1. Dr. Sarita Mangukiya ASSISTANT PROFESSOR BIOCHEMISTRY, GMCS
NUTRITION
Dr. Sarita Mangukiya
ASSISTANT PROFESSOR
BIOCHEMISTRY, GMCS

3. NUTRITION Protein Energy Malnutrition: Predominantly in children
Developing & underdeveloped countries
20 – 50% prevalence
Marasmus kwarshiorkar
To waste sickness of older child
when the next child is born.

4. Kwarshiorkar Marasmus
< 5 yr
< 1 yrs
Weaning with intake of low protein high CHO diet
Premature weaning with low CHO/protein food
Milder atrophy & thining of muscles. Less emaciated look due to oedema
Severe atrophy of limb, abdominal muscles with emaciation.growth failure
Patchy hyperpigmentation, exfoliation, ulceration
Dry, thin wrinkled skin devoid of subcutaneus fat
Atrophy of int. mucosa, pancreatic acini. Failure of digestion. Diarrhoea & flatlulence.
Marked Hypoabuminemia
Hypoalbuminemia

5. Kwarshiorkar Marasmus
Enlarged & fatty Liver. Decreased chol, Trig, - lipoproteins
Sometimes hepatic cirrhosis without fatty infiltration
Anemia, hypoglycemia low BMR, low body temp
poor brain dev. Low IQ
Lower brain dev.
Normal / high insulin, normal / low cortisol, adrenaline
Low blood insulin, high cortisol, adrenaline

9. Deficiency of the amino acid methionine, a precursor of cysteine, may also contribute.
Cysteine is one of the three amino acids present in glutathione, the body's major antioxidant.
If the tissues levels of glutathione decline, this could result in free radicals damaging various molecules and tissues and perhaps damaging cell membranes, increasing their permeability.

10. Treatment Treat secondary infection Oral supplement of nutrition
Parenteral or enteral nutrition

11. Obesity
Obesity is a disorder of body weight regulatory systems characterized by an accumulation of excess body fat.
As adiposity has increased so has the risk of developing associated diseases, such as diabetes, hypertension, and cardiovascular disease

12. Assessment of Obesity
body mass index (BMI) -The BMI gives a measure of relative weight, adjusted for height.
BMI = (weight in kg)/(height in meters)2
Healthy range for the BMI to 25.0.
Overweight -25 and 29.9
Obese- equal to or greater than 30.

13. Anatomic differences in fat deposition

14. Biochemical differences in regional fat depots
Abdominal subcutaneous fat and Visceral fat- Metabolically active than lower body subcutaneous fat.
Endocrine function of adipocyte
Importance of Portal circulation

15. Number of fat cells

16. Body Weight Regulation
Genetic contributions to obesity- identical twins , Families
Environmental and behavioral contributions
ready availability of palatable, energy-dense foods,
sedentary lifestyles, encouraged by TV watching, automobiles, computer usage, and energy- sparing devices in the workplace and at home, decrease physical activity and enhance the tendency to gain weight.

18. Molecules that Influence Obesity
Long term signals- Leptin, Insulin

19. Short term Signals- GIT- Ghrelin (Appetite stimulating hormone)
CCK, Peptides- action on gastric empyting and neural signals to hypothalamus. (Satiety)
Hypothalamus- Neuropeptides(NPY, α- MSH) and neurotransmitter (serotonine and dopamine)

20. Metabolic Changes Observed in Obesity
Dyslipidemias,
Glucose intolerance, and
Insulin resistance
Hypertension

21. Weight Reduction Physical activity Caloric restriction
Pharmacologic and surgical treatment