36. Healthy nutrition. Enteral and parenteral nutrition.

What is healthy nutrition?

Healthy nutrition means eating food that meets the body’s needs:

• Energetic – provides fuel (e.g. carbs & fats → ATP)

• Plastic – supplies building materials (e.g. proteins for growth & repair)

• Catalytic – supports metabolism (e.g. vitamins & minerals as cofactors)

Both qualitatively and quantitatively adequate

Principles of healthy nutrition (comes up in the exam)

1. Balanced Nutrition

2. Varied diet

3. meal distribution

4. high quality food

5. optimal volume

6. appropriate culinary processing

7. raw fruit and veggies

8. consider individual needs

9. meal frequency

1. Balanced Nutrition

• Correct energy intake

• Right macronutrient ratio:

  • Proteins: 10–20%

  • Fats: 20–35%

  • Carbohydrates: 45–60%

• Adequate micronutrients (vitamins, fiber, biologically active substances)

• Ratio varies with age

2. Varied Diet

• Mix of plant, animal, and other sources

• Includes fiber, cereals, fruits, vegetables

3. Meal Distribution

• Breakfast: 20–25% of daily intake

• Lunch: 40–45%

• Dinner: 25–35%

4. High-Quality Food

• Must be safe and hygienically prepared

5. Optimal Volume

• Should provide satisfaction without heaviness

6. Appropriate Culinary Processing

• Avoid acroleins (from overheated oils) – irritate GI tract

• Avoid benzopyrenes (from heavily toasted meats) – carcinogenic

7. Raw Fruits & Veggies

• At least 400 g/day

8. Consider Individual Needs

• Age, health, activity, seasonal availability

9. Meal Frequency

• Children: 5–6 meals/day

• Adults: 3–4 meals/day

Enteral Nutrition (EN) definition

Delivery of nutrients directly into the GI tract (when gut is functional).

routes of EN

• Oral supplements

• Tube feeding:

  • Nasogastric (NG) tube

  • Nasojejunal (NJ) tube

  • PEG/PEJ (percutaneous endoscopic gastrostomy/jejunostomy)

EN- indications

• Inability to eat (e.g. stroke, dysphagia)

• Malnutrition risk with functional gut

• Severe burns, trauma, or cancer

advantages of EN

Advantages:

• Uses natural digestive pathway

• Fewer complications

• Maintains gut mucosal integrity

• Cheaper than parenteral

definition of Parenteral nutrition - PN

Delivery of nutrients directly into the bloodstream (bypasses GI tract).

routes of PN

• Peripheral (PPN) – short-term, less concentrated

• Central (TPN) – via central vein, for long-term or high-energy needs

indications of PN

• Non-functional GI tract (e.g. bowel obstruction, severe ileus, short bowel syndrome)

• Severe malabsorption

• GI fistulas

risks/ complications of PN

• Infections (catheter-related)

• Liver dysfunction

• Electrolyte imbalance

• Refeeding syndrome

components of PN

• Infections (catheter-related)

• Liver dysfunction

• Electrolyte imbalance

• Refeeding syndrome