HEALTH EOT1

CHAPTER1: Principles of Nutrition and Therapeutic Diets

Lesson 1.1: Nutrients We Need

Nutrition is the process which the body uses nutrients in food to grow
and to get energy from food to maintain both the body itself and the
functions that it needs for continued life.

Nutrients are chemical substances in food that the body needs and
use to make energy to grow, develop, reproduce, and help in reducing
the risk of disease.

Carbohydrates, proteins and fats are known as Macronutrients as they

are needed in large (macro) quantities (grams per day) and they provide
energy (measured in calories or kilojoules).

Micronutrients, such as vitamins and minerals, are required by the

body in small (micro) amounts (milligrams or micrograms). The
micronutrients do not provide energy, but they are needed for numerous
biological functions in the human body.

Fats are nutrients that promote normal growth, provide a source of

stored energy, and keep your skin healthy. There are three main types of
dietary fat:

1. Saturated fats can be considered to be ‘unhealthy’ fats as the

body has difficulty breaking these down. This type of fat is
usually solid at room temperature.
2. Unsaturated fats can be considered to be ‘healthier’ fats as the
body is able to use these fats more effectively than saturated
fats and these may help you to be less likely to get heart
disease. This type of fat is usually liquid in room temperature.
3. Trans-fats most are found in foods that use hydrogenated
vegetable oils such as deep fried or baked foods.
Vitamins refer to a group of organic compounds which are essential for
normal growth and nutrition and they help in regulating body functions.

• Water-soluble vitamins such as C and B dissolve in water therefore

they are found in the watery compartments of foods.
• Fat-soluble vitamins such as vitamins A, D, E and K dissolve in fat.
Therefore, they usually occur together in the fats and oils in foods
that you eat.

Minerals are inorganic micronutrients which, like vitamins, do not

provide energy for the body; like vitamins, they also have a wide range
of functions.

1. Major minerals: are present and needed in large amounts in the

body. These include calcium, phosphorus, potassium, sodium,
chloride and magnesium.

2. Trace minerals: are present and needed in smaller amounts in the

body and include iron, zinc, copper, manganese and iodine.

Water makes up approximately 60 percent of an adult’s body weight

and a higher percentage of a child’s. It makes up between 55 and 75
percent of our body mass.

Metabolism is the process of converting the nutrients in the food into

energy that allows your body to
function and grow. Through
metabolism, body cells work to bind
glucose (simple sugar) with oxygen
to produce heat and energy.

Basal Metabolic Rate (BMR).

Lesson 1.2: Healthful Eating

Dietary Guidelines: They are a visual representation based on scientific

evidence and provide information on the types of food we need to eat
for good health and wellbeing.

Nutrition Facts Labels

Lesson 1.3: Managing a Healthy Weight

The Body Mass Index (BMI) is a method used to assess person’s body
size based on his or her height and weight. This measurement tool
indicates if a person is underweight, a healthy weight, overweight or
obese.

BMI = weight (kg) ÷ height 2 (m2)

Every individual is different, and their healthy weight will be
determined by a range of factors:

1. Genetic factors may increase our susceptibility to being

overweight or obese.
2. A healthy body weight results from an appropriate balance
between energy input (from foods and drink) and energy output,
which includes physical activity.
3. Some medications and illnesses can contribute to overweight.

Energy balance refers to the balance of calories consumed

compared to the calories we burn or use up through physical
activity.
Body fat percentage is a comparison of the quantity of fat and muscle
in the body.

Healthy body fat percentage are about 14 to 17 percent for males and
21 to 24 percent for females. All women need at least 12 percent body
fat to be healthy, and all men need at least 2 to 5 percent.

Lesson 1.4: Introduction to Therapeutic Diets

Therapeutic diets can be defined as modifications of a normal diet

or a meal plan to treat or control a specific health condition or
disease.

The Purpose of Therapeutic Diets:

• maintaining, restoring, or correcting nutritional status.

• controlling calorie intake for either losing, gaining, or maintaining
weight.
• balancing the quantity of carbohydrates, fat and protein for control of
diabetes.
• increasing or decreasing the amount of a nutrient such as protein.
• reducing the amount of a nutrient such as sodium.
• excluding some type of foods due to allergies or food intolerance.
• providing texture modifications due to problems with chewing and/or
swallowing
Lesson 1.5: Common Therapeutic Diets Plans

Calorie-Controlled Diet

Diabetic diet is highly recommended for patients with diabetes, a

condition in which the body cannot properly regulate levels of glucose
in the blood.

Diabetic plate

A low-fat, and low-cholesterol diet is recommended for people who

have high levels of cholesterol in their blood such as patients who
experienced atherosclerosis and heart disease. Decrease foods that
are rich in fat and cholesterol.

Low-sodium is called also low-salt diet is recommended for people

with hypertension, congestive heart failure, kidney disease, or edema a
swelling in lower parts of the body or abdomen area. Having less than
one tea spoon of salt a day. Patients have to avoid or limit eating
smoked meats or fish, processed foods, pickles, olives, salty chips and
different nuts.

Protein diet

Fiber diet

A bland diet is an eating plan that emphasizes foods that are easy to
digest. Bland diets are generally helpful for people with digestion
problems or having cancer. Includes foods that are low in fat, low in
fiber, and easy to chew.

Calcium is an important nutrient for the development of strong bones

and teeth. One of-the main causes of osteoporosis in which bones
become brittle and break easily is the poor consumption of calcium,
Vitamin D, and phosphorous during bones development age.Therefore,
a calcium rich diet is recommended.

Malnutrition refers to all deficiencies, excesses, or imbalances in a

person’s intake of energy and/or nutrients.

Modified-Consistency Diets

Diets modified in consistency, or texture, are prescribed for people who

have problems with chewing, swallowing, infections, digestive
disorders, after dental surgery, or people with poor dentition. It is called
soft-diet as well. Foods in this diet maybe chopped, softened, or
mashed.Foods to be avoided in this diet include, raw fruits, vegetables,
nuts, seeds, or coconut.

Liquid Diets
prescribed before or after surgery, before some diagnostic tests, if the patient has
an infectious disease, or digestive problems, or as a first step of restarting oral
feeding

If a patient in a condition that he or she cannot take food by mouth, tube feeding
is the option to be used to ensure that all nutritional needs are met.

Food Allergy Modification

Food allergy is an immune system reaction that occurs soon after eating a certain
harmless food.

Wheat (Gluten) Allergy

Gluten can cause allergic reactions in wheat allergic individuals by eating or

sometimes inhaling wheat products. the key indication of gluten allergy is celiac
disease which is a disorder characterized by malabsorption of virtually all
nutrients.gluten-free diet is recommended. Patients must eliminate wheat, rye,
and barely products such as breads, cakes, cereals, pastas, and more others.

Food Intolerance Modification

Chapter 2: Diabetic Emergencies
Lesson 2.1: Understanding Diabetes

Homeostasis means a state of balance or equilibrium.

Glucose cycle
1. It all starts when we consume nutrient from food we eat. After
digestion has occurred in our stomach, nutrients are absorbed in
the small intestine and useful nutrients including glucose are then
transferred to bloodstreams.

2. Blood glucose is a term that is used to refer for the glucose level in
the blood.(BGL).

There are many factors that determine the blood glucose level such as:

• Type of food: different foods have different amount of carbohydrate

and will produce different amounts of glucose.

• The amount of food you eat each time.

• Carbohydrates come in several forms that take various amount to be

digested and

that affect the blood glucose differently.

• Fat or protein: these forms of nutrients can slow down digestion and
the rate at

which glucose levels rise (high protein foods can raise blood glucose
levels but do so more slowly than foods containing mostly
carbohydrate).

3. Glucose Cellular Uptake

In the bloodstream glucose is able to access a cell wall if and only the
hormone insulin which is released by the pancreas is there.Therefore,
the presence of insulin is critically vital for the cell to uptake the glucose
and get the energy it needs to live and grow.

The pancreas plays an essential role in the digestion and the

production of hormones that regulate the blood sugar.

islets of Langerhans cells (which are present in the pancreas) creates

and releases important hormones directly into the bloodstream. The
two main pancreatic hormones are:

• Insulin: which act in lowering the blood sugar.

• Glucagon: Which acts to raise the blood sugar.

The body balances the amount of insulin and glucose to keep glucose
at a fairly level throughout the day.

Diabetes is a disease that prevents the individual from producing

enough insulin or from using insulin effectively.

Signs and symptoms of diabetes:

Lesson 2.2: Managing Hyperglycemia & Hypoglycemia
Emergencies

.
Hyperglycemia is a medical condition that means high blood sugar
In hyperglycemia, diabetic person has no enough insulin resulting in
elevation of his/her blood glucose levels. It is usually occurring

.gradually as it takes many hours to sometimes days to develop

There are two types of hyperglycemic emergencies:

Diabetic Ketoacidosis (DKA) and Hyperglycemic hyperosmolar syndrome (HHS)

Call emergency without delay or transfer the person to the nearest emergency room if his/
her blood glucose level is high:

➢ In T1D: glucose levels > 350 mg/dl, with nausea and vomiting and/or abdominal pain.

➢ In T2D: glucose levels > 450 mg/dl, with excessive drowsiness. Also, with the above
criteria if

• The patient can’t retain liquids because of nausea and vomiting.

• The level of consciousness changes (confused, agitated, and unresponsive).

• Signs of dehydration (dry skin, sunken eyes, dry mouth...)

• Having fever (body temperature above 38.5C) for more than 48 hours.

Hypoglycemia reflects a medical condition that caused by a very

low blood glucose, when a person’s blood glucose level (BGL)
dropped below 70 mg/dl.

Lesson 2.3: Measuring Blood Glucose Level

Prediabetes is the state when the person does not meet the criteria to
be diagnosed with diabetes but having abnormal glucose levels.

Blood tests are used to diagnose both type 1 and 2 diabetes, as well as
gestetional diabetes

Random Glucose Test (RGT)

This test measures the amount of glucose in the blood at any given
time with no prior requirement to be fasting.

Fasting Glucose Test (FGT)

For this test the person is instructed not to eat or drink anything but
water for 8 to 10 hours, then a sample of blood will be taken to measure
the glucose levels in the blood.

Oral Glucose Tolerance Test (OGTT)

is a series of blood glucose measurements taken after you drink a sweet liquid
that contains certain amount of glucose. OGTT test requires the individual to be
fasting for 8 to 10 hours. An initial test is done while you are fasting ( fasting
glucose levels) then followed by drinking sugary liquid and the blood glucose
levels are tested periodically over the next two hours.

Glycated hemoglobin Test (HbA1c)

The glycated hemoglobin test measures the average blood glucose
level for the past 2 to 3 months.This test basically measures the amount
of glucose attached to the hemoglobin (the oxygen-carrying protein in
the red blood cells).

CHAPTER 3: Principles of Pharmacology and

Medical Mathematics

Lesson 3.1: Introduction to Pharmacology

Pharmacology is the study of drug, including their sources, nature,

actions, and effects in living system and uses.

Pharmacology is central for:

➢ To discover new medicines to help fight new diseases.

➢ Improving the effectiveness of medicines.

➢ Reducing the unwanted side effects of medicines.

➢ Understanding why individual differ in the way they respond to

certain drug, and why some

other causes addiction.

pharmacologist is the scientist who works on researches and

laboratories to develop new drugs, making the current drug safer, as
well as testing the latest drugs to ensure that they are effective and safe
to be used.

A Drug is a substance other than food that changes the structure or the
function of the body or mind. Medications are Drug(s) given in
therapeutic purposes

Sources of Medication:
1. Natural sources
Pharmacognosy refers to the study of natural drug sources such as
plants & animals.
Plant sources: many medications are extracted from plant sources
such as atropine and caffeine.

Animal sources:The body fluids or glands of animals can act as a

sources of medications, the medications obtained from animal sources
include hormones, such as insulin.

Difficulties Of Natural Medication:

• Some are poorly absorbed into the bloodstream.

• Some are broken down quickly by the body.

• Isolating medication from plants or animals is slow and expensive.

• The product may contain harmful impurities.

• Some products are rare and difficult to be found.

2. Microscopic organisms
Microorganisms, e.g. fungi, bacteria, and mold are used as a source of
medication

3. Synthetics or bioengineering
This is the laboratory-produced medication sources.

Example:

• Aspirin (treat pain and fever) is synthetically produced today, was once
an extract of willow bark.

• Insulin is the first drug to be produced from genetically altered

bacteria, initially was extracted from animal sources.

Mechanisms of Action
Mechanism of Action is the specific biomedical interaction through
which a medication substance produces its pharmacological
(desired therapeutic) effect.

1. Binding to and Stimulating a Receptor in the Body

A receptor is proteins found in the cell that have the ability to cause a cell
response when and if binding to a naturally occurring key.Mimicking the
natural key and binding to the receptor will stimulate the cell response
leading to the desired therapeutic action.

2. Binding to and Blocking a Receptor in the Body

Some medications bind to a receptor without causing a response, as it takes
over the place of the key on the receptor.

3. Inhibiting an Enzyme
An enzyme inhibitor is a medication that can interact someway with the
enzyme, disturbing the normal action between an enzyme and the substrate
or by slowing the production of the enzyme.

4. Decreasing the Movement of Chemical Across a Cell Membrane

Some medication works by inhibiting specific pumps and other block specific
channels in the cell membrane

The effect produced by a medication that is not the desired effect is

considered as side effect of the medication.

The side effects can be classified into two categories:

➢Local side effect: This side effect happens locally before a drug is absorbed into
the bloodstream.Usually, it is limited to a certain location such as redness or irritation of
the skin when applying a patch, or cough and dry throat when using an inhaler, diarrhea
can be a local side effect when using antibiotics, as antibiotics can kill the naturally
occurring bacteria in our digestive trac.

➢ Systematic Side Effect: Systematic means affecting all the body or at least
multiple organ systems. In the systematic side effect, the side effects take place after the
drug has been absorbed into the bloodstream. Most of these side effects happen
because the drug is affecting cells other than target cells.

Lesson 3.2: Classes of Drugs and Routs of Administration

Pharmacotherapeutics is the branch of pharmacology that specializes in

studying the therapeutic uses and effects of the medication.

Therapeutic Classes of Medication

the medication has been classified into the below categories:

➢ Preventive medications: medications provided to prevent the incident of the disease

before the onset of happening.Vaccination is an example of the medications that can
forestall the occurrence of the disease.

➢Medications that aimed at the specific cause of the disease: medications that work
directly on the disease-causing factor prevent the disease process from evolving or aim
to reverse it.Antibiotic, is an example of the medication that can work directly on the
aspect that causes the disease.

➢Medications that can amend the pathophysiological processes: medications that

work on correcting the abnormal biological functioning that is associated with a disease
or syndrome.Antihypertensive medication is an example of the medications that can
alter the abnormal physiological changes that are associated with high blood pressure.

➢Medications to relief a specific disease signs: medications that aim in reducing or

removing the disease signs and symptoms without working on the underlying causes.

➢ Medication which targets non-specific disease-related symptoms: are the

medications that works on self-reported symptoms that does not indicate any specific
disease, for example, fatigue is a feature of many acute or chronic medical condition
however using analgesic medication can relief fatigue therefor analgesic medication is
an example of the category of medication that targets non-specific disease-related
symptoms.

➢ Medication that does not treat any specific disease: Some medication such as
anesthetic is not given to treat a disease but it may be given to assess in other
therapeutic and diagnostic procedure.

Route of administration is the pathway by which is administer to the body. There are
two main routes for administering the medication

Pharmacokinetics is the study of the four process that effect the blood concentration of
medication.

Four Processes of Pharmacokinetics

Absorption, Distribution, Metabolism, Excretion (ADME)

• Absorption is the process by which the medications transfer from the site of
administration moving into the bloodstream.

• Distribution refers to the movement of the drug through the bloodstream, into the
tissues, and eventually into the cells.

• Metabolism is the chemical alteration of the medication by the body

• Excretion is the process of eliminating and removing the medication from the body.

Lesson 3.3: Medication Doses and Calculation

A dose is the measured quantity of medication given in a specific time.

Dosage is the prescribed administration of a specific amount, number,

and frequency of a medication dose over a specific period.

Loading dose is the large dose of a medication initiated to optimize the

desired therapeutic concentration of the given medication.

Maintenance dose is the small dose of a medication that is prescribe

at regular intervals aiming to keep the concentration of the medication
at the desired therapeutic level

Factors Contributing for Individual Dosage Differences

Weight, Age, Liver and Kidney Functions

How to Calculate a Medication Dose?

Converting between systems measure:

medication dose Formula:

Chapter 4: Environmental Health and
Community Responsibility

Lesson 4.1: The Changing Environmental Landscape of the United

Arab Emirates

The term ‘environment’ refers to the sum total of the things that make
up our surroundings and comprises a number of identifiable features,
including physical, social, cultural, demographic and economic factors.

A healthcare system refers to the organization of people, institutions,

and resources that deliver health care services to meet the health needs
of target populations.

Environmental health risks are those risks which are external to the
human body but impact on an individual’s wellbeing and behavior.

The ‘global burden of disease’ approach is a method used by health

professionals to measure the impact of diseases, injuries and risk
factors by age, sex and geographical location at any point in time.

Lesson 4.2: The Changing Environmental Landscape of

the United Arab Emirates
Renewable energy sources are the sources that can be used and
produce energy again and again. Solar energy, geothermal energy, wind
energy and biomass energy are examples of renewable energy.
Renewable energy is also known as clean or alternative energy.

STUDY WELL❤
Amna alabdali