Health Occupations

Nutrition

Fundamentals of Nutrition

Good food = Good nutrition Most people are unaware of what nutrients

are needed & why Unable to make good choices to promote

optimal health Nutrition

– Includes all body processes relating to food– Includes digestion, absorption, metabolism,

circulation, & elimination– Use food for energy, maintaining health, & growth

Nutritional Status

State or condition of one’s nutrition Goal = good nutrition Must choose foods needed, NOT the

foods that just taste good

Role of Nutrition

Determines ht, wt, & strength Develops bones & muscles Increases physical agility Increases disease resistance Improves appetite, posture, complexion Aids mental ability Improves emotional & psychological health

Immediate effects of good nutrition Healthy appearance Good attitude Proper sleep & bowel habits High energy level Enthusiasm & freedom from anxiety

Diseases caused by poor nutrition HTN

– Can be caused by excess fat or salt– Leads to heart, blood vessel, or kidney disease

Atherosclerosis– Arteries narrow by accumulation of fatty substances on inner

surfaces– Caused by diet containing large amount of saturated fats &

cholesterol– Can lead to heart attack or stroke

Osteoporosis– Bones become porous & easily break– Common cause is long-term deficiency in Vitamin D, calcium,

and magnesium

Malnutrition

State of poor nutrition May be caused by poor diet or illness Symptoms – fatigue

– Depression– Poor posture– Overweight/underweight– Poor complexion– Lifeless hair– irritability

Malnutrition

Causes deficiency diseases, poor bone & muscle development, decreased mental ability, & death

Affects patients in extreme poverty, drug therapy, & psychological diseases- ALL AGE GROUPS

Obesity is a form of malnutrition – excess food

Essential nutrients

Chemical elements found in food Used by body to perform different

functions As body uses elements, they are

replaced by food eaten

Carbohydrates

1 of 6 essential nutrients Major source of readily usable human energy Commonly called starches or sugars Cheaper source of energy than proteins or

fats, produced mainly by plants Easily digested, grow well in most climates,

keep well without refrigeration Made of carbon, hydrogen, & oxygen

Carbohydrates Main sources

– Bread, grains– Cereal– Noodles– Pasta– Crackers– Potatoes– Corn– Peas– Beans– Fruits, sugars– Syrups

Carbohydrates

Cellulose– Fibrous indigestible form of plant CHO

providing bulk in digestive tract– Causes regular BMs– Best sources

• Bran• Whole grains• Fibrous fruits & vegetables

Lipids – fats & oils

Organic compounds 3 of most common lipids are found in both food

& body– Triglycerides – fats, fatty acids– Phospholipids – ex. Lecithin– Sterols – ex. cholesterol

Made of carbon, hydrogen, & oxygen, but has more oxygen than CHO

Most concentrated form of energy More expensive source of energy than CHO

Lipids

Other functions– Maintains body temp by providing insulation– Cushions organs & bones– Aids in absorption of fat-soluble vitamins– Provides flavor

Sources– Butter, margarine– Oils, cream– Cheese, fatty meats– Egg yolks

Lipids Classified as saturated or polyunsaturated

– Saturated fats – solid at room temp• Meats, eggs, whole milk, cream, butter, cheese

– Polyunsaturated fats – usually soft & oily• Veggie oils, margarine, products made from vegetable oil, fish

peanuts

Cholesterol– Sterol lipid found in body cells & animal products– Used in production of steroid hormones, vitamin D & bile

acids– Component of body cells– Sources – egg yolk, fatty meats, shellfish, butter, cream,

cheese, whole milk, organ meats

Lipids

Also synthesized by liver Transported in bloodstream by 2 carrier molecules

called lipoproteins– HDL – high density lipoproteins

• Good cholesterol• Transports cholesterol back to liver• Prevents plaque from accumulating in arteries

– LDL – low density lipoproteins• Bad cholesterol• Contributes to plaque build-up

Important to limit foods containing fats from animal sources

Proteins

Basic component of all body cells Function

– Builds & repairs tissues– Regulates body functions– Provides energy & heat

Made of carbon, hydrogen, oxygen, nitrogen, may contain sulfur, phosphorus, iron, & iodine

Made up of 22 building blocks called amino acids

Proteins 2 types

– Complete proteins• 9 essential amino acids• Sources – animal foods like meats, fish, milk, cheese, eggs

– Incomplete proteins• Contain any of the remaining 13 amino acids & some, not all of the

9 essentials• Sources – vegetable foods, cereals, soybeans, dry beans, peas,

corn, peanuts

Choose plant foods carefully– Can provide a mixture of amino acids from incomplete

proteins that contain all essential amino acids– Important for vegetarians to select foods wisely

Vitamins

Organic compounds essential to life Important for metabolism, building tissue, &

regulating body processes Allows body to use energy provided by CHO

& proteins Well-balanced diet will usually provide

required vitamins Excess OR deficiency can cause poor health

Vitamins

Antioxidants– Organic molecules that help to protect body from

harmful substances called free radicals• Oxygen used during metabolism causes free radicals to form• These damage tissues, cells, & genes (like oxygen causes

apples to turn brown or metal to rust)• Can lead to the development of chronic diseases like cancer,

heart disease, arthritis

– Found mostly in fruits & vegies• Deactivate free radicals• Prevents damage to skin• Main antioxidants vitamins – A,C,E

Vitamins

Classified – Water soluble

• Dissolve in water• Are not normally stored by body• Easily destroyed by cooking, air, light• Niacin, Vitamin B1, B2, B6, B12, Vit C, Folic acid

– Fat soluble• Dissolve in fat• Can be stored in body• Not easily destroyed by cooking, air, light• Vitamin A, D, E, K

Minerals

Inorganic elements found in all body tissue Regulate body fluids, assist in various

functions, contribute to growth, aid in tissue building

Antioxidants – Selenium, zinc, copper, manganese

Other minerals – calcium, phosphorus, magnesium, sodium, potassium, chlorine, sulfur, iron, iodine, fluoride

Water

Found in all body tissues Functions

– Essential for digestion or breakdown of food– Makes up most of blood plasma & cell cytoplasm– Helps body tissues absorb nutrients– Helps move waste material through body

Found in almost all foods Average person should drink 6 – 8 glasses of

water each day

Utilization of nutrients

Includes process of digestion, absorption, & metabolism

Digestion – process by which body breaks food down into smaller parts, changes the food chemically, & moves the food through the digestive system– Mechanical digestion – food broken up by teeth

• Moved through digestive tract by peristalsis

– Chemical digestion – food is mixed with digestive juices secreted by mouth, stomach, small intestine, liver, gall bladder, & pancreas

• Juices contain enzymes that break down food chemically

Absorption

Process by which blood or lymph capillaries pick up digested nutrients– Nutrients carried by circulation to every

body cell– Most absorption takes place in small

intestine– Large intestine absorbs water, salts, & few

vitamins

Metabolism

Process in which nutrients are used by cells for building tissue, providing energy, & regulating various functions– Nutrients are combined with oxygen, energy & heat

are released– Energy is required for voluntary & involuntary

processes– BMR – Basal Metabolic Rate- rate at which body uses

energy just for maintaining own tissue without doing any work

– Body needs energy constantly – can store for future use

Measuring food energy Foods vary in amounts of energy they contains When body metabolizes nutrients to produce

energy, heat is released Measurement of heat produced during

metabolism is the way the energy content of food is measured– Kilocalorie or calorie– Number of calories in a certain food – caloric value– CHO & protein = 4 cal/g– Fat = 9 cal/g– Vitamins, minerals, & water = 0 cal

Individual’s calorie requirement Number of calories needed by body during a 24

hour period Varies from person to person depending on

activity, age, size, gender, physical condition, & climate

Usually amount of physical activity is main factor because energy used must be replaced

Lose weight = decrease cal, increase exercise Gain weight = increase cal, decrease exercise Weight gain or loss of 1-2 lbs per week is safe

www.mypyramid.gov

7 guidelines for good eating habits Eat a variety of foods – food groups, adjust

portion size & number, vary nutrients Maintain healthy weight Diet low in fat, saturated fat, cholesterol Use salt & sodium in moderation If alcohol is consumed, do so in moderation Choose a diet with plenty of veggies, fruits, &

grains Use sugar in moderation

Therapeutic diets

Modifications of normal diet used to improve specific health conditions

Normally prescribed by dr. & planned by dietician

May change nutrients, calorie count, or texture May be strange or unpleasant to pt – anorexia,

weakness, illness, depression Use patience & tact to convince to eat Understand purpose of diet & provide pt with

explanations

Regular or Standard diet

Balanced diet used for ambulatory pts, may be reduced calories

Rich desserts, creams, salad dressings, & fried food may be eliminated

Otherwise, no restrictions

Liquid diets

Foods must be liquid at body temp Nutritionally inadequate, can only use for short

time periods Clear liquids

– Mostly CHO & water– Apple/grape juice, broths, gelatin, fruit ice, ginger ale,

tea, coffee Full liquids

– Strained soups & cereals, fruit & veggie juices, yogurt, hot cocoa, custard, ice cream, pudding, sherbet, eggnog

Soft diet

Similar to regular, but foods must require little chewing & must be easily digestible

Avoid meat & shellfish with tough connective tissue, rich desserts, coarse cereals, spicy food, fried food, raw fruit/veggies, nuts, coconuts

Uses – postop, pts withy infections, digestive disorders or chewing problems

Diabetic diet - ADA

Used for pts with diabetes – body doesn’t produce enough insulin to metabolize CHO, pts freq take insulin

Diet has exchange lists– Group foods according to type, nutrients, calories– Pts are allowed a certain number of items from

each exchange Avoid sugary foods – candy, sodas, desserts,

cookies, syrup, honey, condensed milk, gum, jam, jelly

Calorie Controlled diet

Can be either low or high calorie Low calorie

– Used for overweight pts– Avoid or limit high calorie foods

High calorie– Used for underweight pts, hyperthyroid, cancer– Includes extra protein & CHO– Avoid high bulk food – green salads, watermelon,

fibrous fruits & high fat foods

Low Cholesterol diet

Restricts cholesterol containing foods Used for patients with heart disease

Fat restricted diet

Used for patients with gall bladder disease, liver disease, obesity, heart disease

Restricts fat

Sodium restricted diets

Can use diabetic exchange lists No added salt, no smoked meats,

processed foods, pickles, sauerkraut, olives, processed cheese

Used for HTN, CHF, kidney disease, edema

Protein diet

Includes low protein & high protein Low protein

– Kidney disease, allergies High protein

– Children, adolescent, pregnant, lactating, preop, postop, burns, fevers, infections

Bland diet

Consists of easily digested foods that do not irritate digestive tract

Avoid – coarse foods, fried foods, highly seasoned foods, pastries, candy, raw fruit & veggies, alcohol, carbonated beverages, smoked/salted meats, nuts, olives, avocados, coconut, whole grain breads & cereals, coffee, tea

Used for pts with ulcerative colitis, diverticulitis, diarrhea