Professional Documents
Culture Documents
Nutrition
Nutrition
I.
PRINCIPLES OF NUTRITION
nutrition study of nutrients and how they are handled by the body as well as the impact of human behavior
and environment on the process of nourishment
nutrients specific biochemical substances used by body for growth, development, activity, reproduction,
lactation, health maintenance, and recovery from illness or injury
- needs change throughout the life cycle in response to changes in body size, activity, growth,
development, and state of health
- considered essential because they either are not synthesized in the body or are made in insufficient
amts. - - must be provided in diet or through supplements
Classes:
II.
A.
B.
METABOLIC REQUIREMENTS
basal metabolism amt of energy required to carry on the involuntary activities of the body at rest, such as
maintaining body temperature and muscle tone, producing and releasing secretions, propelling food
through the gastrointestinal (GI) tract, inflating the lungs, and contracting the heart muscle
- as amt of energy used on physical activity declines, proportion of calories used for basal metabolism
increases
- men have higher basal metabolic rate (BMR) than women because of their larger muscle mass
BMR = 1 cal/kg of body weight per hour for men
BMR = 0.9 cal/kg of body weight per hour for women
- factors that increase BMR include growth, infections, fever, emotional tension, extreme
environmental temperatures, and elevated levels of certain hormones, especially epinephrine
and thyroid hormones
- factors that decrease BMR include aging, prolonged fasting, and sleep
C.
Body Mass Index (BMI) ratio of height to weight, providing a more accurate reflection of total body
fat stores in general population
Kilograms and Meters:
Weight in Kilograms (2.2 lb = 1 kg)
Height2 in meters (39.37 in = 1 m)
- provides an estimation of relative risk factors for diseases such as heart disease, diabetes,
and hypertension
- may not be accurate for people such as athletes, with a large muscle mass, or
people with edema
- BMI of 25 is considered overweight, 30 or greater indicates obesity
Methods of Calculating Calorie Requirements:
1.
Resting Energy Equivalent (REE) amt of calories necessary to maintain body at rest
Male Ex.:
65 kg x 1 cal/kg x 24 hr = 1560 cal/day
Female Ex.:
65 kg x 0.9 cal/kg x 24 hr = 1404 cal/day
- determine calories needed for specific activity level
- REE is multiplied by one of the following:
light activity REE x 0.55 0.65
moderate REE x 0.65 0.7
heavy REE x 0.75 1.0
Male Ex.:
Female Ex.:
CLASSES OF NUTRIENTS
1.
Carbohydrates known as sugars and starches, are organic compounds composed of carbon,
hydrogen, and oxygen
- only animal source of carbohydrate in the diet is lactose, or milk sugar
- relatively easy to produce and store, most abundant and least expensive course of calories
in diet
- more easily and quickly digested than protein and fat
- converted to glucose for transport through the blood or for use as energy
- cells oxidize (burn) glucose to provide energy, carbon dioxide, and water
- depending on persons state of energy balance, the period between when
carbohydrate is consumed and when it is used for energy may vary from
minute to months or longer
- when supply of glucose exceeds what is needed for energy and for maintaining serum
levels, it is stored
- when glycogen stores are adequate, body converts excess glucose to fat and stores it as
triglycerides in adipose tissue
Classifications:
simple sugars (monosaccharides and disaccharides)
complex sugars (polysaccharides)
recommended dietary allowance (RDA) recommendations for average daily amts that
healthy population groups should consume over time
ketosis abnormal accumulation of ketone bodies that is frequently associated with acidosis
2.
3.
4.
E.
Regulatory Nutrients
a.
Vitamins organic compounds needed by the body in small amounts
- active in form of coenzymes together with enzymes, facilitate thousands of chemical
reactions in the body
- needed for metabolism of carbohydrates, protein, and fat
- may be destroyed by light, heat, air, and during preparation
- mild or subclinical deficiencies of vitamin A, B 6, C, folate may affect those that 1) in
certain age groups - - infants, adolescents, pregnant and lactating women,
and older people 2) smoke, abuse alcohol, or use long-term meds 3)
chronically ill, physically or psychologically 4) are poor or finicky eaters - chronic dieters, strict vegetarians, and food faddists
- will never be a substitute for good nutrition and healthy lifestyle practices
- classified as:
water soluble (vitamin C and B-complex) absorbed through intestinal wall
directly into bloodstream
- deficiency symptoms are apt to develop quickly when intake is
inadequate
- toxicities are not likely
fat soluble (vitamins A, D, E, K) absorbed with fat into lymphatic circulation
- secondary deficiencies can occur anytime fat digestion or
absorption is altered
- body stores excesses mostly in the liver and adipose tissue
- daily intake is not imperative
b.
Minerals inorganic elements found in all body fluids and tissues in the form of salts or
combined with organic compounds
- function to provide structure within body, help to regulate body processes
- not broken down or rearranged in the body, but are contained in ash that remains
after digestion
c.
II.
1.
Food Groups
- grain and cereal group are at the base of the pyramid followed by:
fruit and vegetable group
meat and dairy groups
fat, oil, and sweets group at the peak
- pyramid emphasizes grain and cereal group as basic food in diet with less desirable groups
playing a much smaller nutritional role
- all are required, in proper proportions, for healthy diet
2.
3.
A.
DEVELOPMENTAL CONSIDERATIONS
- nutrient needs change in relation to growth, development, activity, and age-related changes in
metabolism and body composition
- periods of intense growth and development cause an increase in nutrient needs
- nutrient needs stabilize during adulthood, although older people may need more or less of some
nutrients
- consistency of food, eating patterns, and significance of food change with physical and psychosocial
development
1.
2.
Toddlers / Preschoolers can feed themselves, verbalize food likes and dislikes and occasionally
use food to manipulate parents
4.
B.
5.
6.
Pregnant and Lactating Women needs increase to support growth and maintain maternal
homeostasis, particularly during 2nd and 3rd trimester
- key nutrient needs include protein, calories, iron, folic acid, calcium, and iodine
7.
SEX
- men differ from women in nutrient requirements due to differences in body composition and
reproductive function
- larger muscle mass translates into higher caloric and protein requirements
- women have proportionately more adipose tissue
- women of childbearing age have higher iron requirements related to menstruation
C.
STATE OF HEALTH
- alteration in nutrient requirements that results from illness and trauma varies with intensity and
duration of the stress
- trauma, like major surgery, burns, and crush injuries, is followed by hormonal changes that
profoundly affect the bodys use of nutrients
- to preserve or replenish body nutrient stores and to promote healing and recovery, requirements
increase dramatically
- chronic disorders, like diabetes, renal disease, hypertension, heart disease, GI disorders, and
cancer, can alter nutrient requirements by influencing nutrient intake, digestion, absorption,
metabolism, utilization, or excretion
D.
ALCOHOL ABUSE
- alters bodys use of nutrients and interferes with normal nutrient absorption
- requirements increase as efficiency of absorption decreases
- need for B vitamins increases because they are used to metabolize alcohol
- impairs nutrient storage, increases nutrient catabolism, and increases nutrient excretion
E.
MEDICATIONS
- absorption may be altered by drugs that:
change the pH of GI tract
increase GI motility
damage intestinal mucosa
bind with nutrients rendering them unavailable
- metabolism can be altered by drugs that:
act as nutrient antagonists
alter enzyme systems that metabolize nutrients
alter nutrient degradation
- some drugs alter renal reabsorption of nutrients and increase or decrease nutrient excretion
F.
III.
OBJECTIVE ASSESSMENT
A.
DIETARY DATA
- after a screening tool identifies a patient at risk, such as in older adults, it is imperative that a
nutritional assessment be completed as a follow-up
1.
24-Hour Recall Method easiest way to collect dietary data, 24-hour recall of all food and beverages
patient normally consumes during an average day
- includes patients usual portion sizes, meal and snack patterns, meal timing, and location
where food is eaten
- information may not be reliable
2.
Food Diaries - frequency questionnaires or diaries may provide a better overall picture of intake
because patient records all food and beverages consumed in a specified period, usually 3 7
days
3.
Risk Factors Disease, Eating poorly, Tooth loss/mouth pain, Economic hardship, Reduced social
contact, Multiple medicines, Involuntary weight loss/gain, Needs assistance in self-care, Elder
years above age 80
B.
C.
ANTHROPOMETRIC DATA
anthropometric used to determine body dimensions
- used to assess growth rate; can give indirect measurements of body protein and fat stores
- standardized equipment and procedures must be used, data must be compared with appropriate
reference standards for patients age and sex
- height and weight, most common measurements, are obtained when patient is admitted to facility
and periodically thereafter or assessed in home
E.
BIOCHEMICAL DATA
- lab test, which measure blood and urine levels of nutrients or biochemical functions that depend on
adequate supply of nutrients, can objectively detect problems in early stages
- most routine biochemical tests measure protein status, body vitamin, mineral and trace element
status
hemoglobin oxygen carrying protein of red blood cells
hematocrit volume of red blood cells packed by centrifugation in given volume of blood are
measures of plasma protein that also reflect persons iron status