Nutrition and Dietary Guidelines Quiz

Chapter 26: Concepts of Basic Nutrition and Cultural Considerations

• This chapter covers basic nutrition concepts and cultural considerations.

Lesson 26.1: Overview of the GI System and Nutritional Needs

• Review the structure and function of the gastrointestinal system.
• Utilize the USDA MyPlate website to assist patients in planning diets.
• List medical conditions resulting from protein, calorie, vitamin, or mineral deficiency/excess.
• Identify patients at risk for nutritional deficits.

Overview of the Gastrointestinal System

• Structures involved in digestion:
  • Mouth
  • Teeth
  • Tongue
  • Pharynx
  • Esophagus
  • Stomach
  • Small intestine
  • Large intestine
  • Anus
• Accessory organs:
  • Salivary glands
  • Liver
  • Gallbladder
  • Pancreas

Functions of the Organs of Digestion

• Mouth: First part of the digestive tract, contains tongue and teeth, receives saliva, mixes food, starts digestion.

  • Tongue: mostly skeletal muscle, most movable organ in the mouth
  • Adults have 32 permanent teeth: cuspids, incisors, bicuspids, molars
  • Parotid glands: largest salivary glands, anterior and inferior to the ear, secrete saliva, begin starch digestion.

• Pharynx: Connects nasal and oral cavities to the esophagus; tongue forces food into pharynx.

• Esophagus: Muscular tube (20 cm), propels food to the stomach, lining secretes mucus.

• Stomach: Located in upper-left quadrant of abdomen, 1.5 L capacity, has two sphincters, temporary storage for food, mixes food with digestive juices, changes food to semiliquid state, begins protein digestion, absorbs vitamin B12.

• Small intestine: (duodenum, jejunum, ileum) mixes food with liver and pancreas secretions, finishes digestion, absorbs nutrients.

• Large intestine: (ascending, transverse, descending, sigmoid colon, rectum, anus, cecum) absorbs fluid and electrolytes, eliminates waste products.

• Liver and gallbladder: concentrate, store, secrete bile into duodenum.

• Pancreas: secretes digestive juices, produces insulin.

Changes in the Digestive System with Aging

• Dental caries and tooth loss, decrease chewing ability.
• Decreased gag reflex, increased aspiration risk.
• Decreased sense of taste, potential loss of appetite.
• Decreased muscle tone at sphincters, increased esophageal reflux risk.
• Decreased gastric secretions, interfere with food digestion.
• Decreased peristalsis, increased risk of constipation.

Metabolism

• Process where large molecules are broken down to smaller molecules, making energy available to the organism.
• Enables absorbed nutrients to enter the bloodstream.
• Digestion converts food into chemical substances (proteins, simple sugars) for energy and cellular metabolism.

Dietary Guidelines (USDA MyPlate)

• Emphasizes fruits, vegetables, whole grains, and fat-free/low-fat milk products.
• Includes lean meats, poultry, fish, beans, eggs, and nuts.
• Is low in saturated fats, trans fats, cholesterol, sodium, and added sugars.

Protein

• Essential for rebuilding and replacing tissues.
• Role in hormone, fluid balance, antibody production, and nutrient transport.
• Provides approximately 4 calories per gram..
• Composed of amino acids (9 essential, 11 nonessential).
• Animal sources (red meat, eggs, milk, poultry, fish—complete/high-quality)
• Plant sources (grains, legumes, vegetables—incomplete/low-quality).
• Recommended intake (DRI) is 46 to 56 g per day for healthy adults but may vary based on activity level, health, and availability of protein.

Protein Deficiency

• Marasmus: Protein-energy malnutrition, occurring primarily in first year of life, characterized by growth retardation and wasting of subcutaneous fat and muscle.
• Kwashiorkor: Condition occurring in infants and young children shortly after weaning from breast milk.

Protein Excess

• Stressful to liver and kidneys, straining their function to rid the body of excess waste protein products.
• Can lead to excess fat accumulation in the body.

Vegetarian Diets

• Lacto-ovo-vegetarian: Includes dairy products, eggs, and plant foods.
• Lactovegetarian: Excludes eggs, includes dairy products and plant foods.
• Vegan: Excludes all animal food sources, including honey.
• Well-planned vegetarian diets offer health benefits (decreased risk of heart disease, hypertension, diabetes, obesity).
• Vegans may have a diet deficient in vitamin B6, B12, iron, zinc, riboflavin, and vitamin D.

Lesson 26.2: Function of Nutrients

• Carbohydrates: The body's main energy source (50-60% of daily diet), supply 4 calories per gram.

  • Regulates protein and fat metabolism, fights infection, promotes growth.
  • Simple carbs (glucose, fructose, lactose) absorbed quickly; complex carbs broken down into simple sugars for use by the body.
  • Fiber cannot be digested, increases stool bulk, aids in elimination, may decrease fat absorption.

• Fats (Lipids): Essential nutrient, concentrated form of energy supply (9 calories/g), source of fatty acids.

  • Adds flavor, contributes to texture, dissolves and transports fat-soluble vitamins and phyto-nutrients.
  • Insulates and controls body temperature, makes food smell better, cushions organs, facilitates nerve signals, feeling of fullness.
  • Oils are liquid at room temperature containing unsaturated fats (e.g., corn oil, safflower oil, canola oil).
  • Omega-3 fatty acids are the most unsaturated form found in fish, walnuts and other similar foods..

• Vitamins: Essential nutrients, taken through food or supplements.

  • Water-soluble (B-complex vitamins and vitamin C), easily absorbed into the bloodstream.
  • Fat-soluble (A, D, E, and K), absorbed with fats, stored in the liver.

• Minerals: Inorganic substances found in animals and plants, essential for metabolism and cellular function; two types:

  • Major minerals, such as calcium, magnesium, sodium, potassium, phosphorus, sulfur, chlorine
  • Trace minerals, such as iron, copper, iodine, manganese, cobalt, zinc, molybdenum, selenium, fluoride, chromium

• Water: Most important nutrient, important for bodily functions (50-69% of the body is water), 1 mL of water per calorie consumed, used in every body process.

Lesson 26.3: Nutrition Influences

• Identify various factors influencing nutrition.
• Explore cultural influences on nutrition practices.
• Compare nutritional needs throughout life's stages.

Clinical Practice (Lesson 26.3)

• Identify patients at risk for nutritional deficits; complete a nutritional assessment on an assigned patient; use therapeutic communication to discuss needed nutritional modification.
• Develop a patient education plan for a prescribed therapeutic diet.

Factors Influencing Nutrition

• Age (infants, toddlers, preschool, school-age, adolescents, adults, older adults)
• Illness
• Emotional status
• Economic status
• Religion (Islam, Judaism, Seventh-Day Adventist)
• Culture (African American, Hispanic, Asian).

Cultural Influences on Nutrition (Specific Groups)

• African American: Traditional diet includes greens, beans, cornbread, sweet potatoes, pork, chicken.
  • High fat, sugar, and salt content are common.
• Hispanic American: High in carbohydrates (beans, rice, corn tortillas).
  • Often high in fat (use of lard in fried foods).
• Asian American: High in carbohydrates; vegetables; low in meat and fish.
  • Use of monosodium glutamate (MSG) might be present; high sodium and fat still possible.
• Middle Eastern American: Includes fermented dairy products (yogurt), meats, grains, fruits, and vegetables.
  • Some foods may be specially prepared according to Muslim religion.

Nutrition Counseling

• Dietary counseling should adapt cultural diet styles while maintaining healthy composition and basic components.
• Patients need guidance on preparing healthier meals (lower in fat and sodium).

Nutritional Needs Through the Life Span

• Infants: Double birth weight by 6 months, triple by 1 year.

  • Breastfeeding recommended by AAP.
  • Formulas available.
  • Solids introduced at 4 to 6 months.

• Toddlers and Preschoolers: Decrease milk intake, increase solid food intake; small portion/serving size.

  • Foods that are easy to chew; avoid combination foods.
  • Offer fun/colorful food, pleasant atmosphere.

• School-age children: Desire for sweets (soda, candy, cake, ice cream).

  • Offer breakfast and nutritious after-school snacks.

• Adolescents: Tend to consume fast food and foods from vending machines.

  • Increased caloric needs during growth spurts.
  • Increased iron needs for adolescent females.

• Adults: Rely on fast and convenience foods.

  • Increased fat, sodium, and sugar intakes.

• Older adults: Increased risk of inadequate nutrition; may need to decrease calorie intake.

  • Physical limitations might affect ability to shop, prepare food.
  • Companionship during meals could be helpful; affordability is a big factor.

Questions and Answers

• Question 1: Water is the most essential nutrient involved in all body chemical processes.

• Question 2: Providing a quick source of protein is NOT a function of fat.

• Question 3: Meat and milk should not be consumed at the same meal for Orthodox Jewish patients.

• Question 4: Most babies double their weight by the end of their first year, and the AAP recommends breastfeeding the first 6 months.

• Question 5: A BMI of 16.5 for an adult male indicates underweight.