Prelim Notes.pdf

NSG104 NUTRITION AND DIET THERAPY ASST. PROF. REYA T. SENO, MAN, RN College OF Health Sciences MSU Iligan Institute of Technology Nutrition in Nursing Meaning and Importance of Nutrition Week 1 Nutrition The study of food in relation to health and how the body makes use of it. ...

NSG104 NUTRITION AND DIET THERAPY ASST. PROF. REYA T. SENO, MAN, RN College OF Health Sciences MSU Iligan Institute of Technology Nutrition in Nursing Meaning and Importance of Nutrition Week 1 Nutrition The study of food in relation to health and how the body makes use of it. FUNCTION OF NUTRITION To maintain life by allowing one to grow and be in a state of optimum health NUTRITION AS A SCIENCE AS APPLIED TO NURSING CARE It prevents occurrence of diseases or illnesses Adapting food patterns based on individual nutritional needs and within the framework of their cultural, economic, psychological situation and style Awareness on the need in specified disease states to modify nutritional factors or therapeutic purposes NUTRIENTS are chemical substances found in food. Role of nutrients: To provide heat and energy To build and repair body tissues To regulate body processes.  SCOPE OF NUTRITION AS A SCIENCE The scope of nutrition covers the following fields: ❑ Basic or fundamental nutrition ❑ Maternal and Child Nutrition ❑ Therapeutic Nutrition ❑ Medical Nutrition Presentation Title CLASSIFICATION OF NUTRIENTS 1. ACCORDING TO FUNCTION a. Body building b. Furnish energy c. Regulate body processes SIX MAJOR NUTRIENTS ❑ Carbohydrates, Fats, Protein ▪ major organic nutrients which are broken down to supply energy ❑ Vitamins, Minerals and Water ▪ taken in the body without being broken down ▪ Helps regulate circulation, respiration, digestion and elimination  CLASSIFICATION OF NUTRIENTS 2. ACCORDING TO CHEMICAL NATURE a. Organic substances b. Inorganic substances 3. ACCORDING TO ESSENTIALITY a. Dietary essentials b. Semi-Essentials c. Non-dietary essentials CLASSIFICATION OF NUTRIENTS 4. ACCORDING TO CONCENTRATION a. Macronutrients ❑ e.g. Water, fats, protein carbohydrates b. Micronutrients ❑ are vitamins and trace minerals QUALITIES OF GOOD FOOD nourishes the body or nutritious it has satiety value prepared under sanitary conditions, aesthetically and scientifically free from toxic agents palatability satisfies the consumer offers variety and planned within socio-economic context Macronutrients CARBOHYDRATES big group of organic compounds prominent in the plant kingdom which contain the element of carbon, hydrogen and oxygen. FUNCTIONS: 1. Chief source of energy 2. Protein sparer 3. Cheap and main energy source 4. Regulator of fat metabolism 5. Sole energy source for the brain and nerve tissue 6. Storage form of energy as glycogen 7. Regulator of intestinal peristalsis and provider of bulk  CLASSIFICATION OF CARBOHYDRATES 1. Simple Carbohydrates are found in food such as fruits, milk, and vegetables A. MONONSACCHARIDES they are sweet they require no digestion Examples: cakes, candy, and other refined sugar products GLUCOSE (dextrose) The principal form in which carbohydrates is used by the body It is moderately sweet sugar found naturally preformed in a few foods Abundant in fruits, sweet corn, corn syrup Can provide energy for the brain Source: Corn syrup, Berries, grapes Author, Date | Page no. 2. FRUCTOSE (levulose) The sweetest of simple sugars. Found in Honey, fruits, some vegetables It is converted to glucose in the body 3. GALACTOSE Not found free in foods It is produced from lactose (milk sugar) by digestion and converted to glucose in the body Source: Lactose B. DISACCHARIDES Made up of 2 monosaccharide They must be changed to simple sugars 1. SUCROSE Processed from cane and beet sugar Found in fruits, vegetables, syrups and sweet food products Converted to glucose and galactose upon digestion Source: sugar cane; candy; granulated sugar; jams and jellies 2. LACTOSE ❑ Found in milk ❑ converted to glucose and galactose in digestion ❑ Less sweet 3. MALTOSE ❑ Not found in free foods ❑ Produced by hydrolysis of starch ❑ Converted to glucose in digestion ❑ Found in certain infant milk formula, beer and malt beverages C. POLYSACCHARIDES Compound of many molecules of simple sugars (complex sugar) 1. Starch ❑ Most significant polysaccharide in human nutrition. ❑ It is converted entirely to glucose upon digestion ❑ Require longer time to digest Sources: cereal grains, potatoes, root vegetables, legumes Author, Date | Page no.  2. DEXTRIN ❑ Not found free in foods ❑ Formed as intermediate products in the breakdown of starch Presentation Title Author, Date | Page no.  3. CELLULOSE ❑ Forms the framework of plants ❑ Non-digestible by humans ❑ Provide important bulk in the diet Sources: stems, leaves of vegetables and fruits, seeds and grains coverings, skin and hulls Presentation Title Author, Date | Page no. CLASSIFICATION: 1. SOLUBLE ❑ delay gastrointestinal transit and delays glucose absorption and lower cholesterol Sources: fruits, legumes, barley, and oats 2. INSOLUBLE ❑ accelerate gastrointestinal transit, increase fecal weight, slow down starch hydrolysis and delay glucose abruption Sources: wheat bran, corn bran, hole grain bread, cereals and vegetables  4. PECTINS ❑ Non-digestible, colloidal polysaccharides having a gel quality ❑ Bind cholesterol reducing the amount the blood can absorb Presentation Title Author, Date | Page no.  5. GLYCOGEN (ANIMAL STARCH) ❑ Formed from glucose and stored in liver and muscle tissue ❑ Converted glucose upon digestion ❑ The hormone glucagon help the liver convert glycogen to glucose Sources: meat and sea foods Presentation Title Author, Date | Page no. 1. COMPLEX ❑ Breads, rice, cereals, pasta, biscuits, potatoes, peas, sweet corn, parsnip, carrots, dried beans, lentils, fruit, milk and yoghurt. 2. SIMPLE ❑ Sugar, honey, jams, marmalades, confectionary, cakes, soft drinks, cordials, sweet biscuits, toppings, flavoured mineral water.  Health effects of starch and fibers ❑ Weight control ❑ Heart disease ❑ Cancer ❑ Diabetes ❑ GIT health Presentation Title Author, Date | Page no. Vegetables, Fiber, and Empty Calorie Foods How the body handles carbohydrates Digestion and Absorption Metabolism Blood Glucose regulation  Hormones Affecting blood glucose levels Hormone Tissue of Origin Metabolic Effects Effect on Blood Glucose Levels Insulin Pancreatic B Cells Enhances entry of glucose into cells; Enhances storage Lowers of glucose as glycogen, or conversion to fatty acids. Somatostatin Pancreatic D Cells Suppresses glucagon release from a cells (acts locally); Raises Suppresses release of Insulin, Pituitary tropic hormones, gastrin and secretin. Glucagon Pancreatic a cells Enhances release of glucose from glycogen; Enhances Raises synthesis of glucose from amino acids or fatty acids. Epinephrine Adrenal Medulla Enhances release of glucose from glycogen; Enhances Raises release of fatty acids from adipose tissue. Cortisol Adrenal Cortex Enhances gluconeogenesis; Antagonizes Insulin Raises ACTH Anterior Pituitary Enhances release of cortisol; Enhances release of fatty Raises acids from adipose tissue. Growth Hormone Anterior Pituitary Antagonizes Insulin Raises Thyroxine Thyroid Enhances release of glucose from glycogen; Enhances Raises absorption of sugars from intestine. Glycogen: Storing carbohydrates Glycogenesis Glycogenolysis Normal blood glucose levels FBS 70-100 mg/dl Normal Adult 80-130 mg/dl DM > 180 – hyperglycemia < 70 - hypoglycemia Hypoglycemia vs hyperglycemia Glycemic responses Glycemic Index (GI)  Glycemic Response: the effect a food has on the blood glucose concentration: how quickly the glucose level rises, how high it goes, and how long it takes to return to normal.  Glycemic Index: numeric measure of the glycemic response of 50 g of a food sample; the higher the number the higher the glycemic response. FACTORS THAT MAY AFFECT GI Amounts of fat, fiber and acid Degree of processing Method of preparation Degree of ripeness (for fruits and vegetables) Whether foods are eaten at the same time Glycemic responses Glycemic Load (GL)  Glycemic Load: a food’s glycemic index multiplied by the amount of carbohydrate it contains to determine impact on blood glucose levels. Dietary Reference Intakes  1 gm = 4 kcal  RDA: 130 g/day  AMDR: 45% - 65% kcal intake per day  Fiber AI:  25g/day women  38 g/day men  Recommendations on fiber  Natural use of fibers can help to normalize function.  Dietary fiber should be increased on a gradual basis to decrease the incidence of GI symptoms such as bloating, flatulence, and diarrhea.  Increased fluid intake should accompany increased levels of fiber in the diet to prevent potential imbalances.  Increased amounts of insoluble fiber can affect the absorption of certain minerals (Ca, Fe, Zn, and Mg).  Food sources rather than fiber supplements are recommended. Carbohydrates in health promotion Reduced Sugars Limit all added sugars. Carbohydrates in health promotion Consider Sugar Alternatives Carbohydrates in health promotion Consider Sugar Alternatives Carbohydrates in health promotion Prevent Dental Carries Choose between-meal snacks that are healthy and teeth friendly. Limit between-meal carbohydrate snacking including drinking soft drinks. Avoid high-sugar items that stay in the mouth for a long time. Brush promptly after eating. Chew gum sweetened with sugar alcohols (e.g., sorbitol, mannitol, and xylitol) or with nonnutritive sweeteners after eating. Use fluoridated toothpaste. Analyzing Glycemic Responses Given the following foods, analyze the GI and GL by answering the following questions per food item Food #1: Apple medium size GI:38, GL: 6  Guide questions: Food #2: White rice 1 cup GI: 64, GL: 33 1. Is it high or low GI? Discuss briefly. Food #3: Ice cream 1 cup GI: 61, GL: 10 2. Is it high or low GL? Discuss briefly. 3. What is the effect of the results towards one’s health? Self-directed learning Make a short report of the dangers of consuming HFCS using the guide questions. 1. What are HFCS? 2. What foods contains HFCS? 3. What are the dangers in consuming HFCS?  NSG104 NUTRITION AND DIET THERAPY ASST. PROF. REYA T. SENO, MAN, RN College OF Health Sciences MSU Iligan Institute of Technology Macronutrients Week 2 FATS OR LIPIDS  FATS OR LIPIDS Are organic compound of carbon, hydrogen and oxygen fatty acid esters of glycerol provide more concentrated source of energy compare to carbohydrates protect against shock and injury (structural fat) CLASSIFICATION OF FATS 1. Simple Lipids ( neutral fats) chemical name is triglycerides compose the 95% fats in the body CLASSIFICATION OF FATS 2. Compound Lipids ❑ combination of fats with other components 3 types: ❑ Phospholipids ❑ Glycolipids ❑ Lipoprotein COMPOUND LIPIDS 1. Phospholipids – compounds of fatty acids, phosphoric acids and nitrogenous base. a. Lecithin most widely distributed of the phospholipids. b. Cephalin – needed to form thromboplastin for the blood clotting process. c. Sphingomyelin- found in brain and other nerve tissue as component of myelin sheath. Compound Lipids 2. Glycolipids- compounds of fatty acids combined with carbohydrates and a nitrogenous bases a. Cerebrocides- components of nerve tissue and cell membranes and play vital role in fat transport. b. Gangliosides – made up of certain glucose, galactose and a complex compound Compound Lipids 3. Lipoproteins ❑ combination of lipid and protein ❑ they are primarily formed in the liver and found in cell, ❑ insoluble in water and combined in protein complex for their transport and activity ❑ it contain cholesterol, neutral fats and fatty acids 3. Derived Lipids simple derivatives from fat digestion or other more complex products 1. Fatty Acids refined fuel forms of fat that the cell burns for energy. They are basic structural units of fat and maybe saturated or unsaturated in nature  SOURCES OF FATTY ACIDS a. Saturated Fats – no hydrogen can be added palmitic and stearic (animal fats including beef) b. Monounsaturated fatty acids – oleic acid is the most abundant (olive and peanut oils) two carbon atoms are combined by a double bond c. Polyunsaturated fatty acids –two or more double bonds are present Linoleic acid is the most common and is abundant in most vegetable oil. SOURCES OF FATTY ACIDS  THE OMEGA-6/OMEGA 3 RATIO Plants produce both Omega-3 and Omega-6 fatty acids Omega-6 -more commonly found in plant-based sources. Omega-3 fatty acids- can be obtained from both plant and marine sources. Sources: cod liver oil, mackerel, salmon, sardines, as well as shellfish like crabs, shrimp, and oysters. DERIVED LIPIDS 2. Glycerol a water-soluble component of triglycerides and is convertible with carbohydrate. It comes out 10% of the fats. 3. STEROIDS fat related substances that contain sterols (CHOLESTEROL) fat like compound found in the: ✓ Body, brain and nerve tissue ✓ Liver, bile ✓ blood  Function of fats ❑ Important sources of calories. ❑ Maintain constant body temperature. ❑ Cushions vital organs against injury. ❑ Fat soluble vitamins A, D, E and K. ❑ Provides satiety and delays the onset of hunger ❑ Contributes flavor and deliciousness to the diet SOURCES OF FATS VISIBLE FATS ❑ lard ❑ Butter ❑ margarine ❑ shortenings ❑ salad oils ❑ meat  SOURCES OF FATS B. INVISIBLE FATS milk cheese eggs nuts meat 1 gm – 9 kcal AMDR: 20%-35%