Chapter 26 Concepts of Basic Nutrition and Cultural Considerations PDF

Chapter 26 Concepts of Basic Nutrition and Cultural Considerations Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Lesson 26.1 Overview of the GI System and Nutritional Needs Theory 1)Review the structure and function of t...

Chapter 26 Concepts of Basic Nutrition and Cultural Considerations Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Lesson 26.1 Overview of the GI System and Nutritional Needs Theory 1)Review the structure and function of the gastrointestinal system. 2)Use the components of the United States Department of Agriculture (USDA) MyPlate website to assist patients in planning their diets. 3)List medical conditions that may occur as a result of protein, calorie, vitamin, or mineral deficiency or excess. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 2  Lesson 26.1 Overview of the GI System and Nutritional Needs Clinical Practice 1)Identify patients at risk for nutritional deficits. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 3 Overview of the Gastrointestinal System  Structures involved in  Accessory organs the digestive system  Salivary gland  Mouth  Liver  Teeth  Gallbladder  Tongue  Pancreas  Pharynx  Esophagus  Stomach  Small intestine  Large intestine  Anus Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 4 Figure 26-1: The gastrointestinal system Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 5 Functions of the Organs of Digestion  Mouth  First part of the digestive tract  Contains tongue and teeth and receives secretions from the salivary glands  Tongue composed of mostly skeletal muscle; the most movable organ of the mouth  Adults have 32 permanent teeth Cuspids, incisors, bicuspids, and molars Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 6  Functions of the Organs of Digestion (cont’d)  Mouth  Receives food and breaks it down into smaller pieces; mixes food with saliva and starts the digestive process  Parotid glands  Largest salivary glands  One on each side  Located anterior and inferior to the ear  Secrete saliva into the mouth  Begins digestion of starches Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 7  Functions of the Organs of Digestion (cont’d)  Pharynx  Connects the nasal and oral cavities to the esophagus; food is forced into the pharynx by the tongue  Esophagus  Muscular tube approximately 20 cm long  Propels food into the stomach from the pharynx using muscular contraction  Lining secretes mucus Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 8  Functions of the Organs of Digestion (cont’d)  Stomach  Located in the upper-left quadrant of the abdomen; has a capacity of approximately 1.5 L  Has two sphincters  Is a temporary storage place for food  Mixes food with digestive juices  Changes food into a semiliquid state  Begins the digestion of proteins  Absorbs vitamin B12 Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 9  Functions of the Organs of Digestion (cont’d)  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 secrete bile into the duodenum  Pancreas: secretes digestive juices; produces insulin Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 10 Changes in the Digestive System that Occur with Aging  Dental caries and tooth loss  Decrease a person’s ability to chew food  Decreased gag reflex  Increases the risk of aspiration  Decreased sense of taste  May lead to loss of appetite Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 11  Changes in the Digestive System that Occur with Aging (cont’d)  Decreased muscle tone at sphincters  Increases risk of esophageal reflux  Decreased gastric secretions  May interfere with digestion of food  Decreased peristalsis  Increased risk of constipation Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 12  Metabolism  Process in which large molecules are broken down into smaller molecules  Makes energy available to the organism  Enables absorbed nutrients to enter bloodstream following digestion  Digestion converts food into chemical substances such as proteins and simple sugars to be used by the body for energy production and cellular metabolism Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 13  Dietary Guidelines  USDA MyPlate  Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products  Includes lean meats, poultry, fish, beans, eggs, and nuts  Is low in saturated fats, trans fats, cholesterol, sodium, and added sugars Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 14  Protein  Constant supply essential for rebuilding and replacing body tissues  Plays a role in hormone production, fluid balance, antibody production, and transportation of nutrients  Supplies approximately 4 calories/g  Composed of amino acids  9 essential  11 nonessential Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 15  Food Sources: Protein  Animal sources  Red meat, eggs, milk and milk products, poultry, fish  Complete, or high-quality proteins  Plant sources  Grains, legumes, and most vegetables  Incomplete, or low-quality proteins Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 16  Food Sources: Protein (cont’d)  Average DRI is 46 to 56 g of protein per day for the healthy adult  Protein intake should be 10% to 15% of the total daily calories  May vary depending on activity level, state of health, and availability of protein food sources Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 17  Proteins  Protein deficiency  Marasmus A form of protein energy and nutrient malnutrition Occurring chiefly in the first year of life, characterized by growth retardation and wasting of subcutaneous fat and muscle  Kwashiorkor A condition occurring in infants and young children soon after weaning from breast milk Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 18  Proteins (cont’d)  Protein excess  Stressful to the liver and kidneys Kidneys must rid the body of excess waste products Liver function is strained with the excess load of protein to metabolize  Can lead to excess fat in the diet Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 19  Vegetarian Diets  Lacto-ovo-vegetarian  Dairy products, eggs, and plant foods included in the diet  Lactovegetarian  Eggs are excluded; dairy products and plant foods included  Vegan  All animal food sources are excluded, including honey Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 20  Vegetarian Diets (cont’d)  Well-planned vegetarian diets offer health benefits  Decreased risk of heart disease, hypertension, diabetes, and obesity  Vegans may have a diet deficient in  Vitamin B6, vitamin B12, iron, zinc, riboflavin, and vitamin D Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 21  Lesson 26.2 Function of Nutrients Theory 4)Discuss the function of proteins, carbohydrates, fats, vitamins, minerals, and water in the human body. 5)Identify food sources of proteins, carbohydrates, fats, vitamins, and minerals. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 22  Carbohydrates  The body’s main source of energy  Should make up 50% to 60% of the daily diet  Supply 4 calories/g  Regulate protein and fat metabolism, fight infection, and promote growth of body tissues  Three main types:  Simple, complex, and fiber Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 23  Carbohydrates (cont’d)  Simple carbohydrates  Glucose is the metabolized form of sugar found in the body and is found in:  Table sugar (sucrose), the major sweetener found in foods  Fruit sugar (fructose)  Milk sugar (lactose)  Quickly absorbed into the bloodstream  Cause a quick rise in serum glucose Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 24  Carbohydrates (cont’d)  Complex carbohydrates  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 provide  Recommended that 85% to 95% of consumed carbohydrates are complex carbohydrates Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 25  Carbohydrates (cont’d)  Fiber  The portion of the carbohydrate that cannot be broken down during digestion  Passes through the intestine undigested  Increases bulk in the stool  Aids in elimination  May decrease absorption of fat  Recommended intake 21 to 38 g/day Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 26  Food Sources: Fiber  Fruits  Apples, bananas, oranges, grapefruits  Cantaloupe, strawberries  Vegetables  Green beans, broccoli, cauliflower, celery  Corn, potato (with skin), sweet potato  Grains and cereals  Breads, All Bran, oatmeal, Shredded Wheat  Legumes (cooked)  Beans: kidney, pinto, lima; black-eyed peas Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 27  Fats (Lipids)  An essential nutrient  Supplies a concentrated form of energy  Supplies 9 calories/g consumed  Provides source of fatty acids  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 Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 28  Fats (cont’d)  Made up of fatty acids and glycerol  Fatty acids are classified as saturated or unsaturated  Fatty liquids at room temperature are called oils  Oils containing unsaturated fats:  Corn oil, safflower oil, canola oil Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 29  Fats (cont’d)  Omega-3 fatty acids  The most unsaturated form of fatty acid  Found in salmon, halibut, sardines, tuna, canola oil, soybean oil, chicken, eggs, and walnuts  Should be added to the diet as sources of unsaturated fats Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 30  Vitamins  Essential nutrients that must be taken in through food sources or supplements  Water-soluble vitamins  Easily absorbed into the bloodstream for use by the body  B-complex vitamins and vitamin C  Fat-soluble vitamins  Absorbed in the small intestine the same as other fats by action of bile in the duodenum and stored in the liver  A, D, E, and K Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 31  Minerals  Inorganic substances found in animals and plants  Essential for metabolism and cellular function  Major minerals  Calcium, magnesium, sodium, potassium, phosphorus, sulfur, chlorine  Trace minerals  Iron, copper, iodine, manganese, cobalt, zinc, molybdenum, selenium, fluoride, chromium Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 32  Water  Water is the most essential of all nutrients  Adult body is 50% to 69% water  Water requirement is 1 mL/calorie of intake  Used in every body process, from digestion to absorption to elimination or secretion; large amount must be stored in the body  General rule: intake needs to be equal to recorded output plus 500 mL Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 33  Question 1 Which nutrient is involved in all of the body’s chemical processes and the most essential of all nutrients? 1)Water 2)Protein 3)Sodium 4)Sugars Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 34  Question 2 All of the following are functions of fats except they: 1)provide a source of fatty acids. 2)add flavor to foods. 3)make food smell appetizing. 4)provide a quick source of protein. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 35  Question 3 Liz has an Orthodox Jewish patient. When ordering her diet it is important to remember that: 1)pork and pork products are allowed. 2)no alcohol is permitted. 3)shellfish are allowed. 4)meat and milk may not be mixed or eaten at the same meal. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 36  Lesson 26.3 Nutrition Influences Theory 6)Identify a variety of factors that influence nutrition. 7)Explore cultural influences on nutrition practices. 8)Compare nutritional needs throughout life’s stages. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 37  Lesson 26.3 Nutrition Influences Clinical Practice 1)Identify patients at risk for nutritional deficits. (Continued from Lesson 26.1) 2)Complete a nutritional assessment on an assigned patient. 3)Use therapeutic communication with a patient while discussing needed nutritional modification. 4)Develop a patient education plan for a prescribed therapeutic diet. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 38  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  Food Safety Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 39  Cultural Influences on Nutrition  African American  Typical foods in the traditional African American diet include a variety of greens, dry beans, cornbread, sweet potatoes, pork, catfish, and chicken  Preferences often contribute to high fat, sugar, and salt content in the traditional African American diet  Hispanic American  Diet is high in carbohydrates such as beans, rice, corn, and tortillas  The diet can be high in fat because of the use of lard in the preparation of fried foods Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 40  Cultural Influences on Nutrition (con’t)  Asian American  Diet is high in carbohydrates and vegetables and low in meat and fish  The use of monosodium glutamate (MSG) to enhance flavor has decreased but dishes may still have a high sodium and high fat content  Middle Eastern American  Preferences include fermented dairy products such as yogurt, meats, grains in the form of wheat or rice at each meal, fresh fruits, and vegetables  Some foods may be specially prepared if the individual practices the Muslim religion Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 41  Nutrition Counseling  Dietary counseling should include modification of the culture’s traditional diet to accomplish a more healthy composition and preparation while maintaining the diet’s basic components  Patients should be taught how meals can be made healthier by preparing food with less fat and sodium Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 42  Nutritional Needs Through the Life Span: Infants  Should double birth weight by 6 months and triple weight by 1 year  Breast milk recommended  AAP recommends breast milk for first full year  Formulas  Modified form of cow’s milk, made more digestible with added carbohydrate and fat content  Solids introduced in diet at 4 to 6 months Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 43  Nutritional Needs Through the Life Span: Toddlers and Preschool  Ages 2 to 5 years  Consume less milk and increase intake of solids  Provide small servings  Offer foods that are easy to chew  Avoid combination foods  Toddlers prefer single-item foods that do not touch each other on the plate  Try colorful foods (e.g., peas, carrots) Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 44  Nutritional Needs Through the Life Span: Toddlers and Preschool (cont’d)  Provide a pleasant environment at mealtimes  Provide plates and utensils in a size that can be easily handled by a small child  Use dishes that are colorful and/or contain pictures of favorite characters  Avoid forcing a child to eat Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 45  Nutritional Needs Through the Life Span: School-Age Children  May desire sweet, non-nutritive foods such as soda, candy, cake, and ice cream  Provide well-balanced breakfast before school  Provide nutritious after-school snacks  High-calorie, high-sodium preferences may predispose to obesity Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 46  Nutritional Needs Through the Life Span: Adolescents  Tend to consume many fast foods, either from restaurants or vending machines  During growth spurt the body requires more calories as well as nutrients  Adolescent females require increased levels of iron after the menstrual cycle begins Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 47  Nutritional Needs Through the Life Span: Adulthood  Rely on fast foods and convenience foods  Obesity and hypertension prevalent  Have increased fat and sodium intake  Have increased sugar intake  Lack exercise Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 48  Nutritional Needs Through the Life Span: Older Adults  Most at risk for inadequate nutrition  May need to decrease calories if activity level is decreased  Physical limitations make food preparation more difficult  Arrange for companionship during meals  Some older adults have limited incomes and must limit food choices Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 49  Question 4 Sandy works in a pediatrician’s office. A mother who brings in her 9-month-old baby is asking nutrition advice and what an appropriate weight would be for her infant. Which statement is appropriate? 1)Most babies double their weight by the end of their first year. 2)The American Academy of Pediatrics recommends breast- feeding for the first 6 months of life. 3)Nutrients found in formulas are easier to digest for babies than breast milk. 4)Most babies double their weight by 6 months and triple it by 1 year. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 50  Question 5 Ashley’s patient has a body mass index (BMI) of 16.5 for an adult male. This would mean her patient is: 1)underweight. 2)overweight. 3)in the recommended range. 4)morbidly obese. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Slide 51