Comprehensive Nutrition and Dietary Fundamentals for Nursing Students

Nutrition

The study of food intake and how food nourishes the body; includes nutrients and is influenced by physiology, psychology, and socioeconomic factors.

Gordon's Nutritional-Metabolic Functional Health Pattern

Assesses patterns of food and fluid intake, fluid/electrolyte balance, healing ability, and the condition of skin, teeth, hair, nails, mucous membranes, height, and weight.

How the Nutritional-Metabolic Pattern guides nursing care

It helps the nurse identify inadequate or excessive intake, hydration problems, impaired healing, weight changes, swallowing issues, and other nutritional risks so individualized goals and interventions can be planned.

Essential nutrients

Nutrients the body cannot make, or cannot make in adequate amounts, so they must be obtained through the diet or supplements.

Examples of essential nutrients

Vitamins, minerals, protein, fats, carbohydrates, and water.

Nonessential nutrients

Substances the body can synthesize in sufficient amounts or that are not required for normal body functioning.

Macronutrients

Energy-yielding nutrients needed in larger amounts: carbohydrates, proteins, and fats.

Micronutrients

Regulatory nutrients needed in smaller amounts, especially vitamins and minerals.

Energy nutrients

Carbohydrates, proteins, and fats.

Regulatory nutrients

Vitamins, minerals, and water; they help regulate body processes.

Carbohydrates — primary role

The most abundant and least expensive worldwide energy source; they are digested more easily and quickly than proteins and fats.

What all carbohydrates are converted to

Glucose.

Carbohydrate calorie value

4 kcal per gram.

Recommended carbohydrate intake

45-65% of total daily caloric intake.

Best complex-carbohydrate sources

Vegetables, peas, beans, and whole grains.

Monosaccharide

A single sugar molecule; the simplest form of carbohydrate.

Disaccharide

A carbohydrate made of two sugar molecules.

Polysaccharide

A complex carbohydrate made of many sugar molecules.

Glycogenesis

The process of converting glucose into glycogen for storage.

What happens to excess glucose

It can be converted to fat and stored as triglycerides in adipose tissue.

Dietary fiber — course concept

Indigestible material that adds bulk to stool, stimulates peristalsis, helps prevent constipation, may improve glucose tolerance, may lower cholesterol, and is associated with lower intestinal cancer risk.

Protein — major functions

Needed to form and maintain body structures including genes, bone, enzymes, muscle, skin, hair, and blood.

Protein calorie value

4 kcal per gram.

Recommended protein intake for adults

10-35% of total daily caloric intake.

Catabolism

Breakdown of molecules and body tissues.

Anabolism

Synthesis or building of complex molecules and tissues.

Nitrogen balance

A comparison between protein breakdown (catabolism) and protein building (anabolism).

Albumin

A serum protein commonly used in this course as an indicator of long-term protein nutritional status or malnutrition.

Prealbumin

A liver-produced serum protein used in this course as an indicator of short-term protein nutritional status or malnutrition.

Fat — calorie value

9 kcal per gram; the most concentrated source of dietary energy.

Triglycerides

The form in which about 95% of dietary fat is found.

Saturated fat

Usually solid at room temperature, such as butter; tends to raise LDL ('bad') cholesterol.

Unsaturated fat

Usually liquid at room temperature, such as olive oil.

High-fat diet risks

Associated in the course slides with increased risk of heart disease, obesity, and correlations with colon and breast cancer.

Course slide guidance about dietary fat

The course slide states to limit fats to less than 10% of caloric intake and to eat saturated fats in moderation. Use your instructor's wording for exams.

Vitamins — general function

Organic compounds needed in small amounts; important in metabolism of carbohydrates, proteins, and fats.

Water-soluble vitamins

B-complex vitamins and vitamin C. They dissolve in water and excess amounts are generally excreted in urine rather than extensively stored.

Fat-soluble vitamins

Vitamins A, D, E, and K. They are stored in body tissues, including the liver, and can accumulate.

Vitamin deficiency effects mentioned in the course

Deficiencies can contribute to problems such as anemia and rickets.

Vitamin D deficiency

Can cause rickets, especially in children.

Common food sources of vitamin A

Liver, dairy products, eggs, and orange/dark-green vegetables.

Common food sources of vitamin D

Fortified milk/foods, fatty fish, egg yolks, and vitamin D produced in skin with sunlight exposure.

Common food sources of vitamin C

Citrus fruits, strawberries, tomatoes, peppers, and broccoli.

Common food sources of B vitamins

Whole/enriched grains, meats, eggs, dairy products, legumes, and leafy green vegetables; specific sources vary by B vitamin.

Minerals

Inorganic compounds found in body fluids and tissues; they provide structure and help regulate body processes.

Macrominerals

Minerals needed in amounts greater than 100 mg/day.

Examples of macrominerals

Calcium, phosphorus, sulfate, sodium, chloride, potassium, and magnesium.

Microminerals / trace minerals

Minerals needed in amounts less than 100 mg/day.

Examples of microminerals

Iron, zinc, manganese, chromium, copper, molybdenum, selenium, fluoride, and iodine.

Iron — key function

Needed for hemoglobin production and oxygen transport.

Calcium — key functions

Important for bones and teeth, muscle contraction, nerve transmission, and blood clotting.

Water — percentage of adult body weight

Approximately 50-60%.

Typical adult daily water need in course slides

About 2,200-3,000 mL/day, with a typical average around 2,600 mL/day.

Water — major functions

Needed for digestion, absorption, circulation, and excretion; regulates body temperature; lubricates tissues and joints; and serves as the fluid medium for chemical reactions.

Why water is especially important

It is more vital to life than food and is not stored in the body in the same way as energy nutrients.

Nutrition during growth

More calories and nutrients are generally needed to support growth.

Nutrition and development

Healthy eating habits formed early can continue throughout life; eating patterns become more stable in the preschool years.

Nutrition and activity

Greater physical activity generally increases energy and nutrient needs.

Nutrition and reproduction

Pregnancy must meet maternal and fetal needs; lactation requires additional nutrition to support milk production and infant growth.

Nutrition and maintenance

Energy intake above needs can lead to weight gain; intake below needs can lead to weight loss.

Nutrition during recovery from illness or injury

Nutritional needs often increase to support healing and recovery.

Nutrition and older adults

Older adults may be at risk for nutritional deficits because of factors such as living alone, fixed income, dental problems, reduced appetite, decreased peristalsis, and dehydration risk.

Dietary energy

Energy obtained from foods and measured in kilocalories (kcal or calories).

Total daily energy expenditure

The total number of calories the body uses in a day.

Energy balance

Daily energy intake should approximately equal daily energy expenditure to maintain stable body weight.

Calorie calculation from carbohydrate

Grams of carbohydrate × 4 kcal.

Calorie calculation from protein

Grams of protein × 4 kcal.

Calorie calculation from fat

Grams of fat × 9 kcal.

BMI

Body mass index; used as an indicator of body fat stores and relative disease risk in adults, but it is not accurate for every individual.

BMI formula

Weight in kilograms ÷ height in meters squared (kg/m²).

Underweight BMI

Less than 18.5.

Healthy/normal BMI

18.5-24.9.

Overweight BMI

25.0-29.9.

Obesity Class I BMI

30.0-34.9.

Obesity Class II BMI

35.0-39.9.

Extreme obesity / Class III BMI

40 or greater.

When BMI can be misleading

Athletes or muscular individuals, people with edema or dehydration, and some older adults.

Children and BMI

Use BMI-for-age percentiles and compare height/weight with age-appropriate growth charts.

Waist circumference risk — women

Risk for chronic disease increases when waist circumference is greater than 35 inches.

Waist circumference risk — men

Risk for chronic disease increases when waist circumference is greater than 40 inches.

Health risks associated with large waist circumference

Higher risk for hypertension, type 2 diabetes, heart disease, and certain cancers.

Normal nutrition

Adequate intake with a functioning GI tract and a diet containing all essential nutrients in appropriate amounts.

RDA

Recommended Dietary Allowance; an intake level designed to meet the nutrient needs of nearly all healthy people in a group.

Adequate Intake (AI)

A recommended intake level used when there is not enough evidence to establish an RDA.

Tolerable Upper Intake Level (UL)

The highest average daily nutrient intake likely to pose no risk of adverse effects for most people.

Estimated Average Requirement (EAR)

An intake level estimated to meet the needs of about half of healthy individuals in a specific age/sex group.

Regular / house / general diet

A diet in which the client chooses the types and amounts of food, with no major therapeutic restriction.

Vegetarian diet

A diet that limits or excludes animal foods to varying degrees depending on the type of vegetarian pattern.

Clear liquid diet

Clear fluids or foods that become liquid at body temperature; examples include apple or cranberry juice, gelatin, coffee, and popsicles. Often used after surgery or for bowel preparation.

Full liquid diet

Includes clear liquids plus foods that are liquid or pourable at room temperature, such as milk, pudding, custard, vegetable juices, cereal gruels, and pasteurized eggs.

Pureed diet

Foods are blenderized into a smooth/liquid form; may be used after oral/facial surgery or with swallowing difficulty.

Mechanically altered / soft diet

Soft, easy-to-chew foods with modified texture; commonly excludes many raw fruits/vegetables, nuts, seeds, and dried fruits.

Dysphagia diet

A texture-modified diet for swallowing difficulty; may include thickened liquids.

Carbohydrate-controlled diet

Provides consistent carbohydrate intake; commonly prescribed for diabetes mellitus.

NPO

Nothing by mouth; may be ordered preoperatively or when aspiration, nausea, or vomiting is a concern.

Dysphagia feeding — positioning

Sit the patient upright during feeding.

Dysphagia feeding — mouth care

Provide mouth care immediately before meals.

Dysphagia feeding — pace/environment

Avoid rushed meals and reduce distractions.

Dysphagia feeding — food/liquid technique

Alternate solids and liquids as appropriate for the prescribed swallowing plan.

Signs of possible aspiration during meals

Frequent throat clearing, coughing, and hoarseness.