BASIC NUTRITION

1. SECTION I BASIC NURSING UNIT 5HEALTH PROMOTION CHAPTER 16 BASIC NUTRITION

2. NUTRITION • All of the processes involved in consuming and utilizing food for energy, maintenance, and growth. • These processes are ingestion, digestion, absorption, metabolism, and excretion.

3. INGESTION • The taking of food into the digestive tract, generally through the mouth. • In special circumstances, ingestion occurs directly into the stomach, through a feeding tube.

4. DIGESTION • Mechanical and chemical processes converting nutrients to a physically absorbable state: • Mastication–chewing • Deglutition–swallowing • Peristalsis–rhythmic, coordinated, serial contractions of smooth muscles of GI tract

5. ABSORPTION • The process whereby the end products of digestion pass through the epithelial membranes in small and large intestines and into blood or lymph systems. • Villi–small finger-like projections that line the small intestine. Most nutrients are absorbed directly through the villi.

6. METABOLISM • The conversion of nutrients into energy. • Anabolism–the constructive process of metabolism, requires energy. • Catabolism–the destructive process of metabolism, releases energy. • Basal metabolism–the energy needed to maintain essential physiologic functions.

7. EXCRETION • The process of eliminating or removing waste products from the body.

8. Water Carbohydrates Fats Proteins Vitamins Minerals NUTRIENTS The body must have six types of nutrients to function efficiently and effectively:

9. WATER • The most important nutrient. • Approximately 55–65% of an adult’s weight is water. • Approximately 70–75% of an infant’s weight is water. • Generally, 1,000 ml of water is needed to process every 1,000 kcal eaten.

10. FUNCTIONS OF WATER • Solvent • Transporter • Regulator of body temperature • Lubricant • Component of all cells • Hydrolysis

11. SOURCES OF WATER FOR THE BODY • Liquids consumed, including water, coffee, juice, tea, milk and soft drinks • Foods consumed, especially vegetables and fruits • Metabolism, which produces water when oxidization occurs

12. WATER DIGESTION, ABSORPTION, STORAGE • Water is absorbed, not digested. • It is not stored and is excreted daily. • Sensible loss–aware of loss of water. • Insensible loss–not aware of loss of water. • Urine, feces, perspiration, and respiration are the four ways the body loses water.

13. SIGNS OF DEFICIENCY AND EXCESS • Dehydration: • Deficiency of water, can cause death. • Occurs from profuse sweating, vomiting, diarrhea, hemorrhage, wound drainage, fever, and edema. • Positive water balance when more water taken in than used or excreted.

14. CARBOHYDRATES • Made of the elements carbon, hydrogen, and oxygen (CHO) • Constitute the chief source of energy for all body functions. • Requirements are 50–60% of total kcal intake per day.

15. CARBOHYDRATE FUNCTIONS • Primary source of energy for the body. • About half-day supply stored in liver and muscles for use as needed. • Spares proteins from being used for energy. • Needed to oxidize fats and for synthesis of fatty acids and amino acids.

16. CLASSIFICATION AND SOURCES • Simple carbohydrates–single sugars or monosaccharides. • Double sugars–two single sugars joined together, called disaccharides. • Complex carbohydrates–many single sugars joined together, called polysaccharides.

17. DIGESTION, ABSORPTION, STORAGE • Digestion begins in mouth, little takes place in the stomach, is completed in the small intestine. • Leave no waste for kidneys to eliminate. • Absorption takes place in the villi. • Excess converted to glycogen and stored in the liver or stored as fat.

18. SIGNS OF DEFICIENCY AND EXCESS • Mild deficiency can cause weight loss and fatigue. • Serious deficiency can cause ketosis. • Excess can cause obesity, tooth decay, irritate the lining of the stomach, or flatulence.

19. FATS • Most concentrated energy source in diet. • Provides 9 kcal per gram. • Also known as lipids. • Composed of carbon, hydrogen, and less oxygen than carbohydrates. • Recommended: no more than 25–30% of daily intake.

20. FUNCTIONS OF FAT • Provides concentrated source of energy. • Needed to absorb fat-soluble vitamins. • Major component of cell membranes and myelin sheaths. • Improves flavor, delays emptying time. • Protects and helps hold organs in place. • Insulates the body.

21. CLASSIFICATION • Triglycerides (true fats) are composed of one glycerol molecule attached to three fatty-acid molecules. • Phospholipids (lipoids) are composed of glycerol, fatty acids, and phosphorus. • Cholesterol (sterol) liver produces over 1000 mg every day.

22. SOURCES OF FATS • Animal fats–lard, butter, milk, cream, egg yolks, meat, poultry, and fish • Plant fats–corn oil, safflower oil, olive oil, cottonseed oil, peanut oil, palm oil, and coconut oil, nuts, and avocado

23. DIGESTION, ABSORPTION, STORAGE • No breakdown occurs in the mouth, very little digestion occurs in the stomach. • Digestion begins in the small intestine. • Final products of fat digestion are fatty acids and glycerol. • 95% absorbed in small intestine. • Excess fats stored as adipose tissue.

24. SIGNS OF DEFICIENCY AND EXCESS • Deficiency occurs when fats provide less than 10% of the total daily kcal requirement. • May result in eczema, retarded growth, weight loss. • Excess can lead to overweight and heart disease.

25. PROTEINS • Made of carbon, hydrogen, oxygen, and nitrogen (CHON). • The only nutrient that can build, repair, and maintain body tissues. • Daily requirement for average adults is 0.8g of protein for each kilogram of body weight.

26. FUNCTIONS OF PROTEINS • Provide amino acids, needed to build, repair, and maintain body tissues. • Assist in regulating fluid balance. • Vital part of enzymes, hormones, blood plasma. • Used to build antibodies. • Can be converted to glucose, for energy.

27. CLASSIFICATION AND SOURCES • Complete proteins–contain all 9 essential amino acids, include meat, fish, poultry, eggs, milk, dairy products and soy beans (the only complete plant protein). • Incomplete proteins–one or more of the essential amino acids are missing, include grains, legumes, nuts, and seeds.

28. PROTEIN DIGESTION AND ABSORPTION • Begins in the stomach. • Most digestion takes place in small intestine. • End product is amino acids, absorbed into the blood by the villi in the small intestine. • Excess amino acids are converted to glucose, glycogen, or fat for storage.

29. SIGNS OF DEFICIENCY AND EXCESS • Muscle wasting. • Edema. • Lethargy and depression. • Marasmus and Kwashiorkor. • Excess can contribute to heart disease, and may be linked to colon cancer, osteoporosis, and kidney damage.

30. VITAMINS • Organic compounds essential to life and health. • Regulate body processes, needed in very small amounts. • No fuel value but required for metabolism of fats, carbohydrates, proteins. • Functions are unique to each vitamin.

31. CLASSIFICATION AND SOURCES • Fat-soluble–require the presence of fats for absorption—vitamins A, D, E, and K. Stored in the body and may result in toxicity. • Water-soluble–require daily ingestion in normal amounts because not stored in the body—B complex and C vitamins.

32. DIGESTION, ABSORPTION, STORAGE • Vitamins do not require digestion. • Fat-soluble vitamins are absorbed into the lymphatic system, excesses are stored in the liver and adipose tissue. • Water-soluble vitamins are absorbed directly into the circulatory system, and excesses are excreted in urine.

33. SIGNS OF DEFICIENCY OR EXCESS • Vitamin deficiencies can occur and result in disease. • Vitamins consumed in excess amounts can be toxic to the body.

34. MINERALS • Inorganic elements that help regulate body processes and /or serve as structural components of the body. • Major minerals–more than 100 mg/day. • Trace minerals–less than 100 mg/day. • Functions are unique to each individual mineral.

35. CLASSIFICATION AND SOURCES • Classified as major minerals or trace minerals. • Found in water and in unprocessed foods. • Some foods are enriched—some vitamins are added to them. • Supplements may be needed during growth periods, some clinical situations.

36. DIGESTION, ABSORPTION, STORAGE The amount of a mineral absorbed by the body is influenced by: • Type of food • Need of body • Health of absorbing tissue

37. SIGNS OF DEFICIENCY AND EXCESS • Deficiency signs unique to each mineral. • Excesses can lead to toxicity. • Concentrated forms of minerals should be used only on advice of a physician. • Excesses can cause hair loss, changesin the blood, hormones, bones, muscles, and nearly all tissues.

38. THE FOOD GUIDE PYRAMID • U.S. Department of Agriculture introduced in 1992. • Each food group provides some, but not all, of the nutrients needed each day.

39. THE FOOD GUIDE PYRAMID (continued)

40. THE VEGETARIAN DIET • Lacto-ovo vegetarians–use dairy products and eggs but no meat, poultry, or fish. • Lacto vegetarians–use dairy products but no meat, poultry, or eggs. • Vegans–avoid all animal foods.

41. FACTORS INFLUENCING NUTRITION • Culture • Religion • Socioeconomics • Fads • Superstitions

42. NUTRITIONAL NEEDS DURING THE LIFE CYCLE • Nutritional needs change as a person grows and develops. • Changes generally based on growth needs, energy needs, nutrient utilization. • Nutritional assessment should be conducted to ascertain the nutritional needs of the individual.

43. BASIC NUTRITIONAL ASSESSMENT • Nutritional status • Height and weight • Meal and snack pattern • Food allergies • Physical activity • Cultural, ethnic, and family influences • Use of vitamin/mineral supplements

44. NUTRITION AND HEALTH • Primary nutritional disease–occurs when nutrition is the cause of the disease. • Secondary nutritional disease–occurs as a complication of another disease or condition.

45. WEIGHT MANAGEMENT • Based on relationship between intake and use of kcal. • Overweight: 11%–19% above • Obesity: 20% or more above • Underweight: 10%–15% under

46. FOOD LABELING • Required on virtually all retail food products. • Labels must follow the approved uniform format and use standard serving sizes and household measurements.

47. FOOD QUALITY AND SAFETY • Proper storage, preparation, sanitation, and cooking are necessary to help prevent or reduce the risk of food-borne illnesses.

48. NURSING PROCESS–ASSESSMENT • Must be performed in a logical fashion and should include a nutritional history, physical examination, and the results of laboratory tests.

49. NURSING DIAGNOSIS • Imbalanced nutrition: • Less than body requirements • More than body requirements • Risk for imbalanced nutrition: more than body requirements • Disturbed body image • Ineffective breastfeeding

50. NURSING DIAGNOSIS(continued) • Impaired dentition • Deficient knowledge (specify) • Impaired oral mucous membrane • Pain • Feeding self-care deficit • Chronic low self-esteem • Risk for impaired skin integrity