Nutrition

There are six major classes of nutrients: carbohydrates, fats, minerals, protein, vitamins, and water.

These nutrient classes can be categorized as either macronutrients (needed in relatively large amounts) or micronutrients (needed in smaller quantities). The macronutrients include carbohydrates, fats, protein, and water. The micronutrients are minerals and vitamins.

The macronutrients (excluding water) provide structural material (amino acids from which proteins are built, and lipids from which cell membranes and some signaling molecules are built), energy.

Some of the structural material can be used to generate energy internally, and in either case it is measured in "Calories" Carbohydrates and proteins provide 4 cal of energy per gram, while fats provide 37 cal per gram.

Vitamins, minerals, fiber, and water do not provide energy, but are required for other reasons. A third class of dietary material, fiber , is also required, and aides in digestion.

Carbohydrates range from simple monosaccharides (glucose, fructose, galactose) to complex polysaccharides (starch).

Fats are triglycerides, some fatty acids, but not all, are essential in the diet as they cannot be synthesized in the body.

Protein molecules contain nitrogen atoms in addition to carbon, oxygen, and hydrogen. The fundamental components of protein are nitrogen-containing amino acids, some of which are essential in the sense that humans cannot make them internally. Some of the amino acids are convertible (with the expenditure of energy) to glucose and can be used for energy production just as ordinary glucose in a process known as gluconeogenesis. This occurs normally only during prolonged starvation.

Most foods contain a mix of some or all of the nutrient classes, together with other substances, such as toxins of various sorts. Some nutrients can be stored internally (e.g., the fat soluble vitamins), while others are required more or less continuously. Poor health can be caused by a lack of required nutrients or, in extreme cases, too much of a required nutrient. For example, both salt and water can cause illness or even death in excessive amounts.

Carbohydrates include sugars, starches and fiber. They constitute a large part of foods such as rice, noodles, bread, and other grain-based products. Carbohydrates may be classified chemically as monosaccharides, disaccharides, or polysaccharides depending on the number of monomer (saccharide or sugar) units they contain. Monosaccharides, disaccharides, and polysaccharides contain one, two, and three or more sugar units, respectively.

Polysaccharides are often referred to as complex carbohydrates because they consist of long, sometimes branched chains of single sugar units. Mono- and disaccharides are called simple carbohydrates.

Carbohydrates are not essential nutrients (with the likely exception of fiber), but are typically an important part of the human diet. While it would not be accurate to categorize all carbohydrates as "bad" nutritionally, some carbohydrate sources may well have deleterious effects on health, especially when consumed in large quantities. Highly processed carbohydrates (sugars and starches) as well as fructose consumed in large quantities have been implicated in negative .

Dietary fiber is a carbohydrate (or a polysaccharide) that is incompletely absorbed in humans and in some animals. Like all carbohydrates, when it is metabolized it can produce four Calories of energy per gram. However, in most circumstances it accounts for less than that because of its limited absorption and digestibility. Dietary fiber consists mainly of cellulose, a large carbohydrate polymer that is indigestible because humans do not have the required enzymes to disassemble it. There are two subcategories: soluble and insoluble fiber. Whole grains, fruits (especially plums, prunes, and figs), and vegetables are good sources of dietary fiber. There are many health benefits of a high-fiber diet. Dietary fiber helps reduce the chance of gastrointestinal problems such as constipation and diarrhea by increasing the weight and size of stool and softening it. Insoluble fiber, found in whole-wheat flour, nuts and vegetables, especially stimulates peristalsis -- the rhythmic muscular contractions of the intestines which move digesta along the digestive tract. Soluble fiber, found in oats, peas, beans, and many fruits, dissolves in water in the intestinal tract to produce a gel which slows the movement of food through the intestines. This may help lower blood glucose levels because it can slow the absorption of sugar. Additionally, fiber, perhaps especially that from whole grains, is thought to possibly help lessen insulin spikes, and therefore reduce the risk of type 2 diabetes.

Fat: A molecule of dietary fat typically consists of several fatty acids (containing long chains of carbon and hydrogen atoms), bonded to a glycerol. They are typically found as triglycerides (three fatty acids attached to one glycerol backbone). Fats may be classified as saturated or unsaturated depending on the detailed structure of the fatty acids involved. Saturated fats have all of the carbon atoms in their fatty acid chains bonded to hydrogen atoms, whereas unsaturated fats have some of these carbon atoms double-bonded, so their molecules have relatively fewer hydrogen atoms than a saturated fatty acid of the same length. Unsaturated fats may be further classified as monounsaturated (one double-bond) or polyunsaturated (many double-bonds). Furthermore, depending on the location of the double-bond in the fatty acid chain, unsaturated fatty acids are classified as omega-3 or omega-6 fatty acids. Trans fats are a type of unsaturated fat with trans-isomer bonds; these are rare in nature and in foods from natural sources; they are typically created in an industrial process called (partial) hydrogenation. There are nine calories in each gram of fat.

Essential fatty acids: Most fatty acids are non-essential, meaning the body can produce them as needed, generally from other fatty acids and always by expending energy to do so. However, in humans, at least two fatty acids are essential and must be included in the diet. An appropriate balance of essential fatty acids—omega-3 and omega-6 fatty acids—seems also important for health, although definitive experimental demonstration has been elusive. Both of these "omega" long-chain polyunsaturated fatty acids are substrates for a class of eicosanoids known as prostaglandins, which have roles throughout the human body. They are hormones, in some respects. The omega-3 eicosapentaenoic acid (EPA), which can be made in the human body from the omega-3 essential fatty acid alpha-linolenic acid (LNA), or taken in through marine food sources, serves as a building block for series 3 prostaglandins. The omega-6 dihomo-gamma-linolenic acid (DGLA) serves as a building block for series 1 prostaglandins, whereas arachidonic acid (AA) serves as a building block for series 2 prostaglandins. Both DGLA and AA can be made from the omega-6 linoleic acid (LA) in the human body, or can be taken in directly through food. An appropriately balanced intake of omega-3 and omega-6 partly determines the relative production of different prostaglandins, which is one reason why a balance between omega-3 and omega-6 is believed important for cardiovascular health. In industrialized societies, people typically consume large amounts of processed vegetable oils, which have reduced amounts of the essential fatty acids along with too much of omega-6 fatty acids relative to omega-3 fatty acids.

The conversion rate of omega-6 DGLA to AA largely determines the production of the prostaglandins PGE1 and PGE2. Omega-3 EPA prevents AA from being released from membranes, thereby skewing prostaglandin balance away from pro-inflammatory PGE2 (made from AA) toward anti-inflammatory PGE1 (made from DGLA). Moreover, the conversion (desaturation) of DGLA to AA is controlled by the enzyme delta-5-desaturase, which in turn is controlled by hormones such as insulin (up-regulation) and glucagon (down-regulation). The amount and type of carbohydrates consumed, along with some types of amino acid, can influence processes involving insulin, glucagon, and other hormones; therefore the ratio of omega-3 versus omega-6 has wide effects on general health, and specific effects on immune function and inflammation, and mitosis (i.e. cell division).

Saturated fats (typically from animal sources) have been a staple in many world cultures for millennia. Unsaturated fats (e. g., vegetable oil) are considered healthier, while trans fats are to be avoided. Saturated and some trans fats are typically solid at room temperature (such as butter or lard), while unsaturated fats are typically liquids (such as olive oil or flaxseed oil). Trans fats are very rare in nature, and have been shown to be highly detrimental to human health, but have properties useful in the food processing industry, such as rancidity resistance.

Proteins are the basis of many animal body structures (e.g. muscles, skin, and hair). They also form the enzymes that control chemical reactions throughout the body. Each molecule is composed of amino acids, which are characterized by inclusion of nitrogen and sometimes sulphur (these components are responsible for the distinctive smell of burning protein, such as the keratin in hair). The body requires amino acids to produce new proteins (protein retention) and to replace damaged proteins (maintenance). As there is no protein or amino acid storage provision, amino acids must be present in the diet. Excess amino acids are discarded, typically in the urine. For all animals, some amino acids are essential (an animal cannot produce them internally) and some are non-essential (the animal can produce them from other nitrogen-containing compounds). About twenty amino acids are found in the human body, and about ten of these are essential and, therefore, must be included in the diet. A diet that contains adequate amounts of amino acids (especially those that are essential) is particularly important in some situations: during early development and maturation, pregnancy, lactation, or injury (a burn, for instance). A complete protein source contains all the essential amino acids; an incomplete protein source lacks one or more of the essential amino acids.

It is possible to combine two incomplete protein sources (e.g. rice and beans) to make a complete protein source, and characteristic combinations are the basis of distinct cultural cooking traditions. Sources of dietary protein include meats, tofu and other soy-products, eggs, legumes, and dairy products such as milk and cheese. Excess amino acids from protein can be converted into glucose and used for fuel through a process called gluconeogenesis. The amino acids remaining after such conversion are discarded.

Protein is an important component of every cell in the body. Hair and nails are mostly made of protein. The body uses protein to build and repair tissues. In addition, protein is used to make hormones and other chemicals in the body. Protein is also an important building block of bones, muscles, cartilage, skin, and blood.

The protein requirement for each individual differs, as do opinions about whether and to what extent physically active people require more protein. The 2005 Recommended Dietary Allowances (RDA), aimed at the general healthy adult population, provide for an intake of 0.8 - 1 grams of protein per kilogram of body weight (according to the BMI formula), with the review panel stating that "no additional dietary protein is suggested for healthy adults undertaking resistance or endurance exercise". Conversely, Di Pasquale (2008), citing recent studies, recommends a minimum protein intake of 2.2 g/kg "for anyone involved in competitive or intense recreational sports who wants to maximize lean body mass but does not wish to gain weight".

Water: It is not fully clear how much water intake is needed by healthy people, although some assert that 6–8 glasses of water daily is the minimum to maintain proper hydration. The notion that a person should consume eight glasses of water per day cannot be traced to a credible scientific source. The effect of, greater or lesser, water intake on weight loss and on constipation is also still unclear. The original water intake recommendation in 1945 by the Food and Nutrition Board of the National Research Council read: "An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods." The latest dietary reference intake report by the United States National Research Council recommended, generally, (including food sources): 2.7 liters of water total for women and 3.7 liters for men. Specifically, pregnant and breastfeeding women need additional fluids to stay hydrated. According to the Institute of Medicine—who recommend that, on average, women consume 2.2 litres and men 3.0 litres—this is recommended to be 2.4 litres (approx. 9 cups) for pregnant women and 3 litres (approx. 12.5 cups) for breastfeeding women because an especially large amount of fluid is lost during nursing.

For those who have healthy kidneys, it is somewhat difficult to drink too much water, but (especially in warm humid weather and while exercising) it is dangerous to drink too little. People can drink far more water than necessary while exercising, however, putting them at risk of water intoxication, which can be fatal. In particular, large amounts of de-ionized water are dangerous.

Normally, about 20 percent of water intake comes in food, while the rest comes from drinking water and assorted beverages (caffeinated included). Water is excreted from the body in multiple forms; including urine and feces, sweating, and by water vapor in the exhaled breath.

Overeating vs. Hunger

Although a lot of the focus regarding malnutrition centers around undernourishment, overeating is also a form of malnutrition. Overeating is much more common in the United States, where for the majority of people, access to food is not an issue. The issue in these developed countries is choosing the right kind of food. Fast food is consumed more per capita in the United States than in any other country. The reason for this mass consumption of food is the affordability and accessibility. Oftentimes the fast food, low in cost and nutrition, are high in calories and heavily promoted. When these eating habits are combined with increasingly urbanized, automated, and more sedentary lifestyles, it becomes clear why gaining weight is difficult to avoid. However, overeating is also a problem in countries where hunger and poverty persist. In China consumption of high-fat foods have increased while consumption of rice and other goods have decreased. Overeating and hunger are equally serious issues depending on what part of the world you live in. Overeating leads to many diseases such as, heart disease and diabetes, that result in death. To aid in fixing this issue of overeating, health care could recognize obesity as a disease and cover weight-loss and other nutritional interventions. An encouraging first step in this direction is Mutual of Omaha's decision to cover intensive dietary and lifestyle modification program of patients with heart disease, an initiative they hope will eliminate costly prescriptions and prevent surgeries months or years down the road. A logical next step for the industry might be to cover regular nutrition checkups, akin to dental check-ups, as part of a basic insurance coverage.