​ANGELES UNIVERSITY FOUNDATION​

Angeles City
COLLEGE OF NURSING

Module 1 Introduction to Nutrition and Its Principles as a Science

Module Overview

Nutrition is the science of food, the nutrients and other substances therein, their
action, interaction and balance in relation to health and disease and the processes by
which an organism ingests, digests, absorbs, transports, utilizes and excretes food
substances.

Food is essential as it provides vital nutrients for survival, and helps the body
function and stay healthy. Food is comprised of macronutrients which includes
carbohydrate, protein and fat that not only offer calories to fuel the body and give it
energy but play specific roles in maintaining health. Food also supplies micronutrients
like vitamins and minerals and phytochemicals that do not provide calories but serve a
variety of critical functions to ensure the body operates optimally.

Nutrition plays an important role in the overall health of an individual. The study
of nutrition has remained to be a dynamic part on how it affects the physiological
condition of the human body as it greatly impacts how the individual is able to perform
his activities of daily living, stay protected against diseases and/or how one can recover
from an illness/ disease, and how it generally affects the quality of life that an individual
gets to enjoy. Along with proper exercise, good, healthy lifestyle and proper nutrition,
an individual is ensured of an optimal kind of life.

In this module, you will learn about nutrition and its basic concepts as to: (1)
definition of terms related to nutrition; (2) basic concepts in nutrition; (3) evolution of
nutrition as a science; (4) malnutrition problems in the Philippines; (4) nutrition and the
critical role of the nurse as a part of the health care team (5) nutrition and nursing
process; (6) assessment of the nutritional status of an individual through the
anthropometric method
 You will spend ​4 hours in this module. Below are the details of the content and
the estimated time of completion.

Part of the module Estimated time

allotment

Pre-Discussion activity 10 minutes

Discussion

1. Viewing activity 5 minutes

2. Video conferencing 1 75 minutes
3. Discussion board 20 minutes
4. Video conferencing 2 75 minutes
5. Viewing activity 5 minutes

Summary and conclusion 10 minutes

Assessment activities 40 minutes
Multiple choice (30 items)
Total number of minutes / 240 minutes / 4 hours
hours

Module Learning Outcomes

Pursuant to the Commission on Higher Education (CHED) Memorandum Order No. 15,
the required policies, standards and guidelines in the nursing program parallels this
module’s aim to satisfactorily meet the following learning outcomes:

● LO1 Integrate the relevant principles of social, physical, natural and health
sciences that affects the current nutritional status of individuals

Learning Objectives
At the end of the discussion, the learner will be able to:

1. Define terms related to nutrition.

2. Discuss the basic concepts in nutrition.
3. Discuss the evolution of nutrition as a science.
Pre-Discussion Activity (ungraded)

You will answer a pretest to check your level of knowledge prior to discussion
using a poll feature via Myclass. These are sample questions regarding nutrition and its
basic concepts of nutrition in terms of evolution as a science, malnutrition problems in
the Philippines, critical role of the nurse as a part of the healthcare team, nutrition’s
application to the nursing process and nutritional assessment of individuals.

​DISCUSSION

1. Viewing of Videos: Basic concept of food and nutrition

https://www.youtube.com/watch?v=17Lm_hvu5MY​. (2.13min) To set the

discussion, you should take note of the basic concept of food and nutrition.

​2.​ ​Video Conferencing 1:​ Your Professor will lead a discussion on nutrition and its
basic concepts as to definition of terms related to nutrition, basic concepts in
nutrition and evolution of nutrition as a science.

DISCUSSION:

BASIC CONCEPT​

Nutrition

● Concerns the food people eat and how their bodies use it
● It is the science of food and the substances found in food and how they are
related to health and diseases
● It is the science of food, the nutrients and other substances therein, their action,
interaction and balance in relation to health and disease and the processes by
which an organism ingests, digests, absorbs, transports, utilizes and excretes
food substances. (Council of Foods and Nutrition)
● It is the relationship between man and his food and implies the psychological and
social as well as the physiological and biochemical aspects (Yudkin)

Human Nutrition
● The process of meeting human health needs in the context of basic human
personal needs by nutritional means.
Principles of the Human Nutrition:

1. Food is a basic need of humans. - part of ​Maslow’s hierarchy of needs

-humans need enough food to live and the

right assortment of foods for optimal health.

2. Foods provide energy (calories), nutrients, and other substances needed for
growth & health.- people eat food for ​many different reasons

CALORIE​ – a unit of measure of the amount of

energy supplied by food

NUTRIENTS – chemical substances in food that the body uses for a variety of
functions

PHYTOCHEMICALS/ PHYTONUTRIENTS – pigments that act as antioxidants in

the body

3.Health problems related to nutrition originate within cells

- Nutrient functions at cellular level

The functions of each cell are maintained by the nutrients it receives --- state of
OPTIMAL CELLULAR

4. Poor nutrition can result from both inadequate and excessive levels of nutrient intake.

DEFICIENCY​ – inadequate NI (​Depletion of tissue

reserves of the nutrient​)

TOXICITY​ – excessive NI (​Saturation of tissue reserves

of the nutrient)​

5. Humans have adaptive mechanisms for managing fluctuations in food intake.

✔ Conserve nutrients ​when ​dietary supply is low

✔ Eliminate nutrients​ when ​excessively high amounts

are present

o E.g. Iron, Calcium

Absorption is regulated f​ or these nutrients

so that the amount absorbed changes in response to the body’s need

6. ​Malnutrition can result from poor diet, disease state, genetic factor, or combinations
of these causes.

✔ Results from either ​inadequate or ​excessive availability of energy or nutrients

w/in the cells

▪ PRIMARY Malnutrition

▪ SECONDARY Malnutrition

▪ NUTRIENT-Gene Interaction (Nutrigenomics)

Examples of Effects of Nutrient-Gene Interaction on Health:

o High alcohol intake during pregnancy in ​some women increases the risk for fetal
alcohol syndrome (FAS ) in her fetus

o The fetuses of ​other women w/ different genetic traits are NOT AFFECTED by
high alcohol intake

o Regular ​intake of green tea reduces the risk of prostate cancer in certain
individuals with PARTICULAR genetic traits

o Whereas in others, it does NOT

Examples of ​SINGLE-gene Disorders​ that affect Nutrient Needs

DISORDER EFFECT

PKU (Phenylketonuria) ✔ Causes build up of phenylalanine

in the blood
✔ Lack of enzyme Phenylalanine
Hydroxylase that metabolizes the ✔ High levels during growth lead to
essential AA MR & poor growth

GALACTOSEMIA ✔ Inability to use galactose to

produce energy
 ✔ Interferes w/ the utilization of sugar ▪ MUST AVOID ALL MILK
galactose found in lactose containing galactose for life

HEMOCHROMATOSIS ✔ Absorb more Fe than normal

✔ Produce CHON that controls how ✔ Excessive levels have toxic effects
much iron is absorbed from food on tissues (liver, heart)

▪ Medication, low Fe & Vit. C

7. Some groups of people are at higher risk of becoming inadequately nourished than
others.

▪ GREATER NEED FOR NUTRIENTS:

✔ Pregnant women or BF mothers

✔ Children

✔ People who are ill

✔ Frail elderly persons

▪ HIGHEST RISK FOR NUTRITIONAL INSULTS:

✔ Poor people

▪ Compromised the soonest & THE most

✔ Cases of food shortages (War or Natural Disaster)

8. Poor nutrition can influence the development of certain chronic diseases.

▪ Low nutrient intake ​(Vegetables, Fruits & Whole Grains)

 ▪ Excessive nutrient intake (​ Calories & Sugars)

✔ Associated with the development of chronic inflammation & oxidative stress

✔ Contribute to the development of more than one disease & produce disease by
more than one mechanism (​YEARS to become APPARENT)​

9. Adequacy, variety, and balance are key characteristics of a healthy diet.

✔ Healthy dietary patterns are:

o Plant-based food (REGULAR consumption: V, F&DB)

o Fish & seafood

o Low fat dietary products

o Poultry & lean meat

o Nuts & seeds

o Whole grains

10. There are no “good” or “bad” foods.

▪ Hotdogs, ice cream, candy, bacon, French fries

▪ Vegetables, fruits & whole grains

✔ People tend to classify foods as ​good or bad

✔ NO FOOD can be firmly labeled a

​ s good or bad

✔ All foods can fit into a ​healthful diet as long as nutrient needs are met at
calorie-intake levels​ that maintain a healthy body weight.

Human Health Needs

Four basic frames of reference help us identify human needs in our clients:

1) Age group needs

2) Stress factors
 3) Health status
4) Basic Human needs

Why is nutritional science applied to nursing?

▪ The ​recognition of the role of nutrition i​ n preventing diseases or illness.

▪ The ​concern for adapting food patterns of individuals to their nutritional needs
within the framework of ​their cultural, economic & psychological situation.

▪ The ​awareness of the need in specified disease states to modify nutritional

factors ​for therapeutic purpose.

Food
● Any substance, organic or inorganic, when ingested or eaten nourishes the body
by building and repairing tissues, supplying heat and energy and regulating body
processes.
● In any article, whether simple, mixed or compound, which is used as a drink or
food, confectionary or condiment. It includes articles used as component for such
(Food and Drug Administration).

● Factors Influencing Food Selection:

1. Food Availability
2. Food Palatability
3. Cost and Convenience
4. Social Factor
5. Psychological Factors
6. Nutritional Factors
 3. Discussion Board

1. What condition can result from the consumption of excessive/ inadequate

quantities of food over an extended period of time?
2. What is the effect of a disproportion among the essential nutrients on an
individual?

4. ​Video Conferencing 2: Your Professor will lead a discussion on the malnutrition

problems in the Philippines, the critical role of the nurse as a part of the health care
team in line with nutrition, the relationship of nutrition and the nursing process and
assessment of the nutritional status of an individual through the anthropometric
method

​Learning objectives:

At the end of the discussion, the learner will be able to:

1. Discuss the malnutrition problems in the Philippines

2. Discuss the critical role of the nurse as a part of the health care team.
3. Identify and discuss the method of evaluating nutritional status.
4. Assess the nutritional status of an individual through the Anthropometric method.

Nutrient​ - is a chemical component needed by the body for one or more of these
functions: to provide energy, to build and repair tissues and to regulate bodily
processes. The essential nutrients are carbohydrates, fats, proteins, minerals,
vitamins and water.

Nutrient Classification:

1.​ According to function

​
2.​ ​According to chemical nature

3.​ ​According to essentiality

4.​ ​According to concentration

NUTRITION AND THE HEALTH CARE TEAM​

Since sound nutrition is fundamental to health maintenance and a significant support in
any medical care, it is imperative that all practitioners incorporate these nutrients in
everyday practice. You, as a practitioner, will help to strengthen the nutritional base of
your patient care by doing the following three basic things:
 1.​ D
​ evelop a sound basic working knowledge of nutrition

2.​ U
​ se of human approach

3.​ A
​ pply principles of nutrition education to every patient situation

Nutrition education is necessary to:

a.​ I​ mprove individual nutritional status

b.​ C
​ ombat malnutrition and misinformation

c.​ P
​ rovide tools for expanded, sound self care and

d.​ M
​ otivate persons toward desired food behavior changes

NUTRITION AND THE NURSING PROCESS

Assessment Phase - ​ ​Involves data gathering from patient history and laboratory
reports as well as physical assessment

Diagnosis Phase - ​Nursing diagnosis is derived from the information obtained during
assessment. Once nursing diagnoses are identified, planning is required to reduce or
eliminate these problems.

Implementation Phase ​- ​Involves in putting the plan into action; nursing interventions
are carried out and then tested

Evaluation Phase ​- ​Any action that is implemented must be evaluated so that the nurse
can assess the client’s progress in attaining the goals.

NUTRITIONAL STATUS

Nutritional status or Nutriture is the degree to which the individual’s physiological

need for nutrients is being met by the food he or she is eating. It is the state of balance
in the individual between the nutrient intake and nutrient expenditure or need.

Evaluation of the nutritional status involves examination of the individual’s

physical condition, growth and development, behavior, blood and tissue levels of
nutrients and the quality and the quantity of the nutrient intake.

Optimum or good nutrition means that the body has adequate supply of essential
nutrients that are efficiently utilized such that growth and good health are maintained at
the highest possible level.
 Malnutrition or poor nutrition is a condition that results from lack of one or more
essential nutrients (nutritional deficiency) or it may be due to excessive nutrient supply
to the point of creating harmful or toxic effects (over nutrition or hypervitaminosis).

Nutritional deficiencies may be caused by a primary factor or secondary

(conditioning factors). The primary factor refers to faulty diet while secondary factors
are multiple and include all conditions within the body that reduce the ultimate supply of
nutrients to the cells.

Forms of Malnutrition
1. Undernutrition is a pathologic process resulting from the consumption of
inadequate quantities of food over an extended period of time.
2. ​Overnutrition is a pathological state resulting from the consumption of an
excessive quantity of food over an extended period of time
3. ​Specific deficiency ​is a pathological state resulting from a relative or absolute
lack of an individual nutrient.
4. ​Imbalance is a pathological state resulting from a disproportion among the
essential nutrients with or without the absolute deficiency of any nutrient.

Primary Nutrition Problems in the Philippines

1. Protein – Energy Malnutrition (PEM)- ​due to lack of energy and protein in the diet
(especially among preschoolers)

Kwashiorkor ​– consists of depigmentation of the hair and skin, edema in the limbs and
flabby moonlike face, growth failure, skin lesions, apathy and low resistance to infection

● Often developed in a child, after weaning from breast, on the birth of the next
​
sibling is given a diet consisting mainly of starchy foods or sugar-water. Hence,
child may get calories but not protein
● ​Term used in Ghana, Africa meaning “red boy”

Marasmus ​– characterized by a shrunken, wizened “old man” a living skeleton with skin
and bone.

● Lack of both calories and protein

● From the Greek word “wasting”

2. ​Vitamin A Deficiency – will result in poor eyesight in extreme cases, blindness,

low body resistance to diseases and skin will become rough and dry.

3.​ I​ ron​ ​Deficiency Anemia

● Common among infants 3 months to 2 years of age
 ● In toddlers, anemia is traced to slow chronic unsuspected bleeding
brought about by intestinal parasites
● Parasites – interfere with nutrient utilization by competing with their host
for their own food needs.
● ​It can also be found in school children, adolescent, adult and aged
people.

4. Iodine deficiency
● ​Findings of the Department of Health revealed that this country has the
most goiter cases in Southeast Asia.

5.​ E ​ obesity
​ xcessive of Nutrition –

Causes of Malnutrition:

1. Poverty
2. Faulty food intake
3. Poor distribution of food supply
4. Large family size
5. Low level of education among household members
6. Intra familial food distribution
7. Urbanization
8. Widespread incidence of infectious diseases and parasitism due to poor
sanitation
9. Wrong infant feeding and weaning practices

Effects of Malnutrition
1.​ ​Increased susceptibility to infections
2.​ ​Impaired physical and mental development
3.​ ​Impaired national development (drain to national economy)

3.1. In health, additional burden of medical services, hospitalization, etc.

3.2. In education, more school absences, dropouts, etc. thereby reducing the
number and quality of our manpower potentials.

3.3 ​ In agriculture and industry, losses through performance, absenteeism and

accident processes.
3.4​ ​ In socio-political context, it means greater unrest and disorder.

Causes of Overnutrition
1. Faulty food intake

2. Changes in physical activity and lifestyle

3. Environmental and Global Factors

ASSESSMENT OF NUTRITIONAL STATUS
1.​ ​Anthropometric data
2.​ ​Psychosocial data
3.​ ​Biochemical data
4.​ ​Clinical examination
5.​ ​Medical history
6.​ ​Dietary history and intake data

Methods of Assessing Dietary Intake

1. ​24 hour Recall – the individual completes a questionnaire or is interviewed

by a nutritionist or nurse experienced in dietary to recall everything that he or
she ate within the last 24 hours.
2.​ ​Food frequency questionnaire
3.​ ​Dietary history – it contains additional information about the following:
● economics
● physical activity
● ethnic and cultural background
● home and life meal patterns
● appetite
● allergies, intolerances and food avoidances
● dental and oral health
● gastrointestinal
● chronic diseases
● medication
4. ​Food diary or record – the client is asked to write down everything he or she
eats and drinks for a certain time period.
5. ​Observation of food intake – it requires a nurse to know the amount and kind
of food presented to the person and the record of the amount actually eaten.

ASSESSMENT OF NUTRITURE THROUGH ANTHROPOMETRIC SURVEY

(OPERATION TIMBANG)

Through a nationwide survey known as Operation Timbang (OPT),

malnourished children are identified and located in the community. This is usually done
after/before massive deworming. Usually held twice a year by local Barangay Nutrition
Scholars (BNS). Weights of children under five years old (72months old) are taken and
classified as to their nutritional status.

1. Viewing activity: Watch this video related to the effect of malnutrition to children
in the Philippines :​ ​https://www.youtube.com/watch?v=EiwYfk5QF2o
Video Length: (2.40min)
Summary and conclusion:

Your professor discussed different terms and basic concepts in nutrition. Tackled
the malnutrition problems in the Philippines, the critical roles of the nurse. Identified and
discussed the method of evaluating nutritional status. Demonstrated how to assess the
nutritional status of an individual through the anthropometric method.

The learner gained knowledge on basic concepts of nutrition. Recognized the

malnutrition problems in the Philippines and determined the roles of the nurses. Listed
the different methods used in evaluating nutritional status. Appreciated Operation
Timbang as a health program used in malnourished children located in the community.
The learner watched and gained understanding on the video presented. The learner
actively participated in the activity such as answering on the Discussion Board thru
MyClass.

Assessment Activities (40 minutes)

Quiz : Multiple choice: (30 items exam)

Recommended Readings/Viewings:

● Caudal, Maria Lourdes (2019). Basic Nutrition and Diet Therapy 2​ Edition, C
nd

and E Publishing
● Dudek, Susan G. (2018). Nutrition Essentials for Nursing Practice, 8​ Edition. th

Philadelphia: Wolters Kluwer Health/ Lippincott Williams & Wilkins

● Basic concept of food and nutrition: Retrieved on July 22, 2020 from
​https://youtu.be/4WgkZXKSO-E​
● Philippines: Nutrition crisis hinders children's performance in schools Retrieved
on July 22, 2020 from​ ​https://www.youtube.com/watch?v=EiwYfk5QF2o

References

● Drummond, Karen Eich and Reyes-Murphy, Alison (2018). Nutrition Research:

Concepts & Application, 1​ Edition. Burlington, MA: Jones & Barlett Learning
st​

● Dudek, Susan G. (2018). Nutrition Essentials for Nursing Practice, 8​ Edition.th

Philadelphia: Wolters Kluwer Health/ Lippincott Williams & Wilkins

● Escott-Stump, Sylvia (2015). Nutrition and Diagnosis-related Care, 8​ Edition.th

Philadephia, PA: Wolters Kluwer

● Grodner, Michele, et.al. (2016). Nutrition Foundations and Clinical Applications, A
Nursing Approach, 5​ Edition. Missouri:Elsevier Mosby
th​

● Caudal, Maria Lourdes (2019). Basic Nutrition and Diet Therapy 2​ Edition, C
nd

and E Publishing
● Dudek, Susan G. (2018). Nutrition Essentials for Nursing Practice, 8​ Edition.th

Philadelphia: Wolters Kluwer Health/ Lippincott Williams & Wilkins

● Basic concept of food and nutrition: Retrieved on July 22, 2020 from
​https://youtu.be/4WgkZXKSO-E
 ● Philippines: Nutrition crisis hinders children's performance in schools Retrieved
on July 22, 2020 from​ ​https://www.youtube.com/watch?v=EiwYfk5QF2o

Prepared by:

Rhocette M. Sn Agustin, RN, MN

Peer reviewed by:

Myron L. Roque, RN, MN

Karen D. Sembrano, RN, MN
Reviewed and evaluated by:

Jennie C. Junio, RN, MAN

Brenda B. Policarpio RN, RM, MN
Level II Coordinators

Approved by:

Zenaida S. Fernandez, RN, Ph. D.

Dean