1. Community and Public Health
Nutrition
lec 7-Nutrition for Health Promotion and
Disease Prevention 1
Diet, Nutrition and the Infectious Diseases
1-immune system
2-HIV/AIDS
Dr. Siham Gritly
Dr. Siham Gritly 1

2. Ref Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth
Edition. 2011, 2008 Wadsworth, Cengage Learning
• Diet cannot directly
prevent or cure infectious
diseases, but good nutrition
can strengthen, and
malnutrition can weaken,
the body’s defenses
mechanisms against them
Dr. Siham Gritly 2

3. glossary
• infectious diseases: diseases caused by bacteria, viruses,
parasites, or other microorganisms that can be transmitted
from one person to another through air, water, or food; by
contact; or through vector organisms such as mosquitoes.
• antibodies: large proteins of the blood and body fluids,
produced by the immune system in response to the invasion of
the body by foreign molecules (usually proteins called
antigens). Antibodies combine with and inactivate the foreign
invaders, thus protecting the body.
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4. • antigens: substances that elicit the formation of
antibodies or an inflammation reaction from the
immune system.
• phagocytes: white blood cells (neutrophils and
macrophages) that have the ability to ingest and
destroy foreign substances.
• Phagocytosis: the process by which phagocytes
engulf and destroy foreign materials.
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5. • Lymphocytes; white blood cells that participate
in acquired immunity; B-cells and T-cells.
• B-cells: lymphocytes that produce antibodies. B
stands for bone marrow, where the B-cells
develop and mature.
• T-cells: lymphocytes that attack antigens. T
stands for the thymus gland, where the T-cells
mature.
• Cytokines; special proteins that direct immune
and inflammatory responses
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6. Diet and Disease Prevention
• Concept of diseases
• Many scientists defined diseases in different
ways;
• *Webster defined it as "a condition which body
health is impaired, a departure from state of
health, an alteration of the human body
interrupting the performance of vital function".
• *Oxford defined disease as "a condition of the
body of some part of organ of the body in which
its functions are disrupted deranged"
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7. • *Ecologist defined disease as "a mal-adjustment
of the human organism to the
environment'
• *pathologist defined disease as "abnormal
variation in the structure of function of any
part of the body“
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8. Diet and Health Promotion
• Diet and nutrition are important factors in the
promotion and maintenance of good health and
reducing risk of chronic and infectious
diseases throughout the life
• Diet have strong effects, both positive and
negative, on health throughout life
• physical activity also play important role in
health promotion and disease prevention
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9. Nutrition and the Infectious Diseases
• infectious diseases: diseases caused by
bacteria, viruses, parasites, or other
microorganisms that can be transmitted from
one person to another through air, water, or
food; by contact; or through vector organisms
such as mosquitoes.
• Example AIDS
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10. ref. Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth
Edition. 2011, 2008 Wadsworth, Cengage Learning
• “Nutrition cannot prevent or cure infectious
diseases, but adequate intakes of all the
nutrients can help support the immune system
as the body defends against disease-causing
agents. If the immune system is impaired
because of malnutrition or diseases such as
AIDS, a person becomes vulnerable to
infectious disease”.
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11. The Immune System
Three types of human body;1-Natural or innate,2-
Adaptive immunity,3-Passive immunity
Adaptive immunity involves the
lymphocytes produced antibodies in
response to the invasion of the body by
foreign molecules (usually proteins called
antigens) or people exposed that to
immunization against diseases through
vaccination
Passive immunity is come from another
source and it lasts for a short time. For
example, antibodies in a mother's breast
milk provide a baby with temporary
immunity to diseases the mother has been
exposed to.
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12. The Immune System
The body’s first lines of defense—
the skin, mucous membranes, and
GI tract normally prevent foreign
substances (natural or innate). If
these barriers fail, then the organs
and cells of the immune system
race into action. Foreign substances
that gain entry into the body and
elicit such a response are called
antigens. Examples include
bacteria, viruses, toxins, and food
proteins that cause allergies.
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13. Organs of The Immune System
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Organs of the
immune system:
• Spleen
• Lymph nodes
• Thymus

14. Cells of the immune system:
• Cells of the immune system:
• • Phagocytes
• • Neutrophils
• • Macrophages
• • Lymphocytes
• 1-B-cells
• 2-T-cells
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15. Lymph tissues include the thymus, lymph nodes,
and spleen.
The immune system is made up of a
network of cells, tissues, and organs that
work together to protect the body. The cells
involved are white blood cells,
Leukocytes are produced or stored in many
locations in the body, including the thymus,
spleen, and bone marrow. For this reason,
they're called the lymphoid organs. There
are also clumps of lymphoid tissue
throughout the body, primarily as lymph
nodes, that house the leukocytes.
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16. Cells of the immune system
Two types of white blood cells, defend the body
against infectious diseases
phagocytes
lymphocytes
• the phagocyte engulfs and digests foreign
body's, in a process called phagocytosis.
• Phagocytes also secrete special proteins called
cytokines that activate the metabolic and
immune responses to infection
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17. White blood cell engulfing yeast
the phagocyte cell engulfs and digests foreign body's, in a
process called phagocytosis.
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White blood cell
(phagocyte) engulfing
yeast cell. (Phagocytosis.
Colored Scanning Electron
Micrograph (SEM) of a
cultured lymphocyte
phagocytosing (engulfing)
a yeast cell. At right, the
lymphocyte white blood
cell (blue) is using

18. White blood cell Lymphocytes:
There are two distinct types of lymphocytes:
B-cells and T-cells.
B-cells respond to infection by
rapidly dividing and producing large
proteins known as antibodies
(immunoglobulins).
Antibodies travel in the bloodstream
to the site of the infection. There
they stick to the surfaces of antigens
and kill or otherwise inactivate them,
making it easy for the phagocytes to
ingest
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19. • Lymphocytes: The T-cells travel directly to the
invasion site to fight the invaders.
• T-cells recognize the antigens displayed on the
surfaces of phagocyte cells and multiply in
response.
• Then they release powerful chemicals to destroy
all the foreign particles that have this antigen on
their surfaces.
• As the T-cells begin to win the battle against
infection, they release signals to slow down the
immune response.
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20. A number of different cells are considered phagocytes.
Two types of immune system cells ingest and destroy
foreign antigens by phagocytosis: neutrophils and
macrophages.
The most common type is the neutrophil, which
primarily fights bacteria
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21. Nutrition and Immunity
• the immune system responds to change in
nutrition status. Malnutrition has great effect
on immunity system .
• Impaired immunity opens the way for
infectious diseases, which typically raise
nutrient needs and lower food intake.
• Impaired immunity is a characteristic of
protein-energy malnutrition (PEM).
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22. Nutrients known to affect immunity
• • Fatty acids
• • Folate
• • Iron
• • Protein
• • Selenium
• • Vitamin A
• • Vitamin B6
• • Vitamin C
• • Vitamin E
• • Zinc helps with the development of white bloods
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23. • Selenium (Se) constituent of glutathione
peroxidase which has antioxidant function
• antioxidant protects the cell membrane against
oxidative damage by H2O2
• This function is important in preventing lipid
oxidation and protect cell against superoxide
free radicals
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24. • Zinc also promotes wound healing, regulates
immune function, serves as a co-factor for
numerous antioxidant enzymes, and is
necessary for protein synthesis and the
processing of collagen
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25. ref. Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth
Edition. 2011, 2008 Wadsworth, Cengage Learning
• without sufficient protein to make antibodies, the
immune system loses its ability to fight infections.
• Deficiencies of vitamins and minerals also diminish
the immune response,
• interactions between nutrients may enhance or impair
immunity.
• optimal immunity depends on optimal nutrition—
enough, but not too much, of each of the nutrients.
• People with weakened immune systems, such as the
elderly, may benefit from a nutritious diet and
supplements of selected nutrients
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26. AIDS (Acquired Immune Deficiency
Syndrome)
• HIV (human immunodeficiency virus): the
virus that causes AIDS. The infection
progresses to become an immune system
disorder that leaves its victims defenseless
against numerous infections.
• AIDS (acquired immune deficiency
syndrome): the late stage of HIV infection, in
which severe complications develop.
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27. Viruses are parasite consists of nucleic acids (DNA or RNA.
Only one of the nucleic acid should be present at a time in the
virus. Viruses are dependent entirely on the host cell for their
replication. The cell of the virus encode with the proteins that
coat virus nucleic acid molecules to form virus particles or
Virion (or protein complex).
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28. Virion functions are;
• 1-protects the nucleic acid of the virus from
environmental factors during its transmission from
host to another and from cell to cell, environmental
factors as; enzymes, ultraviolet irradiation.
• 2-virion initiate the infection by binding to specific
surface of the cell and thus enable viruses to induce
infection (indicate the presence of pathogens).
• 3-virion act as structural and functional support for
delivering the virus into host cell.
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29. The human immune system is the site of
the attack by the virus
Acquired immune deficiency
syndrome (AIDS) is a set of
symptoms and infection
resulting from the damage to
the human immune system.
This condition progressively
reduces the effectiveness of
the immune system and
leaves individuals
susceptible to infection and
tumors.
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30. Pathogenesis of the disease
• HIV is transmitted through direct contact of a
mucous membrane or the bloodstream with a
bodily fluid containing HIV, such as
• Blood
• Semen
• Vaginal fluid
• Breast milk
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31. monocytes and macrophages act as viral
receptor
• On entering the virus invade the immune
system cells monocytes and macrophages.
• Those cells act as viral receptor.
• The virion binds with the cell and allows the
virus to enter the cells.
• Incubation period is long, usually infected
person develop AIDs in 5-7 years.
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32. Monocytes and macrophages act as reservoir of
the virus.
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33. Transmission of the disease
• HIV transmission involve
• Anal intercourse which is the main route of
transmission in male homosexual, bisexual and
heterosexual.
• Vaginal
• Oral sex
• Blood transfusion
• contaminated needles
• exchange between mother and baby during
pregnancy, childbirth or breastfeeding
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34. • Sexual transmission
• Sexual transmission occurs with the contact
between sexual secretions of one person with
the rectal, genital or oral mucous membranes
of another oral sex.
• Infected male transmit the virus in his semen
to recipients' body through rectal mucosa.
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35. • During vaginal intercourse, the virus
penetrates the vaginal mucosa and inter to
blood stream. During female to male
transmission the virus being present in infected
female in the vagina and cervical secretion
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36. • Transmission through blood transfusion and
intravenous drugs
• Transmission may occur by intravenous drugs and
through blood transfusion, usually virus present in
blood plasma of infected person, which is the
major risk for infection the risk also extended to
people who give and receive tattoos.
• Blood transfusion infection had been reduced by
screening all blood donation and heat treating
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37. • Mother-to-child transmission
• The transmission of the virus from the mother to the
child can occur during the last weeks of pregnancy
and at childbirth.
• In the absence of treatment, the transmission rate
between a mother and her child during pregnancy,
labor and delivery is 25%.
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38. • Breastfeeding also increases the risk of
transmission by about 4 %.
• HIV-infected mothers should avoid breast-feeding
their infant.
• It is difficult to diagnose infected child with
HIV in the first few month of gestation
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39. Main features of the disease
are persistent fever for more
than 3 month, weight loss,
diarrhea, anemia, infection
such as pneumonia and other
bacterial infection. Central
nervous system is a major
target for the infection and
dementia may develop (mental
illness), the virus inter the
brain and damage of the brain
cells occur.
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40. Health and sexual education is the key for
prevention and limiting the disease
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41. Nutrition and AIDs
http://www.webmd.com/hiv-aids/guide/nutrition-hiv-aids-enhancing-quality-
life
• Medication along with proper nutrition is a
major component of maintaining good health
and quality of life for people living with
HIV/AIDS.
• People living with AIDS have impaired
immune systems and therefore are more
susceptible to infections and diseases due to
foodborne pathogens
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42. • For people with HIV/AIDS, energy
requirements often increase in order to
maintain their regular body weight
• The (WHO) recommends vitamin A
supplements for all young children 6 to 59
months old that are at high risk of vitamin A
deficiency every 4 to 6 months
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43. The Basic Principles of Nutrition and HIV
ref http://www.webmd.com/hiv-aids/guide/nutrition-hiv-aids-enhancing-quality-
life
• The principles include:
• Eating a diet high in vegetables, fruits, whole
grains, and legumes
• Choosing lean, low-fat sources of protein
• Limiting sweets, soft drinks, and foods with
added sugar
• Including proteins, carbohydrates, and a little
good fat in all meals and snacks
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44. ref http://www.webmd.com/hiv-aids/guide/nutrition-hiv-aids-enhancing-quality-
life
• Recommendation for Calories are the energy in
foods that provide body with fuel. To maintain your
lean body mass, you may need to increase calories.
To get enough calories:
• Consume 17 calories per pound of your body weight
if you've been maintaining your weight.
• Consume 20 calories per pound if you have an
opportunistic infection.
• Consume 25 calories per pound if you are losing
weight.
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45. • Recommendation for Protein helps build muscles,
organs, and a strong immune system. To get enough
of the right types of protein
• Aim for 100-150 grams a day, if you are an HIV-positive
man.
• Aim for 80-100 grams a day, if you are an HIV-positive
woman.
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46. • If you have kidney disease, don't get more than
15%-20% of your calories from protein;
• Choose extra-lean beef, skinless chicken
breast, fish, and low-fat dairy products.
• To get extra protein, spread nut butter on fruit,
vegetables, or toast; add cheese to sauces,
soups, potatoes, or steamed vegetables; add
canned tuna to salads or casseroles
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47. • Recommendation for Carbohydrates
• To get enough of the right types of carbohydrates:
• Eat five to six servings (about 3 cups) of fruits and
vegetables each day.
• Choose legumes and whole grains, such as brown rice
and whole-wheat flour, oats, and barley and potato as
your starch sources.
• If you are diabetic or pre-diabetic or have insulin
resistance, then most of your carbohydrates should
come from vegetables.
• Limit simple sugars, such as candy, cake, cookies, or
ice cream.
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48. Effects of Protein-Energy Malnutrition (PEM)
on the Body’s Defense Systems
Body’s Defense
System
Effects of PEM
Skin Thinned, with less connective tissue to serve
as a barrier to protect underlying tissues;
delayed skin sensitivity reaction to antigens
Digestive tract
and other body
linings
Antibody secretions and immune cell number
reduced
Lymph tissues Immune system organs reduced in size; cells
of immune defense depleted
General
response
Invader kill time prolonged; circulating
immune cells reduced; antibody response
impaired
Dr. Siham Gritly 48

49. • http://www.webmd.com/hiv-aids/guide/nutrition-hiv-aids-enhancing-quality-life
• Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth Edition.
2011, 2008 Wadsworth, Cengage Learning
• http://www.livestrong.com/article/354549-the-effect-of-exercise-on-the-cardiorespiratory-
system/#ixzz2UUaL51TH
• http://www.mayoclinic.com/health/medical/IM00642
• Scott K. Powers & Edward T. Howley; Theory and Application to Fitness and
Performance, 6th edition. EXERCISE PHYSIOLOGY
• Sports Fitness Advisor: The Cardiovascular System and Exercise
• Read more: http://www.livestrong.com/article/192489-immediate-effects-of-exercise-
on-the-cardiovascular-system/#ixzz1miWxuYrs
• Diastolic Blood Pressure During Exercise | eHow.com
• Lactate Theshold Training. Len Kravitz, and Lance Dallec
Dr. Siham Gritly 49

50. • Diet, nutrition, and the prevention of chronic diseases. Report of a WHO
Study Group. Geneva, World Health Organization, 1990(WHO Technical
Report Series, No. 797).
• Diet, physical activity and health. Geneva, World Health Organization,
2002 (documents A55/16 and A55/16 Corr.1).
• http://www.webmd.com/hiv-aids/guide/nutrition-hiv-aids-enhancing-quality-
life
• Sareen Gropper, Jack Smith and James Groff, Advanced Nutrition and
Human Metabolism, fifth ed. WADSWORTH
• Melvin H Williams 2010; Nutrition for Health, Fitness and Sport. 9th ed,
McGraw Hill
• Heymsfield, SB.; Baumgartner N.; Richard and Sheau-Fang P. 1999.
Modern Nutrition in Health and Disease; Shils E Maurice, Olson A.
James, Shike Moshe and Ross A. Catharine eds. 9th edition
• Guyton, C. Arthur. 1985. Textbook of Medical Physiology. 6th edition,
W.B. Company
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