1. Nutrition in Health and Disease
Chapter 34
Nutrition in Health and Disease

2. Nutrition and Digestion
Nutrition: ingestion, digestion, absorption, metabolism of food
Good nutrition results in longer life spans and healthier individuals

3. Nutrition and Digestion
Digestion: physical and chemical changes to food that body makes to make it absorbable
Absorption: transfer of nutrients from gastrointestinal tract into bloodstream

4. Types of Nutrients
Nutrients: ingested substances that help body stay in homeostatic state
Two groups: those that provide energy and those that do not
Both groups necessary for good health
(See Table 34-1: Types of Nutrients)

5. Types of Nutrients Provide energy: Do not provide energy:
Carbohydrates
Fats (lipids)
Proteins
Do not provide energy:
Vitamins
Minerals
Water
Fiber

6. Types of Nutrients Carbohydrates Utilization in body>>
[FIGURE 34-2]

7. Types of Nutrients Triglycerides
Three fatty acids attached to a glycerol molecule >>
[FIGURE 34-3]

8. Types of Nutrients Proteins Amino acids Complete proteins
Consider complementary
[FIGURE 34-4]

9. Types of Nutrients Energy nutrients (organic) Carbohydrates
Carbon, hydrogen, oxygen
Units called sugars
Glucose is sugar body uses most efficiently
Polysaccharides: complex carbohydrates
Sources: fruits, vegetables, cereal grains, sugar

10. Types of Nutrients Energy nutrients (organic) Fats
Also called lipids; carbon, hydrogen, oxygen
Exist as triglycerides in body
Unsaturated fats
Saturated fats in foods from animal sources
Trans unsaturated fatty acids (trans fats) are unhealthy
(See Table 34-2: Grams of Fat per Serving of Some Common Foods)

11. Types of Nutrients Energy nutrients (organic) Proteins
Carbon, hydrogen, oxygen, nitrogen
Unit of protein: amino acid
Sources: meats and animal products

12. Types of Nutrients Energy nutrients (organic) Energy balance
Amount of energy measured in calories
Formula for measuring calories
Metabolism: total of all changes, chemical and physical, that take place in the body
Basal metabolic rate (BMR)
Body will store excess energy in form of fat

13. Types of Nutrients Energy nutrients (organic) Energy balance
Largest % of calories should come from carbohydrates
45% to 65% total calories consumed
20% to 35% fat
10% to 35% protein

14. Types of Nutrients Diet of Americans: high in fat and calories
MyPlate food guidance system >>
[FIGURE 34-6]

15. Types of Nutrients MyPlate food guidance system Orange: grains
Green: vegetables
Red: fruits
Blue: dairy products
Purple: protein
(See Table 34-3: Health Benefits of Regular Physical Activity)

16. Types of Nutrients Other nutrients (inorganic) Vitamins
Complex molecules
Functions
Facilitates cellular metabolism
Act as component of tissue structure
Classes
Fat-soluble
Water-soluble
(See Table 34-4: Vitamin Sources and Functions)

17. Types of Nutrients Other nutrients (inorganic)
Antioxidants: fights free radicals
Betacarotene (vitamin A)
Vitamin C
Vitamin E
Selenium

18. Types of Nutrients Other nutrients (inorganic) Antioxidants
Vitamin B1 (thiamin)
Vitamin B2 (riboflavin)
Niacin
Vitamin B6 (pyridoxine)
Folic acid
Vitamin B12 (cobalamin)
Multivitamin supplements may help reduce risk for certain diseases

19. Types of Nutrients Other nutrients (inorganic) Herbal supplements
Medicinal plants (botanicals or phytomedicines)
Alternative or complementary therapy
Some helpful; others are harmful
Herbs can interact unfavorably with certain prescriptions, over-the-counter medications, anesthetics

20. Types of Nutrients Other nutrients (inorganic) Minerals
Singular elements
Some required in large amounts
Two groups: major and trace
Electrolytes
Must be balanced in body

21. Types of Nutrients Other nutrients (inorganic) Major minerals
Calcium (Ca)
Phosphorus (P)
Potassium (K)
Sodium (Na)
Chlorine (Cl)
Magnesium (Mg)
Sulfur (S)
Trace minerals: required in smaller quantities
(See Table 34-5: The Seven Major Minerals and Their Food Sources)

22. Types of Nutrients Other nutrients (inorganic) Water
Important nutrient
Functions in human body
Major solvent
Medium in which most biochemical reactions of body take place
Essential for removal of toxic waste
Component of many structures

23. Types of Nutrients Other nutrients (inorganic) Water
Functions in human body
Composes 50–60% of human body
Major component of blood
Lubricates
Helps control temperature of body
Must be replenished daily
6 to 8 glasses per day

24. Types of Nutrients Other nutrients (inorganic) Fiber
Carbohydrate in composition
From plant sources
Not digested or absorbed into body
Adds bulk to feces

25. Types of Nutrients Other nutrients (inorganic) Fiber
Conditions caused by lack of fiber: diverticulitis, colorectal cancer, constipation
Types: carbohydrates and lignin
Diet contain 20 to 35 g of fiber per day

26. Reading Food Labels Items on nutrition label: Serving size Calories
Daily percentage (%) value
Fat and cholesterol
Sodium
Carbohydrates
[FIGURE 34-8]

27. Reading Food Labels Other information Comparing labels Ingredients
Compare equal amounts
Note amount of fat and saturated fat
(See Critical Thinking box)

28. Nutrition at Various Stages of Life
Pregnancy and lactation
Require increase in various nutrients
Protein requirements doubled
Increase intake of vitamins, calcium, phosphorus, iron
Increase in calories
Quality foods high in minerals, vitamins, protein

29. Nutrition at Various Stages of Life
Breast-feeding
Nutrition infant receives from breast milk perfect combination of water, lactose, fat, protein
No allergic reactions to mother’s milk
Nutritionally sound, economical, sterile
Easily digested; does not cause gastrointestinal upsets

30. Nutrition at Various Stages of Life
Breast-feeding
Infants receive temporary antibodies to many diseases
Mother and infant bond
Helps contract uterus; bring it back to nonpregnant state
Mother will continue to require nutritious foods

31. Nutrition at Various Stages of Life
Infancy
Continuous growth
Triple birth weight in first year of life
2 to 3 times more protein and calories per kilogram of body weight than normal adult
Overfeeding in infancy might lead to childhood obesity
Breast milk
Need for iron

32. Nutrition at Various Stages of Life
Childhood
Healthy eating habits
Importance of physical activity
Childhood obesity serious problem
Fast foods and carbonated sodas
Parental education

33. Nutrition at Various Stages of Life
Adolescence
Greatest levels of growth
Generally begins sooner with females
Growth spurts
Iron requirements increase for females
Calcium requirements increase because of rapid bone development

34. Nutrition at Various Stages of Life
Adolescence
Bulimia and anorexia nervosa
Bulimia: individuals binge on food and then purge (vomit); use of laxatives common
Anorexia nervosa: severely restricting caloric intake and exercising excessively
Eating disorders
Both can be life threatening
Girls more likely than boys to suffer

35. Nutrition at Various Stages of Life
Older adults
Aging natural process
Cellular metabolism tends to slow
Decline in physical activity
Decreased requirement for calories
Increased requirement for nutrients, vitamins, protein during illness
Decreased absorption in digestive tract

36. Nutrition at Various Stages of Life
Older adults
Difficulties presented because of:
Individual’s psychological state
Economic status
Physiological factors
General unwillingness to change eating habits

37. Therapeutic Diets Weight control Obesity: 20% overweight
Underweight: 10% to 15% below average
Amount of calories ingested in balance with amount used
Obesity serious health problem
Genetics may play a role

38. Therapeutic Diets Weight control Obesity causes increased risk for:
Hypertension
Heart and lung disease
Hip and knee problems
Certain cancers
Diabetes
Obesity shortens life span

39. Therapeutic Diets Diabetes mellitus
Reduced or no production of insulin, or reduced or no response to insulin
5% of population
Most patients not dependent on insulin
Control condition by diet, exercise, weight

40. Therapeutic Diets Diabetes mellitus Type 2 diabetes and obesity
Diabetes major cause of death
Changes in lifestyle: weight loss, regular exercise, nutritious diet can prevent type 2 diabetes
Prevention most important

41. Therapeutic Diets Cardiovascular disease
Leading cause of death in United States; much is preventable
Hypertension
Atherosclerosis
Arteriosclerosis
Lipoproteins (LDL and HDL)
Serum cholesterol

42. Therapeutic Diets Cardiovascular disease Myocardial infarction
Heart muscle allowed to rest to facilitate proper healing
Healthy diet, moderate exercise, cessation of smoking, weight management

43. Therapeutic Diets Cancer
Some substances ingested or inhaled are carcinogenic
Normal regulatory mechanisms within cell have broken down
Cells continue to grow in unrestrained manner
Need for increased calories and nutrients
Total parenteral nutrition (TPN)

44. Diet and Culture
MAs come into contact with patients from different ethnic groups
Diets based on traditional cultures
Patients who are vegan or vegetarian need additional dietary discussion
Patients choose their diets for variety of reasons (cultural, religious, ethical beliefs)
(See Table 34-6: Sample Food Choices of Various Cultural, Religious, and Ethnic Groups)
(See Procedure 34-1: Provide Instruction for Health Maintenance and Disease Prevention)
This project was funded at $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance Community College and Career Training Grants, as implemented by the U.S. Department of Labor’s Employment and Training Administration. Rogue Community College is an equal opportunity employer/program. Auxiliary aids and services, alternate form and language services are available to individuals with disabilities and limited English proficiency free of cost upon request.
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