ATI/NCLEX NUTRITION REVIEW PART 1

Introduction to Nutrition

• Proper daily nutrition allows clients to heal and enhances their quality of life.
• As a nurse, noting changes in a client’s weight related to their health status is important; Unintentional weight gain or loss could indicate a negative health change.

Physiology of Digestion

• Digestion is the process where the body breaks down food into simple substances, which are then absorbed as nutrients or eliminated as waste.
• The digestive system enables organs and tissues to receive necessary nutrients for function.
• Muscular contractions called peristalsis propels food through the digestive organs.
• The digestive process involves organs such as the mouth, esophagus, stomach, liver, gallbladder, pancreas, small intestine, large intestine, rectum, and anus.
• Saliva starts food decomposition, and digestion continues as food moves through different organs.
• The esophagus connects the mouth to the stomach, transporting food.
• The stomach holds and digests food using acids and enzymes, retaining food for 2 to 8 hours.
• The liver filters toxins from the blood and produces bile to break down carbohydrates, proteins, and fats.
• The gallbladder stores bile produced by the liver and releases it as needed.
• The pancreas produces insulin, which regulates sugar metabolism.
• The small intestine further breaks down food, absorbing nutrients into the bloodstream.
• The large intestine removes water and electrolytes from remaining food particles, converting the rest into feces.
• Billions of beneficial bacteria in the large intestine aid this process.
• Feces are stored in the rectum before being expelled through the anus.
• Common digestive issues include diarrhea, constipation, nausea, vomiting, abdominal pain, gas, and bloating.
• Nurses should frequently assess clients for digestive issues.
• PNs should report data on clients who are experiencing digestive issues to the RN or provider.

Healthy Eating Patterns

• Healthy eating patterns involve a balanced diet, monitored caloric intake, and adequate nutrient consumption.
• A balanced diet provides the nutrients needed for maintaining health and well-being.
• Calories, the energy stored in food, support bodily processes like walking, breathing, and running.
• Daily nutrition should come from fresh fruits and vegetables, legumes, whole grains, and lean proteins.
• Individuals should eat nutrient-dense foods like low-fat or fat-free dairy products, fruits, vegetables, and whole grains to stay within the calorie limit.
• A balanced diet includes a variety of foods from grains, dairy, vegetables, fruits, and proteins.
• Unhealthy foods with added sugar, salt, and trans fats should be avoided or limited.
• Daily dietary intake for adults should include 2 cups of fruit, 2½ cups of vegetables, 6 ounces of grains, 5½ ounces of protein, and 3 cups of dairy products.
• The USDA's "My Plate" is a visual guide for what and how much to eat from each food group.
• Eating patterns can affect weight (loss, gain, or maintenance).
• The cause of unintentional weight loss should be identified to rule out underlying health issues.
• Eating whole grains, fruits, and vegetables aids weight control through bulk and fiber content.
• Fiber intake helps control hunger, reducing calorie consumption.
• A healthy weight-loss plan involves losing 1 to 2 pounds per week through lifestyle and dietary changes, along with exercise.
• A weight loss of 5% to 10% of total body weight can improve blood pressure, blood glucose, and cholesterol levels.
• The cause of unintentional weight gain should be identified.
• Clients may pursue weight gain after unintentional weight loss, illness, or to increase muscle mass.
• Healthy weight gain aims to increase muscle or bone mass.
• Nutrient-rich foods are preferred over empty-calorie ones for weight gain.
• Weight gain, like weight loss, should be a steady process.

Nutrient Requirements

• Nutrients are essential for disease prevention, growth, health promotion, and nourishment.
• Nutrient requirements depend on gender, age, and activity level.
• Macronutrients (protein, carbohydrates, and fat) are eaten in large amounts and provide energy.
• Micronutrients (vitamins and minerals) are needed in small amounts.
• Protein is a major building block, providing amino acids for structure, function, and modulation of physiological processes.
• It helps repair, build, and maintain body tissue.
• Protein sources include beans, soy, nuts, meats, eggs, and fish.
• Daily protein requirements vary based on activity level, age, and gender (ranging between 2 and 6½ ounces).
• Protein supplements may be used if indicated, or for those with poor protein intake related to health issues like chemotherapy.
• Carbohydrates are converted into sugar to provide energy for cells, organs, and tissues.
• They should make up 45% to 65% of total daily calories and are the body’s primary fuel source.
• Healthy carbohydrates are found in vegetables, fruits, milk, nuts, grains, legumes, and seeds.
• Sugars (fructose, sucrose, lactose) are the simplest carbohydrates.
• Starches and fiber are complex carbohydrates found in fruits, vegetables, beans, and whole grains.
• The glycemic index, a food's ability to raise blood glucose, should be considered when consuming carbohydrates.
• High glycemic index foods (potatoes, white bread, processed snacks) raise blood glucose rapidly.
• Low glycemic index foods (legumes, vegetables, fruits, whole grains) raise blood glucose slowly, stabilizing energy.
• Fats help the body absorb vitamins and provide energy.
• Limited quantities of fat are part of a healthy diet and influence cholesterol levels.
• Trans and saturated fats should be limited or avoided; monounsaturated fats are preferred.
• Trans fats in processed foods raise LDL cholesterol (“bad cholesterol”) and lower HDL cholesterol (“good cholesterol”).
• Saturated fats in full-fat dairy products can increase heart disease risk and raise total blood cholesterol.
• Monounsaturated fats in nuts, olives, olive oil, seeds, and avocados can lower cholesterol and reduce heart disease risk.
• Excessive monounsaturated fat intake can lead to weight gain.
• Vitamins promote health, ward off disease, and support body functions, including healthy vision, bones, and skin.
• They must be obtained from diet since the body does not produce them.
• Vitamin supplements can prevent deficiencies if indicated.
• Water-soluble vitamins (Vitamin C and Vitamin B complex) are carried to body tissues but not stored.
  • Vitamin B1 (thiamine) converts nutrients to energy. Sources: Whole grains, pork, seeds, trout
  • Vitamin B2 (riboflavin) aids energy production and fat metabolism. Sources: Yogurt, milk, organ meats, almonds
  • Vitamin B3 (niacin) helps produce energy from food. Sources: Meat, fish nuts, grains, legumes
  • Vitamin B5 (pantothenic) aids in fatty acid synthesis. Sources: Mushrooms, tuna, avocado, chicken
  • Vitamin B6 (pyridoxine) helps the body release sugar for energy and immune function. Sources: Organ meats, salmon, tuna, potatoes
  • Vitamin B7 (biotin) breaks down carbohydrates, fats, and protein. Sources: Organ meats, eggs, salmon, sunflower seeds
  • Vitamin B9 (folate) is necessary for proper cell division. Sources: Leafy green vegetables, orange juice, eggs, beans, avocado
  • Vitamin B12 (cobalamin) aids red blood cell formation, and proper nervous system and brain function. Sources: Clams, beef, salmon, milk, yogurt
  • Vitamin C (ascorbic acid) promotes iron absorption, wound healing, bone formation, and immune function. Sources: Brussels sprouts, citrus fruits, spinach, berries, tomatoes, potatoes
• Fat-soluble vitamins are stored in the liver and fatty tissues for later use.
  • Vitamin A aids bone formation, vision, tooth formation, immune function, and cellular function. Sources: Fish liver oil, beef liver, dairy products, green leafy vegetables, sweet potatoes
  • Vitamin D for bone and teeth development, calcium and phosphorus absorption and metabolism. Sources: Fish oil, milk, eggs, dairy products, and sunlight
  • Vitamin E fights infection, healthy red blood cells. Sources:almonds, wheat germ, sunflower seeds, and spinach
  • Vitamin K aids blood clotting and bone health. Sources: Spinach, liver, butter, kale, parsley
• Minerals help the body develop and function normally, including iron, zinc, and calcium.
• Calcium strengthens bones and teeth, aids nerve signal transmission, and facilitates muscle contraction and relaxation.
• Zinc boosts the immune system and promotes wound healing.
• Iron, a part of hemoglobin, provides oxygen to muscles.
• Macrominerals are needed in larger amounts.
  • Calcium aids in proper function and structure of teeth and bones, muscle function, blood pressure regulation. Sources: Milk, milk products, broccoli, leafy greens, legumes
  • Phosphorus - Healthy bones and teeth, assists with acid–base balance. Sources: Eggs, fish, poultry, milk
  • Magnesium supports muscle contraction, immune system health, and nerve transmission. Sources:Legumes, green vegetables, seafood
  • Sodium aids in fluid balance, nerve transmission, and muscle contraction. Sources: Salt, soy sauce, processed foods, meats
  • Chloride aids in fluid balance and stomach acid. Sources: Salt, meats, soy sauce, processed foods
  • Potassium promotes fluid balance, muscle function, and nerve transmission. Sources: Bananas, fruit, legumes, whole grains
  • Sulfur is located in protein molecules. Sources: Eggs, meat, fish, legumes
• Trace minerals are needed in smaller amounts.
  • Iron transports oxygen throughout the body. Sources: Organ meats, red meats, leafy green vegetables, iron-fortified foods
  • Magnesium Part of several enzymes. Sources: Nuts, some fish, brown rice, avocado, spinach, and bananas
  • Copper aids in iron metabolism. Sources: Legumes, whole grains, organ meats, water
  • Zinc supports normal growth, wound healing, and immune function. Sources: Meats, fish, whole grains, vegetables
  • Iodine regulates thyroid function. Sources: Seafood, iodized salt, dairy products
  • Fluoride promotes bone and teeth development. Sources: Fluorinated water, foods and beverages prepared with fluorinated water
  • Selenium defends against oxidative damage. Sources: Grains, meats, seafood
• Water is essential for body function, making up more than half of body weight.
• It promotes brain function, hydrates and flushes wastes, regulates temperature, and acts as a lubricant.
• Water sources include drinking water, fruits, and vegetables.
• The National Academy of Sciences recommends a daily total water intake from beverages and food of 2.7 to 3 liters for females and 3.5 to 3.7 liters for males.

Nutritional Value of Food

• A food’s nutritional value is determined by its impact on the body.
• Empty calories have very little nutritional value, lacking essential vitamins and minerals.
• Processed foods, cookies, chips, and sweetened drinks can have empty calories.
• A varied diet of vegetables, fruits, grains, protein, low-fat dairy products, and healthy oils increases nutritional value.
• Limiting empty calories, sodium, saturated fats, and added sugars reduces the risk of heart disease and other conditions.
• Calorie density is the number of calories a food contains related to its volume or weight.
• Low-calorie-dense foods allow larger consumption without adding calories while still feeling full (e.g., fruits and vegetables).
• High-calorie-dense foods contain more calories per smaller portion (e.g., French fries).
• Low-calorie-dense foods promote a nutrient-rich diet and aid in weight loss or maintenance.

Reading Nutritional Labels

• Nutritional labels provide information about nutrients, supporting informed dietary decisions.
• Nutritional labels cover serving size, calories, nutrient breakdown, and percent daily values.
• The serving size indicates the number of servings in the package, using units like cups or pieces.
• It represents the amount people usually consume, not a recommendation.
• Everything on the label is measured in relation to the serving size.
• Calories indicated are calculated in relation to the serving size.
• Consuming too many calories per day increases the likelihood of weight gain.
• The nutrient breakdown lists saturated fats, sodium, and added sugars, which should be monitored to reduce cardiovascular and hypertension risk.
• Total sugars include those naturally occurring in foods; added sugars are added during processing.
• Added sugars are listed below total sugars, as they are included in the total sugars count.
• Adequate daily intake of dietary fiber, vitamin D, calcium, iron, and potassium provides health benefits.
• Fiber improves bowel movements, lowers cholesterol, improves blood glucose levels, and decreases caloric intake.
• Daily fiber intake for females should be 25 g, and for men, 38 g.
• Daily consumption of iron, calcium, potassium, and vitamins decreases risks of anemia, osteoporosis, and hypertension.
• The percent daily value (%DV) is the percentage of the recommended daily value for each nutrient in a single serving, helping avoid exceeding daily values.
• The %DV is based on the nutrient and may be stated in grams, micrograms, or milligrams.
• If the amount of a nutrient per serving is less than 5% of the daily value, it is considered low; 20% or more is considered high.
• Guidelines recommend higher %DV of vitamin D, calcium, potassium, iron, and fiber, and lower %DV of sodium, added sugars, and saturated fat.
• Net carbohydrates is the amount of carbohydrates in a product minus the fiber and sugar alcohols.
• To calculate net carbs (if not shown on the label), subtract fiber and sugar alcohols from total carbohydrates per serving.

Age and Other Considerations

• Adults need 150 min of moderate-intensity physical activity per week and 2 days of muscle-strengthening activity.
• Children and adolescents need at least 60 min of physical activity daily.
• Physical activity, age, and sex influence daily caloric needs.
• Clients who exercise need more calories than those with a sedentary lifestyle.
• Females need fewer calories than males on average due to less muscle mass and more fat.
• Good nutrition remains important with aging, though older clients may need less calories depending on activity level.
• Older adults can be prone to unintentional weight loss and dehydration due to changes in senses or decreased appetite related to medications.
• Chewing and swallowing problems can make it difficult for older adults to eat a healthy diet.
• Good nutrition can help prevent diseases such as high blood pressure, osteoporosis, heart disease, and type 2 diabetes.
• Whole foods, drinking enough liquids, and avoiding foods high in cholesterol, fat, and empty calories can help meet older adult clients' nutritional needs.