Clinical Nutrition التغذية الاكلينكية

1. Clinical Nutritionالتغذية الاكلينكية

2. Objectives • Define wellness • Name the six classes of nutrients and their primary functions • Recognize common characteristics of well-nourished people • Recognize symptoms of malnutrition • Describe ways in which food and health are related • List the four basic steps in nutrition assessment

3. Wellness • Achieving wellness that integrates body, mind, and spirit should be the main goal in life. • This can be accomplished through lifestyle changes such as focusing on healthy food choices, not smoking, participating in regular physical activity, and maintaining a healthy weight.

4. Nutrients • To maintain health and function properly, the body must be provided with nutrients. • Nutrients: Chemical substances necessary for life Functions • Provide energy, growth • Build and repair tissue • Regulate body processes

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

6. 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

7. Carbohydrates • Provides major source of energy • Examples: cereal grains, vegetables, fruits, nuts, and sugars

8. Fats (lipids) • Provides energy • Highest kilocalorie value (9 kcal per gm) • Sources of fat: meats, milk, cream, butter, cheese, egg yolks, oils, nuts

9. Protein • Builds and repairs body tissues • Provides energy (4 kcal per gm) • Only one of the six nutrients that contains nitrogen • Sources of protein: meats, fish, poultry, eggs, milk, cheese, corn, grains, nuts, and seeds

10. Vitamins • Organic compounds • Regulate body processes • Examples: vitamins A, B, C, D, E and K

11. Minerals • Inorganic compounds • Regulate body processes • Examples: calcium, phosphorus, potassium, sodium, chloride, iron, magnesium, zinc

12. Water • Major constituent of all living cells • Composed of hydrogen and oxygen

13. The Six Essential Nutrients and Their Functions

14. Characteristics of Nutritional Status

15. Characteristics of Nutritional Status

16. Characteristics of Nutritional Status

17. Characteristics of Nutritional Status

18. Malnutrition • Overnutrition • Excess energy or nutrient intake • Undernutrition • Deficient energy or nutrient intake • Overnutrition is a larger problem in the United States than undernutrition.

19. 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

20. Deficiency Diseases • Deficiency Disease • Iron deficiency • Iron-deficiency anemia • Beriberi • Night blindness • Goiter • Kwashiorkor • Marasmus • Nutrients Lacking • Iron • Iron • Thiamin • Vitamin A • Iodine • Protein • All nutrients

21. Deficiency Diseases

22. Deficiency Diseases • Deficiency Disease • Pellagra • Rickets • Scurvy • Exophthalmia • (blindness) • Nutrients Lacking • Niacin • Calcium and vitamin D • Vitamin C • Vitamin A

23. Nutritional Assessment • Anthropometric measurements • Clinical examination • Biochemical tests • Dietary-social history

24. Anthropometric Measurements • Height • Weight • Head circumference (children) • Upper arm measurement • Skinfold

25. Anthropometric Measurements Height Weight

26. Anthropometric Measurements Head circumference Triceps skinfold

27. Clinical Examination

28. Clinical Examination

29. Clinical Examination

30. Clinical Examination

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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.