NDT Lecture [NCM 105] _ Module 1_ The Art of Nutrition.pdf

Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition 1 Basic Nutrition Terms and Concepts ➔ May occur because the diet is poor or because of...

Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition 1 Basic Nutrition Terms and Concepts ➔ May occur because the diet is poor or because of a digestion and metabolism problem ➔ Excess nutrient intake which leads to condition 1.1 Terms such as obesity, heart disease, hypertension, hypercholesterolemia Art of Nutrition ➔ Application of nutrition science to meet Optimal Nutrition individual needs for the goal of optimal health ➔ A person is receiving and using the essential status. nutrients to maintain health and well being at the highest possible level Nutrition ➔ Science of the processes by which the body uses Kilocalorie (kcal) food for energy, maintenance and growth. ➔ Unit of measure used to express the fuel value of ➔ Science of food, the nutrients, and other carbohydrates, proteins and fats substances within food; their action, interaction ➔ CHO, CHON, fats and alcohol are the only and balance in relation to health and disease sources of kilocalories and the process by which the organism ingests, ➔ 1 kcal = 4 kJ (Kilojoules) digests, absorbs, transports, uses and excrete Diet substances (Council of the American Medical ➔ Food and drink that a person regularly consumes Association). ➔ Balanced Diet - Provides the recommended Food amount of essential nutrients ➔ Products derived from plants (fruits and ➔ Meal - Breakfast, lunch or dinner vegetables) or animals (meat, seafood, etc.) Health ➔ Important for health and survival providing fuel ➔ More than the absence of the disease for bodily functions and materials for growth, ➔ High level health and wellness are present when repair and general health an individual is actively engaged in moving Nutrient toward the fulfillment of his or her potential ➔ Chemical substance present in food Public Health ➔ Needed by the body ➔ Field of medicine that is concerned with ➔ 6 main classes: Carbohydrates (CHO), Protein safeguarding and improving the health of the (CHON), Fats, Vitamins, Minerals & Water (H2O) community as a whole Macronutrients Holistic Health ➔ Nutrients needed by the body in large amount ➔ A system of preventive medicine that takes into ➔ Measured in grams or liter account the whole individual ➔ Carbohydrates (CHO), Protein (CHON), Fats, and ➔ Promotes personal responsibility for well being Water (H2O) and acknowledges the total influences-biologic, Micronutrients psychological and social- that a ect health , ➔ Nutrients needed by the body in small amount including nutrition, exercise and emotional ➔ Measured in milligrams (mg) or micrograms (µg) well-being ➔ Vitamins and Minerals Medical Nutrition Therapy (MNT) Good Nutritional Status ➔ Previously known as diet therapy ➔ Appropriate intake of the macronutrients and ➔ Treatment of disease through nutritional therapy the various micronutrients Necessary for the following reasons: ➔ Can be achieved if there is good digestion, ➔ To maintain or improve nutritional status absorption and cellular metabolism of the ➔ To improve clinical or subclinical nutritional nutrients deficiencies ➔ To maintain, decrease or increase body weight Malnutrition or Poor Nutritional Status ➔ To rest certain organs of the body ➔ There is prolonged lack of one or more nutrients ➔ To eliminate particular food constituents to which retard physical development or causes the which the individual may be allergic or intolerant appearance of specific clinical conditions S.N. Sean 1  Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition ➔ To adjust the composition of the normal diet to Classification Based on Chemical Nature; Organic and meet the ability of the body to absorb, Inorganic Nutrients metabolize and excrete certain nutrients and Organic Nutrients other substances ➔ Contains the carbon atom ➔ Carbohydrates, protein, fats and vitamins Inorganic Nutrients 1.2 Food and Dietary Components ➔ Does not contain carbon Food Components: ➔ Water and minerals ➔ Nutrient - Can be useful, neutral or unfavorable Classification Based on Source; Natural and Synthetic ➔ Non-Nutrient - Food additives, Phytochemicals, Nutrients Zoochemicals Natural Nutrients Non-Nutrient Components ➔ Obtained from plants and animals ➔ Food Additives, preservatives, flavors, colors Synthetic Nutrients ➔ Keep food safe for an extended period of time ➔ Man-made used in correcting deficiencies ➔ Used to enhance the nutrient content, texture, ➔ Ex.: vitamin & mineral pills color and flavor Classification Based on Essentiality ➔ Since some may carry risks, regulation is Dietary Essential Nutrient (vitamins) needed ➔ Those the body cannot make in su cient Phytochemicals quantity to meet its requirement; must be ➔ Found in edible fruits, vegetables and other obtained from the diet plant derived foods ➔ Linoleic (Omega-6)& Linolenic Acids (Omega-3) ➔ Contain health promoting properties in the Non-Dietary Essential Nutrients body ➔ Can be produced by the body in enough ➔ Currently under extensive study in the amounts during normal conditions prevention of chronic diseases ➔ Cholesterol, alanine, cystine ➔ Ex.: Lycopene (Tomatoes), Allylic Sulfides (Garlic) The Energy Giving Nutrients Zoochemicals ➔ Carbohydrates, Protein and Fats ➔ Found in animal foods that are not essential ➔ Give out calories when chemically broken down nutrients but may have health promoting in the body properties ➔ Provide the fuel/energy for body functioning ➔ Ex.: Zeaxanthin and Lutein (Egg); Omega-3 ➔ Carbohydrates, protein and fats contain the Fatty Acids (Fish) elements Carbon, Hydrogen and Oxygen; ➔ While protein contains an additional Nitrogen Nutrient Components ➔ Alcohol is a potential source of energy but is ➔ Chemical substances found in food and is used in NOT A NUTRIENT. It hinders growth and repair the body to provide energy, build and repair of the body body tissues and to regulate life processes ➔ Can be classified based on the amount needed Kilocalories produced per gram of… by the body, chemical nature, source and essentiality Kilocalorie Conversion Classification based on the amount needed by the Carbohydrates 1g 4 kcal body; Macronutrients and Micronutrients Macronutrients Protein 1g 4 kcal ➔ Nutrients needed by the body in large scale ➔ Carbohydrates, proteins, fats and water Fats 1g 9 kcal Micronutrients Alcohol* 1g 7 kcal ➔ Nutrients needed by the body in small or little amounts Note: Alcohol is NOT a nutrient C & P 19 4 Rca) ➔ Vitamins and minerals = = A 1g 7k(a) = = S.N. Sean 2 # 91(a) = 19 =  Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition 1.3 Nutritional Tools Philippines and USA ➔ Pyramid Food Guides: ➔ Customized according to individual cultures China and Korea ➔ Pagoda Shape Food Guide Pyramids ➔ A pictorial type of the daily food guide. ➔ Teaches the principle of eating a variety of food European Countries everyday, the need for moderation in some food ➔ Pie or Plate groups while emphasizing the importance of other food. Pinggang Pinoy ➔ A practical guide in planning a diet for Filipinos. ➔ Foods are classified into groups on the basis of similarity in nutrient contents. Canada ➔ Rainbow Body-Building Foods ➔ Rich in protein and minerals ➔ Ex.: meat, fish, poultry, eggs, dried beans Energy Giving Foods ➔ Rich in carbohydrates and fats ➔ Ex.: rice and rice products, corn, root crops, sugar and sweets, pasta, butter, etc. Body Regulating Foods ➔ Rich in vitamins and minerals, fiber and water ➔ Ex.: fruits and vegetables S.N. Sean 3  Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition The 10 Kumainments Recommended Energy/Nutrient Intake (REI/RNI) ➔ The 10 Kumainments is the popular version of ➔ Level of intake of energy or nutrient which is the revised Nutritional Guidelines For Filipinos considered adequate for the maintenance of by the Food and Nutrition institute of the DOST. health and well-being of healthy persons in the population. (more on age) Adequate Intake (AI) ➔ Daily nutrient intake level that is based on observed or experimentally-determined approximation of the average nutrient intake by a group (groups) of apparently healthy people that are assumed to sustain a defined nutritional state. Tolerable Upper Intake Level or Upper Limit (UL) ➔ Highest average daily nutrient intake level likely to pose no adverse health e ects to almost all individuals in the general population. Portion Control ➔ Hand can be used as a useful guide to controlling food portions. nounce & -4 Ounce teaspoon 1/2 Cup table spoon 1 CUP 1-2 Philippine Dietary Reference Intake 2015 (PDRI 2015) ➔ For planning and assessing diets of healthy groups and individuals. ➔ Collective term comprising reference value for energy and nutrient levels of intakes. Components: Estimated Average Requirement (EAR) ➔ Daily nutrient intake level that meets the median or average requirement of healthy individuals in particular life stage and sex group, corrected for incomplete utilization or dietary nutrient bioavailability. (more on sex) S.N. Sean 4  Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition Information on Food Labels: Name of Product ➔ Tells what the consumer is buying and must not give a false information Name, Address of Manufacturer, Packer or Distributor ➔ For comment/complaint or question the consumer may wish to ask Place of Origin ➔ May appear misleading if place of origin is not stated Food Exchange Lists Preparation Instructions ➔ Foods are divided into several main groups ➔ Especially on high risk foods; to kill all bacteria which contain about the same amounts of during cooking macronutrients and calories Weight or Quantity ➔ Allows an individual to meet specific CHO, ➔ Will help consumer compare products fairly CHON, fat and energy needs based on the recommended calculated diet given by a Storage Instructions medical doctor or a dietitian ➔ Should be given so that the date mark is valid Example of food exchange list: Open Date Markings ➔ “Consume before” or “Use before” or “Expiration Food One serving = 15 g of Carbs date” ➔ Signifies the end of the estimated shelf life of a Bagel ¼ or 1 oz product Biscuit 2 ½ inches ➔ Beyond which certain quality attributes become significantly impaired Bread 1 slice “Best Used By” Pancake or Wa e 4 inches ➔ Indicates the end of a period after which certain qualities of a product is expected to deteriorate Cold Cereal (unsweetened) ¾ cup ➔ May still be satisfactory for human consumption but the best quality is no longer guaranteed Granola ¼ cup TheIngredient List Couscous ⅓ cup ➔ Tells you what is in the food ➔ In descending order of predominance by weight Pasta ⅓ cup ➔ Required on all products containing more than one ingredient Rice ⅓ cup ➔ Generic and collective names must be avoided Exchange List: Food containing 15 grams of Carbohydrates ➔ Include also additives that were used Food Labels ➔ Provide information about the product’s contents, ingredients and nutritional value, etc. ➔ Allow consumers to make healthier food choices ➔ Help consumers see how a food fits into their overall daily diet ➔ FDA (Food and Drug Administration) Philippines is the government’s major implementer of nutrition labeling S.N. Sean 7  Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition Servings per container 2 Nutrition As An Aspect of Total Health Care ➔ Suggests the number of servings in the food package 2.1 Total Health Care Nutrition Facts Panel ➔ Product makers are required to give information Nutrition on certain nutrients ➔ An integral part of health care ➔ Each package should reflect the amount of ➔ With physical, social, psychiatric and economic specified nutrients and food constituents for one aspects (1) serving ➔ The mandatory components and the order in Health Care Team which they must appear consist of the total ➔ Composed of all health care professionals who calories, calories from fat, total fat, sodium, total work with a given person or family with a carbohydrates, dietary fiber, sugars, protein, common goal - optimal health Vitamin A, Vitamin C, Calcium and Iron. ➔ Medical Professionals – Doctors (MD), Nurses ➔ Other nutrient information on the label is (RN), Nutritionist-Dietician (RND), Physical voluntary Therapists (PT), Pharmacists (RPh) ➔ Social Professionals – Social Worker, Occupational Therapist (OT), Psychologist ➔ Community Resource Personnel - Barangay Health Workers (BHW) Team Approach ➔ Because of unique perspective in needs assessment and health care planning ➔ Involve the individual in planning Healthcare Providers ➔ Usually MDs or Doctors ➔ Final health care decisions often are the responsibility of the physician ➔ Should be kept informed of concerns of the ➔ health care team and their recommendation Nurses ➔ Can provide good insight because of in depth patient contact ➔ Assessment and monitoring of patient’s eating habits and health status are important roles of the nurse Social Workers Total fat, Saturated fat, Cholesterol and Sodium ➔ Expertise in community resources including ➔ Yellow; need to be controlled financial counseling, technical support and Dietary Fiber, Vit. A, Vit. C, Calcium, Iron educational resources ➔ Blue or green; get enough of these nutrients ➔ Can help a person identify and express barriers Nutrient Claim Guide Physical Therapists ➔ Health claims, a relationship between a nutrient ➔ Helps a person enhance physical capabilities and the risk of a disease or health condition that had been impaired by illness or trauma ➔ Ex.: “Fat free”, “Low fat”, “Sugar free” ➔ Ex.: increase muscle strength S.N. Sean 8  Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition Occupational Therapists 3 Factors A ecting Food Intake & Principles ➔ Emphasizes the remaining strengths in Meal Planning ➔ Identifies adaptive devices that would enhance independent functioning (ex. long handled 3.1 Factors A ecting Food Intake spoon, reaching devices). ➔ Occupational Therapy – goal is to increase the Biopsychosocial Concerns amount and type of ADL that an individual with ➔ Interplay between external environment and impairment can perform. internal forces Speech Language Pathologists ➔ External could be psychologic and social factors ➔ Assess swallowing ➔ Internal could be genetic or biologic ➔ Prevention of aspiration of food ➔ Determine the degree of risk of aspiration and Habit and Preferences make appropriate plans that other healthcare ➔ Selection of food is tied to a person’s routine and professionals can use in developing their plans. practices. ➔ Ex.: for PT, correct positioning for swallowing; OT ➔ Taste, smell, texture and appearance also mainly for feeding devices; RND for food consistency dictate an individual’s food option. Pharmacists Cost, Availability and Convenience ➔ Responsible for preparing the nutritional ➔ People select foods which they can a ord to buy, solutions that the physician prescribes. which are readily available and do not require ➔ Parenteral nutrition much time to prepare or cook. ➔ Drug and nutrient interactions ➔ In today’s modern lifestyle, foods that are fast and delicious are frequently chosen. Registered Dietitians ➔ Interpret the science of how food is used by the Social Pressure body in health and disease states. ➔ Close friends share similar food choices. ➔ Evaluate how MNT can promote a positive ➔ Special occasions are associated with the nutritional status. serving of specific foods and it is often impolite to refuse food or drink o ered by a host. Nutritionists ➔ An educator as well as a counselor Culture and Tradition ➔ All RDs are nutritionists ➔ Each area of the world and every region of a country has their own typical foods and ways of combining them into meals. ➔ Religious rules about foods can further dictate the composition of diet. ➔ Muslims refrain from eating pork. Advertising ➔ Commercial ads and packaging of the food industry are quite successful in enticing the public to choose certain foods. ➔ Food producers spend enormous amounts of money on marketing and promotion in order to create demand for their merchandise. Body Image ➔ People may opt for food or diet they link with ideals of body image. ➔ Ex.: Ketogenic Diet, Intermittent Fasting NOTE: ➔ Nutritional guidance should be based on willingness to change and interest in doing so. ➔ In order to make change, recognition that change is needed is generally the first step. S.N. Sean 9  Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition Medical Conditions and Health Benefits Moderation ➔ There are health conditions that limit the foods a ➔ Having enough but not in excess of what is person can select. needed. ➔ A client with hypertension might need to adhere Variety to a low salt diet. ➔ Foods chosen di er from one day to the next; ➔ The chemotherapy treatment for cancer can selecting foods from di erent food groups; interfere with the person’s appetite. eating a variety of food helps ensure adequate Emotional State nutrient intake. ➔ Some individuals eat in response to emotional ➔ No single food contain all the nutrients we need stimuli such as boredom, anxiety and depression. Nutritional Density ➔ Select foods that deliver the most nutrients for the least amount of food energy (calories). NOTE: ➔ A person’s daily food choices may benefit or harm his body’s health only a little but when these choices are repeated over the years, the reward or choice becomes major. 3.2 Principles in Meal Planning Positive Meal Environment ➔ Focus on positive conversations; avoid points of potential conflict and frictions. ➔ Use soft music, candles or both to facilitate a quiet, relaxed atmosphere. ➔ Eat slowly to promote satiety and aim for 2 or 3 di erent food groups in a meal. ➔ Encourage children to eat with the family; but do not force them to eat. Encourage the “one taste rule” and emphasize that tastes are learned. ➔ Serve foods that look appealing by using a combination of colors, textures and sizes ➔ Watch portion sizes; smaller portions are useful for small appetite and for weight control ➔ Promote relaxing activities before and after meals Adequacy ➔ Foods chosen contain enough important nutrients, fiber and energy. Proportionality ➔ Proper distribution of overall food intake throughout the day or week. Balance ➔ Does not overemphasize one nutrient or food type at the expense of another. Calorie Control ➔ Food provides the amount of calories a person needs to sustain appropriate weight. S.N. Sean 10 Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition S.N. Sean 6 Nutrition and Diet Therapy Lecture A.Y. ‘24 - ‘25 | YEAR 2 | SEM 1 Module 1: The Art of Nutrition S.N. Sean 5