Nutrition & Diet Therapy Textbook PDF

1-1 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  1 The Relationship of Nutrition and Health  Objectives ⚫ Name the six classes of nutrients and their primary functions. ⚫ Recogniz...

1-1 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  1 The Relationship of Nutrition and Health  Objectives ⚫ Name the six classes of nutrients and their primary functions. ⚫ Recognize common characteristics of well-nourished people. ⚫ Recognize the symptoms of malnutrition. ⚫ Describe ways in which nutrition and health are related. ⚫ List the four basic steps in nutrition assessment. 1-3  Nutrients ⚫ Chemical substances necessary for life ⚫ Functions  Provide energy  Build and repair tissue  Regulate body processes: circulation, respiration, digestion, and elimination 1-4 (continues) (continued) Nutrients Six classes 1. Carbohydrates 2. Fats (lipids) 3. Proteins 4. Vitamins 5. Minerals 6. Water 1-5 (continues) (continued) Nutrients ⚫ No nutrient can work alone. ⚫ Essential nutrients: those found only in foods ⚫ Organic nutrients: carbohydrates, fats, proteins, vitamins ⚫ Inorganic nutrients: water, minerals 1-6  Organic Nutrients ⚫ Organic  Must be broken down before use  Contains carbon, hydrogen, and oxygen  Function: provide energy, regulate body processes, and repair tissues 1-7  Inorganic Nutrients ⚫ In simplest form when ingested ⚫ Function: regulate body processes 1-8  Carbohydrates ⚫ Provide major source of energy ⚫ Examples: cereal grains, vegetables, fruits, nuts, and sugars 1-9  Fats (Lipids) ⚫ Provide energy ⚫ Highest kilocalorie value ⚫ Sources: meats, milk, cream, butter, cheese, egg yolks, oils, nuts 1-10  Proteins ⚫ Build and repair body tissues ⚫ Provide energy ⚫ Only one of the six nutrients that contain nitrogen ⚫ Sources: meats, fish, poultry, eggs, milk, cheese, corn, grains, nuts, and seeds 1-11  Vitamins ⚫ Organic compounds ⚫ Regulate body processes ⚫ Examples: vitamins A, B, C, D, E, and K 1-12  Minerals ⚫ Inorganic compounds ⚫ Regulate body processes ⚫ Examples: calcium, phosphorus, potassium, sodium, chloride, iron, magnesium, and zinc 1-13  Water ⚫ Major constituent of all living cells ⚫ Composed of hydrogen and oxygen 1-14  The Six Essential Nutrient Classes and Their Functions ⚫ Organic nutrients ⚫ Function  Carbohydrates  Provide energy  Fats  Proteins  Build and repair tissues and provide energy  Vitamins  Regulate body processes 1-15 (continues) (continued) The Six Essential Nutrient Classes and Their Functions ⚫ Inorganic nutrients ⚫ Function  Minerals  Regulate body processes  Water  Regulate body processes 1-16  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 and vinegar, soda ▪ Snack: pretzels, soda ▪ Dinner: spaghetti with tomato sauce, garlic bread, wine 1-17 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Discuss the answers to the following questions: ▪ What nutrients are missing in the client’s diet? ▪ Why are these nutrients important for this client? 1-18 1-18 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  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. 1-19 1-19 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Characteristics of Nutritional Status ⚫ Good ⚫ Poor  Alert expression  Apathy  Shiny hair  Dull, lifeless hair  Clear complexion  Greasy, blemished complexion  Good color  Poor color 1-20 (continues) (continued) Characteristics of Nutritional 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 1-21 (continues) (continued) Characteristics of Nutritional Status ⚫ Good ⚫ Poor  Well-developed bone  Bowed legs, “pigeon structure breast”  Normal weight for  Overweight or height underweight  Erect posture  Slumped posture  Emotional stability  Easily irritated, depressed, poor attention span 1-22 (continues) (continued) Characteristics of Nutritional 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 1-23  Divide into groups of two. Assess your partner for signs of good nutrition. Identify common characteristics associated with good nutrition exhibited in your partner. 1-24 1-24 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Shiny hair Clear skin Clear eyes Erect posture Alert Firm flesh on well-developed bone structures Pink gums and well-developed teeth Normal weight for height 1-25 1-25 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Malnutrition ⚫ Overnutrition  Excess energy or nutrient intake ⚫ Undernutrition  Deficient energy or nutrient intake ⚫ Overnutrition is a larger problem than undernutrition in the U.S. ⚫ The supersizing, fast food industry contributes to overnutrition. 1-26  Cumulative Effects of Nutrition ⚫ Excesses ⚫ Deficiencies  Excess nutrients over  Nutrients lacking for time extended period  Examples:  Examples: iron atherosclerosis- deficiency, beriberi, obesity, hypertension, scurvy osteomalacia diabetes, gallbladder osteoporosis, rickets disease, some cancers goiter 1-27  Nutrient Deficiency ⚫ Primary: inadequate dietary intake ⚫ Secondary: due to causes other than dietary intake ⚫ Both can result in malnutrition. 1-28  Deficiency Diseases ⚫ Deficiency disease ⚫ Nutrients lacking  Iron-deficiency  Iron anemia Thiamin  Beriberi  Vitamin A  Night blindness  Iodine  Goiter  Protein  Kwashiorkor 1-29 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Deficiency Diseases ⚫ Deficiency disease ⚫ Nutrients lacking  Marasmus  All nutrients  Osteomalacia-  Calcium, vitamin D, phosphorus, magnesium, and fluoride  Osteoporosis  Calcium and vitamin D 1-30 (continues) (continued) Deficiency Diseases ⚫ Deficiency disease ⚫ Nutrients lacking  Pellagra  Niacin  Rickets  Calcium and  Scurvy vitamin D  Xerophthalmia  Vitamin C  Vitamin A 1-31 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Nutritional Assessment ⚫ Anthropometric measurements ⚫ Clinical examination ⚫ Biochemical tests ⚫ Dietary and social history 1-32  Anthropometric Measurements ⚫ Height ⚫ Weight ⚫ Head, chest, and abdominal circumference (children) ⚫ Upper arm measurement ⚫ Skinfold 1-33  Clinical Examination ⚫ Clinical signs ⚫ Possible deficiencies  Pallor, blue half  Iron, copper, zinc, circles beneath B12, B6, biotin eyes  Edema  Protein  Bumpy  Vitamin A “gooseflesh  Lesions at corner  Riboflavin of mouth 1-34 (continues) (continued) Clinical Examination ⚫ Clinical signs ⚫ Possible deficiencies  Glossitis  Folic acid  Numerous “black  Vitamin C and blue” spots and tiny, red “pin prick” hemorrhages under the skin  Emaciation  Carbohydrates, proteins, calories 1-35 (continues) (continued) Clinical Examination ⚫ Clinical signs ⚫ Possible deficiencies  Poorly shaped  Vitamin C bones or teeth, or delayed appearance of teeth in children  Slow clotting time of  Vitamin K blood 1-36 (continues) (continued) Clinical Examination ⚫ Clinical signs ⚫ Possible deficiencies  Unusual  Niacin nervousness, dermatitis, diarrhea in same client  Tetany  Calcium, potassium, sodium  Goiter  Iodine  Eczema  Fat 1-37  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 1-38 (continues) (continued) Biochemical Tests ⚫ Blood urea nitrogen ⚫ 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 1-39 (continues) (continued) 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 1-40 (continues) (continued) Biochemical Tests ⚫ Other tests  Hemoglobin (Hgb)  Hematocrit (Hct)  Red blood cells (RBCs)  White blood cells (WBCs)  Lipid profile (high- and low-density lipoprotein, serum triglycerides)  Urinalysis 1-41 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Dietary and 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 1-42 (continues) (continued) Dietary and Social History ⚫ Social history  Consideration of financial resources to obtain needed food, and to properly store and cook food  Food-drug interactions that can lead to malnutrition 1-43  Conclusion ⚫ Nutrition and health are directly related. ⚫ The effects of poor nutrition are cumulative. ⚫ There are six essential nutrient classes: carbohydrates, fats, proteins, minerals, vitamins, and water. ⚫ Nutritional assessment is the best way to determine deficiencies that can result from lack of nutrients. 1-44