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Delmar LearningDelmar LearningCopyright © 2003 Delmar Learning, a Thomson Learning company
Nutrition and Diet TherapyNutrition and Diet Therapy8th Edition8th Edition
byby
Ruth Roth and Ruth Roth and Carolynn TownsendCarolynn Townsend
Delmar LearningDelmar LearningCopyright © 2003 Delmar Learning, a Thomson Learning company
Nutrition and Diet TherapyNutrition and Diet TherapyPowerPointPowerPoint Presentation Presentation
Written byWritten by
Susan L. Robson, MSN, RNP-Susan L. Robson, MSN, RNP-cc
Copyright © 2003 Delmar Learning, a Thomson Learning company
Section 1
Fundamentals of Nutrition
Copyright © 2003 Delmar Learning, a Thomson Learning company
Chapter 1
The Relationship of Food and Health
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 5
Objectives
Name the six classes of nutrients and their primary functions
Recognize common characteristics of well-nourished people
Recognize symptoms of malnutrition
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 6
Objectives
Describe ways in which food and health are related
List the four basic steps in nutrition assessment
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 7
Nutrients
Chemical substances necessary for life
Functions• Provide energy• Build and repair tissue• Regulate body processes
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 8
Nutrients
Six classes• Carbohydrates• Fats (lipids)• Proteins• Vitamins• Minerals• Water
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 9
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
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 10
Carbohydrates
Provides major source of energy
Examples: cereal grains, vegetables, fruits, nuts, and sugars
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 11
Fats (lipids)
Provides energy
Highest kilocalorie value
Sources of fat: meats, milk, cream, butter, cheese, egg yolks, oils, nuts
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 12
Protein
Builds and repairs body tissues
Provides energy
Only one of the six nutrients that contains nitrogen
Sources of protein: meats, fish, poultry, eggs, milk, cheese, corn, grains, nuts, and seeds
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 13
Vitamins
Organic compounds
Regulate body processes
Examples: vitamins A, B, C, D, E and K
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 14
Minerals
Inorganic compounds
Regulate body processes
Examples: calcium, phosphorus, potassium, sodium, chloride, iron, magnesium, zinc
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 15
Water
Major constituent of all living cells
Composed of hydrogen and oxygen
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 16
The Six Essential Nutrients and Their Functions
Organic Nutrients FunctionCarbohydrates Provide energy
Fats Provide energy
Proteins Build & repair tissues
Vitamins Regulate body processes
Inorganic Nutrients FunctionMinerals Regulate body processes
Water Regulates body processes
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 17
Stop and ShareStop and Share
A client is at home recovering from surgery. You ask the client what they have eaten over the past 24 hours. The client states the following:
• Breakfast: 2 doughnuts, orange juice• Lunch: lettuce salad with oil & vinegar,
soda• Snack: pretzels, soda• Dinner: spaghetti with tomato sauce, garlic
bread; wine
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 18
Stop and ShareStop and Share
Discuss the answers to the following questions:
• What nutrients are missing in the client’s diet?
• Why are these nutrients important for this client?
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 19
Stop and ShareStop and Share
The client is missing protein and water in the diet.
Protein is needed to build and repair body tissues after surgery.
Water is needed to prevent dehydration.
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 20
Characteristics of Nutritional Status
Good Poor
Alert expression Apathy
Shiny hair Dull, lifeless hair
Clear complexion Greasy, blemished complexion
Good color Poor color
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 21
Characteristics of Nutritional Status
Good Poor
Bright, clear eyes Dull, red-rimmed eyes
Pink, firm gums and well-developed teeth
Red, puffy, receding gums, and missing or cavity-prone teeth
Firm abdomen Swollen abdomen
Firm, well-developed muscles
Underdeveloped, flabby muscles
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 22
Characteristics of Nutritional Status
Good Poor
Well-developed bone structure
Bowed legs, “pigeon breast”
Normal weight for height
Over- or underweight
Erect posture Slumped posture
Emotional stability Easily irritated, depressed, poor attention span
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 23
Characteristics of Nutritional Status
Good Poor
Good stamina Easily fatigued
Seldom ill Frequently ill
Healthy appetite Excessive or poor appetite
Healthy, normal sleep habits
Insomnia at night, fatigued during the day
Normal elimination Constipation or diarrhea
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 24
Stop and ShareStop and Share
Divide into groups of 2.
Assess your partner for signs of good nutrition.
Identify common characteristics associated with good nutrition exhibited in your partner.
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 25
Stop and ShareStop and Share
Shiny hair Clear skin Clear eyes Erect posture Alert expressions
Firm flesh on well-developed bone structures
Pink gums and well-developed teeth
Normal weight for height
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 26
Malnutrition
Overnutrition• Excess energy or nutrient intake
Undernutrition• Deficient energy or nutrient intake
Overnutrition is a larger problem in the United States than undernutrition.
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 27
Stop and ShareStop and Share
Identify at least 5 signs of malnutrition present in this child.
Courtesy of the Centers for Disease Control and Prevention, Public Health Image Library
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 28
Stop and ShareStop and Share
Poor quality hair Mottled
complexion Dull expression
Spindly arms and legs
Bloated abdomen
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 29
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
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 30
Deficiency Diseases
Deficiency DiseaseIron deficiency
Iron-deficiency anemia
Beriberi
Night blindness
Goiter
Kwashiorkor
Marasmus
Nutrients LackingIron
Iron
Thiamin
Vitamin A
Iodine
Protein
All nutrients
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 31
Deficiency Diseases
Deficiency Disease Nutrients Lacking
Osteomalacia Calcium, vitamin D, phosphorus, magnesium, and fluoride
Osteoporosis Calcium and vitamin D
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 32
Deficiency Diseases
Deficiency DiseasePellagra
Rickets
Scurvy
Xerophthalmia
(blindness)
Nutrients LackingNiacin
Calcium and vitamin D
Vitamin C
Vitamin A
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 33
Nutritional Assessment
Anthropometric measurements
Clinical examination
Biochemical tests
Dietary/social history
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 34
Anthropometric Measurements
Height
Weight
Head circumference (children)
Upper arm measurement
Skinfold
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 35
Anthropometric Measurements
Height Weight
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 36
Anthropometric Measurements
Head circumference Triceps skinfold
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 37
Clinical Examination
Clinical Signs Possible Deficiencies
Pallor, blue half circles beneath eyes
Iron, copper, zinc, B12, B6, biotin
Edema Protein
Bumpy “gooseflesh” Vitamin A
Lesions at corner of mouth
Riboflavin
Glossitis Folic acid
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 38
Clinical Examination
Clinical Signs Possible Deficiencies
Numerous “black and blue” spots and tiny, red “pin prick” hemorrhages under the skin
Vitamin C
Emaciation Carbohydrates, proteins; kcal
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 39
Clinical Examination
Clinical Signs Possible Deficiencies
Poorly shaped bones or teeth or delayed appearance of teeth in children
Vitamin C
Slow clotting time of blood
Vitamin K
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 40
Clinical Examination
Clinical Signs Possible Deficiencies
Unusual nervousness, dermatitis, diarrhea in same patient
Niacin
Tetany Calcium, potassium, sodium
Goiter Iodine
Eczema Fat
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 41
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
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 42
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
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 43
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
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 44
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
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 45
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
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 46
Dietary/Social History
Social history• Consideration of financial resources to
obtain needed food, and properly store and cook food
• Food-drug interactions that can lead to malnutrition
Chapter 1 Copyright © 2003 Delmar Learning, a Thomson Learning company 47
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.