Nutrition And Diet Therapy PDF

NUTRITION AND DIET THERAPY Prepared by: Francheska S. Datu, RN Bryan N. Guevara RN Introduction: Nutrition Nutrition The study of food in relation to health of the individual, community or society and the process through which...

NUTRITION AND DIET THERAPY Prepared by: Francheska S. Datu, RN Bryan N. Guevara RN Introduction: Nutrition Nutrition The study of food in relation to health of the individual, community or society and the process through which food is used to sustain life and growth. Food Any substance, organic or inorganic when ingested or eaten nourishes the body by building and repairing tissues, supplying heat and energy and regulating bodily processes. Introduction:Nutrients Nutrients from food and fluids are used by the body for growth, energy, and bodily processes. Essential nutrients refer to nutrients that are necessary for bodily functions but must come from dietary intake because the body is unable to synthesize them.Essential nutrients can be further divided into macronutrients and micronutrients.  Macronutrients are nutrients that people regularly require in large quantities to provide their body with energy to perform bodily functions and daily activities. Most of the body’s energy and calories come from macronutrients. Each type of macronutrient has its own benefits and purpose in maintaining a healthy body. The exact amount of each macronutrient a person requires may vary based on individual factors such as weight, age, and preexisting health conditions. Carbohydrates Proteins Fats Carbohydrates Foods can also be categorized according to their glycemic index, a measure of how quickly glucose levels increase in the bloodstream after carbohydrates are consumed. The glycemic index was initially introduced as a way for people with diabetes mellitus to control their blood glucose levels. For example, processed foods, white bread, white rice, and white potatoes have a high glycemic index. They quickly raise blood glucose levels after being consumed and also cause the release of insulin, which can result in more hunger and overeating. However, foods such as fruit, green leafy vegetables, raw carrots, kidney beans, chickpeas, lentils, and bran breakfast cereals have a low glycemic index. These foods minimize blood sugar spikes and insulin release after eating, which leads Types Carbohydrates C ar b o h y d ra t e s a r e s u g a r s a n d ienergy m p. o r ta n t e n e r g y s o u r c e t h a t st a r c h a n d r e a n p r o v id es 4 k cal / g o f Simple carbohydrates are small molecules (called monosaccharides or disaccharides) and break down quickly. As a result, simple carbohydrates are easily digested and absorbed into the bloodstream, so they raise blood glucose levels quickly. Examples of simple carbohydrates include table sugar, syrup, soda, and fruit juice. Complex carbohydrates are larger molecules (called polysaccharides) that break down more slowly, which causes slower release into the bloodstream and a slower increase in blood sugar over a longer period of time. Examples of complex carbohydrates include whole grains, beans, and vegetables. , GLGYCEMIC INDEX The glycemic index is a measure used to determine how much a food can affect your blood sugar levels. Several factors affect the glycemic index of a food, including the ripeness, nutrient composition, and cooking method Proteins Proteins are peptides and amino acids that provide 4 kcal/g of energy. Proteins are necessary for tissue repair and function, growth, energy, fluid balance, clotting, and the production of white blood cells. Protein status is also referred to as ntognbaane.celri Nitrogen is consumed in dietary intake and excreted in the urine and feces. If the body excretes more nitrogen than it takes in through the diet, this is referred to as a negative nitrogen balance. Negative nitrogen balance is seen in patients with starvation or severe infection. Conversely, if the body takes in more nitrogen through the diet than what is excreted, this is referred to as a positive nitrogen balance.During positive nitrogen balance, excess protein is converted to fat tissue for storage.  Proteins are classified as complete, incomplete, or partially complete. Complete proteins must be ingested in the diet. They have enough amino acids to perform necessary bodily functions, such as growth and tissue maintenance. Examples of foods containing complete proteins are soy, quinoa, eggs, fish, meat, and dairy products. Incomplete proteins do not contain enough amino acids to sustain life. Examples of incomplete proteins include most plants, such as beans, peanut butter, seeds, grains, and grain products. Incomplete proteins must be combined with other types of proteins to add to amino acids and form complete protein combinations. Partially complete proteins have enough amino acids to sustain life, but not enough for tissue growth and maintenance. Because of the similarities, most sources consider partially complete proteins to be in the same category as incomplete proteins. FATS Fats consist of fatty acids and glycerol and are essential for tissue growth, insulation, energy, energy storage, and hormone production. Fats provide 9 kcal/g of energy. While some fat intake is necessary for energy and uptake of fat-soluble vitamins, excess fat intake contributes to heart disease and obesity. Due to its high-energy content, a little fat goes a long way.  Fats are classified as saturated, unsaturated, and trans fatty acids Saturated fats come from animal products, such as butter and red meat (e.g., steak). Saturated fats are solid at room temperature. Recommended intake of saturated fats is less than 10% of daily calories because saturated fat raises cholesterol and contributes to heart disease. Unsaturated fats come from oils and plants, although chicken and fish also contain some unsaturated fats. Unsaturated fats are healthier than saturated fats. Examples of unsaturated fats include olive oil, canola oil, avocados, almonds, and pumpkin seeds. Fats containing omega-3 fatty acids are considered polyunsaturated fats and help lower LDL cholesterol levels. Fish and other seafood are excellent sources of omega-3 fatty acids. Trans fats are fats that have been altered through a hydrogenation process, so they are not in their natural state. During the hydrogenated process, fat is changed to make it harder at room temperature and have a longer shelf life. Trans fats are found in processed foods, such as chips, crackers, and cookies, as well as in some margarines and salad dressings. Minimal trans fat intake is recommended because it increases cholesterol and contributes to heart disease. Micronutrients:Vitamins and Minerals Micronutrients are required by the body for proper functioning. They maintain our brain, skin, bones, muscles, nerves, Vitamins Vitamins are necessary for many bodily functions, including growth, development, healing, vision, and reproduction. Most vitamins are considered essential because they are not manufactured by the body and must be ingested in the diet. Vitamin D is also manufactured through exposure to sunlight. Vitamins are classified as water soluble or fat soluble. Water- soluble vitamins are not stored in the body and include vitamin C and B-complex vitamins: B1 (thiamine), B2 (riboflavin), B3 (niacin), B6 (pyridoxine),B9 (folic acid). and B12 (cyanocobalamin). Additional water-soluble vitamins include biotin and pantothenic acid. Excess amounts of these vitamins are excreted through the kidneys in urine, so toxicity is rarely an issue, though excess intake of vitamin B6, C, or niacin can result in toxicity.  Water-soluble vitamins Water-Soluble Sources Functions Deficiency Vitamin Citrus fruits, broccoli, Infection prevention, Early Signs: weakness, weight loss, greens, sweet wound healing, myalgias, and irritability. Late Signs: peppers, C (Ascorbic collagen formation, scurvy; swollen, spongy gums; loose tomatoes, iron absorption, amino teeth; bleeding gums and skin; poor Acid) lettuce, acid metabolism, wound healing; edema; leg pain; potatoes, antioxidant, and bone anorexia; irritability; and poor growth in tropical fruits, growth in children. children. and strawberries  Nerve function; Fatigue, memory deficits, metabolism of Nuts, liver, insomnia, chest pain, carbohydrates, fat, B1 whole grains, abdominal pain, anorexia, amino acids, (Thiamine) pork, and numbness of extremities, glucose, and legumes muscle wasting, heart failure, alcohol; appetite and shock in severe cases. and digestion. Protein and Eggs, liver, leafy carbohydrate B2 Pallor, lip fissures, and seborrheic greens, milk, and metabolism, healthy (Riboflavin) dermatitis. whole grains skin, and normal vision.  Pellagra characterized by skin Fish, chicken, Glycogen metabolism, lesions at pressure points/sun eggs, dairy, cell metabolism, exposed skin, glossitis (swollen mushrooms, tissue regeneration, B3 (Niacin) tongue), constipation progressing to peanut butter, fat synthesis, nerve bloody diarrhea, abdominal pain, whole grains, function, digestion, abdominal distention, nausea, and red meat and skin health. psychosis, and encephalopathy. Rare due to presence in most foods. Organ meats, fish, Peripheral neuropathy, seizures refractory B6 Protein metabolism and and various fruits to antiseizure medications, anemia, (Pyridoxine) red blood cell formation. and vegetables glossitis (swollen tongue), seborrheic dermatitis, depression, and confusion.  Coenzyme in protein Liver, legumes, metabolism and cell leafy greens, growth, red blood cell Glossitis (swollen tongue), confusion, seeds, orange B9 (Folic Acid) formation, and depression, diarrhea, anemia, and fetal juice, and prevention of fetal neural tube defects. enriched refined neural tube defects in grains utero. Pernicious anemia from lack of intrinsic factor Mature red blood cell in intestines. Early Signs: weight loss, B12 Meat, organ meat, formation, DNA/RNA abdominal pain, peripheral neuropathy, (Cyanocobalami dairy, seafood, synthesis, new cell formation, weakness, hyporeflexia, and ataxia. Late Signs: n) poultry, and eggs and nerve function. irritability, depression, paranoia, and confusion. Fat-soluble vitamins Fat-soluble vitamins are absorbed with fats in the diet and include vitamins A, D, E, and K.They are stored in fat tissue and can build up in the liver. They are not excreted easily by the kidneys due to storage in fatty tissue and the liver, so overconsumption can cause toxicity, especially with vitamins A and D.  Fat-soluble vitamins Fat-Soluble Vitamin Source Function Deficiency Toxicity Retinol: fortified milk and dairy, egg yolks, and Night blindness, rough Eyesight, epithelial, fish liver oil scaly skin, dry eyes, and A (Retinol) bone and tooth Dry, itchy skin; headache; poor tooth/ bone Beta carotene: development, nausea; blurred vision; development. Causes green leafy normal cellular and yellowing skin poor growth and vegetables, and proliferation, and infections common with (carotenosis). dark orange immunity. mortality >50%. fruits and vegetables  Changed to active Rickets, poor dentition, tetany, Hypercalcemia Milk, dairy, sun form with sun osteomalacia, muscle aches and resulting in nausea, exposure, egg exposure. Needed for weakness, bone pain, poor vomiting, D calcium/ phosphorus calcium absorption leading to anorexia, renal yolks, fatty fish, and liver absorption, immunity, hypocalcemia and subsequent failure, weakness, and bone strength. hyperparathyroidism and tetany. pruritus, and polyuria. Green leafy Rare. Occasionally vegetables, whole Anticoagulant, Red blood cell breakdown leading to muscle weakness, E grains, liver, egg antioxidant, and cellular anemia, neuron degeneration, fatigue, GI upset with yolks, nuts, and protection. neuropathy, and retinopathy. diarrhea, and plant oils hemorrhagic stroke.  Green leafy Rare, but can vegetables and interfere with Rare in adults. Prolonged green Needed for clotting times, hemorrhaging effectiveness of vegetables producing K (especially in newborns certain clotting factors causing morbidity & anticoagulant *produced by in the liver. mortality), and jaundice. medications bacteria in (Warfarin). intestines Minerals Minerals are inorganic materials essential for hormone and enzyme production, as well as for bone, muscle, neurological, and cardiac function. Minerals are needed in varying amounts and are obtained from a well-rounded diet. In some cases of deficiencies, mineral supplements may be prescribed by a health care provider. Deficiencies can be caused by malnutrition, malabsorption, or certain medications, such as diuretics.  Minerals are classified as either macrominerals or trace minerals. Macrominerals are needed in larger amounts and are typically measured in milligrams, grams, or milliequivalents. Macrominerals include sodium, potassium, calcium, magnesium, chloride, and phosphorus. Macrominerals. Trace minerals are needed in tiny amounts. Trace minerals include zinc, iron, chromium, copper, fluorine, iodine, manganese, molybdenum, and selenium.  Macrominerals Macromineral Source Function Sodium Table salt, spinach, and milk Water balance Legumes, potatoes, bananas, Muscle contraction, cardiac muscle function, Potassium and whole grains and nerve function Bone and teeth development, nerve function, Dairy, eggs, and green leafy Calcium muscle contraction, immunity, and blood vegetables clotting  Raw nuts, spinach (cooked has higher magnesium Cell energy, muscle function, cardiac Magnesium content), tomatoes, and function, and glucose metabolism beans Chloride Table salt Fluid and electrolyte balance and digestion Red meat, poultry, rice, oats, Phosphorus Bone strength and cellular function dairy, and fish Trace Mineral Source Function Eggs, spinach, yogurt, whole grains, Immune function, healing, and Zinc fish, and brewer’s yeast vision Red meat, organ meats, spinach, shrimp, tuna, salmon, kidney beans, Hemoglobin production and Iron peas, and lentils (nonanimal forms collagen production are harder to absorb, so need more!) Whole grains, meat, and brewer’s Chromium Glucose metabolism yeast  Hemoglobin production, collagen, elastin, Shellfish, fruits, nuts, and Copper neurotransmitter organ meats production, and melanin production Fluoridated water and Retention of calcium in bones Flourine toothpaste and teeth Energy production and thyroid Iodine Iodized salt and seafood function Manganese Whole grain and nuts Not fully understood Organ meats, green leafy Not fully understood; Molybdenum vegetables, legumes, whole detoxification grains, and dairy Broccoli, cabbage, garlic, whole Selenium grains, brewer’s yeast, celery, Not fully understood onions, and organ meats Sugar recommendations WHO sugar recommendations: maximum of 5 to 10 teaspoons of free sugar per day Keep this in mind!!! Coca Cola contains 36 grams of Sugar 4 grams is equals to 1 teaspoon of sugar and that’s about 9 teaspoons Recommended Daily Intake Sugar Reference:WHO. Recommended Daily Intake Sugar To reduce the risk of unhealthy weight gain and tooth decay, the World Health Organization (WHO) recommends reducing the intake of free sugars to below 10 energy percent at all stages of life. The term "free sugars" is used here to refer to all sugars added to foods and beverages. But also those sugars that occur naturally in honey, syrup, fruit juice concentrates and fruit juices. For an average adult (with a calorie intake of 2,000 kcal), 10 energy percent is equivalent to no more than 50 grams of sugar per day (about 10 teaspoons or 14 sugar cubes). For children, the maximum recommended intake of free sugar - depending on age and gender. For adolescents and those who are active in sports, it can be more. 1-3 years old children, 10 energy percent is equivalent to about 30 grams of sugar per day (about 6 teaspoons) For children 4 to 6 years, it is about 35 grams of free sugar per day and for children 7 to 10 years, it is about 42 grams of free sugar per day. For illustration, a glass of lemonade (250 ml) contains an average of 18 grams of free sugar. Sugar Substitutes A sugar substitute is a food additive that provides a sweetness like that of sugar while containing significantly less food energy than sugar- based sweeteners, making it a zero-calorie or low-calorie sweetener.  Sugar Substitutes Honey vs. Agave ASPARTAME is an artificial non-saccharide sweetener 200 times sweeter than sucrose and is commonly used as a sugar substitute in foods and beverages. It is available in the United States under the brand names Nutrasweet and Equal and is an ingredient in many soft drinks and food items. SIDE EFFECT: Effects on body weight Effects on appetite Effects on metabolism Other associated risks >certain types of cancer, including lymphoma, leukemia, urinary tract tumors, and neurological tumors >type 2 diabetes >preterm delivery >toxicity in the kidneys >toxic liver disease ASPERTAME  FATS: LIPIDS Lipids are fatty, waxy, or oily compounds that are essential to many body functions and serve as the building blocks for all living cells. Lipids help regulate hormones, transmit nerve impulses, cushion organs, and store energy in the form of body fat. Types of Lipids Triglycerides Phospholipids Sterols 1.Triglycerides are the most common type of lipid in our body and come from fats and oils in our diet. Triglycerides are important because they give us high-density energy(saturated,unsaturated and trans) low-density lipoprotein lipoprotein 2. Phospholipids make up the outer layer of cells in the Phospholipids STEROLS Sterols are a kind of steroid they bind and block the cholesterol absorption in human body. You might have heard about plant sterols or phytosterols. These substances are found in foods especially in fruits,vegetables,cereals and Physiologic Value of Food 1. Metabolism and Digestion 2. Energy from Foods Energy The Calories The Joules Calculation of Food Value Components of Energy Expenditure Nutrition Tools - Standards and Guidelines Metabolism Chemical process of transforming foods into complex tissue elements and of transforming complex body substance into simpler ones, in which substance are change in other substance to sustain life. Anabolism construct substance and consume energy. Catabolism break down substance and release energy Digestion DIGESTION process of breaking down food into substances like carbohydrates, proteins, fats, and vitamins that aid the body into different functions. DIGESTIVE SYSTEM The digestive system is made up of the gastrointestinal tract (Gl tract),liver, pancreas, gall bladder. GASTROINTESTINAL TRACT  PARTS OF THE HUMAN DIGESTIVE SYSTEM MOUTH Start of digestion Breaks down the food via chewing process and saliva in a form that the body can absorb and use ESOPHAGUS Pharynx-Transfers food from the mouth to the esophagus. Warms, moisten and filters air STOMACH Sac-like organ with tough muscular walls.Holds, mixes, and grinds food Secretes acid and powerful enzyme -> carry on the process of breaking down food. SMALL INTESTINE Long loosely coiled tube and can be more than 20 ft. long WHAT are the 3 parts of SMALL INTESTINE? WHAT are the 3 parts of SMALL INTESTINE?  3 parts: Duodenum: accomplishes a good deal of chemical digestion, as well as a small amount of nutrient absorption. Jejunum: finishes chemical digestion (enzymatic cleavage of nutrients) and absorbs most fats and proteins. Ileum: absorbs vitamin B12, bile salts, and all digestion products which were not absorbed in duodenum and jejunum. The stomach & small intestine are supported by 3 organs in digesting food: PANCREAS - secretes enzymes that break down fat, protein, &carbohydrates LIVER - produces & secretes bile that helps in digestion and absorption of fats & soluble viramins-Cleanses & purifies the blood GALL BLADDER - pear-shaped reservoir of bile; contracts & sends bile to the small intestine. LARGE INTESTINE Long muscular tube; 5-6 ft Connects the caecum to the rectum Food travels via peristaltic movements or contractions. STOOL - kept in the sigmoid colon until a mass movement empties it into the rectum one or twice a day. (36 hours) Made up of food debris & bacteria (synthesize various vitamins and processes waste products) RECTUM- 8-inch chamber that connects the colon to the anus and Holds the stool until defecation Once stool is in the rectum, it sends signal to the brain and then decides when recta contents can be released or not. ANUS - end of digestive tract that consists of: Upper anus - specialized to detect rectal contents. Pelvic floor muscles - creates an angle between the rectum & the anus that stops stool from coming out when it is not supposed to Anal Sphincters - provide control in the Energy from Foods Energy Is the force or power that enables the body to do its work.Energy deals mostly In the chemical energy locked in the food stuff by reason of chemical process. The Calorie Is a unit of heat measurement and that could come from a variety of sources:Fats,proteins, carbohydrates or sugars these are important sources of calories, which people need to live and function. A.If not burn,excess will remain and stored as Fats=Weight Gain B. If we burn more than we replenish=Weight Loss The Joules is the standard unit of measure for potential Calculation of Food Value Conversion!!! 1 lbs =0.45 kg 1 ft= 12 inches 12 inches= 0.3048 meter 100 cm=1 meter UNDERWEIGHT 18.5 HEALTHY 18.5 - 24.9 OVERWEIGHT 25 - 29.9 OBESE1 30 - 34.9 OBESE 2 35 - 39.9 EXTREMLY OBESE 40up Calculation of Food Valu: Identifying BMI Class  Calculation of Food Value J 1 Joule = 1 calorie 1 KiloCalorie (kcal) = 1000 calories 1 KiloJoule (kJ) = 1000 Joules 1 KiloCalorie= 4.18 joules  Calculation of Food Value Calorific values of three main components of food: carbohydrates 1 g = 4 kcal protein 1 g= 4 kcal fat 1 g= 9 kcal Alcohol(not a nutrient) 1g=7kcal  Energy expenditure Your energy expenditure is simply the number of calories your body uses. Energy requirements are the amount of food energy that should be eaten to compensate for caloric expenditure. It's important to learn these energy requirements to have a good energy balance. Is the total amount of energy your body uses to perform various functions Basal Metabolic Rate (BMR): This is the energy your body needs to maintain basic physiological functions at rest, such as breathing, blood circulation, and cell production. BMR accounts for about 60-70% of your total energy expenditure. Thermic Effect of Food (TEF): This is the energy required for digestion, absorption, and metabolism of food. TEF typically makes up about 10% of your total energy expenditure. Physical Activity: This includes all the energy expended during physical movement, from exercise to everyday activities like walking or fidgeting. Physical activity can vary greatly between individuals and can account for 20-30% of total energy expenditure.  Components of Energy Expenditure Basal Metabolic Rate needed to maintain essential physiological functions, including growth, pregnancy, lactation. Thermic Effect of Food necessary for digestive and metabolic utilization of nutrients. Physical Activity for muscle contraction and movements  Nutrition Tools Standards and Guidelines Estimated Average Requirement (EAR): Is a nutrient intake value used in dietary planning and assessment. It represents the daily intake level estimated to meet the requirements of 50% of healthy individuals in a particular life stage and gender group. Recommended Dietary Allowance (RDA): Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals  Nutrition Tools Standards and Guidelines.Adequate Intakes (AI) Is a term used in nutrition to describe the average daily nutrient intake level that is assumed to be sufficient for maintaining health in a specific group of people. Tolerable Upper Intake Levels (UL) Are the maximum daily amounts of a nutrient that are unlikely to cause adverse health effects for almost all individuals in the general population  Nutrition Tools- Standards and Guidelines AMDR ACCEPTABLE MACRONUTRIENT DISTRIBUTION RANGES (AMDRs) are defined as a range of intakes for a particular macronutrient that is associated with reduced risk of chronic disease while providing adequate amounts of essential nutrients. The AMDR for carbohydrate is 55-70%, for fat is 15-25%, and for protein is 7-20% of the energy intake for adults. The subjects who did not meet the AMDRs for carbohydrate, fat and protein were considered to be the non-AMDR group.  Dietary Guidelines and Food Guides USDA FOOD GUIDE (United States Department of Agriculture) The USDA food pyramid was created in 1992 and divided into six horizontal sections.It was updated in 2005 with black and white vertical wedges replacing the horizontal sections and renamed MyPyramid. In an effort to restructure food nutrition guidelines, the USDA rolled out its new MyPlate program in June 2011. My Plate is divided into four slightly different sized quadrants, with fruits and vegetables taking up half the space, and grains and protein making up the other half. The vegetables and grains portions are the largest of the four. MyPyramid:USDA  MyPyramid Vegetables Contain many vitamins and minerals; however, different vegetables contain different balances of micronutrients, so it is important to eat a wide variety of types. Vegetables are very low in fats and calories, but ingredients added in preparation can often add these. watercress, lettuce, arugula, sprouts, napa cabbage, cucumber, and celery  MyPyramid Grains provide complex carbohydrates, which are a good source of energy and provide much nutrition when unrefined. corn, wheat, pasta, and rice.  MyPyramid Fruits are the sweet-tasting seed-bearing parts of plants.Fruits are low in calories and fat and are a source of natural sugars, fiber and vitamins. Processing fruit when canning or making into juices may add sugars and remove nutrients. there are a number of botanical fruits which are conventionally not considered fruits in cuisine because they lack the characteristic sweet taste, tomatoes or avocados.  MyPyramid Milk dairy products are produced from the milk of mammals. They include milk, yogurt and cheese. However, many dairy products are high in saturated fat and cholesterol. Meats and beans Is a major source of protein.The category of meats, poultry, and fish include beef, chicken, pork, salmon, tuna, shrimp, and eggs. MyPlate:USDA Food-based dietary guidelines - Philippines Official name: (Filipino: Mga Gabay sa Wastong Nutrisyon Para sa Pilipino). Publication year: The Philippines published its first dietary guidelines in 1990. They were revised in 2000 and again in 2012. Intended audience: The guidelines are directed at the general population and also include messages on the feeding of infants and children.  Nutritional guidelines for Filipinos The Philippines uses the daily nutritional guide pyramid and has developed pyramids for different population groups. The pyramid is divided into levels of recommended consumption. Messages about exercise and personal and environmental hygiene serve as support messages for the pyramid. The healthy food plate for Filipino adults PINGGANG PINOY completes the messages of the pyramid by showing adequate distribution of nutritious foods in a meal. Go Foods: These are energy-giving foods, rich in carbohydrates and fats. They help you stay active and energized. Examples include: ◦Healthy fats from sources like avocado and nuts Grow Foods: These are protein-rich foods that help in body growth and repair. They are essential for building muscles, bones, and other tissues. Examples include: Dairy products like milk, cheese, and yogurt Meat, fish, eggs, and poultry Glow Foods: These foods are rich in vitamins and minerals that help maintain healthy skin, hair, and overall body function. They boost the immune system and keep you glowing. Examples include: Fruits and vegetables Leafy greens like spinach and kale Colorful veggies like carrots and bell peppers  Nutritional Guidelines for Filipinos (NGF) The Nutritional Guidelines for Filipinos (NGF) Is a set of dietary guidelines based on the eating pattern, lifestyle, and health status of Filipinos. The NGF contains all the nutrition messages to healthy living for all age groups from infants to adults, pregnant and lactating women, and the elderly.  Nutrition messages Eat a variety of foods every day to get the nutrients needed by the body. Breastfeed infants exclusively from birth up to 6 months, then give appropriate complementary foods while continuing breastfeeding for 2 years and beyond for optimum growth and development. Eat more vegetables and fruits every day to get the essential vitamins, minerals and fibre for regulation of body processes. Consume fish, lean meat, poultry, eggs, dried beans or nuts daily for growth and repair of body tissues. Consume milk, milk products and other calcium-rich foods, such as small fish and shellfish, every day for healthy bones and teeth. Consume safe foods and water to prevent diarrhea and other food and water-borne diseases. Use iodized salt to prevent iodine deficiency disorders. Limit intake of salty, fried, fatty and sugar-rich foods to prevent cardiovascular diseases. Attain normal body weight through proper diet and moderate physical activity to maintain good health and help prevent obesity. Be physically active, make healthy food choices, manage stress, avoid alcoholic beverages and do not smoke to help prevent lifestyle-related non- communicable diseases.  Food Exchange List Is a system of determining a daily food plan based on units, or exchanges, of various food types. Each item on an exchange list can be swapped with any other food item on the same list in the portion size listed. The exchange food groups is based on eight groups of foods. Because they have similar amounts of protein, carbohydrate, and fat, foods within each exchange group generally provide the same.  Food Exchange List Starches/Breads Fruits Milk Other Carbohydrates Vegetables Meats Very Lean Meats Fats Food Exchange List  Food Labels Understanding the Nutrition Facts label on food items can help you make healthier choices. The label breaks down the amount of calories, carbs, fat, fiber, protein, and vitamins per serving of the food, making it easier to compare the nutrition of similar products. Be sure to look at different brands of the same foods—nutrition information can differ a lot In general, eat more foods that are higher in vitamins, minerals (such as calcium and iron), and fiber. Eat fewer foods that are higher in added sugars, saturated fat and sodium (salt), and avoid trans fat. For example: one product brand may have more calories and sugar than another brand for the same serving size. Reference: CDC Centers For Disease Control and Prevention  Food Labels UFC Banana Heinz Ketchup Ketchup  Food Labels CHECK THE LABEL!!! Check the Serving size first. All the numbers on this label are for a 2/3-cup serving. This package has 8 servings. If you eat the whole thing, you are eating 8 times the amount of calories, carbs, fat, etc., shown on the label.  Food Labels CHECK THE LABEL!!! Total Carbohydrate shows you types of carbs in the food, including sugar and fiber. Choose foods with more fiber, vitamins, and minerals. Choose foods with lower calories, saturated fat, sodium, and added sugars. Avoid trans fat. FLUID S What is a fluid? 60% of body made from fluids Where is it all? 90% of blood is water 75% of muscle is water 25% of bone is muscle 10% of fat made from water  Functions of Fluids 1. Dissolve and transport substances 2. Transport many nutrients and waste,Carbs, amino acids, water soluble vitamins, minerals and medications 3. Fat soluble substances do not dissolve in fluids but transport with help of proteins 4. Protect Us:Cerebrospinal fluid cushions the brains and Amniotic fluid protects fetus 5. Moisten us: Saliva,Tears,Mucus,Fluid in joints and Mucus barrier in gut 6.Maintain body temp 37 C:Water isn’t easy to heat and being made mostly water helps keep us cool 7. Sweating Water evaporates out and so does heat which cools blood vessels close to skin and keeps body at regular body temperature 8. Water balance: State of equilibrium  FLUIDS :Fluid Gains and Losses Not drinking enough fluids can lead to dehydration, which can have several negative effects on your body. Physical Symptoms: You might experience dry mouth, dark-colored urine, muscle fatigue, dizziness, and extreme thirst. Cognitive Effects: Dehydration can cause confusion, irritability, and difficulty concentrating. Digestive Issues: Lack of fluids can lead to constipation and abdominal pain3. Skin Health: Your skin may become dry, flaky, and less elastic. Serious Complications: Severe dehydration can result in heat exhaustion, heat cramps, heatstroke, seizures, and even kidney failure. FLUIDS :Fluid Gains and Losses Medline Plus  Fluid Gains 50%=Drinking Water 30%=Other beverages includes coffee, tea, soft drinks, milk, and fruit juices. Caffeinated beverages are thought to have transient diuretic effects but this is unlikely to have an impact on hydration in practical terms as they also contain water and, thus, make a contribution to total fluid intakes Alcoholic beverages do have a diuretic effect in practice and may have a detrimental impact on hydration depending on the amounts consumed.  Fluid Gains 20%=All solid foods contain water. For example, the water content of most fruits and vegetables generally exceeds 85%, while rice and pasta contains around 70% water. Even dry foods, such as crackers, may contain 5% water. Water-based foods, such as soups, sauces, ice cream, and custards contribute significantly to water intake.  Fluids in Health Promotion women - about 2.7 liters (L) or 11 cups of fluid men -about 3.7 L (16 cups) Not all of that fluid has to be water intake. Whole, nutrient- rich foods and beverages, including the following, also count toward your fluid intake: Tea,Coffee,Sparkling water,Coconut water Onthe other hand, alcohol is dehydrating and does not count as fluid. Soda counts but is not a healthychoice.  Nutrition Across the Life Span The Human Life Cycle Human bodies change significantly over time, and food is the fuel for those changes. People of all ages need the same basic nutrients—essential amino acids, carbohydrates, essential fatty acids, and twenty-nine vitamins and minerals—to sustain life and health. However, the amounts of nutrients needed differ. Throughout the human life cycle, the body constantly changes and goes through different Nutrition Across the Life Span The major stages of the human life cycle are defined as follows: A. Pregnancy. The development of a zygote into an embryo and then into a fetus in preparation for childbirth. B. Infancy. The earliest part of childhood. It is the period from birth through age one. C. Toddler years. Occur during ages two and three and are the end of early childhood. D. Childhood. Takes place from ages four to eight. E. Puberty. The period from ages nine to thirteen, which is the beginning of adolescence. F. Older adolescence. The stage that takes place between ages fourteen and eighteen. G. Adulthood. The period from adolescence to the end of life and begins at age nineteen. Nutrition during Pregnancy The Academy of Nutrition and Dietetics Key components of a healthy lifestyle during pregnancy: 1. Appropriate weight gain 2.A balanced diet 3.Regular exercise 4.Appropriate and timely vitamin and mineral supplementation Dietary and Caloric Recommendation s To maintain a healthy pregnancy, approximately 300 extra calories are needed each day. These calories should come from a balanced diet of protein, fruits, vegetables and whole grains. Sweets and fats should be kept to a minimum. A healthy, well-balanced diet can Nutrition during Pregnancy Fluid Intake During Pregnancy Fluid intake is also an important part of pregnancy nutrition. Follow these recommendations for fluid intake during pregnancy: You canoftake glasses in enough water fluids each day, by drinking in addition several to the fluids in juices and soups. Avoid all forms of alcohol. Nutrition during Pregnancy Ideal Foods to Eat During Pregnancy The following foods are beneficial to your health and fetal development during pregnancy: 1) Vegetables: carrots, sweet potatoes, pumpkin, spinach, cooked greens, tomatoes and red sweet peppers (for vitamin A and potassium) 2) Fruits: cantaloupe, honeydew, mangoes, prunes, bananas, apricots, oranges, and red or pink grapefruit (for potassium) 3) Dairy: fat-free or low-fat yogurt, skim or 1% milk, soymilk (for calcium, potassium, vitamins A and D) 4) Grains: ready-to-eat cereals/cooked cereals (for iron and folic acid) 5) Proteins: beans and peas; nuts and seeds; lean beef, lamb and pork; salmon, trout, herring, sardines and pollock Nutrition during Pregnancy Foods to Avoid During Pregnancy 1) Avoid eating the following foods during pregnancy: 2) Unpasteurized milk and foods made with unpasteurized milk (soft cheeses, including feta, queso blanco and fresco, Camembert, brie or blue-veined cheeses—unless labeled “made with pasteurized milk") 3) Hot dogs and luncheon meats (unless they are heated until steaming hot before serving) 4) Raw and undercooked seafood, eggs and meat. Do not eat sushi made with raw fish (cooked sushi is safe). 5) Refrigerated pâté and meat spreads and Refrigerated smoked seafood. Nutrition during Pregnancy Guidelines for Safe Food Handling Follow these general food safety guidelines when handling and cooking food: Wash. Rinse all raw produce thoroughly under running tap water before eating, cutting or cooking. Clean. Wash your hands, knives, countertops and cutting boards after handling and preparing uncooked foods. Cook. Cook beef, pork or poultry to a safe internal temperature verified by a food thermometer. Chill. Promptly refrigerate all perishable food Nutrition during Pregnancy Prenatal Vitamin and Mineral Supplements Most health care providers or midwives will prescribe a prenatal supplement before conception or shortly afterward to make sure that all of your nutritional needs are met. However, a prenatal supplement does not replace a healthy diet. The Importance of Folic Acid that all women of childbearing age consume 400 micrograms (0.4 mg) of folic acid each day. Folic acid is a nutrient found in: Some green leafy vegetables Most berries, nuts, beans, citrus fruits and fortified breakfast cereals Some vitamin supplements. Nutrition during Pregnancy Folic acid can help reduce the risk of neural tube defects, which are birth defects of the brain and spinal cord. Neural tube defects can lead to varying degrees of paralysis, incontinence and sometimes intellectual disability. Folic acid is the most helpful during the first 28 days after conception, when most neural tube defects occur. Unfortunately, you may not realize that you are pregnant before 28 days. Therefore, your intake of folic acid should begin before conception and continue throughout your pregnancy. For example, women who take anti-epileptic drugs may need to take higher doses of folic acid to prevent neural tube defects Folic acid Stages of Pregnancy first trimester – conception to 12 weeks. second trimester – 13 to 27 weeks. third trimester – 28 to 40 weeks Common Nutrition-Related Problems of Pregnancy >Morning Sickness: a From the hormonal changes taking place early in pregnancy Eating crackers, hard candies, or other dry, starchy foods before getting up in the morning. INTERVENTION eating small, frequent meals as soon as you feel hungry, and avoiding any specific foods causing nausea or vomiting are suggested strategies to alleviate morning sickness. >Heartburning the hormones produced during pregnancy to relax uterus muscles also relax the muscles to the gastrointestinal tract.This relaxation can cause heartburning or constipation. INTERVENTION:Limit high fat food, avoiding caffeine, and chocolate Eating small, frequent meals, remaining upright after eating >Constipation As the hormones of pregnancy alter her muscle tone and the growing fetus crowds her intestinal organs, an expectant mother may complain of constipation. INTERVENTION A high-fiber diet, plentiful fluid intake, and regular exercise will help to relieve this problem.  Common Nutrition-Related Problems of Pregnancy Pregnancy can cause complications for the mother and the child. These can include: PIH Pregnancy-induced hypertension which includes: a G )o eta sn tih ay lperteo n is b P )reacm lp ais cE )a clmp ais d G )eto a sn tid alb iets Common Nutrition-Related Problems of Pregnancy Pregnancy-induced hypertension (PIH): high blood pressure that develops during the second half of pregnancy. High blood pressure About 5-10% of pregnant women experience high blood pressure during the pregnancies Pregnancy -induced hypertension is responsible for 16% of pregnancy related deaths in the U.S Common in mothers under 18 and over 35, low income, chronic hypertension or kidney disease Common Nutrition-Related Problems of Pregnancy Gestational hypertension; an abnormal rise in blood pressure that occur after the 20th week of pregnancy Gestational hypertension may signal the potential for more serious condition called preeclampsia. Preeclampsia: a condition characterized by hypertension, fluid retention, and protein in the urine. Eclampsia: a severe extension of preeclampsia characterized by convulsions Common Nutrition-Related Problems of Pregnancy INTERVENTION Low sodium diet is prescribe to prevent preeclampsia. Calcium may play a role in preventing hypertension Calcium supplement has found may reduce the risk of high blood pressure and preeclampsia Pregnant teens, individual with inadequate calcium intake and women who are known to be at risk of developing pregnancy induced hypertension No un tiridu n rigLacta on ti 1.Physiology of Lactation-Lactation involves the synthesis of milk components, including protein, lactose and lipids, and the movement of the milk through the milk ducts to the nipple. 2. Recommended Diet Adequate nutrition of the mother makes a highly significant contribution to successful lactation. A nursing mother produces 30 ounces of milk a day, on the average, with wide variations possible. Current recommendations suggest that 400 calories to support this milk production come from added food and that the rest come from the stores of fat the mother's body has accumulated during pregnancy for this purpose Nu otn iridun rig n Ia fncy The growth of infants directly reflects their nutritional well-being, and is the major indicator of their nutritional status. A baby grows faster during the first year of life Doubling its birth-weight during the first 4 to 6 months and a Tripling its birth-weight by the end of the year. Adequate nutrition during infancy critical is to support this rapid growth and development. 2 types of Feeding >Breastefed n ig >Forma u F led nig Brea etfsd nig Breastefed n igM klo firthen Ia fnt Breastfeeding has both emotional and physical health advantages. Emotional:Emotional bonding Health Benefits: During the first 2 or 3 days of lactation, the breast produces colostrum, a premilk substance containing antibodies and white cells from the mother's blood.Breast milk also contains antibodies, although not as much colostrum.They both contain the bidfidus factor that favors the growth "friendly" of the probiotic bacteria such as Lactobacillus bifidus in the infant's digestive tract so that other, harmful bacteria cannot grow there. Breast milk also contains the powerful antibacterial agent. Lactoferrin,As well as other factors,Several enzymes, Several hormones and Lipids that helps to protect the infant against infection. Infant formulas are manufactured with the approximate nutrient composition of breast milk. The parents can see that the baby is getting enough milk during feedings. Other family members can get close to the baby and develop a warm relationship in feeding sessions..Feeding cow's milk to infants may increase the risk of iron-deficiency anemia and cow's milk protein allergy “ Food for the Infant Solid foods may normally be added to a baby's diet when the baby is between 4 and 6 months old, depending on readiness. The following are indicators of readiness: can sit with support and can control head interest in food the weight is twice their birth weight. Nutrition Stages of Life 1) Toddler 2) Pre-school 3) School age 4) Adolescent 5) Adult 6) Older adult Toddler and Pre-school School age Adolescent Adult Older adult Nutrient Needs in Older Adults The energy requirements for people ages 51 and older are: Women 1,600 to 2,200 calories Men 2,000 to 2,800 calories depending on activity level. The decrease in physical activity that is typical of older adults also influences nutrition requirements. MIDTERM MALNUTRITION What Is Malnutrition? Malnu tirti onrefers to getting too little or too much of certain nutrients. It can lead to serious health issues, including stunted growth, eye problems, diabetes, and heart disease. Malnutrition is a condition that results from nutrient deficiency or overconsumption. Typse of malnutrition include 1. Undernutrition: This type of malnutrition results from not getting enough protein, calories or micronutrients. 2.Overnutrition: Overconsumption of certain nutrients, such as protein, calories or fat, can also lead to malnutrition. This usually results in overweight or obesity. However, micronutrient deficiencies can also occur with overnutrition.It’s possible to be overweight or obese from excessive calorie consumption but not get enough vitamins and minerals at the same time.That’s because foods that contribute to overnutrition, such as fried and sugary foods, tend to be high in calories and fat but low in other nutrients. Common Causes of Malnutrition The WHO estimates that over 460 million adults and 150 million children are undernourished, while more than two billion adults and children are overweight or obese. Commoncauesofmanurtonn iu lde:tcsil Food insecurity or a lack of access to sufficient and affordable food Digestive problems and issues with nutrient absorption: Conditions that cause malabsorption, such as Crohn’s disease, celiac disease and bacterial overgrowth in the intestines, can cause malnutrition. Excessive alcohol consumption: Heavy alcohol use can lead to inadequate intake of protein, calories and micronutrients Mental health disorders: Depression and other mental health conditions can increase malnutrition risk. One study found that the prevalence of malnutrition was 4% higher in people with depression compared to healthy individuals Inability to obtain and prepare foods: Studies have identified being frail, having poor mobility and lacking muscle strength as risk factors for malnutrition. These issues impair food preparation skills.  Population at Risk Popu a otln itshatarepronetomn alu otn iriu clde:  People living in developing countries or areas with limited access to food: Undernutrition and micronutrient deficiencies are especially common in Sub-Saharan Africa and Southern Asia  Individuals with increased nutrient needs, especially children and pregnant or breastfeeding women: In some developing countries, 24–31% of pregnant and breastfeeding mothers are malnourished  People that live in poverty or have low incomes: Low socioeconomic status is associated with malnutrition.  Older adults, particularly those who live alone or have disabilities: Research shows that up to 22% of older adults are malnourished and over 45% are at risk of malnutrition  People with issues that affect nutrient absorption: People with Crohn’s disease or ulcerative colitis may be up to four times more likely to have malnutrition than those without these conditions.  Signs and Symptoms Thgen isa sndy smptomo sm fa n lu otn iridependo sn t’i type Undernutrition typically results from not getting enough nutrients in your diet. We giho tls Losoa ftandmuse cm l as H ow lolcheka sndu snkeneyes Asweo n llstomach Dryhariandskn i D a ey ledwoundh n eia gl Fa gtu ie rIrta ity b ili cD u tiy flcioncentra n tig Depo re n isandanex ty i Kwashiorkor and Marasmus Kwas hio k o r roccurs in people who have a severe protein deficiency. Children who develop kwashiorkor are often older than children who develop marasmus. Having a diet that’s mainly carbohydrates can lead to this condition. The symptoms of kwashiorkor include :edema, or puffy or swollen appearance due to fluid retention, bulging of the abdomen and inability to grow or gain weight. You’re at an increased risk for kwashiorkor if you live in a rural area where there’s limited access to protein-rich foods. Children who have been weaned off of breast milk are also at an increased risk if they don’t have access to protein-rich foods. Kwashiorkor and Marasmus Marasmus occurs more often in young children and babies. It leads to dehydration and weight loss. Starvation is a form of this disorder. The symptoms of marasmus include:  weight loss  dehydration  chronic diarrhea  stomach shrinkage You’re at an increased risk for marasmus if you live in a rural area where it’s difficult to get food or an area that has a food shortage. Babies, including babies who aren’t breast-fed, young children, or older adults also have an increased risk for marasmus. Kwashiorkor and Marasmus Marasmus symptoms Kwashiorkor symptoms weight loss an inability to grow or gain weight edema, or swelling of the hands and dehydration feet stomach shrinkage stomach bulging diarrhea  Kwashiorkor and Marasmus Kwashiorkor Marasmus Causes ofKwah sor ikorandMaram s us The main cause of both of these conditions is a lack of access to food. Some things that may affect a person’s access to food include: Famine caregiver’s inability to get food due to lack of transportation or a physical inability living in poverty Other things that may lead to these conditions include: having an eating disorder lacking education about dietary needs taking medication that interferes with the absorption of nutrients having a medical condition that increases your body’s need for calories DEFICIENCY PROBLEMS FINAL S Bca Cisoncepta snd Pn ripceio slD fetT iherapy 1. General or Regular diet 2. Vegetarian Diet 3. Therapeutic Diet 4. Nutrient Modification Diet 5. Tube Feeding BacC sioncepta sndPn rip ceiso lD feti Therapy 1.General or Regular Diet A general or regular diet is a healthy meal plan that includes a variety of healthy foods from all the food groups. Example:My Plate/My Pyramid 2.Vegetarian Diet Vegetarianism is the practice of abstaining from the consumption of meat. It may also include abstaining from eating all by-products of animal slaughter.Many people object to eating meat out of respect for BacC sioncepta sndPn rip ceiso lD feti Therapy 3. Therapeutic Diet A therapeutic diet is a meal plan that controls the intake of certain foods or nutrients. It is part of the treatment of a medical condition and are normally prescribed by a physician and planned by a dietician. A therapeutic diet is usually a modification of a regular diet. It is modified or tailored to fit the nutrition needs of a particular person. Therapeutic diets are modified for (1) nutrients, (2) texture, and/or (3) food allergies f or ood intolerances.  Commonreao snth serapeu cd em tis aybe o T r d e r e o m a ni t a d : i n 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 ofdiabetes 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 To provide texture modifications due to problems with chewing and/or swallowing  3.Common therapeutic diets include: Texturemo ca od iftn i CelarLqiu diD eit Fqu ilu ldideit SotfBalndDeit Mechan cS ailo ta fnd/orPured eti LowF bierD eit Therapeu cD tietsi 1. Clear liquid diet –Includes minimum residue fluids that can be seen through. Examples are juices without pulp, broth, and Jell-O. Rationale:Is often used as the first step to restarting oral feeding after surgery or an abdominal procedure.Can also be used for fluid and electrolyte replacement in people with severe diarrhea.Should not be used for an extended period as it does not provide enough calories and nutrients. Therapeu cD tietsi 2. Full liquid diet -Includes fluids that are creamy. Examples: Some examples of food allowed are ice cream, pudding, thinned hot cereal, custard, strained cream soups, and juices with pulp. Rationale:Used as the second step to restarting oral feeding once clear liquids are tolerated. Used for people who cannot tolerate a mechanical soft diet.Should not be used for extended periods. Therapeu cD tietsi 3. Soft Bland Diet A soft bland diet includes foods that are soft, not very spicy, and low in fiber. If you are on a bland diet, you should not eat spicy, fried, or raw foods. You should not drink alcohol or drinks with caffeine in them. Examples: Milk and other dairy products, low-fat or fat-free only. Potatoes,Canned fruit as well as apple sauce, bananas, and melons Fruit juices and vegetable juices (some people, such as those with GERD, may want to avoid citrus and tomato) Breads, crackers, and pasta made with refined white flour Eggs,Tofu,Soup, especially broth. Rationale A bland diet can be used alongside lifestyle changes to help address the symptoms of ulcers, heartburn, GERD, nausea, and vomiting. You may also need a bland diet after stomach or intestinal surgery. Therapeu cD tietsi 4. Mechanical Soft and or Puree diet designed for people who have trouble chewing and swallowing. Chopped, ground and pureed foods are included in this diet, as well as foods that break apart without a knife. Example: Smooth puddings, custards, yogurts, and pureed desserts. Soft bananas, pureed fruits, and most canned and cooked fruits without seeds or skins. Rationale The goal of the mechanical soft diet is to provide a balanced diet with adequate amounts of protein and calories for people who have Therapeu cD tietsi 5. Low Fiber Diet limits the types of vegetables, fruits and grains that you can eat. Examples: Some of the foods that are allowed on a low-fiber diet include milk, cheese, yogurt, meat, fish and eggs. People who are lactose intolerant should avoid milk and dairy products if they cause stomach pain or diarrhea. Rationale You have narrowing of the bowel. This may be due to a tumor or an inflammatory disease, such as Crohn's disease and ulcerative colitis. You have had bowel surgery. Therapeu cD tietsi 6.Food allergy or food intolerance modification A. Food allergies are due to an abnormal immune response to an otherwise harmless food.Foods implicated with allergies are strictly eliminated from the diet.Appropriate substitutions are made to ensure the meal is adequate. The most common food allergens are milk, egg, soy, wheat, peanuts,tree nuts, fish, and shellfish. A gluten free diet would include the elimination of wheat, rye, and barley.Replaced with potato, corn, and rice products. Therapeu cD tietsi Food intolerance modification The most common food intolerance is intolerance to lactose (milk sugar) because of a decreased amount of an enzyme in the body. Other common types of food intolerance include adverse reactions to certain products added to food to enhance taste, color, or protect against bacterial growth. 4 N.utern itmocd a io ftinsd eti AD.aibectdieit B L.owsod uimd eti C L.owa ftd etior olwchoesltero d leti D H.gihbiferdeit E R.ena dleti A D.aibectideit Diabetic diet These diets control calories, carbohydrates, protein, and fat intake in balanced amounts to meet nutritional needs, control blood sugar levels, and control weight. Portion control is used at mealtimes as outlined in the ADA “Exchange List for Meal Planning.” Most commonly used calorie levels are: 1,200, 1,500, 1,800 and 2,000. A D.aibectideit Rationale: Helps to keep blood glucose level, blood pressure and cholesterol within the range set by your healthcare professional. Helps you reduce weight or maintain a healthy weight. B L.owsodu imdeitLS May also be called a 2 gram Sodium Diet. Limits salt and salty foods such as bacon, sausage, cured meats,canned soups, salty seasonings, pickled foods, salted crackers, etc. Rationale: Eating too much sodium can lead to high blood pressure, which may raise your risk of heart attack and stroke.Is used for people who may be “holding water” (edema) or who have high blood pressure, heart disease, liver disease, or first stages of kidney disease. C L.owa ftd etioo rlwcho esltero d leti LF Is used to reduce fat levels and/or treat medical conditions that interfere with how the body uses fat such as diseases of the liver, gallbladder, or pancreas. Limits fat to 50 grams or no more than 30% calories derived from fat.Is low in total fat and saturated fats and contains approximately 250-300 mg cholesterol. D H.gihb fierdeit Is prescribed in the prevention or treatment of a number of gastrointestinal, cardiovascular, and metabolic diseases. Example: Increased fiber should come from a variety of sources including fruits, legumes, vegetables, whole breads, and cereals. Rationale: Helps maintain bowel health. A high-fiber diet may lower your risk of developing hemorrhoids and small pouches in your colon (diverticular disease). Studies have also found that a high-fiber diet likely lowers the risk of colorectal cancer. Some fiber is fermented in the colon. E R.ena d leit for renal/kidney people. The diet plan is individualized depending on if the person is on dialysis Lab work is followed closely. Example The diet restricts sodium, potassium, fluid, and protein specified levels. Mechanically altered or soft diet –is used when there are problems with chewing and swallowing. Changes the consistency of the regular diet to a softer texture.Includes chopped or ground meats as well as chopped or ground raw fruits and vegetables. Rationale: maintaining renal function, preventing complications, and providing adequate nutrients. Because cardiovascular disease and hypertension are highly correlated with renal disease, sodium reduction is a major goal of the renal diet. 5 T.ubefed n igs A.Tube feedings are used for people who cannot take adequate food or fluids by mouth. All or parts of nutritional needs are met through tube feedings. Some people may receive food by mouth if they can swallow safely and are working to be weaned off the tube feeding. 5 T.ubefed n igs Example: 5 T.ubefed n igs Rationale: Feeding tubes are used to ensure that someone unable to swallow can still get needed nutrients, fluids, and medication. The need for the tube might be temporary or permanent due to a chronic condition. The kind of tube will depend on the condition and how long it's needed 5 T.ubefed n igs 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 Nourishments – ordered as a snack food or beverage items to be given between meals mid-morning and/or mid- afternoon HS snack – ordered as a snack food or beverage items to be given at the hour of sleep. 5 T.ubefed n igs Types of Tube Feeding 1.Total Parenteral Nutrition TPN Parenteral nutrition is the intravenous administration of nutrition outside of the gastrointestinal tract. Total parenteral nutrition (TPN) is when the IV administered nutrition is the only source of nutrition the patient is receiving. Rationale: TPN administers proteins, carbohydrates, fats, vitamins, and minerals. It aims to prevent and restore nutritional deficits, allowing bowel rest while supplying adequate 5 T.ubefd n iT g:sPN Example 5 T.ubefed n igs 2.Enteral Feeding Enteral nutrition is nutrition delivered using the gut. This can refer to oral, gastric, or post pyloric feeds. There are many indications requiring a feeding tube to deliver nutrition or hydration. This is known as tube feeding, enteral feeding, or gavage Types/Examples: Nasogastric tube. Nasoduodenal tube. Nasojejunal tube. Gastrostomy tube. Jejunostomy tube. Gastrojejunal tube. 5 Tu.befd n ig:snteral E 5 T.ubefed n igs Rationale: Enteral feeding is indicated in patients who cannot ingest adequate amounts of calories, but have sufficient gastrointestinal function to allow digestion and absorption of feeding solutions delivered into the gastrointestinal tract via an enteral feeding device  GENG GENG thanks&seeu, futureRN