Food Nutrition Past Paper 2023/2024 (Tanta University)

**Tanta University** **Faculty of nursing** **Master specialty degree** **2023/2024** ***( Food nutrition and meal preparation)***  **Under supervision** **Prof. Dr / Lulah Abd Al wahab** **Professor of community health nursing** **Prepared by:** **Lucy Mekhail Ramzy**...

**Tanta University** **Faculty of nursing** **Master specialty degree** **2023/2024** ***( Food nutrition and meal preparation)***  **Under supervision** **Prof. Dr / Lulah Abd Al wahab** **Professor of community health nursing** **Prepared by:** **Lucy Mekhail Ramzy** **Sara Samir Rabie** **General objective:** **Specific objectives:** - **Define of nutrition** - **Define nutrient.** - **Discuss Daily requirements of nutrients :** - **Enumerate benefits** **of meal planning** - **Discuss principles of meal planning** - **Identify Methods of meal planning** - **Define Food preparation.** - **Discuss 4 steps to food safety** - **Enumerate WHO \"Golden Rules\" for Safe Food Preparation** - **Food purchasing** - **Enumerate Guidelines for Safe Food Handling** - **DeFine Proper Food storage** - **Define modified diet** - **Discuss Considerations for modified diet** - **Enumerate Common reasons for therapeutic diets** - **LIST Common therapeutic diets** - **Enumerate Different types of modified diets.** - **DiscussRole of home health care provider in feeding sick people frequently.** - References **Outline:** - **Definition of nutrition** - **Definition of nutrient.** - **Daily requirements of nutrients** - **benefits of meal planning** - **principles of meal planning** - **Methods of meal planning** - Food preparation. - **4 steps to food safety** - **WHO \"Golden Rules\" for Safe Food Preparation** - **Food purchasing** - **Guidelines for Safe Food Handling** - **Proper Food storage** - **modified diet** - **Considerations for** **modified diet** - **Common reasons for therapeutic diets** - **Common therapeutic diets** - **Different types of modified diets.** - **Role of home health care provider in feeding sick people frequently.** - **References.** ***Introduction:*** The science of nutrition concerns everything the body does with food to carry on its functions. Food provides essential substances called nutrients. The body needs these nutrients to help it make energy; to grow, repair, and maintain its tissues; and to keep its different systems working smoothly. Smart nutrition and food choices can help prevent disease. Eating the right foods can help your body cope more successfully with an ongoing illness. The effective management of food intake and nutrition are both key to good health. Understanding good nutrition and paying attention to what you eat can help you maintain or improve your health. - ***Definition of nutrition:*** - ***Definition of nutrients:*** - ***Daily*** ***requirements of nutrients :*** - Overall general health - Physical activity demands - Sex - Weight - Height - Body shape - ***major nutrients of food:*** - - **Simple Carbohydrates: **These are also referred to as simple sugars, containing single monosaccharide units and found in natural sources of food i.e. milk, fruits and vegetables. These carbohydrates add certain sweetness to the food. They raise the level of blood glucose quickly but are easier to break down. - **Complex Carbohydrates: **These are also referred to as polysaccharides, meaning they contain hundreds or thousands of such monosaccharide units. These are typically found in wheat grain, white bread, kernel and cakes. They are relatively less sweet than simple carbohydrates and also raise blood glucose level rather slowly. However, these are tougher to break down. - **fats:** - **Proteins:** - **minerals:** **Mineral Type** **Sources** **Functions** **Deficiency Disease** ------------------ ---------------------------------------------------------- ------------------------------------------------------------------------- ------------------------------------------------------------------ Calcium Tofu, Dairy products, Salmon, Cabbage, Kale and Broccoli Essential for efficient functioning of nervous system and healthy bones Weak bones,  lower than normal bone density and stunted growth Phosphorous Lean meats, grain and milk Essential for the maintenance of acid-base balance in body Loss of appetite, bone fragility, muscle weakness, poor physique Iodine Green leafy vegetables, Seafood, iodised salt Formation of thyroid hormone Goitre- Enlargement of thyroid gland, mental disability. Sodium Table salt, celery Helps keep control on blood pressure Nausea, irritability Iron Whole grain, eggs, leafy vegetables and meats Essential for haemoglobin formation in rbc. Anaemia -- weakness, fatigue, shortness of breath  - **water:** Water performs the essential function of absorbing nutrients from our food. It also helps in releasing waste from our body in form of sweat and urine - Water is body\'s principal chemical component and makes up about 50% to 70% of body weight. The body depends on water to survive. - **fibers:** - **vitamines:** **Vitamin Type** **Sources** **Functions** **Deficiency Diseases** ------------------------------ --------------------------------------------------------------------------------------- ---------------------------------------------------------- --------------------------------------------------------------- Vitamin A Leafy green vegetables, oranges, carrots, Pumpkin, Soy, Sweet potatoes Forms and helps maintain bones, skin, tissue and teeth Color blindness, night blindness- poor visibility at night. Vitamin B1 (thiamine) Dried herbs, sunflower seeds, whole grain cereals, sesame seeds, brown rice Enables cells to turn carbohydrates into energy Beriberi-  loss of appetite, loss of weight. Vitamin B2 (riboflavin) Almonds, Asparagus, bananas, green beans, wheat bran, dried spices Maintains Body growth and RBCs i.e. Red Blood Cells Skin disorders, Cheilosis-breaking of lips Vitamin B12 (cyanocobalamin) Mutton, fish, beef, lobster, clams, eggs, oysters, crab Helps in maintenance of central nervous system and RBCs Pale skin, lack of RBC, Less stamina and less appetite. Vitamin C Fresh herbs, cauliflower, papaya, oranges, strawberries, guava Promotes healthy gums and teeth Scurvy i.e. gum disease (gingivitis). Vitamin D Sunshine, Mushrooms, liver, fish and eggs Necessary for the healthy development of bones and teeth Rickets and Osteomalacia -- weakening and softening of bones. Vitamin E Soyabean oil, red chilli powder, pine nuts, apricots, green olives and cooked spinach Helps in processing vitamin K and formation of RBCs  Muscle weakness and transmission problems in nerve impulses Vitamin K Green leafy vegetables, Soyabean oil.  Essential for blood coagulation Excessive bleeding from wound.  - **benefits of meal planning:** - Meal-planning saves you time - Save at the checkout manage your budget more effectively. - Plan for a healthier diet - Cut out those bad habits - useful for people who are not able to eat certain foods for medical reasons - **Principles of meal planning:** - **Adequacy**: By adequacy, I mean the meal plan or meals we eat provide enough energy, major macronutrients (protein, fat, carbohydrate), micronutrients (calcium), and fluid that our bodies need to function optimally and to support life-long health. This means we\'re eating enough to support our bodies through day-to-day activities - **Balance:** All of the major food groups are present in meals, and generally two are present at snacks. The body needs adequate amounts of carbohydrate, fat, and protein to function well. - **Variety: **Get the nutrition we need from a variety of foods. Switch things up to help ensure your body gets exposed to a variety of phytochemicals and miconutrients - **Moderation**:providing enough but not too much especially from micronutrients - **Energy control:**Management of foods energy intake - **Energy density:**Measures the Kcal per gram of foods - - **Methods of meal planning:** According to two methods: A. **[B) The food plate:]** IMG\_256 **4 steps to food safety** There are 4 basic steps to food safety at home, these are known as the four C's:  1. cleaning -- making sure your hands, surfaces and equipment are clean before, during and after cooking 2. cooking -- making sure food is cooked throughout to kill harmful bacteria 3. chilling -- making sure foods are stored at the correct temperature to prevent growth of harmful bacteria 4. avoiding cross-contamination -- preventing the spread of bacteria to surfaces and ready-to-eat food - Wash hands thoroughly before you start preparing food - Keep all kitchen surfaces meticulously clean - Since foods are so easily contaminated, any surface used for food preparation must be kept absolutely clean. **Food purchasing guidlines** - Avoid buying any cans that are deeply dented (one that you can lay your finger into), bulging, rusting or have a dent on either the top or side seam. Deeply dented or bulging cans may be a warning sign of botulism, while cans with a sharp dent may damage the seam and allow bacteria to enter the can. - Check Dairy and Milk Products - When buying dairy products, choose cartons and containers that are cold. - Make sure the eggs are clean and aren't broken or cracked. - Buy milk and other dairy products toward the end of your shopping trip. This will lessen the time these items are out of refrigeration. - Buy fish only from reputable sources such as grocery stores and seafood markets. - Make sure packaged seafood is well-packed in ice and that packages are tightly sealed and free of dents and tears. Avoid packages containing ice crystals. This is a sign the seafood has previously thawed. - Always look for the Safe Food Handling label on packages of bacon and fresh sausage. This label means the meat has undergone safe processing and includes handling and cooking tips. - Select meats and poultry after shopping for non-perishable items. - Separate Certain Foods - Put raw meat, poultry and seafood in plastic bags before placing them in your cart. This keeps them from leaking and dripping onto ready-to-eat foods such as bread or produce. **Guidelines for Safe Food Handling** - - - - - - - - Take groceries home immediately and store them right away. If you must run errands and will be out longer than 30 minutes, bring a cooler with chill packs for perishable foods. The temperature of refrigerated food can go up 8 to 10 degrees Fahrenheit on a typical trip home from the store. within one hour. - Keep perishable foods out of the hot trunk in summer and place in the air-conditioned car instead. - Promptly refrigerate or freeze perishable items as soon as you get home. - - -  - Eggs, milk, milk products (cheese, yogurt), salad dressings, and mayonnaise should be refrigerated. - Refrigerate fresh fruit only after it is ripe. - Ensure refrigerators and freezers are in good working order. Keep a thermometer in each to ensure the temperature is correct. Refrigerators should be kept at or below 40 degrees F. Freezers should be kept at 0 degrees F. - Cooked foods and leftovers should be used within 1 days. - Clean the refrigerator once per week and discard perishable items. Ensure there is enough space between items in the refrigerator so that air can circulate and keep foods properly chilled. **[Modified diet ]** ***[Considerations for modified diet:]*** - To implement a diet that has been specifically designed to target IBD or auto-immune conditions. - To have a strong positive desire to improve your diet and include more healthy diversity. - When feel empowered by the idea of making your own food and exploring the addition of the healthy variety of fruits and vegetables available to you. - When have enough time, support, energy, and financial stability to make these changes comfortably. **Common reasons for therapeutic diets:** - To maintain nutritional status - To restore nutritional status - To correct nutritional status - To decrease calories for weight control - To provide extra calories for weight gain - To balance amounts of carbohydrates, fat and protein for control of diabetes - To provide a greater amount of a nutrient such as protein - To decrease the amount of a nutrient such as sodium - To exclude foods due to allergies or food intolerance - No concentrated sweets diet - Diabetic diets - No added salt diet - Low sodium diet - Low fat diet and/or low cholesterol diet - High fiber diet - Renal diet - Mechanical soft diet - Puree diet Liquid tube feedings in place of meals Liquid tube feedings in addition to meals **5. Additional feedings** -- In addition to meal, extra nutrition may be ordered as: Supplements -- usually ordered as liquid nutritional shakes once, twice or three times per day; given either with meals or between meals **Diet name** **Person** **Food allowed** **Food not allowed** --------------------------------- --------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- Heart-Healthy Diet Heart disease, hypertension, high cholesterol, post-cardiac surgery Oats, brown rice, skinless poultry, fish (especially omega-3-rich like salmon), nuts, seeds, olive oil, plenty of fruits (like berries, apples) and vegetables (like spinach, carrots) Trans fats (found in some processed foods), high-sodium foods (like canned soups), red meats, sugary treats, full-fat dairy Diabetic Diet Diabetes (Type 1 and 2), prediabetes, insulin resistance Fiber-rich whole grains (quinoa, barley), lean proteins (chicken, fish), non-starchy vegetables (broccoli, cucumbers), low-glycemic fruits (berries, apples), legumes Sugary desserts, white bread, pasta made with white flour, sugary cereals, fruit juices Renal Diet Chronic kidney disease, kidney stones Cauliflower, blueberries, garlic, buckwheat, olive oil, egg whites High potassium foods (bananas, oranges), high phosphorus foods (dairy, whole grains), processed foods with added salts Low Sodium Diet Hypertension, heart failure, kidney disease, liver cirrhosis Fresh vegetables and fruits, unsalted nuts, grains like rice and pasta, fresh meats, herbs and spices for flavor Deli meats, canned soups and vegetables, salted snacks, pre-packaged meals, condiments like soy sauce and ketchup Gluten-Free Diet Celiac disease, non-celiac gluten sensitivity, wheat allergy Gluten-free grains (rice, quinoa, corn), most dairy products, fresh meats and fish, fruits and vegetables, nuts and seeds Anything containing wheat, barley, rye, and their derivatives; certain processed foods, beers, and malt beverages Low Residue Diet Inflammatory bowel disease, Crohn's disease, ulcerative colitis, diverticulitis White bread and pasta, white rice, well-cooked vegetables without skin or seeds, canned fruits. Whole grains, raw fruits and vegetables, nuts, seeds, popcorn, dried fruits High Fiber Diet Constipation, irritable bowel syndrome, diverticulosis Whole grains (whole wheat bread, brown rice), legumes (beans, lentils), fruits (apples, pears), vegetables (carrots, broccoli), nuts, and seeds Processed foods low in fiber, white bread, non-whole grain cereals, canned fruits and vegetables High Calorie, High Protein Diet Malnutrition, cancer, certain infections, wound healing, muscle wasting Lean meats, dairy products (milk, cheese), nuts and nut butters, seeds, legumes, whole grains, avocado Low-calorie foods, diet beverages, foods low in protein such as rice cakes, plain salads without protein Lactose-Free Diet Lactose intolerance, certain digestive disorders Lactose-free milk and dairy products, non-dairy milks (almond, soy, rice), lactose-free yogurts and cheeses, meats, grains, fruits and vegetables egular milk, standard dairy products like cheese and yogurt, anything containing lactose or milk derivatives Pureed Severe dysphagia, poor oral phase abilities Smooth, homogeneous foods like pureed fruits, vegetables, and meats \-\-\-- Liquidized Difficulty managing semi-solid foods Foods pureed and thinned to a liquid consistency \-\-\-- - **Role of home health car provider in nutrition:** - Assessing the patient's needs from multiple angles we can best ensure they receive adequate nutrition during their recovery process. This often involves working closely with other healthcare providers such as physicians, dietitians, and nurses who may be involved with the treatment plan in order to develop an effective strategy for meeting dietary goals set - Home health care services provide nutritional support to patients in a +-----------------------------------+-----------------------------------+ | **Program** | **Description** | +===================================+===================================+ | Meal Delivery | Providing healthy meals prepared | | | and delivered to the patient's | | | | | | home | +-----------------------------------+-----------------------------------+ | Dietary Counseling | Educating patients about how food | | | choices affect their physical\` | | | | | | condition | +-----------------------------------+-----------------------------------+ | Nutrition Education | Learning about nutrients needed | | | for good health | +-----------------------------------+-----------------------------------+ | Nutrition Assessment | Identifying any nutritional | | | deficiencies | +-----------------------------------+-----------------------------------+ | Vitamin Supplements | Taking vitamins or other forms of | | | nutritional supplementation | | | | | | as directed by a doctor | +-----------------------------------+-----------------------------------+ - Working closely with other healthcare professionals such as nutritionists allows homehealth care services to effectively provide comprehensive nutritional support for their patients. This partnership helps ensure that each person has access to the specialized help they need in order to maintain a healthy diet long term. - By monitoring progress and evaluating outcomes regularly, home health care providers are able to adjust treatment plans accordingly and improve overall quality of life for their clients. - Use different colored foods for visual appeal. - Keep foods separated on the serving plate. The plate should look like any other plate. It should not be a mix of all the foods into one pile. - If a patient has a weak side, feed to the stronger side. - Encourage or feed only small bites at a time. Allow the patient to chew/swallow completely before serving the next bite. If necessary, check the inside of their mouth for pocketed food. - Be cautious about patient positioning during feeding, especially for patients who have trouble chewing or swallowing. - Always sit a patient in an upright position to avoid choking or aspiration (when food enters areas of the respiratory tract such as the lungs where it does not belong, which could lead to pneumonia).. - Keep the patient in an upright position for 30-60 minutes after eating. - - - - - - - - - -