Nutrition CH 42

Nutrient Classifications Energy supply Carbohydrates Protein Lipids Regulate body processes Vitamins Minerals Water

BMR Factors Men @ 1 cal/kg/hr Women @ 0.9 cal/kg/hr Growth Infections Hormones Environment Aging

Carbohydrates Sugars & starches Simple or complex Most abundant AND least expensive food source in the world Adults need 50 – 100 g/day Converted to glucose in body for energy Provides 4 kcal/g

Protein Necessary for body structures Complete – animal sources Adults need 0.8 g/kg/day Complete – animal sources Incomplete – plant sources Calorie value = 4 kcal/g

Fats Don’t dissolve in water and blood Carried by proteins Mixture of saturated & unsaturated Most animal fats are saturated Most vegetable fats are unsaturated Saturated raises cholesterol Unsaturated lowers cholesterol

More about Fats Primarily digested in small intestine Most concentrated source of dietary energy 9 kcal/g Dietary recommendations = < 30 % of total intake/day

Vitamins Needed for metabolism 2 types Absorbed in intestines Water soluble = B, C Fat soluble = A, D, E, K Absorbed in intestines

Minerals Provide either structure or aid in regulating body processes By-product of digestion 2 types Macro = calcium, phosphorus, magnesium Micro = zinc, iron, manganese, iodine

Water 50 – 60% of adult weight 2/3 contained within the cells = intracellular 1/3 in plasma, body fluids = extracellular Medium needed for ALL of the body’s chemical reactions Aids digestion, absorption, circulation and excretion

Food Guides Food Pyramid RDA ADA

Food Habit Factors Technology Geography Health Developmental stage Culture/religion/tradition Education Social status

Developmental Considerations Increased needs Infancy/childhood Adolescence Pregnancy/lactation Activity Aging decreases need

Risk Factors Gender Developmental factors Overall health Alcohol abuse Medications Megadoses of nutrient supplements

Assessing Nutritional Status History Dietary Medical Socioeconomical Physical Weight/height Anthropometric Lab data

What to Assess Usual dietary intake Allergies or intolerances Preparation and storage of food Dietary practices Eating disorder patterns

Enteral Nutrition Short-term Long-term NGT Tube through abdominal wall into stomach = PEG

Tube Considerations Patient safety Patient comfort Need for instruction How to use When to use Care of

Parenteral Nutrition TPN = Total parenteral nutrition PPN = Partial parenteral nutrition Complications Insertion problems Infection Metabolic alterations Fluid & electrolyte imbalances Phlebitis