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