Nutrition And Diet Therapy (NCM 105) PDF

NUTRITION AND DIET THERAPY (NCM 105)   Prepared by: Nadine Faith Wacas Gomez, BSN-RN-MSN BASIC CONCEPTS IN NUTRITION AND DIET THERAPY Introduction In this module, you will learn the basic terms, concepts principles in the study of nutrition. What food does to our body, ho...

NUTRITION AND DIET THERAPY (NCM 105)   Prepared by: Nadine Faith Wacas Gomez, BSN-RN-MSN BASIC CONCEPTS IN NUTRITION AND DIET THERAPY Introduction In this module, you will learn the basic terms, concepts principles in the study of nutrition. What food does to our body, how the body uses nutrients and the relationship between health and nutrition are also explained. The different nutrition tools, standards, and guidelines and nutrient recommendation for a healthy diet for clients are also included.  You will learn and be made aware of the importance of nutrition to one’s health and performance and this will help prepare you as a nurse in applying appropriate concepts/principles of anatomy and physiology, biochemistry, social sciences/humanities, health assessment and health education in nutrition and diet therapy in providing total patient care.  These basic concepts and principles will be integrated in the different topics in Nutrition and Diet therapy. Nutrition is the study of food and how the body use of it. It deals not only with the quantity and quality of food consumed but also with the process of receiving and utilizing it for the growth and renewal of the body and for the maintenance of the different body functions. FUNCTION OF NUTRITION The basic function of nutrition is to maintain life by allowing an individual to grow and be in a state of optimum health. The following are reasons why nutritional science is applied to nursing care: 1. The recognition of the role of nutrition in preventing disease or illnesses 2. The awareness of the need in specified disease states to modify nutritional factors for the therapeutic purpose.  Nutrients are classified according to the following: 1. Function = those that form tissues in the body are body building nutrients while those that furnish heat and energy are fats, carbohydrates and proteins. 2. Chemical properties= Nutrients are either organic or inorganic 3. Essentiality= Nutrients are classified based on their significant contribution to the body’s physiological functioning. 4. Concentration= Nutrients are either in large amounts or in little amounts. What are the basic terms to understand in the study of nutrition? A. DEFINITION OF TERMS A. Nutrition is the science of the processes by which the body uses food for energy, maintenance and growth. Good nutritional status implies appropriate intake of the macronutrients – carbohydrates, proteins and fats and the various vitamins and minerals often referred to as “micronutrients” because they are needed in small quantities. It is concerned with how food is produced, processed, handled, sold, prepared, and eaten and with what happens to food in the body-how it is digested, absorbed and used. If there is a good digestion, absorption and cellular metabolism of these nutrients in the diet, a person can generally achieve good nutritional status. B. Food is any substance, organic or inorganic, when eaten or ingested, nourishes the body by building and repairing tissues, supplying heat and energy and regulating bodily processes. Food sustains life second to oxygen. C. Diet is the sequence and balance of meals a day. It is concerned with the eating patterns of individual s or a group. Some people may eat twice a day; others may eat four times; still others may seem to be chewing all day. D. Enzymes are organic catalyst that are protein in nature and are produced by living cells. A catalyst hastens chemical reactions without itself undergoing change. Biocatalyst like enzymes are responsible for most chemical reactions in the body. An enzyme system is composed of the protein part called apoenzyme and a cofactor, which is sometimes called activator or coenzyme. Certain vitamins and minerals acts as co-enzyme in metabolic reactions. E. Hormones are organic substances produced by special cells of the body which are discharge into the blood to be circulated and brought to specific organs and tissues that are remote from the source or point of manufacture. They regulate vital processes which are highly specific. Most hormones are produced by endocrine or ductless glands. Some are protein in nature and others are related to lipids. F. Optimal nutrition means that a person is receiving and using the essential nutrients to maintain health and well-being at the highest possible level. G. Health is currently recognized as being more than the absence of disease. High level health and wellness are present when an individual is actively engaged in moving toward the fulfilment of his or her potential. The art of nutrition includes the application of nutrition science to meet individual needs for the goal of optimal health status. I. Public health is the field of medicine that is concerned with safeguarding and improving the health of the community as a whole. J. Holistic health is a system of preventive medicine that takes into account the whole individual. It promotes personal responsibility for well-being and acknowledges the total influences-biologic, psychologic and social – that affect health, including nutrition, exercise and emotional well- being.  K. Medical nutrition therapy (MNT) (referred to in the past as diet therapy) is the treatment of disease through nutritional therapy by registered dietitians. MNT may be necessary for one or more of the following reason: -To maintain or improve nutritional status -To improve clinical or subclinical nutritional deficiencies -To maintain, decrease, or increase body weight -To rest certain organs of the body -To eliminate particular food constituents to which the individual may be allergic or intolerant. -To adjust the composition of the normal diet to meet the ability of the body to absorb, metabolize and excrete certain nutrients and other substances. L. Malnutrition or poor nutritional status is a state in which a prolonged lack of one or more nutrients retards physical development or causes the appearance of specific clinical manifestations (anemia, goiter, rickets, etc.). This may occur because the diet is poor or because of a digestion and metabolism problem. Excess nutrient intake creates another form of malnutrition when it leads to conditions such as obesity, heart disease, hypertension, and hyperchlolesterolemia (high fat or lipid levels in blood). M. Nutrients are chemical substances found in food, that provide energy, structure, and regulation for the body processes of maintenance and repair, growth and reproduction. Nutrients must be consumed in the proper amounts and proportion to meet nutritional needs and maintain health. A nutrient is a chemical component needed by the body for one or more of these general functions: to provide energy, to build and repair tissues and to regulate life processes. Nutrients are found chiefly in foods and normal nutrition necessitates the ingestion of nutrients from natural food sources. Some nutrients are manufactured in the body (a process called biosynthesis) while some are made in the laboratory. O. Nutrient density refers to the concentration of nutrients in a given amount of a food source relative to the caloric content; considers calories, CHO, fats, proteins, vitamins, minerals and water; the higher the nutrient density, the greater the nutritional value in a small amount of food. A nutrient dense food is one that has a high proportion of micronutrients in relation to the macronutrients. Empty calories implies the opposite. Foods that are high in nutrient density provide more nutrients per kcal and are used to improve the diet for clients at risk for nutritional deficiency. Foods that are low in nutrient density provide fewer nutrients per kcal and thus a higher calorie intake is needed to obtain needed nutrients.  6 General groups of nutrients A. Water – Indispensable and abundant, provides the environment in which nearly all the body’s activities are conducted. It participates in many metabolic reactions and supplies the medium for transporting vital materials to cells and waste product away from them. B. Protein- Contains nitrogen as well as carbon, hydrogen and oxygen. The body cannot make protein from carbohydrate and fat, because they contain no nitrogen. Each protein is made up of chains of amino acids joined together. Essential amino acids: amino acids that the body cannot synthesize in amounts sufficient to meet physiological needs (indispensable). Nonessential amino acids: amino acids that the body can synthesize. C. Fat – is actually a subset of the class of nutrients known as lipids but the term fat is often used to refer to all lipids. It is concentrated source of energy. The lipid family includes triglycerides (fats and oils), phospholipids and sterols. It is an important source of energy for our body when we are at rest. D. Carbohydrates- are organic compounds and are abundant in plant and widespread in nature. Functions: Chief source of energy, cheap and main energy food, protein sparer, sole energy source for the brain and nerve tissues and storage form of energy as glycogen. Source= vegetable, fruits group, milk, sugars and sweets are important sources of carbohydrates next to bread and cereals and cane. E. Vitamins – are chemical compounds that the body needs in small amounts to help it function properly. The vitamins are also organic, but they do not provide energy. Instead, they facilitate the release of energy from carbohydrate, fat, and protein. F. Minerals – The major minerals are found in large quantities in the body, whereas the trace minerals occur in smaller amounts. Minerals are inorganic elements that retain their chemical identities, they usually receive special handling and regulation in the body. It binds with other substance or interacts with other minerals, thus limiting their absorption HEALTH EFFECTS OF STARCH AND FIBERS 1. Weight Control= Fibers rich in complex carbohydrates tend to be low in fat and added sugars and can promote weight loss. 2. Heart Disease= High carbohydrate diets, rich in whole grains, can protect an individual against heart disease and stroke. 3. Cancer= High carbohydrate diets can help prevent many types of cancer. 4. Diabetes= High carbohydrates, low fat diets help control weight. 5. Gastrointestinal health= Dietary fibers enhance the health of the large intestine. According to chemical nature- Nutrients are either organic or inorganic. Organic substances are those carbon-containing compounds with the exception of carbon and cyanide. The organic nutrients are; protein, fat, carbohydrates, vitamins. Inorganic compounds are minerals and water. All persons need the same kinds of nutrients, but the amounts vary according to the following factors; A. Age B. State of health C. Sex D. Specific physiologic condition E. Body size F. Physical activity G. Body size H. Physical Activity NUTRITION CONCEPTS Nutrition is the food you eat and how the body uses it. We eat food to live, to grow, to keep healthy and well and get energy for work and play.  Food is made of different nutrients needed for growth and health A. All nutrients needed by the body are available through food. B. Many kinds and combination of food can lead to a well-balanced diet. C. Each nutrient has specific uses in the body. D. No food by itself, has all the nutrients needed for growth and health. E. Most nutrients do their best work when teamed with other nutrients F. Adequate nutrition is essential to good health. G. The nutrients in our body are in dynamic equilibrium. H. Dietary intake and nutrient need should be individualize A. CLASSIFICATION OF NUTRIENTS 1. MACRONUTRIENTS are present in relatively large amounts. Example of which are fat, protein and carbohydrate. 2. MICRONUTRIENTS include all vitamins and the trace minerals NUTRIENT REFERENCE VALUES A. Dietary Reference Intakes (DRIs) The DRIs represent a set of four standards used to provide a comprehensive measure of nutrition and long-term guidelines that are utilized to both assess and plan diets for healthy individuals in both the United states and Canada. They include updated RDAs, upper limits for safe intake (Tolerable Upper Limits or UL), Estimated Average Requirements (EAR) and Adequate Intake (AI). DRIs are outlined by age and gender. The DRIs are standards used to support both group and individual diet planning for healthy individuals; >Determination of age, gender and life –stage groups help to prioritize nutritional concerns >Recognition of children, adolescents, adults, the elderly, and pregnant/lactating women is critical in determining nutritional requirements for these groups. NUTRIENT STANDARDS 1.Recommended Dietary Allowances (RDAs) The RDAs represent the average daily recommended intake to meet the nutrient requirements of 97% to 98% of healthy individuals by life stage, age and gender. The recommendations are based on specific criteria indicators for estimating requirements, such as plasma and serum nutrient concentrations, and are set high enough to account for daily variations in intake. When estimating the nutritional needs of people with health disorders, health professionals use the RDAs as a starting point and adjust them according to the individual’s need. 2. Estimated Average Requirement (EAR) EAR values are used to determine RDA values; they are not used as a stand-alone reference. The EAR is the amount of a nutrient that is estimated to meet the requirement of half of healthy people in a lifestyle, age or gender group. “Average” actually means median. By definition, the EAR exceeds the requirements of half of the group and falls below the requirements of the other half. The EAR is not based solely on the prevention of nutrient deficiencies but includes consideration for reducing the risk of chronic disease and takes into account the bioavailability of the nutrient—that is, how its absorption is impacted by other food components 3. Adequate Intake (AI) AI is set when an RDA cannot be determined due to lack of sufficient data on requirements. It is a recommended average daily intake level thought to meet or exceed the needs of virtually all members of a life stage or gender group based on observed or experimentally determined estimates of nutrient intake by groups of healthy people. The primary purpose of the AI is as a goal for the nutrient intake of individuals. This is similar to the use of the RDA except that the RDA is expected to meet the needs of almost all healthy people, while in the case of an AI, it is not known what percentage of people are covered. 4. Tolerable Upper Intake Level (UL) The Tolerable Upper Intake Level is the highest level of average daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. It is not intended to be a recommended level of intake; there is no benefit in consuming amounts greater than the RDA or AI. Dietary Guidelines and Food Guide The appropriate diet at any stage of life is one that supplies sufficient energy and all the essential nutrients in adequate amounts for health. For more than 50 years, professionals from the government and academics have made recommendations on such basic needs. For more than two decades there has been increasing concern about the eating patterns of Filipino people. National health policy makers have linked several specific dietary factors to chronic diseases among the population. This connection between diet and disease has, in turn, led to publication of guidelines to promote healthier eating habits. What is food exchange? The word exchange refers to the food items on each list which may be substituted with any other food item on the same list. One exchange is approximately equal to another in carbohydrate, calories, protein and fat within each food list. Importance of Food Labels Food safety is not the responsibility of a single person or the Regulatory body or the food industry alone. It is a shared responsibility between the government, producers, industry, and consumers. Food Labelling is one such legal requirement to ensure that the consumers can get a clear understanding of the food they are consuming. The label is a key communication tool between the manufacturer and the consumer, hence it should be truthful, transparent, and clearly depict what is present in the packet that the consumer intends to buy. As a consumer, you should always read the labels before buying food products. It is very important to know how to read and understand the context for understanding what you are eating. What should you look for on the Labels? When you pick a product from the supermarket shelf, ensure to look for information such as ingredients list, manufacturing date, expiry/ use by date, allergen declaration, storage instructions, nutritional information, and any claims made regarding the product. All this information will let you know what kind of food you are buying and will help you make informed choices The education framework provides specific recommendations for making food choices that will improve the quality of an average American diet. These recommendations are interrelated and should be used together. Taken together, they would result in the following changes from a typical diet: Increased intake of vitamins, minerals, dietary fiber, and other essential nutrients, especially of those that are often low in typical diets Lowered intake of saturated fats, trans fats, and cholesterol, and increased intake of fruits, vegetables, and whole grains to decrease risk for some chronic diseases Calorie intake balanced with energy needs to prevent weight gain and/or promote a healthy weight. The recommendations in the framework fall under four overarching themes: Variety—Eat foods from all food groups and subgroups. Proportionality—Eat more of some foods (fruits, vegetables, whole grains, fat-free or low-fat milk products), and less of others (foods high in saturated or trans fats, added sugars, cholesterol salt, and alcohol). Moderation—Choose forms of foods that limit intake of saturated or trans fats, added sugars, cholesterol, salt, and alcohol. Activity—Be physically active every day. Thank you!