nutrition

nutrition care process

Assessment, Diagnosis, Intervention, Monitoring, Evaluation (ADIME)

IDNT

International Dietetics and Nutrition Terminology

Academy of Nutrition and Dietetics Code of Ethics

Non-maleficence, Autonomy, Beneficence, Justice

Cholesterol Levels (mg/dL)

LDL: Less than 100

HDL: 40-60. Higher the better. 60 is protective.

Total: Less than 200

Blood Pressure Levels (mm Hg)

Ideal: Less than 120/80

Elevated:120-129/ 80

Stage I Hypertension: 130-139/ 80-89

Stage II Hypertension: >140 /or >90

Blood Glucose Levels (mg/dL)

Normal: 70-89

Prediabetes: 100-125

Diabetes: 126 or higher

Post meal: Less than 140

Blood Glucose Levels for Diabetics (mg/dL)

Before meals: 80-130

1 - 2 hours after meals: Less than 180

Hyperglycemia: >180

Hypoglycemia: <70

Sugar Recommendations

50 g (4 tbsp) = 10% of 2,000 calories

AHA recommendation:

-Women: <25 g (6 tsp)

-Men: <36 g (9 tsp)

Carbohydrates

1. Sugars (Simple Carbohydrates)

Most basic form of carbs and are digested quickly to provide a rapid burst of energy.

2. Starches (Complex Carbohydrates)

Complex chains of simple sugars that your body breaks down for a slower, steady release of energy.

3. Fiber (Complex Carbohydrates)

Body cannot digest. It passes through the intestines, aiding in digestion, regulating blood sugar, and keeping you full.

• Soluble Fiber: Dissolves in water to form a gel, which helps slow digestion, balance blood sugar, and lower cholesterol (found in oats, beans, and apples).

• Insoluble Fiber: Adds bulk to your stool and speeds up the passage of food to prevent constipation (found in whole grains, corn, leafy vegetables, skins of fruits and veggies)

Sugars (Simple Carbohydrates)

Most basic form of carbs and are digested quickly to provide a rapid burst of energy. Made of one or two sugar molecules.

• Naturally Occurring: Found naturally in healthy whole foods like fruits.

• Added Sugars: Refined sugars added to foods during processing (e.g., table sugar in soda, desserts, and candy).

Monosaccharides (Single Sugar Molecules)

• Glucose: The body's primary fuel source, found in honey, dried fruits, and as a building block in many foods.

• Fructose: Known as "fruit sugar," it occurs naturally in fruits, vegetables, and honey.

• Galactose: Generally found in combination with glucose in milk and dairy products.

Disaccharides (Two Sugar Molecules)

• Sucrose: Commonly known as table sugar. Derived from sugarcane or sugar beets. Glucose + fructose.

• Lactose: Known as "milk sugar.” Glucose + galactose.

• Maltose: Found in malt beverages and beer. Glucose + glucose

Starches (Complex Carbohydrates)

Complex chains of simple sugars that your body breaks down for a slower, steady release of energy.

• Sources: Found in plant-based foods, especially grains, legumes, and certain vegetables.

• Examples: Whole-wheat pasta, brown rice, oatmeal, potatoes, corn, peas, and lentils.

Fiber (Complex Carbohydrates)

Body cannot digest. It passes through the intestines, aiding in digestion, regulating blood sugar, and keeping you full.

• Soluble Fiber: Dissolves in water to form a gel, which helps slow digestion, balance blood sugar, and lower cholesterol (found in oats, beans, and apples).

• Insoluble Fiber: Adds bulk to your stool and speeds up the passage of food to prevent constipation (found in whole grains, corn, leafy vegetables, skins of fruits and veggies)

Starchy vs Non-starchy Vegetables

Starchy: Denser, higher in calories, and contain more carbs (starch). Long-lasting energy.

• Potatoes (Russet, red, Yukon gold)

• Sweet potatoes and yams

• Corn and sweet peas

• Beans and lentils (black beans, chickpeas, kidney beans)

• Winter squashes (butternut, acorn)

• Plantains

Non-starchy: Lower in carbs & calories. Have high water and fiber content. Keep you full without adding extra calories.

• Leafy greens (spinach, arugula, kale, romaine)

• Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, cabbage)

• Cucumbers, celery, and zucchini

• Bell peppers, eggplant, and tomatoes

• Onions, mushrooms, and radishes

• Asparagus, carrots, and green beans

Nutrients

Chemical substances obtained from food and used by the body for energy, structural materials, and regulating agents (supports growth, maintenance, and repair of tissues)

Six Nutrients

Macronutrients: Carbs, proteins, lipids. Kcals provide energy.

Micronutrients: Vitamins & minerals. mg

Water

Daily percentage ranges of macronutrients (ADMR)

Carbs: 45-65% (4 kcal/g)

Protein: 10-35% (4 kcal/g)

Fat: 20-35% (9 kcal/g)

Five Food Groups

• Fruits

• Veggies

• Grains

• Dairy

• Protein

Dietary Reference Intakes (DRI’s)

• RDA (Recommended Dietary Allowance)

  • AI (Adequate Intake)

• UL (Tolerable Upper Limit)

• ADMR (Acceptable Macronutrient Distribution Range)

• DV (Daily Value)

Assessment (ABCDE)

Anthropometrics, Biochem, Clinical, Dietary, Exam

Short term enteral nutrition

1. Nasogastric (NG)- nose to stomach

2. Orgastric (OG)- mouth to stomach

3. Nasoduodenal (ND)- nose to duodenum. Req pump. No bolus

4. Nasojejunal (NJ)- nose to jejun. Req pump. No bolus. High asp risk

Long term enteral nutrition

1. Gastrostomy- tube to stomach. Surgery. Bolus

2. PEG Tube- Thru endoscope to stomach wall. Cheaper. Infection risk. Outpatient

3. Jejunostomy- tube to jejunum. Req pump. Bypass stomach. Clog risk

High fiber foods

1. legumes (lentils & black beans: 1 cup: 15 g)

2. chia seeds (2 tbs: 10 g. 70-80 insoluble fiber)

3. raspberries (1 cup: 8 g)

4. green peas (1 cup: 9g)

5. broccoli, brussel sprouts, corn (1 cup: 4-5 g)

6. avocado (1/2 med: 7 g)

7. whole wheat spaghetti (1 cup: 6 g)

8. edamame (1 cup: 8 g)

9. tempeh (3 oz: 7 g)

Daily fiber recommendation

women: 25 g (51+: 21 g)

men: 38 g (51+: 30 g)

Omega 3 vs Omega 6

Omega-3

-18 carbon atoms and three double bonds

-EPA and DHA found in fatty fish

-alpha LINOLENIC acid (ALA) found in plants like chia seeds, walnuts, flaxseed

-body converts small amounts of ALA into EPA and DHA

Omega-6

-LINOLEIC

-vegetable oils, seeds, nuts

-18 carbon atoms and two double bonds

Ketoacidosis DKA

Probiotics vs Prebiotics

PRObiotics

-live bacteria or yeasts

-help keep healthy gut balance and digestion

-Yogurt, kefir, sauerkraut, kimchi, and kombucha

PREbiotics

-Garlic, onions, leeks, asparagus, slightly underripe bananas, and oats provide the specialized fibers that feed your microbiome

-all prebiotics are a type of fiber, but not all fiber is a prebiotic.