1. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 1 The Relationship of Nutrition and Health

2. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Objectives Name six classes of nutrients and their primary functions Recognize common characteristics of well- nourished people Recognize symptoms of malnutrition (continues)

3. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Objectives Describe ways in which nutrition and health are related List four basic steps in nutrition assessment

4. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Chemical substances necessary for life Functions: –Provide energy –Build and repair tissue –Regulate body processes Circulation, respiration, digestion, and elimination (continues)

5. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Six classes: 1.Carbohydrates (CHO) 2.Fats (lipids) 3.Proteins 4.Vitamins 5.Minerals 6.Water (continues)

6. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients No nutrient can work alone Essential nutrients –Found only in foods Organic nutrients –Must be broken down to be used by body Inorganic nutrients –Already in their smallest components

7. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Six Essential Nutrient Classes and Their Functions Organic nutrientsFunction CarbohydratesProvide energy FatsProvide energy ProteinsBuild and repair tissues and provide energy VitaminsRegulate body processes (continues)

8. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Six Essential Nutrient Classes and Their Functions Inorganic nutrientsFunction MineralsRegulate body processes WaterRegulate body processes

9. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Stop and Share Consider the following scenario: –A client is recovering from surgery at home. You ask what she has eaten during the last 24 hours. She answers: Breakfast: two doughnuts, orange juice Lunch: lettuce salad with oil and vinegar, soda Snack: pretzels, soda Dinner: spaghetti with tomato sauce, garlic bread, wine –What nutrients are missing in her diet? Why are these nutrients important for her? (continues)

10. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Stop and Share She is missing protein and water in her diet Protein is needed to build and repair body tissues after surgery Water is needed to prevent dehydration

11. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Characteristics of Nutritional Status GoodPoor Alert expressionApathy Shiny hairDull, lifeless hair Clear complexionGreasy, blemished complexion Good colorPoor color Bright, clear eyesDull, red-rimmed eyes (continues)

12. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Characteristics of Nutritional Status GoodPoor Pink, firm gums and well- developed teeth Red, puffy, receding gums and missing or cavity-prone teeth Firm abdomenSwollen abdomen Firm, well-developed muscles Underdeveloped, flabby muscles Well-developed bone structure Bowed legs and “pigeon breast” (continues)

13. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Characteristics of Nutritional Status GoodPoor Normal weight for heightOverweight or underweight Erect postureSlumped posture Emotional stabilityEasily irritated or depressed and poor attention span Good staminaEasily fatigued (continues)

14. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Characteristics of Nutritional Status GoodPoor Seldom illFrequently ill Healthy appetiteExcessive or poor appetite Healthy, normal sleep habitsInsomnia at night and fatigued during day Normal eliminationConstipation or diarrhea

15. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Stop and Share Divide into groups of two Assess your partner for signs of good nutrition Identify common characteristics associated with good nutrition exhibited in your partner (continues)

16. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Stop and Share Shiny hair Clear skin Clear eyes Erect posture Alertness Firm flesh on well- developed bone structures Pink gums and well- developed teeth Normal weight for height

17. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Malnutrition Overnutrition –Excess energy or nutrient intake Undernutrition –Deficient energy or nutrient intake Overnutrition is larger problem than undernutrition in United States (U.S.) –Supersizing, fast-food industry contributes to problem

18. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Supersize USA: The Fattest Cities in the U.S. 1.Miami, FL 2.Oklahoma City, OK 3.San Antonio, TX 4.Las Vegas, NV 5.New York, NY 6.Houston, TX 7.El Paso, TX 8.Jacksonville, FL 9.Charlotte, NC 10.Louisville-Jefferson, KY

19. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cumulative Effects of Nutrition Excesses –Excess nutrients over time –E.g., atherosclerosis, obesity, hypertension, diabetes, gallbladder disease, some cancers Deficiencies –Nutrients lacking for extended period –E.g., iron deficiency, beriberi, scurvy, osteomalacia, osteoporosis, rickets, goiter

20. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrient Deficiency Primary –Inadequate dietary intake Secondary –Due to causes other than dietary intake Both can result in malnutrition

21. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deficiency Diseases Deficiency diseaseNutrients lacking Iron-deficiency anemiaIron BeriberiThiamin Night blindnessVitamin A GoiterIodine KwashiorkorProtein (continues)

22. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deficiency Diseases Deficiency diseaseNutrients lacking MarasmusAll nutrients OsteomalaciaCalcium, vitamin D, phosphorus, magnesium, and fluoride OsteoporosisCalcium and vitamin D (continues)

23. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Deficiency Diseases Deficiency diseaseNutrients lacking PellagraNiacin RicketsCalcium and vitamin D ScurvyVitamin C XerophthalmiaVitamin A

24. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutritional Assessment Anthropometric measurements Clinical examination Biochemical tests Dietary and social history

25. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anthropometric Measurements Height Weight Head, chest, and abdominal circumference –For children Upper arm measurement Skinfold measurement with caliper

26. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Clinical Examination Clinical signsPossible deficiencies Pallor, blue half-circles beneath eyes Iron, copper, zinc, B 12, B 6, or biotin EdemaProtein Bumpy “gooseflesh”Vitamin A Lesions at corner of mouthRiboflavin (continues)

27. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Clinical Examination Clinical signsPossible deficiencies GlossitisFolic acid Numerous black-and-blue spots and tiny, red pin-prick hemorrhages under skin Vitamin C EmaciationCarbohydrates, proteins, or calories (continues)

28. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Clinical Examination Clinical signsPossible deficiencies Poorly shaped bones or teeth, or delayed appearance of teeth in children Vitamin C Slow clotting time of bloodVitamin K (continues)

29. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Clinical Examination Clinical signsPossible deficiencies Unusual nervousness, dermatitis, and diarrhea in same client Niacin TetanyCalcium, potassium, or sodium GoiterIodine EczemaFat

30. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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 (continues)

31. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Biochemical Tests Blood urea nitrogen (BUN) –May indicate renal failure, insufficient renal blood supply, or blockage of urinary tract Serum creatinine –Indicates amount of creatinine in blood –Used to evaluate renal function (continues)

32. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Biochemical Tests Creatinine excretion –Indicates amount of creatinine excreted in urine during 24- hour period –Used in estimating body muscle mass –Muscle mass depleted, as in malnutrition Level will be low (continues)

33. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Biochemical Tests Other tests –Hemoglobin (Hgb) –Hematocrit (Hct) –Red blood cells (RBCs) –White blood cells (WBCs) (continues)

34. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Biochemical Tests Other tests –Lipid profile High- and low-density lipoprotein Serum triglycerides –Urinalysis

35. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Dietary and Social History Evaluation of food habits –24-hour recall Types, amounts, and preparation of all foods eaten in last 24 hours –Food diary Written record of all food and drink ingested in specified period –Computer diet analysis Determines nutrient deficiencies or toxicities (continues)

36. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Dietary and Social History Social history –Consideration of financial resources to do the following: Obtain needed food Properly store and cook food –Food-drug interactions that can lead to malnutrition

37. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Conclusion Nutrition and health directly related Effects of poor nutrition cumulative Six essential nutrient classes: –Carbohydrates, fats, proteins, minerals, vitamins, and water Nutritional assessment –Best way to determine deficiencies that can result from lack of nutrients