Clinical nutrition

1. Clinical nutrition

2. basic concepts Health: The merging and balancing of five physical and psychological dimensions of health: physical, mental, emotional, social, and spiritual. Nutrition: The study of essential nutrients and the process by which nutrients are used and quality of nutrients Nutrients: Substances in food required by the body for energy, growth, maintenance and repair.

3. Role of nutrition: Physical health of the body .depends on the quantity and quality of nutrients, Intellectual health relies on a well functioning brain and central nervous system, (iron deficiency . anemia affects intellectual health), Emotional health may be influenced by poor eating habits (hypoglycemia), Social health often centers around food-related occasions, and Spiritual health often has ties to food.

4. Health promotion: increases the level of health of individuals, families, groups, and communities. Role of nutrition: Healthy people 2010, defines some objective nutrition as decreasing daily fat intake, and less total caloric intake.

5. Wellness: is a lifestyle that enhance each of the five dimensions of health. Wellness nutrition approaches food consumption as a positive way to nourish the body. Consuming a diet based on lower fat/higher fiber and moderate caloric consumption is essential to convey competency to care for ourselves

6. Disease prevention: Is the recognition of a danger to health that could be reduced or alleviated through specific actions or changes in life style behaviors. There are three levels of prevention, Primary: activities to avert the initial development of a disease or poor health, low fat and high fiber diet is important;

7. Secondary: early detection to halt or reduce the effects of a disease or illness, sodium intake restriction may control HTN, and consequently avoid HD;

8. Tertiary: to minimize further complications or to assist in the restoration of health. Direct treatments of many disorders have a dietary components (ulcer, coronary heart disease -Nutrition is consider as vital component in personal health care. -Promotion of health, and prevention of disease for all people, rests on whole food supply.

9. -Human nutrition depends on attitudes toward food, and eating pattern through our life span, under influence of community, nation, and over all world. -We need nutrition for maintenance of growth, activity ,and reproduction.

10. -The body need energy to carry out vital function as breathing, and the people need energy to perform physical activity, that could be met by food .

11. -Dietetics is the health profession ,having primary responsibility of application of nutritional care, in various state of health , and disease, with assistance of nurse and physician.

12. Definition of nutrition: -Nourishment that sustain life, it begins from the moment of conception until death . -The food people eat, and how it nourishes their bodies. Kinds of nutrients: 1- Macro nutrients : -Fats, carbohydrates ( CHO), proteins . -Supply energy, build tissue. 2- Micro nutrients : -Vitamins( vits ),minerals.

13. NB:- water is the over all vital nutrients, enter in all of life process, -Metabolism: sum of chemical process in the body, to sustain life, and health . -Need in small amount. -Regulate, and control body process.

14. -Source of energy: 1-Carbohydrates CHO : -Primary source of energy. -Sugar is simple CHO food, while starch is complex CHO food . -The quick source of energy is glycogen. -Each one gram of CHO, yield 4kilocalories . -50to60% of energy taken from CHO diet .

15. 2-Fats: -Comes from plants and animals. -Saturated fat from animals . -Unsaturated fat from vegetables, and oil products . -Each one gram of fat yield 9 kilocalories. -25to30% of energy taken from fat .

16. 3-Proteins: -The body take energy from protein, when there is insufficient amount of CHO, and fat . -Each one gram of protein yield 4kilo calories. -15to29%of total energy taken from protein. -The primary function of protein ,are building and energy. NOTE: caloric is unit of heat used in the nutritional science, each 1000 calories equal 1 kilocalorie.

17. *Tissue building 1-Protein the primary source: -Responsible for tissue building . -The necessary unit of building is called amino acid. 2-Minerals : -Calcium and phosphorus help in building, and maintain bone tissue. -Iron help in build of hemoglobin of red blood cell. 3-Vitamins: -Vit C build tissue, and prevent bleeding in tissue . 4-Fatty acid .

18. -Metabolic regulation ,and control: 1-Vitamines: -Many vits act as co-enzyme or cell enzyme, to govern chemical reactions in cell metabolism , example B-complex vits . 2-Minerals : -Act as co-enzyme factors of cell metabolism. Example: the trace element cobalt act with B12, to prevent occurrence of pernicious anemia,

19. 3-Water and fiber : -Regulate the passage of food through gastro intestinal tract (GIT), that help in absorption of different nutrient . -Remember : water is the fundamental agent for life, provide the basis of metabolic process .

20. Nutritional assessment: Nutritional assessment is the process of determining nutritional status. It may reveal nutrient deficiencies or excesses. The deficiency may be primary due to inadequate intake or secondary as a result of body inefficient use of nutrients. We can use two levels: evaluating the dietary intake, and evaluating the intake besides considering how the body uses the nutrients.

21. Diet Evaluation: 24-hour recall, usual food intake, a food record, a food frequency checklist, or a diet history. One the data collected, they can be analyzed.

22. Assessment of nutritional status: 1. Clinical examination, observing eyes, mucous membranes, skin, hair, mouth, teeth, and tongue. 2. Biochemical analysis of body tissue, blood and urine tests, iron. 3.Anthropometric measurements, Ht, wt, limp circumference.

23. Levels of nutritional status Ideal nutrition: Positive nutrition -Well developed body Ideal weight Good muscle development, and tone -The skin is smooth, and clear, hair is glassy -The eye clear, and bright .

24. Posture is good . -Facial expression is alert . Appetite, digestion ,and elimination are normal . mentally and physically alert Having essential nutrition, to resist infectious disease. - -Sleep well at nigh

25. -Border line nutrition - -Poor eating habits, Whose living in stress environment, with low income . -Has no reservoir of nutrition . -At risk of physical illness

26. 3-Malnutrition : Nutrients energy are not enough to meet day to day needs .- Associated with poverty .-- Affect infants, children, pregnant women, and elderly. - Increase infant mortality rate, because of poverty, low income and, un-educated mother.

27. - Children and pregnancy ,develop anemia result in , Low resistance to infectious disease. Impaired learning ability. - Reduce activity level .- -Apathy . Elderly suffering of chronic disease.

28. Over nutrition .- -Over weight and obesity . -Excess energy intake . Lead to chronic disease, as hyper tension, and DM . Note: * -Specific dietary factors lead to: -Coronary heart disease( CHD). - High blood pressure( HTN ).- - Stroke( CVA).- - Some type of cancer . - -DM. Obesity .

29. Recommendation for good nutrition : Eat variety of food , Well balanced diet. - Maintain ideal weight. - -Avoid too much fat ,saturated fat, and cholesterol. Eat food with adequate starch, and fiber .- -Avoid too much sugar. -Avoid too much sodium. Avoid alcohol intake.