS IN PROKARYOTES AND EUKARYOTES GLYCOLYSI S FATE OF PYRUVATE THREE IMPORTANT ROUTES TAKEN BY PYRUVATE AFTER GLYCOLYSIS: (a)In Some Microorganisms Pyruvate Form From Glucose Is Transform Anaerobically Into Ethanol And CO2 A Process Called ALCOHOLIC FERMENTATION (b)The supply of oxygen is insufficient, pyruvate cant be oxidized further .Under such conditions it is then reduced to lactate (ANAEROBIC GLYCOLYSIS (c)Pyruvate so formed enters mitochondria where it is (a) (b) (c) KREB CYCLE: DISCOVERED BY ‘HANS KREB’ ALSO CALLED TCA CYCLE(TRICARBOXYLIC ACID) IT TAKES PLACE IN MITOCHONDRIA PROCESS: OXIDATION OF PYRUVATE TO ACETYLYCOA:-PYRUVATE ENTERS MITOCHONDRIA THROUGH TRANSPORT PROTEIN UNDER GOES OXIDATIVE DECARBOXYLATION TO PRODUCE CO2 AND NADH ACETLY-COA FUNCTION AS SUBSTRATE ENTRANT FOR KREB CYCLE SYNTHESIS OF GLUCOSE FROM NONCARBOHYDRATE PRECURSORS • It occurs mainly in liver Synthesis of glucose from pyruvate utilizes many of the same enzymes as glycolysis PRECURSORS OF GLUCONEOGENESIS Lactate,pyruvate,glycerol Citric acid Some amino acids Brain ,central nervous system,erythrocyte,kidney are dependent on glucose for continous supply of energy. Human brain require 120g energy per day and about 160g needed by the entire body Glucose is the only source that supplies energy to skeltal muscle, under anaerobic conditions Although glycolysis and gluconeogenesis share several steps but these pathways are not simple the reverse of each other. During gluconeogenesis seven steps are catalyzed by the same enzyme used in glycolysis,three are reversible Conversion of glucose-6-phosphate by hexokinase Conversion of fructose-6-phosphate to fructose 1:6 biphosphate Conversion of phosphoenol pyruvate to pyruvate by pyruvate kinase GLUCONEOGENESIS PATHWAY LACTOSE INTOLERANCE (HYPOLACTASIA) LACK OF THE ENZYME LACTASE CAUSES INABILITY TO DIGEST LACTOSE IN MILK PRODUCTS THERE ARE FEW WITH COMPLETE INTOLERANCE,MOST CAN INGEST SMALL QUANTITIES OF MILK PRODUCTS SOME PEOPLE ARE REALLY ALLERGIC TO MILK.THIS ALLERGY SEEMS TO BE INCREASING IN AN INFANT PREMATURE BABIES SOME TIMES HAVE LACTOSE INTOLERANCE.CHILDREN WHO BORN AT FULL TERM USUALLY DO NOT SHOW SIGNS OF LACTOSE INTOLERANCE UNTIL THEY ARE THREE YEARS OLD BIG PROBLEM-CALCIUM DEFICIENCY CAUSES: BOWEL SURGERY INFECTION FROM SMALL INTESTINE FROM VIRUSES OR BACTERIA,WHICH MAY DAMAGE THE CELLS(MOST OFTEN IN CASE OF CHILDREN) INTESTINAL DISEASE SUCH AS CELIAC SPRUE SYMPTOMS • • • • • • ABDOMINAL BLOATING ABDOMINAL CRAMPS DIARRHOEA FLATULENCE NAUSEA SLEEPLESSNESS TREATMENT: DECREASING OR REMOVING MILK PRODUCTS FROM THE DIET USUALLY IMPROVES THE SYMPTOMS PEOPLE WITH LOW LACTASE CAN DRINK 2-4 OUNCES OF MILK AT ONE TIME SOME OF THE MILK PRODUCTS ARE EASIER TO DIGEST:BUTTERMILK AND CHEESES FERMENTED MILK PRODUCTS(YOGHURT) ICE CREAMS,MILKSHAKES LACTOSE FREE MILK,MILK PRODUCTS • • Autosomal inherited error of metabolism in which patients are born with absent or low level of 2 digestive enzymes :SUCARSE AND ISOMALTASE Sucrase is the intestinal enzyme that aids in breakdown of sucrose into glucose and fructose which are used by the body as fuel Isomaltase is one of the several enzyme that helps to digest starch • • • • • • SYMPTOMS: VOMITING WATERY DIARRHEA COLIC FATIGUE DEHYDRATION ABDOMINAL CRAMPS Fructose Malabsorption Disorder, logically, is the inability to absorb fructose (which is the sugar which occurs naturally in many foods – mostly fruit). SYMPTOMS: • Bloating(from small intestine to large intestine) • Diarrhea or constipation • Flatulence • Vomiting OTHER SYMPTOMS INCLUDE: • Aching eyes • Fuzzy head • Fatigue CAUSES: • Inherited or acquired abnormality of fructose transporting protein GLUT-5 (other family members are often affected) Overuse of High Fructose Corn Syrup (HFCS) or fruit juices in children (toddler’s diarrhea) Small intestinal bacterial growth(SIBO) Celiac disease Chemotherapy or radiation (damage of small intestinal mucosa) Dumping syndrome AVOID FOOD THAT CONTAIN Fructose High-fructose corn syrup Table sugar (sucrose) Powdered sugar Fruit and fruit juices Honey Regular sodas Flavored water Sorbitol Sports drinks Sweetened milk or sweetened milk beverages SOURCES OF CARBOHYDR ATES CEREALS- RICE,WHEAT,BAJ RA,OATS FRUITS AND VEGETABLESCARROTS,CAULIF LOWER,BROCOLL I LEGUMESPEANUTS,LENTIL ,PEAS,BEANS A healthy adult should consume 30-40gms Of Fibre per day • Daily Requirement Of A Person Depends Upon The Nature Of Physical Work Of A Person: A man with moderate physical work needs 275g anda woman with moderate physical work needs 200g Probably 55% of your daily calorie should come from carbohydrate Excessive intake of carbohydrate more than required leads to obesity THE PROCESS OF CORONARY HEART DISEASE BEGINS WITH THE CORONARY ARTERIES BECOME NARROWED BY A GRADUAL BUILD UP OFF FATTY MATERIAL WITHIN THEIR WALL. . THE MAJOR UNDERLYING CAUSE TO DEATH DUE TO ATHEROCLEROSIS IT IS A SLOW PROGRESSIVE DISEASE BEGINS IN CHILDHOOD AND TAKES DECADES TO ADVANCE PLAQUE(THE BUILD UP OF LIPID/CHOLESTROL)IN THE ARTERY WALL FORMS AS A RESPONSE TO INJURY TO THE ENDOTHELIUM IN THE ARTERY WALL ATHEROSCLEROSIS DEVELOPS GRADUALLY. CHEST PAIN OR CHEST DISCOMFORT (ANGINA) PAIN IN ONE OR BOTH ARMS, THE LEFT SHOULDER, NECK, JAW, OR BACK SHORTNESS OF BREATH DIZZINESS FASTER HEARTBEATS NAUSEA ABNORMAL HEARTBEATS FEELING VERY TIRED. REDUCE TOTAL FAT-MEANS REDUCE YOUR TOTAL CALORIE INTAKE INCREASE YOUR FRUITS AND VEGETABLES TO FIVE PORTION A DAY INCREASE YOUR CARBOHYDRATE(PASTA CEREALS,BREAD) IF NECESSARY REDUCE YOUR WEIGHT TO THE RECOMMENDED LEVEL OF YOUR SEX AND AGE INCREASE YOUR PHYSICAL ACTIVITY TAKE SAFETY BEYOND THE RED ZONE! CORONARY ARTERY BECOMES BLOCKED -USUALLY BY A CLOT BLOOD FLOW IS CLOSED OFF AND ATTACK BEGINS IF THE BLOCKAGE CONTINUES ,PARTS OF THE HEART MUSCLE START TO DIE HEART MAY STOP BEATING CHEST DISCOMFORTPRESSURE,SQUEEZING,PAIN IN CENTRE OF CHEST DISCOMFORT IN BOTH ARMS,NECK,JAW,STOMACH NAUSEA BREAKING OUT IN COLD SWEAT SHORTNESS OF BREATH DELAY CAN BE DEADLY!!!!!! Limit unhealthy fats and cholesterol A high blood cholesterol level can lead to a buildup of plaques in your arteries, called atherosclerosis, which can increase your risk of heart attack and stroke. Choose low-fat protein sources Legumes — beans, peas and lentils — also are good sources of protein and contain less fat and no cholesterol choose lower fat options, such as skim milk rather than whole milk Eat more vegetables and fruits Vegetables and fruits are good sources of vitamins and minerals; they are low in calories and rich in dietary fiber. Select whole grains Whole grains are good sources of fiber and other nutrients that play a role in regulating blood pressure and heart health. HYPERTENSION OCCURS WHEN BLOOD MOVING THROUGH ARTERIES PLACES TOO MUCH FORCE AGAINST THE ARTERY WALLS HYPERTENSION INVOLVE MANY ORGANS AND SYSTEMS INCLUDING HEART,ENDOCRINE GLANDS,KIDNEYS. SYSTOLIC BLOOD PRESSURE DIASTOLIC BLOOD PRESSURE Higher value found Lower value found during contraction of during relaxation or the caediac cycle resting phase of cardiac cycle • • • Age: The older a person is, the greater the likelihood that he or she will develop high blood pressure, especially elevated systolic readings. Family history (heredity): The tendency to have high blood pressure appears to run in families. Gender: Generally men have a greater likelihood of developing high blood pressure than women. Alcohol use: Drinking more than one to two drinks of alcohol per day tends to raise blood pressure in those who are sensitive to alcohol. Lack of exercise (physical inactivity): A sedentary lifestyle contributes to the development of obesity and high blood pressure. HEADACHE DIZZINESS NAUSAE AND VOMATING CHEST PAIN HEART ATTACK KIDNEY FAILURE EYE DAMAGE WITH PROGRESSIVE VISION LOSS • • • • • Lose extra pounds and watch your waistline Blood pressure often increases as weight increases. In general, the more weight you lose, the lower your blood pressure. Regular physical activity — at least 30 to 60 minutes most days of the week lower your blood pressure by 4 to 9 millimeters of mercury (mm Hg). Eat a healthy diet Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 14 mm Hg. Reduce sodium in your diet Even a small reduction in the sodium in your diet can reduce blood pressure by 2 to 8 mm Hg. The recommendations for reducing sodium are: Limit sodium to 2,300 milligrams (mg) a day or less. Limit the amount of alcohol you drink Alcohol can be both good and bad for your health. In small amounts, it can potentially lower your blood pressure by 2 to 4 mm Hg. GROUP OF DISEASE CHARACTERIZED BY HIGH LEVELS BLOOD GLUCOSE RESULTING FROM DEFECTS IN INSULIN PRODUCTION, INSULIN ACTION OR BOTH COMPLICATIONS: HEART ATTACK STROKE KIDNEY DISEASE EYE DISEASE NERVE DAMAGE TYPE1(INSULIN DEPENDENT DIABETES MELLITUS)IDM TYPE2(NON-INSULIN DEPENDENT DIABETES MELLITUS) FORMERLY IT IS CALLED JUVENILE DIABETES IT IS ALSO KNOWN AS ADULT ONSET DIABETES AUTO-IMMUNE DISORDER -A PROBLEM WITH BODY’S IMMUNE SYSTEM 90-95% PEOPLE HAVE THIS TYPE OF DIABETES BETA CELLS OF ISLETS OF LANGERHANS IN THE PANCREAS MAKE INSULIN WITH THIS FORM OF DIABETES ,THE BETA CELLS OF PANCREAS NO LONGER TO MAKE INSULIN DUE TO WEAK IMMUNE SYSTEM WHEN ENOUGH BETA CELLS ARE TYPE2 DIABETIC PEOPLE PRODUCE INSULIN ,BUT EITHER DOESN’T MAKE ENOUGH INSULIN OR THEIR BODIES DO NOT USE THE INSULIN THEY MAKE PEOPLE CAN DEVELOP TYPE2 DIABETES AT ANY AGE SYMPTOMS: POLYPHAGIA-EXCESSIVE EATING POLYUREA-EXCESSIVE URINATION POLYDIPSIA-EXCESSIVE FLUID INTAKE BLURRED VISION POOR WOUND HEALING IRRITABILITY PLAIN TEA, COFFEE AND LEMONADE(WITHOUT SUGAR), CLEAR SOUP, GREEN LEAFY VEGETABLES, KHEERA, KAKRI, KARELA. DILUTED KHATTI LASSI ETC. EAT LOW CALORIE SWEETNERS. USES WHOLE GRAIN AND PULSES. REDUCE SALT PREFER BAKING, ROASTING, STEAMING INSTEAD OF FRYING FOODS. AVOID FAST AND FEASTS. DIVIDE YOUR WHOLE DAY RATIO IN 5 TO 6 SMALL MEALS RATHER THAN 2-3 HEAVY MEALS. Celiac disease is the digestive disease that damage the small intestine and interferes with the absorption of nutrients from the food People who have celiac disease cannot tolerate gluten a protein in wheat,rye and barley When people with celiac disease eat foods that contain gluten, their immune system responds by damaging or destroying villi(the tiny finger like protrusions lining the small intestine) Abdominal bloating Chronic diarhoea Vomiting Constipation Weight loss Abdominal pain NATURALLY GLUTEN FREE FOODS Dairy products – eggs, full cream milk, low fat milk, condensed milk, fresh cream some custards and soymilks. Fruits and vegetables –fruit juices, nuts and peanut butter Cereal and baking products – corn (maize) flour, soya flour, lentil flour, rice (all types), rice flour, rice bran, potato flour, buckwheat, millet, amaranth, breakfast cereals made from corn and rice without malt extract from barley Bread, cakes and biscuits – most rice crackers, corn cakes, rice crispbreads Pasta and noodles – gluten free pasta, rice noodles, rice or bean vermicelli Condiments – tomato paste, jam, honey, maple syrup, cocoa, all kinds of vinegars (except malt), some sauces and some salad dressings. Snacks – plain chips and corn chips, popcorn and plain chocolate. Drinks – tea, coffee, mineral water, wine, spirits and liqueurs. ESSENTIALSOF HUMAN NUTRITION, OXFORD FOOD SCIENCE AND NUTRITION, OXFORD SUNETRA RODAY FOODS FACTS AND PRINCIPLES, N.SHAKUNTLAMANAY FOOD, NUTRITION AND DIET THERAPY, KRAUSE’S A TEXT BOOK OF BIOCHEMISTRY, SATYANARAYAN NUTRITION AND DIETETICS, KUMOD KHANNA FOODS AND NUTRITION, JYOTI SINGH FOODS AND NUTRITION, V. SHRILAKSHMI