Podcast
Questions and Answers
Which of the following is NOT a source of fiber?
Which of the following is NOT a source of fiber?
Which type of fats are typically liquid at room temperature?
Which type of fats are typically liquid at room temperature?
Which of these fruits provides significant amounts of fiber?
Which of these fruits provides significant amounts of fiber?
What is the main function of fiber in the diet?
What is the main function of fiber in the diet?
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Which of the following fatty acids is classified as the most unsaturated?
Which of the following fatty acids is classified as the most unsaturated?
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Which of the following is true about simple carbohydrates?
Which of the following is true about simple carbohydrates?
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What is the recommended percentage of complex carbohydrates in a diet?
What is the recommended percentage of complex carbohydrates in a diet?
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Which of the following foods is an example of a complex carbohydrate?
Which of the following foods is an example of a complex carbohydrate?
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What is one of the main functions of fiber in the diet?
What is one of the main functions of fiber in the diet?
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Which type of sugar is glucose primarily associated with?
Which type of sugar is glucose primarily associated with?
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How does fiber affect the absorption of carbohydrates?
How does fiber affect the absorption of carbohydrates?
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Which type of carbohydrate causes a quick rise in blood sugar?
Which type of carbohydrate causes a quick rise in blood sugar?
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What is the recommended daily intake of fiber?
What is the recommended daily intake of fiber?
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What is the primary function of water in the body?
What is the primary function of water in the body?
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What is the general guideline for fluid intake based on output?
What is the general guideline for fluid intake based on output?
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Which age group has the highest water requirement due to rapid growth?
Which age group has the highest water requirement due to rapid growth?
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What is a common characteristic of the traditional African American diet?
What is a common characteristic of the traditional African American diet?
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How does the Hispanic American diet primarily differ from other diets?
How does the Hispanic American diet primarily differ from other diets?
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Which factor does NOT significantly influence nutrition choices?
Which factor does NOT significantly influence nutrition choices?
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Why might individuals from certain cultures have dietary preferences?
Why might individuals from certain cultures have dietary preferences?
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Which food safety practice is essential for ground beef and chicken?
Which food safety practice is essential for ground beef and chicken?
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Study Notes
Chapter 26: Concepts of Basic Nutrition and Cultural Considerations
- ATI Fundamentals Chapter 39
- ATI Nutrition Chapter 1
Overview of the Gastrointestinal System (p. 467)
- Structures involved in the digestive system
- 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
- Contains tongue and 32 permanent teeth
- Receives secretions from salivary glands
- Tongue composed of skeletal muscle
- Receives food and breaks it down into smaller pieces, mixes food with saliva, starting digestion
- Parotid glands: largest salivary glands, one on each side (anterior and inferior to the ear)
- Secrete saliva into the mouth, beginning digestion of starches
Pharynx
- Connects nasal and oral cavities to the esophagus
- Food forced into pharynx by the tongue
Esophagus
- Muscular tube approximately 20 cm long
- Propels food into the stomach
- Lining secretes mucus
Stomach
- Located in the upper-left quadrant of the abdomen, capacity approximately 1.5L
- Has two sphincters that prevent gastric acid from moving back up the esophagus
- Temporary storage place for food
- Mixes food with digestive juices (gastric acids)
- Changes food into a semiliquid state
- Begins digestion of proteins
- Absorbs vitamin B12
Small Intestine
- (Duodenum, jejunum, ileum)
- Mixes food with secretions from liver and pancreas
- Finishes digestion
- Absorbs nutrients
Large Intestine
- (Ascending, transverse, descending, and sigmoid colon; rectum, anus; cecum)
- Absorbs fluid and electrolytes
- Eliminates waste products
Liver and Gallbladder
- Concentrate, store, and secret bile into the duodenum when stimulated by fatty foods
Pancreas
- Secretes digestive juices
- Produces insulin
Changes in the Digestive System that Occur with Aging
- Dental carries and tooth loss
- Decrease ability to chew
- Decreased gag reflex
- Increases aspiration risk
- Decreased sense of taste
- May lead to loss of appetite
- Decreased sphincter tone
- Increase reflux risk
- Decreased gastric secretions
- May interfere with digestion
- Decreased peristalsis
- Increased constipation risk
Metabolism
- Process in which large molecules are broken down into smaller molecules
- Makes energy available to the body
- Enables absorbed nutrients to enter the bloodstream following digestion
- Digestion converts food into chemical compounds (proteins and simple sugars) to be used for energy production and cellular metabolism
Dietary Guidelines
- USDA MyPlate
- Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk products
- Includes lean meats, poultry, fish, beans, eggs, and nuts
- Low in saturated fats, trans fats, cholesterol, sodium, and added sugars
- Variety of foods from each group needed to achieve a healthy diet
- See also the AHA 2015 Diet and Lifestyle Recommendations
Protein
- Constant supply essential for rebuilding and replacing body tissues
- Plays a role in hormone production, fluid balance, antibody production, and transportation of nutrients
- Composed of amino acids
- 9 essential and 11 nonessential
- Animal sources contain all 9 essential amino acids
- Red meat, eggs, milk, poultry, fish (Complete protein)
- Plant sources are incomplete proteins
- Grains, legumes, most vegetables (Incomplete protein)
Protein Dietary Reference Intakes :
- Average DRI is 46 to 56 g of protein per day for healthy adults
- Combination of meat and plant sources.
- Protein intake should be 10% to 15% of total daily calories.
- May vary based on activity level, health, and availability of protein food sources.
- Individuals highly active or ill need more protein.
Protein Deficiency
- Marasmus
- Severe starvation, a form of protein-energy and nutrient malnutrition
- Occurs chiefly in the first year of life
- Characterized by growth retardation and wasting of subcutaneous fat and muscle
- Kwashiorkor
- Condition occurring in infants and young children soon after weaning from breast milk
- Severe protein deficiency, even with adequate intake of other nutrients
- Symptoms: Edema, skin pigment changes, impaired
Protein Excess
- Stressful to the liver and kidneys
- Kidneys remove excess waste products
- Liver strained with excess protein to metabolize
- Can lead to excess fat in the diet
- Leads to obesity, heart disease, and certain types of cancer
Vegetarian Diets
- Well-planned vegetarian diets may offer health benefits.
- Lacto-ovo-vegetarian: Dairy products, eggs, and plant foods included
- Lactovegetarian: Eggs excluded; dairy products and plant foods included
- Vegan: Excludes all animal foods, including honey
- May have a diet deficient in vitamin B6, vitamin B12, iron, zinc, riboflavin, and vitamin D
Carbohydrates
- The body's main source of energy
- Should make up 50% to 60% of the daily diet
- Regulate protein and fat metabolism
- Fight infection and promote growth of body tissues
- Three main types
- Simple carbohydrates (monosaccharides)
- Complex carbohydrates (polysaccharides)
- Fiber
Simple Carbohydrates
- Glucose: metabolized form of sugar, found in Table sugar (sucrose), fruit sugar (fructose), and high-fructose corn syrup added to foods.
- Milk sugar (lactose)
- Quickly absorbed into the bloodstream
- Cause a quick rise in serum glucose
Complex Carbohydrates
- Oatmeal, whole-grain breads, pasta, cereals, and rice
- Broken down into simple sugars for use by the body.
- Provide a more consistent serum glucose level than simple sugars
Fiber Carbohydrate
- The portion of the carbohydrate that cannot be broken down during digestion; passes through intestines undigested
- Increases bulk in the stool, aiding in elimination
- May decrease fat and cholesterol absorption.
- Delays carb absorption, beneficial to diabetic patients.
- Recommended intake 21 to 38 g/day
Food Sources of Fiber
- Fruits: Apples, bananas, oranges, grapefruits, cantaloupe, strawberries
- Vegetables: Green beans, broccoli, cauliflower, celery, corn, potato
- Grains: Whole wheat breads, all bran, oatmeal, shredded wheat
- Legumes: Kidney beans, pinto beans, lima beans, black-eyed peas
Fats (Lipids)
- Essential nutrient
- Supplies concentrated form of energy
- Made up of fatty acids and glycerol.
- Called triglycerides
- Adds flavor to foods and contributes to texture
- Dissolves and transports fat-soluble vitamins and fat-soluble phytonutrients (carotenoids)
- Insulates and controls body temperature
- Makes food smell appetizing
- Cushions and protects body organs.
- Facilitates transmission of nerve impulses
- Gives feeling of fullness after eating
Fats: Saturated vs. Unsaturated
- Fatty acids are classified as saturated or unsaturated
- Fatty liquids at room temperature are called oils.
- Most oils are unsaturated fats (corn oil, safflower oil, canola oil)
- Omega-3 fatty acids are a form of unsaturated fatty acid found in salmon, halibut, sardines, tuna, canola oil, soybean oil, chicken, eggs, and walnuts
Fats: Cholesterol
- Component of fat linked to heart disease and hardening of the arteries.
- Found in animal products and oils (palm and coconut)
- Blood studies associated with fats
-HDL (high-density lipids): Want these high, helps remove cholesterol from arteries
- LDL (low-density lipids): Want these low, main source of buildup in arteries
- Triglycerides: Fats found in the blood; high levels may increase risk of heart disease
Vitamins
- Essential nutrients that must be taken through food sources or supplements.
- Water-soluble vitamins are easily absorbed into the bloodstream and used by the body.
- Fat-soluble vitamins are absorbed like other fats, by action of bile in the duodenum and are stored in the liver. (A, D, E, and K)
Minerals
- Inorganic substances found in animals and plants
- Essential for metabolism, cellular function, and proper nerve and muscle function.
- Mineral actions are interrelated; a deficiency in one impacts the action of another.
- Major minerals: Calcium, magnesium, sodium, potassium, phosphorus, sulfur, and chloride
- High sodium foods listed in Table 26.5, p.469
- Trace minerals: Iron, copper, iodine, manganese, cobalt, zinc, molybdenum, selenium, fluoride, chromium
Water
- Most essential nutrient
- Water requirement is 1 mL/calorie of intake
- Used in every body process
- Large amount must be stored in the body
- General rule: Intake needs to be equal to recorded output + 500 mL
Factors Influencing Nutrition
- Age: Infants, toddlers, preschool, school-age, adolescents, adults, and older adults
- Illness: Increased need
- Emotional status: Overeating or undereating
- Economic status: Limited income, healthy choices
- Religion: Islam, Judaism, Seventh-Day Adventist
- Culture: African American, Hispanic, Asian
- Food safety: Wash fruits and vegetables; Cook ground beef and chicken thoroughly
Cultural Influences on Nutrition
- African American: Variety of greens, dry beans, cornbread, sweet potatoes, pork, catfish, and chicken - High in fat, sugar, and salt content
- Hispanic American: High in carbohydrates (beans, rice, corn, tortillas) - Can be high in fat (lard use)
- Asian American: High in carbohydrates and vegetables, low in meat and fish. - Use of monosodium glutamate (MSG) to enhance flavor, may still have high sodium and fat content.
- Middle Eastern American: Fermented dairy products (yogurt), meats, grains (wheat or rice), fruits, and vegetables - Foods may be prepared according to religious practices.
Nutrition Counseling
- Modify culture's traditional diet to achieve a healthier composition while maintaining basic components.
- Teach how to make meals healthier by preparing food with less fat and sodium.
Nutritional Needs Through the Life Span:
Infants
- Double birth weight by 6 months, triple by 1 year
- Breast milk recommended (AAP)
- Formulas: Modified cow's milk, more digestible with added carbohydrate and fat
- Solids introduced gradually, one at a time, starting at 4 to 6 months. (Rice or oatmeal is a good choice, no eggs or fish in first year)
Toddlers/Preschool
- Ages 2 to 5 years
- Consume less milk, increase с intake
- Provide small servings and easy-to-chew foods
- Avoid combination foods, try colorful foods.
- Provide a pleasant environment and appropriate plates/utensils.
School-Age Children
- May desire sweet, non-nutritive foods (soda, candy, cake, ice cream)
- Provide nutritious breakfast before school and after-school snacks
- High-calorie, high-sodium preferences may lead to obesity.
- Obesity becomes a health issue during school years.
Adolescents
- Tend to consume fast foods.
- Increased caloric and nutrient needs during growth spurts
- Adolescent females need increased iron after menstrual cycle begins
- Adrenals are very aware of appearance and concern can lead to eating disorders.
Adults
- Focused on work, child rearing, and family
- Often rely on fast foods and convenience foods
- Increased prevalence of obesity and hypertension
- Increased fat, sodium, and sugar intake
- Lack of exercise
Older Adults
- High risk for inadequate nutrition
- May need to decrease calories if activity decreases (nutrient requirements don’t change).
- Physical limitations may make food preparation more difficult; arrange for companionship during meals.
- Limited incomes and cognitive decline may limit food choices.
Nutrition Assessment
- Determine factors impacting nutrition (diagnosis, surgery, etc.)
- Medical, family, and social history
- Physical examination: (Assess BMI – Fig 26.5, pg. 485)
- Lab studies (Recommended BMI is 18.5 to 24.9)
Nutrition Implementation
- Assist patients with meal trays and feeding when needed
- Pleasant environment, free of odors.
- Position patient upright.
- Verify correct diet order for the correct patient.
- Serve hot food hot and cold food cold.
- Provide enteral or total parenteral nutrition.
- Patient education: Therapeutic diet.
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Test your knowledge on dietary fiber and fats with this quiz. You'll explore the sources of fiber, the characteristics of fats, and their functions in nutrition. Challenge yourself and discover important insights about healthy eating.
