CARBOHYDRATES: 3 different categories exist. Sugars are carbohydrates that include both the monosaccharides glucose, fructose, and galactose and the disaccharides sucrose, lactose, and maltose. Other sugars include dextrose, brown sugar, honey, malt syrup, corn syrup, corn sweetener, high fructose corn syrup, invert sugar, molasses, raw sugar, etc. Starches are carbohydrates is a polysaccharide polymer of glucose molecules found within certain types of foods, including tubers, grains, and beans and peas. Breads and pasta are also primarily composed of starch refined starches are sometimes added as thickeners and stabilizers. Fiber is a type of carbohydrate includes fibrous molecules of both plants and animals that cannot be chemically digested absorbed by the GI tract. Sources of fiber include vegetables, lentils, peas, beans, whole grains, oatmeal, berries, and nuts. Sugars and starch are usually converted to glucose, which is one of the primary nutrients supplying energy to cells. Each glucose molecule is oxidized during the process of cellular respiration into a net of 30 ATP molecules, equivalent to approx. 4 kilocalories of energy per gram of glucose. Glucose is not considered an essential nutrient since it is made in the body. Fiber serves a different purpose; it doesnt get absorbed and simply adds bulk to the lumen of the GI tract. Some fiber decreases LDL levels.

LIPIDS: are a diverse group of biologically active, hydrophobic molecules that include triglycerides, phospholipids, steroids (including cholesterol), and eicosanoids. Triglycerides are composed of glycerol and fatty acids. FAs are categorized into three groups. Saturated fatty acids have no double bonds, are solid at room temperature, and dietary sources include the fat in meat, milk, cheese, coconut oil, and palm oil. Unsaturated fatty acids have one double bond, are liquid at room temperature, and come from nuts and certain vegetable oils. Polyunsaturated fatty acids have two or more double bonds, are also liquid at room temperature, and sources include some vegetables oils. Triglycerides are also a primary nutrient supplying energy to cells. Oxidation of triglyceride molecules yields approx. 9 kilocalories of energy per gram of fat- more than twice that of glucose. Fats are also necessary for the absorption of fat-soluble vitamins A, D, E, K. The only two fatty acids that the body needs, but cannot produce are alpha-linoleic acid and linoleic acid. Cholesterol is required as a component of the cell membrane and also is the precursor molecule for the formation of steroid hormones, bile salts, and vitamin D. It is either made through our diet or is synthesized by metabolic pathways within the liver.

PROTEINS: most structurally and functionally diverse molecules, are synthesized from 20 different amino acids. The specific amount of protein required in the diet is generally dependent upon one's age and sex, but ranges between approx. 45-60 grams daily. Required protein is increased when fighting an infection, following an injury, under certain conditions of stress, and during pregnancy. It is also higher in infants and children to synthesize protein molecules needed for growth. Eight of the 20 AAs are essential in adults and must be obtained from the diet. Complete proteins provide all 20 AAs and include animal proteins; incomplete proteins do not provide all 20 AAs and include plant proteins. There is no storage of extra AAs. A diet based solely on plant-based protein tends not have all essential AAs. Proteins are also a source of nitrogen; it is needed for synthesizing other nitrogen-containing molecules, such as nitrogenous bases of nucleic acids and porphyrin. Adequate availability of nitrogen is expressed as nitrogen balance. A negative nitrogen balance, when more nitrogen is excreted than absorbed, can be fatal. AAs absorbed from our diet are used by our cells to build all of the structural and functional proteins found within the body.

VITAMINS: organic molecules required from normal metabolism; can be water or fat soluble. Good sources of vitamins include meat, eggs, beans, legumes, nuts,vegetables, and fruits. Water soluble vitamins include both the B vitamins and vitamin C. B vitamins serve as coenzymes in various enzymatic chemical reactions. Vitamin C is required for the synthesis of collagen, which is an important protein in connective tissue. This vitamin, along with vitamins A and K, functions as an antioxidant by removing free radicals. Fat soluble vitamins are absorbed from the GI tract within the lipid of micelles and ultimately enter the lymphatic capillaries (lacteals). Excess levels can be stored in body fat. VitA is a precursor molecule for the formation of the visual pigment retinal. VitD is modified to form calcitriol: a hormone that increases calcium absorption for the GI tract. VitE helps stabilize and prevent damage to cell membranes. VitK is required for synthesis of specific blood clotting proteins.

MINERALS: are inorganic ions such iron, calcium, sodium, potassium, iodine, zinc, magnesium, and phosphorus. Many foods that are a good source of vitamins are a good source of minerals. Iron is present both in hemoglobin within the mitochondria in the electron transport system to bind electrons. Calcium is required for the formation and maintenance of the skeleton, muscle contraction, exocytosis of neurotransmitters, and blood clotting. Sodium and potassium function to maintain a resting membrane potential in excitable cells and are required in the propagation of an action potential. Iodine is needed to produce thyroid hormone. Zinc has roles in both protein synthesis and would healing. All minerals are essential and must be obtained from the diet. Two categories: major minerals (needed at levels greater than 100 mg/day) and trace minerals (needed at levels less than 100 mg and include chromium, cobalt, copper, fluoride, iodine, iron, manganese, molybdenum, selenium, and zinc. Minerals absorbed from the GI tract are stored to varying degrees within the body. These reserves are hedges against unexpected decreases in availability; however, if stored minerals are depleted, clinical problems may occur. Note that some foods are fortified by adding one or more essential nutrients, which may or may not be normally present in the food, to increase its nutritional value.

PROTEINS: 0.8 grams of protein per kg of body weight. This is because we need essential and nonessential AAs to build the myriad of proteins that we constantly use in our body.

LIPIDS: in adults is 20-35% of total calories per day from fat. That is around 44-77 grams of fat per day if you consume 2,000 calories a day. Lipids are crucial for alternative sources of energy when glucose levels might be low.

CARBOHYDRATES: should make up around 45-65% of your total daily calories. Therefore, based on a normal diet, between 900-1,300 calories should be from carbohydrates. We need an abundance of carbs since cellular respiration depends on the oxidation of glucose molecules as the main energy source for producing ATP within our cells

Believing a multivitamin per day could cause the patient to not understand and not believe her diet is causing her extreme symptoms.

Raw water can contain unhealthy minerals, ions, particles, bacteria, or parasites that could make the patient even more ill. It also lacks fluoride, a major component of bones and teeth. Begin to drink normal tap water to get clean, fluoride-infused water to reestablish homeostasis.

No animal protein that can deliver essential AAs needed for building the myriad proteins found in the body. Cooking foods releases many of the nutrients and drastically helps the body metabolize food in the digestive tract. Begin to cook foods and specifically add foods rich in plant-based protein that contains essential AAs.

It is a dangerous feedback loop to continue to limit your nutrients when the lack of nutrients is already causing the patient's malnutrition. Doing this will further her obsession with healthy food and cause her to be further malnourished. Reestablishing homeostasis by education patient that her extremely limited diet is causing her malaise.