Unit 2 Promotion and Nutrition

why study health promotion and nutrition?

there is a strong relationship between food and health

• growth and development

• mental development

• body composition

• disease prevention

good

_____ nutrition is essential for good health

nutrition

the study of the relationship between human and foods

nutrients

the chemical substances supplied by foods. required for growth, maintenance, and repair

macronutrients

carbohydrates
fats
proteins

micronutrients

minerals
vitamins
water

primary level of prevention

Eating healthier fights against obesity, which causes heart disease, stroke, type 2 diabetes, some cancers, joint disease, and fertility issues

secondary level of prevention

If someone is found to have one of the obesity related illnesses then healthy diet changes can slow down or even reverse the disease

tertiary level of prevention

People with diseases that cause swallowing disorders can be helped to maintain nourishment and prevent choking events with nutrional intervention

nutrigenetics

the study of how food affects a person’s genes and how a person’s genes affect the way the body responds to food
- MTHFR is involves in the metabolism of folic acid and maintenance of the normal blood level of homocysteine

nutrigenomics

one of the newest areas in the realm of nutritional science is the scientific discipline of nutritional genetics; broadly defined as the relationship between nutrients, diet, and gene expression
- Science is evolving, and nutritional genetics aims to identify what nutrients to eat to “turn on” healthy geens and “turn off” genes that cause disease
Ex. dietary cholesterol performs an inhibitory effect on the transcriptions B-hydroxy-B- methyl-glutaryl-CoA reductase gene

essential nutrients

we have to consume them to get the nutrient (ex vitamin C) essential to consume

non-essential nutrient

our body can create to make/use nutrient

conditionally essential

nutrient our body can normally create, but environmental factors may prevent our bodies to make it (vitamin D- exposure to light)

functions of nutrients

source of energy
tissue growth and maintenance
regulation of basic processes of the body

macronutrients

chemical elements that humans consume in the largest quantities, provides the bulk of energy requirements (fats, proteins, carbs)

micronutrients

nutrients for humans required in small quantities throughout life (trace minerals, vitamins, water)

malnutrition

occurs when the body ingests, absorbs and is able to use too few or too many nutrients. loss of balance between nutritional needs and nutritional intake

importance of fiber

• Dietary fibers are polysaccharides that are highly branches and cross-linked

• Very beneficial to our health

• Diets high in fiber reduce the risk for obesity and diabetes, which are primary risk factors for cardiovascular disease

• Fiber feeds the beneficial bacteria in your gut

food insecurity

limited or uncertain of availability of safe, nutritionally adequate food

nutrient- dense foods

are those foods that provide substantial amounts of vitamins and minerals and relatively few calories
(fruits, vegetables, lean proteins)

energy- dense foods

such as alcohol and foods high in added sugar or processed cereals

function/role of protein in our body

-Tissues structure (part of organ tissues, muscle, hair, skin, nails, bones, tendons, ligaments, and blood plasma)
-Part of cell plasma membrane
-Involved in metabolic, transport, and hormone systems
-Make up enzymes that regulate metabolism]
-Involved in acid/base balance to maintain a neutral environment in our bodies

role of fats

• Energy reserve

• Protects vital organs

• Insulation

• Transport fat soluble vitamins

role of carbohydrates

• Fuel during high intensity exercise

• Spares protein (to preserve muscle mass during exercise)

• Fuel for the central nervous system

role of water

• Moistens tissues such as those in mouth, eyes, and nose

• Protects body organs and tissues

• Helps prevent constipation

• Helps dissolve minerals and other nutrients to make them accessible to the body

• Regulates body temperature

• Lubricates joints

• Lessens the burden on the kidney and liver by flushing out waste products

• Carries nutrients and oxygen to cells

zoo-chemicals

animal source

phytochemicals

plant source

water

50-75% of body composition

fat

women: 18-22%
men: 15-19%
of body composition

ash (minerals)

6% of body composition

protein (muscle)

15% of body comp

my plate

used for people to make healthier more balanced meals

dietary guideline goals

• maintain calorie balance over time achieve and sustain healthy weight

• focus on consuming nutrient dense foods and beverages

Dietary guidelines DOs

• Prevent or reduce overweight by improving (balancing) calorie consumption with physical activity throughout all life stages

• Reduce daily sodium intake

• Consume less than 10% of daily calories from saturated fats

• Avoid trans fats (synthetic fats)

• Limits refined grains, added sugars, solid fats

• Consume alcohol only in moderation

• Increase fruits and vegetables (variety)

• Consume ½ of grains as whole grains

• Consume leaner proteins/fewer protein sources with “solid” fats

• Increase seafood consumption

• Increase low/non-fat dairy products

• Choose foods with more calcium, vitamin D, fiber, potassium

dietary guidelines DON't

no don'ts!

nutritional status

bodys condition as it relates to intake and use of nutirents

dietary status

describes what the person has been eating

nutritional screening

looking for risks (allergies, dysphagia)

anthropometric measurments

height, weight, bmi

nurses role

• asses nutritional status including intake of food, tolerance, response

• identify nutritional risk and make referrals (dietary) as appropriate

• teach/provide nutritional information to patients/families

dietary reference intake

a nutrient-based reference value that can be used for assessing and planning diets for the healthy general population
Components:
- Estimated average requirements, recommended dietary allowances, adequate intakes, acceptable macronutrient distribution range, tolerable upper intake levels

CHO

major source of energy

added sugars

sugars and syrups that are added to foods during processing or preparation

major sources of added sugars

soft drinks, sports drinks, cakes, cookies, pies, fruitades, fruit punch, dairy desserts, and candy

benefits of complex carbs

• Beneficial to health

• Replacing refined grains with whole grains decrease the risk for obesity, type 2 diabetes, and cardiovascular disease

• Complex carbs = long chains of simply sugars that ca be unbranches or branches

benefits of dietary fibers

• Diets high in fiber reduce the risk for obesity and diabtests, which are primary risk factors for cardiovascular disease

• Helps reduce blood cholesterol levels and may lower the risk of heart disease

• Fiber-containing foods, help provide a feeling of fullness with fewer calories and may help with weight managements

• Dietary fibers are insoluble

obesity

(dietary excess and imbalance) health problems resulting from over consumption rank among the leading causes of morbidity and mortality

obesity can cause

• cardiovascular disease: high blood pressure (hypertension), coronary heart disease (CHD), stroke (CVA- cardiovascular accident)

• cancer

• osteoporosis

• osteoarthritis

• diabetes

saturated fats

solid at room temperature (from animal products) (less healthy)

unsaturated fats

liquid at room temperature (from plants)

hydrogenated fats

adding hydrogen to fat of vegetable origin to extend shelf life/make it harder

Decreased because they are highly saturated

Hydrogenated oils should be increased or decreased - why?

sources of cholesterol

present only in animal foods

function of cholesterol

• component of bile salts - aid in digestion

• Essential component of cell membrane

• Found in brain, nerve tissue, and in blood

• Precursor for steroid hormone production

fat free

the food contains no more than 0.5 grams of fat per serving

low fat

legally defined as a food that contains no more than 3 grams of fat in a serving

low saturated fat

legally defined as food that contains no more than 1 gram of saturated fat per serving n

low cholesterol

defined as a food that contains less than 20 mg of cholesterol per serving

protein

building blocks of the body’s tissues and organs; composed of four element (carbon, hydrogen, oxygen, and nitrogen)

amino acids

four elements arrange in building blocks, linked by peptide bond to form polysaccahride

essential amino acids

must be available simultaneously and in sufficient quantity for synthesis of body proteins, classified as essential if the body is unable to make it in sufficient amounts to meet metabolic needs

nonessential amino acids

those that the body ordinarily can build in sufficient quantities to meet its needs

Bed rest, muscle nutrition, malnutrition

What are some underlying causes(that you may see in the patients you care for) of negative nitrogen balance?

antibodies are proteins

Describe the role of proteins in
The immune system

the main protein is albumin which helps maintain blood volume by drawing fluid back into the veins from body tissues and helps maintain blood pressure

the role of proteins in circulation

glucose is the most efficiently used source of energy, but fat and protein can be adapted as backup sources - when body has insufficient glucose available, the body will utilize body protein tissue to meet the energy needs of the brain and spinal cord

the role of protein as an energy source

complete proteins

foods that supply all nince essential amino acids in sufficient quantity to maintain tissue and support growth (from animal sources - meat, poultry, fish, eggs, milk, cheese)

incomplete proteins

lack one or more of the essential amino acids (most plant foods - grains, vegetables, legumes, nuts, seeds)

animal

Most complete proteins come from which (animal or plant) sources?

3 major energy nutrients

Carbohydrate = 4 kilocalories/ gram
Protein = 4 kilocalories/ gram
Fat= 9 kilocalories/ gram

REE (resting energy expenditure)

accounts for 60-70% of total energy expenditure to maintain body function, respiration, and cell processes.

thermic effect of food

energy is needed to chew, swallow, digest, and absorb.

physical activity

uses less kcal than REE, 25-50% human energy expenditure.

kilocalorie density

the kcal contained in given volume of food (calories/gram).

vitamin A

Function is dim light vision and differentiation of epithelial cells. Found is egg yolk, fortified milk, fish (performed in liver) and carrots, sweet potatoes, squash, apricots, cantaloupe, spinach, collards, spinach, broccoli, cabbage.

vitamin D

Increases intestinal absorption of calcium, stimulates bone production, and decreases urinary excretion of calcium. Found in sunlight on skin, fortified milk, cod liver oil, salmon, herring, tuna, eggs, liver, and fortified cereals.

vitamin E

Antioxidant, protects polyunsaturated fatty acids in red blood cell membranes from oxidation in lungs. Sources are sunflower, safflower, and canola oil, almonds, hazelnuts, and peanuts, broccoli, cooked spinach, fortified ready to eat cereals.

vitamin K

used in synthesis of several clotting factors including prothrombin and assists vitamin D to synthesize a regulatory bone protein. Sources are collards, spinach, brussel sprouts, cabbage, broccoli, soybean and canola oils, and synthesis in intestine.

vitamin c

Contribute in wounds, burn, fracture healing, antioxidants. Sources are oranges, animals synthesize in liver.

Vitamins A,D,K

what vitamins are fat soluble

Vitamins C and B

what vitamins are water soluble

calcium (ca)

Bone and teeth, nerve conduction, muscle contraction, blood clotting. (Milk, salmon, clams, oysters).

phosphorus

Bone and teeth, DNA and RNA buffers for enzymes, ADP, and ATP (Lean meat, fish, poultry, milk, nuts, legumes).

Na (sodium)

Fluid balance, electrochemical impulses (Table salt, processed food, milk products).

K+ (potassium)

Nerve impulse; muscles (Banana, cantaloupe, winter squash, green vegetables, legumes, salt substitute).

Mg (magnesium)

ADP and ATP, DNA and protein synthesis, cardiac and smooth muscle contraction (Green veggies, seafood, peanut butter, legumes, coffee, cocoa).

sulfur

Amino acids, shape to hair, skin, and nails (Complete protein foods).

chloride

Hydrochloric acid, fluid and acid base balance (Salt, processed food, salty snacks, eggs, meat, and seafood).

Diarrhea, vomiting, kidney disease, heavy sweating

What is a common cause of sodium deficiency (hyponatremia)?

Banana, cantaloupe, winter squash, green leafy veggies, legumes

List 5 good sources of Potassium:

iron

I: Function: Formation of hemoglobin. II: 3 factors that interfere with iron absorption:

• Ca+ blocks the uptake of both heme and nonheme iron

• Zinc or manganese

• Coffee after a meal

I: Infants and young children.
II: Adolescents in early growth.
III: Women in childbearing years.
IV: Pregnant women.

what populations are at risk for inadequate iron intake?

body weight

What is the single most important indicator of fluid status in the human body?

pregnancy and lactation

well balanced diet and nutrient stores

• increased energy (calories)- growth of placenta, uterus, and fetus

• increased fat (fatty acids)

• increased protein (fetal growth, maternal blood volume expansion)

• increased vitamins and minerals (c, b12, folic acid, D, iron, iodine, fluoride, zinc)

alcohol (fetal alcohol syndrome)
soft cheese and cold cuts
some fish
undercooked/raw meats
unwashed produce
reduce caffeine- less than 300mg/ day

food substances to avoid during pregnancy and lactation

morning sickness
leg/muscle cramping
constipation
heart burn

what are some nutritional complications during pregnancy?

hypermesis

• dehydration, electrolyte imbalance, weight loss, esophageal rupture, and renal failure (rare

• hypertension

• gestational diabetes (nutritional complication during pregnancy)

breastfeeding benefits to mother

• return to pre-pregnant weight

• uterine involution

• birth spacing

• deceased risk of certain cancers (breast, ovarian)

breastfeeding benefits to infant

• protection against illness (immunity)

• decreased allergies

• negative association with obesity later in life