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Delmar LearningDelmar LearningCopyright © 2003 Delmar Learning, a Thomson Learning company

Nutrition and Diet TherapyNutrition and Diet Therapy8th Edition8th Edition

byby

Ruth Roth and Ruth Roth and Carolynn TownsendCarolynn Townsend

Delmar LearningDelmar LearningCopyright © 2003 Delmar Learning, a Thomson Learning company

Nutrition and Diet TherapyNutrition and Diet TherapyPowerPointPowerPoint Presentation Presentation

Written byWritten by

Susan L. Robson, MSN, RNP-Susan L. Robson, MSN, RNP-cc

Copyright © 2003 Delmar Learning, a Thomson Learning company

Section 1

Fundamentals of Nutrition

Copyright © 2003 Delmar Learning, a Thomson Learning company

Chapter 1

The Relationship of Food and Health

Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 5

Objectives

Name the six classes of nutrients and their primary functions

Recognize common characteristics of well-nourished people

Recognize symptoms of malnutrition


Objectives

Describe ways in which food and health are related

List the four basic steps in nutrition assessment


Nutrients

Chemical substances necessary for life

Functions• Provide energy• Build and repair tissue• Regulate body processes


Nutrients

Six classes• Carbohydrates• Fats (lipids)• Proteins• Vitamins• Minerals• Water


Nutrients

Organic• Contains carbon,

hydrogen, oxygen• Carbon is found

in all living things• Example:

carbohydrates, fats, proteins, vitamins

Inorganic• In simplest form

when ingested• Function:

regulate body processes

• Example: water, minerals


Carbohydrates

Provides major source of energy

Examples: cereal grains, vegetables, fruits, nuts, and sugars


Fats (lipids)

Provides energy

Highest kilocalorie value

Sources of fat: meats, milk, cream, butter, cheese, egg yolks, oils, nuts


Protein

Builds and repairs body tissues

Provides energy

Only one of the six nutrients that contains nitrogen

Sources of protein: meats, fish, poultry, eggs, milk, cheese, corn, grains, nuts, and seeds


Vitamins

Organic compounds

Regulate body processes

Examples: vitamins A, B, C, D, E and K


Minerals

Inorganic compounds

Regulate body processes

Examples: calcium, phosphorus, potassium, sodium, chloride, iron, magnesium, zinc


Water

Major constituent of all living cells

Composed of hydrogen and oxygen


The Six Essential Nutrients and Their Functions

Organic Nutrients FunctionCarbohydrates Provide energy

Fats Provide energy

Proteins Build & repair tissues

Vitamins Regulate body processes

Inorganic Nutrients FunctionMinerals Regulate body processes

Water Regulates body processes


Stop and ShareStop and Share

A client is at home recovering from surgery. You ask the client what they have eaten over the past 24 hours. The client states the following:

• Breakfast: 2 doughnuts, orange juice• Lunch: lettuce salad with oil & vinegar,

soda• Snack: pretzels, soda• Dinner: spaghetti with tomato sauce, garlic

bread; wine



Discuss the answers to the following questions:

• What nutrients are missing in the client’s diet?

• Why are these nutrients important for this client?



The client is missing protein and water in the diet.

Protein is needed to build and repair body tissues after surgery.

Water is needed to prevent dehydration.


Characteristics of Nutritional Status

Good Poor

Alert expression Apathy

Shiny hair Dull, lifeless hair

Clear complexion Greasy, blemished complexion

Good color Poor color



Good Poor

Bright, clear eyes Dull, red-rimmed eyes

Pink, firm gums and well-developed teeth

Red, puffy, receding gums, and missing or cavity-prone teeth

Firm abdomen Swollen abdomen

Firm, well-developed muscles

Underdeveloped, flabby muscles



Good Poor

Well-developed bone structure

Bowed legs, “pigeon breast”

Normal weight for height

Over- or underweight

Erect posture Slumped posture

Emotional stability Easily irritated, depressed, poor attention span



Good Poor

Good stamina Easily fatigued

Seldom ill Frequently ill

Healthy appetite Excessive or poor appetite

Healthy, normal sleep habits

Insomnia at night, fatigued during the day

Normal elimination Constipation or diarrhea



Divide into groups of 2.

Assess your partner for signs of good nutrition.

Identify common characteristics associated with good nutrition exhibited in your partner.



Shiny hair Clear skin Clear eyes Erect posture Alert expressions

Firm flesh on well-developed bone structures

Pink gums and well-developed teeth

Normal weight for height


Malnutrition

Overnutrition• Excess energy or nutrient intake

Undernutrition• Deficient energy or nutrient intake

Overnutrition is a larger problem in the United States than undernutrition.



Identify at least 5 signs of malnutrition present in this child.

Courtesy of the Centers for Disease Control and Prevention, Public Health Image Library



Poor quality hair Mottled

complexion Dull expression

Spindly arms and legs

Bloated abdomen


Relation of Food to Health

Cumulative• Excess nutrients

over time• Examples:

atherosclerosis, obesity, hypertension, diabetes, gallbladder disease, some cancers

Deficiencies• Nutrients lacking

for extended period

• Examples: iron deficiency, beriberi, scurvy, osteomalacia, osteoporosis, rickets, goiter


Deficiency Diseases

Deficiency DiseaseIron deficiency

Iron-deficiency anemia

Beriberi

Night blindness

Goiter

Kwashiorkor

Marasmus

Nutrients LackingIron

Iron

Thiamin

Vitamin A

Iodine

Protein

All nutrients


Deficiency Diseases

Deficiency Disease Nutrients Lacking

Osteomalacia Calcium, vitamin D, phosphorus, magnesium, and fluoride

Osteoporosis Calcium and vitamin D


Deficiency Diseases

Deficiency DiseasePellagra

Rickets

Scurvy

Xerophthalmia

(blindness)

Nutrients LackingNiacin

Calcium and vitamin D

Vitamin C

Vitamin A


Nutritional Assessment

Anthropometric measurements

Clinical examination

Biochemical tests

Dietary/social history


Anthropometric Measurements

Height

Weight

Head circumference (children)

Upper arm measurement

Skinfold



Height Weight



Head circumference Triceps skinfold


Clinical Examination

Clinical Signs Possible Deficiencies

Pallor, blue half circles beneath eyes

Iron, copper, zinc, B12, B6, biotin

Edema Protein

Bumpy “gooseflesh” Vitamin A

Lesions at corner of mouth

Riboflavin

Glossitis Folic acid




Numerous “black and blue” spots and tiny, red “pin prick” hemorrhages under the skin

Vitamin C

Emaciation Carbohydrates, proteins; kcal




Poorly shaped bones or teeth or delayed appearance of teeth in children

Vitamin C

Slow clotting time of blood

Vitamin K




Unusual nervousness, dermatitis, diarrhea in same patient

Niacin

Tetany Calcium, potassium, sodium

Goiter Iodine

Eczema Fat


Biochemical Tests

Serum albumin level• Measures main protein in blood• Determines protein status

Serum transferrin level• Indicates iron-carrying protein in blood indicates iron stores low indicates body lacks protein


Biochemical Tests

Blood urea nitrogen (BUN)• may indicate renal failure, insufficient renal

blood supply, or blockage of the urinary tract

Serum creatinine• indicates amount of creatinine in blood• used to evaluate renal function


Biochemical Tests

Creatinine excretion• indicates amount of creatinine excreted in

urine over a 24-hour period• used in estimating body muscle mass• muscle mass depleted, as in malnutrition;

level will be low


Biochemical Tests

Other tests• Hemoglobin (Hgb)• Hematocrit (Hct)• Red blood cells (RBCs)• White blood cells (WBCs)• Lipid profile (high & low-density

lipoprotein, serum triglycerides)• Urinalysis


Dietary/Social History

Evaluation of food habits.• 24-hour recall: Client interviewed by the

dietitian and asked to give types, amounts, and preparation of all foods eaten in past 24 hours

• Food diary: written record of all food and drink ingested in a specified period

• Computer diet analysis to determine nutrient deficiencies or toxicities


Dietary/Social History

Social history• Consideration of financial resources to

obtain needed food, and properly store and cook food

• Food-drug interactions that can lead to malnutrition


Conclusion

Nutrition and health are directly related.

Effects of poor nutrition are cumulative.

There are six essential nutrients: carbohydrates, fats, proteins, minerals, vitamins, and water.

Nutritional assessment is the best way to determine deficiencies that may result from lack of nutrients.

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