Chapter 01

Nutrition and Diet Therapy
8th Edition
by
Ruth Roth and
Carolynn Townsend
Delmar Learning
Copyright © 2003 Delmar Learning, a Thomson Learning company
Nutrition and Diet Therapy
PowerPoint Presentation
Written by
Susan L. Robson, MSN,
RNP-c
Delmar Learning
Section 1
Fundamentals of Nutrition

Chapter 1
The Relationship of Food and Health

Objectives
 Name the six classes of nutrients and

their primary functions
 Recognize common characteristics of
well-nourished people
 Recognize symptoms of malnutrition
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 5

Objectives
 Describe ways in which food and health

are related
 List the four basic steps in nutrition
assessment

Nutrients
Chemical substances necessary for life

Functions
• Provide energy
• Build and repair tissue
• Regulate body processes

Nutrients
Six classes
• Carbohydrates
• Fats (lipids)
• Proteins
• Vitamins
• Minerals
• Water

Nutrients
Organic Inorganic
• Contains carbon, • In simplest form
hydrogen, oxygen when ingested
• Carbon is found • Function:
in all living things regulate body
• Example: processes
carbohydrates, • Example: water,
fats, proteins, minerals
vitamins

Carbohydrates
Provides major source of energy

Examples: cereal grains, vegetables,
fruits, nuts, and sugars

Fats (lipids)
Provides energy
Highest kilocalorie value
Sources of fat: meats, milk, cream, butter,
cheese, egg yolks, oils, nuts

Protein
Builds and repairs body tissues

Provides energy
Only one of the six nutrients that contains
nitrogen
Sources of protein: meats, fish, poultry,
eggs, milk, cheese, corn, grains, nuts, and
seeds

Vitamins
Organic compounds
Regulate body processes
Examples: vitamins A, B, C, D, E and K

Minerals
Inorganic compounds
Regulate body processes
Examples: calcium, phosphorus,
potassium, sodium, chloride, iron,
magnesium, zinc

Water
Major constituent of all living cells

Composed of hydrogen and oxygen

The Six Essential Nutrients and
Their Functions
Organic Nutrients Function
Carbohydrates Provide energy
Fats Provide energy
Proteins Build & repair tissues
Vitamins Regulate body processes
Inorganic Nutrients Function
Minerals Regulate body processes
Water Regulates body processes
Stop and Share
A client is at home recovering from
surgery. You ask the client what they have
eaten over the past 24 hours. The client
states the following:
• Breakfast: 2 doughnuts, orange juice
• Lunch: lettuce salad with oil & vinegar,
soda
• Snack: pretzels, soda
• Dinner: spaghetti with tomato sauce, garlic
bread; wine
Stop and Share
Discuss the answers to the following
questions:
• What nutrients are missing in the client’s
diet?
• Why are these nutrients important for this
client?

Stop and Share
The client is missing protein and water in
the diet.
Protein is needed to build and repair body
tissues after surgery.
Water is needed to prevent dehydration.

Characteristics of Nutritional
Status
Good Poor
Alert expression Apathy
Shiny hair Dull, lifeless hair
Clear complexion Greasy, blemished

complexion
Good color Poor color

Status
Good Poor
Bright, clear eyes Dull, red-rimmed eyes
Pink, firm gums and Red, puffy, receding

well-developed teeth gums, and missing or
cavity-prone teeth
Firm abdomen Swollen abdomen
Firm, well-developed Underdeveloped, flabby

muscles muscles
Status
Good Poor
Well-developed bone Bowed legs, “pigeon
structure breast”
Normal weight for Over- or underweight
height
Erect posture Slumped posture
Emotional stability Easily irritated,

depressed, poor
attention span
Status
Good Poor
Good stamina Easily fatigued
Seldom ill Frequently ill
Healthy appetite Excessive or poor
appetite
Healthy, normal sleep Insomnia at night,
habits fatigued during the day
Normal elimination Constipation or
diarrhea
Stop and Share
Divide into groups of 2.

Assess your partner for signs of good
nutrition.
Identify common characteristics associated
with good nutrition exhibited in your
partner.

Stop and Share
 Shiny hair  Firm flesh on

 Clear skin well-developed
bone structures
 Clear eyes
 Pink gums and
 Erect posture
well-developed
 Alert expressions teeth
 Normal weight
for height

Malnutrition
Overnutrition
• Excess energy or nutrient intake
Undernutrition
• Deficient energy or nutrient intake
Overnutrition is a larger problem in the
United States than undernutrition.

Stop and Share
Identify at least 5
signs of
malnutrition present
in this child.
Courtesy of the Centers for Disease Control and Prevention, Public

Health Image Library

Stop and Share
 Poor quality hair  Spindly arms and

 Mottled legs
complexion  Bloated abdomen
 Dull expression

Relation of Food to Health
Cumulative Deficiencies
• Excess nutrients • Nutrients lacking
over time for extended
• Examples: period
atherosclerosis, • Examples: iron
obesity, deficiency,
hypertension, beriberi, scurvy,
diabetes, osteomalacia,
gallbladder osteoporosis,
disease, some rickets, goiter
cancers
Deficiency Diseases
Deficiency Disease Nutrients Lacking

Iron deficiency Iron
Iron-deficiency anemia Iron
Beriberi Thiamin
Night blindness Vitamin A
Goiter Iodine
Kwashiorkor Protein
Marasmus All nutrients

Deficiency Diseases

Osteomalacia Calcium, vitamin D,
phosphorus,
magnesium, and
fluoride
Osteoporosis Calcium and vitamin D

Deficiency Diseases

Pellagra Niacin
Rickets Calcium and vitamin D
Scurvy Vitamin C
Xerophthalmia Vitamin A
(blindness)

Nutritional Assessment
Anthropometric measurements
Clinical examination
Biochemical tests
Dietary/social history

Anthropometric Measurements
Height
Weight
Head circumference (children)
Upper arm measurement
Skinfold

Height Weight

Head circumference Triceps skinfold

Clinical Examination
Clinical Signs Possible Deficiencies

Pallor, blue half circles Iron, copper, zinc, B12,
beneath eyes B6, biotin
Edema Protein
Bumpy “gooseflesh” Vitamin A
Lesions at corner of Riboflavin

mouth
Glossitis Folic acid
Numerous “black and Vitamin C

blue” spots and tiny, red
“pin prick” hemorrhages
under the skin
Emaciation Carbohydrates, proteins;

kcal

Poorly shaped bones or Vitamin C

teeth or delayed
appearance of teeth in
children
Slow clotting time of Vitamin K
blood

Unusual nervousness, Niacin

dermatitis, diarrhea in
same patient
Tetany Calcium, potassium,
sodium
Goiter Iodine
Eczema Fat
Biochemical Tests
Serum albumin level

• Measures main protein in blood
• Determines protein status
Serum transferrin level
• Indicates iron-carrying protein in blood
•  indicates iron stores low
•  indicates body lacks protein

Biochemical Tests
Blood urea nitrogen (BUN)

• may indicate renal failure, insufficient renal
blood supply, or blockage of the urinary
tract
Serum creatinine
• indicates amount of creatinine in blood
• used to evaluate renal function

Biochemical Tests
Creatinine excretion
• indicates amount of creatinine excreted in
urine over a 24-hour period
• used in estimating body muscle mass
• muscle mass depleted, as in malnutrition;
level will be low

Biochemical Tests
Other tests
• Hemoglobin (Hgb)
• Hematocrit (Hct)
• Red blood cells (RBCs)
• White blood cells (WBCs)
• Lipid profile (high & low-density
lipoprotein, serum triglycerides)
• Urinalysis

Dietary/Social History
Evaluation of food habits.

• 24-hour recall: Client interviewed by the
dietitian and asked to give types, amounts,
and preparation of all foods eaten in past 24
hours
• Food diary: written record of all food and
drink ingested in a specified period
• Computer diet analysis to determine
nutrient deficiencies or toxicities

Dietary/Social History
Social history
• Consideration of financial resources to
obtain needed food, and properly store and
cook food
• Food-drug interactions that can lead to
malnutrition

Conclusion
Nutrition and health are directly related.

Effects of poor nutrition are cumulative.
There are six essential nutrients:
carbohydrates, fats, proteins, minerals,
vitamins, and water.
Nutritional assessment is the best way to
determine deficiencies that may result
from lack of nutrients.

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Chapter 01

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Nutrition and Diet Therapy

Copyright © 2003 Delmar Learning, a Thomson Learning company

The Relationship of Food and Health

Copyright © 2003 Delmar Learning, a Thomson Learning company

 Name the six classes of nutrients and

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 5

 Describe ways in which food and health

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 6

Chemical substances necessary for life

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 7

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 8

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 9

Provides major source of energy

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 10

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 11

Builds and repairs body tissues

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 12

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 13

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 14

Major constituent of all living cells

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Alert expression Apathy

Shiny hair Dull, lifeless hair

Clear complexion Greasy, blemished

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 20

Pink, firm gums and Red, puffy, receding

Firm, well-developed Underdeveloped, flabby

Emotional stability Easily irritated,

Divide into groups of 2.

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 24

 Shiny hair  Firm flesh on

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Courtesy of the Centers for Disease Control and Prevention, Public

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 Poor quality hair  Spindly arms and

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Deficiency Disease Nutrients Lacking

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Deficiency Disease Nutrients Lacking

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Deficiency Disease Nutrients Lacking

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Head circumference Triceps skinfold

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Clinical Signs Possible Deficiencies

Bumpy “gooseflesh” Vitamin A

Lesions at corner of Riboflavin

Clinical Signs Possible Deficiencies

Numerous “black and Vitamin C

Emaciation Carbohydrates, proteins;

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 38

Clinical Signs Possible Deficiencies

Poorly shaped bones or Vitamin C

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 39

Clinical Signs Possible Deficiencies

Unusual nervousness, Niacin

Serum albumin level