1. Nutrition What is it? Why study it? Who needs it? 4/24/2017 6:22 AM
Food is critical to life. Good food is critical to good health. Some diseases that are strongly associated with foods and the diet include Osteoporosis (calcium), Type 2 Diabtes (obesity), Heart Disease (cholesterol), and hypertension (sodium). Some diseases are caused by a deficiency of nutrients, diseases like Pellegra (Niacin), Scurvy (Vitamin C), and Goiter (iodine). Adequate intakes of fiber and Vitamin D are thought to decrease the occurrence of cancer.
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2. Nutrition What is Nutrition?
Nutrition - the study of the food people eat and how their bodies use that food
Science – food requirements for body maintenance and function
Art – how foods and food information are presented
Nutrition is the study of the food people use and how their bodies use that food. Like nursing, nutrition is both a science and an art. The science of nutrition is concerned with the body’s requirements for food to maintain life. This is based upon scientific knowledge and research. The art of nursing is more concerned with how foods and food information is presented.
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3. Nutrition Science Art Research Meal Planning Regulatory Controls
Relationship to Disease
Interactions with Medications
Art
Meal Planning
Meal Presentation
Environment
Patient Considerations
Nutrition is a science because it’s based upon a body of knowledge, and that knowledge continues to be rigoursly tested with scientific research. Globally, WHO (World Health Organization), and nationally, FDA (Food and Drug Administration) apply standards based upon this scientific knowledge. It is scientific fact that too much or too little of certain foods contribute to disease and disorders and that foods interact with medications. The art of nutrition is concerned with how do we guide people to make healthier choices, how we plan, prepare, and present meals, and how we honor people’s ethnic and cultural choices when we present those choices.
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4. Nutrition Why study Nutrition? Good Nutrition is essential to Wellness
Poor Nutrition contributes to Disease
Nurses need to keep themselves Healthy
Nurses need to Educate patients
Nurses need to study nutrition because good nutrition is essential to wellness and because poor nutrition contributes to disease. Nurses need to personally maintain good nutrition to keep themselves healthy and nurses need to promote good nutrition to keep their patients healthy. A sound basis of nutrition also helps the student nurse prepare for the more advanced Diet Therapy course in Term II.
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5. YOU DO Nutrition Who needs to know about Nutrition? 4/24/2017 6:22 AM
So, who needs to learn about nutrition? You do!
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6. Wellness is more than the absence of disease
Nutrition
The World Health Organization (WHO) defines health as ‘the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.' Nutrition contributes to all areas of wellness. Not everyone achieves optimum nutrition, sometimes because of limited resources, sometimes by poor food choices.
Wellness is more than the absence of disease
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7. Nutrition Food Insecurity
Poverty – Poor Access – Poor Knowledge
Food insecurity – Limited or uncertain availability of food. Food insecurity can be due to poverty, poor access or poor knowledge. Food insecurity is usually associated with underdeveloped countries, but food insecurity is a problem here in the United States with the homeless, children, and the elderly. Efforts to provide nutritious foods to these populations include soup kitchens, food stamps, school breakfast and lunch programs, and meals on wheels for the elderly.
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8. Nutrition The Course Syllabus Unit I (5 Hrs) – Food Analysis, Test
Unit II (5 Hrs) – Test
Unit III (7 Hrs) – Group Project, Test
Unit IV (5 Hrs) – Test
This course is divided into 4 units. There will be a one hour exam at the completion of each unit. Each test is designed to test the material learned in each unit. In addition, there will be a food analysis project that will be assigned tonight. This project is due before Unit II begins.
Later in the course, there will be a group cultural project. Each group will present nutrition and health information specific to a different cultural or ethnic group. There will be 4 – 5 students in a group. Groups won’t be assigned until near the completion of Unit I. This will give each of you a chance to meet your fellow students and have a say in who you would like to be grouped with. The syllabus breaks down the percentage of each test and project.
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9. Nutrition The Nutrition Health Care Team Physician Dietitian Nurse
Patient
Who are the members of the nutrition health care team? The physician is the only person who can prescribe, or order, a therapeutic diet. Therapeutic diets are diets that either restrict or emphasize certain food items. This might be a low salt diet, a high fat diet, a diabetic diet, or even no diet at all, something we call NPO. A therapeutic diet is based upon the observations and recommendations made by many health care team members.
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10. Nutrition The Nutrition Health Care Team Physician Dietitian Nurse
Patient
The registered dietitian specializes in analyzing and meeting the nutritional needs of people. Not everyone who calls themselves a dietitian is a registered dietitian. Titles like ‘board certified nutritionist,’ ‘professional nutritionist,’ or even ‘licensed nutritionist,’ lack credibility. The registered dietitian uses the initials RD after his or her name. The registered dietitian is the nutritional expert. It is the registered dietitian who recommends therapeutic diets, but, remember, only the physician can actually order the diet.
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11. Nutrition The Nutrition Health Care Team Physician Dietitian Nurse
Patient
Nurses come in all sizes and shapes. Some are RN’s with a baccalaureate degree, others with an associates degree. There are also LPN’s, hopefully you someday. Some states use the term LVN rather than LPN. Nurses are responsible for not only bringing the food to their patients, but also for assessing and evaluating their patients’ responses to that diet. Nurses help develop, support, and carry out the nutritional plan recommended by the registered dietitian and prescribed by the physician. Nurses are responsible for nutritional assessments and are often the first person to notice when a diet needs to be changed.
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12. Nutrition The Nutrition Health Care Team Physician Dietitian Nurse
Patient
And, of course, the patient is always a part of his or her own health team. Patients need to be motivated to comply with good nutrition. This motivation usually comes from sound knowledge and it is often the nurse who provides this sound knowledge.
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13. Nutrition Functions of Nutrients Provide Energy Build Tissue
Regulate Body Cellular Functions
Food is made of nutrients. Nutrients are the chemicals in food that are critical to human growth and function. Most foods have more than one nutrient, but all foods have some nutrients. The functions of nutrients are to 1) provide energy, 2) build tissue, and 3) regulate body cellular functions. Remember that all body functions take place at the cellular level.
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14. Nutrition Providing Energy Energy is the capacity to do work
Energy is the capacity to do work. Just as your vacuumn cleaner requires electrical energy to work, so does your body require nutrient energy to function. Electrical energy is measured in amps, volts, and watts. Organic energy is measured in Calories and joules.
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15. Nutrition Providing Energy
Energy is measured in kilocalories or Calorie
1000 calories = 1 kilocalorie
1 kilocalorie = 1 Calorie
In the study of nutrition, energy is measured in kilocalories or the Calorie with a capital C. There is a difference between a calorie with a lower case c and a Calorie with an uppercase C. If we were in the chemist’s lab, we’d we a little more careful. Here, in nutrition, we will assume all calories, whether the c is lower or upper case, mean the kilocalorie. One kilocarie is the amount of heat (or energy) required to raise the degree of one cubic centimeter of water one degree celsius.
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16. Nutrition Providing Energy Caloric Measurement is approximate
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17. Nutrition Digestion Metabolism Absorption 4/24/2017 6:22 AM
This is due to each person’s system being a little different. People with high metabolic rates are probably going to absorb fewer calories, people with low metabolic rates are probably going to absorb more calories. Age, gender, activity levels, illness, medications, and a host of other factors affect the actual amount of nutrients and calories absorbed as well. Still, we can offer some standard numbers to help determine the energy content, or calories, of specific foods.
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18. Nutrition Macronutrients – The Energy Providers Carbohydrates
Fuel Factor
1 gm = 4 kcal
The nutrients that provide energy are the Macronutrients. The first of these are carbohydrates. Carbohydrates are sugar, candies, breads, cereals, and potatoes. All plants, including fruits and vegetables, contain carbohydrates as well. Each gram of a carbohydrate yields 4 kilocalories. A penny weighs about a gram.
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19. Nutrition Carbohydrates
1 tsp table sugar weighs 4 gm. How many kilocalories?
If each gram of a carbohydrate yields 4 Calories, then how many Calories in a 4 gm packet of sugar? Answer = 16 calories.
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20. Nutrition Macronutrient Carbohydrates Good Carbs? Bad Carbs?
Good carbohydrates? Bad carbohydrates? Carbohydrates aren’t well thought of these days, and, yet, the whole wheats are proven to be associated with good health. More about these good carbs and bad carbs next class when we discuss the Food Pyramid.
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21. Nutrition Macronutrients – The Energy Providers Fats (Lipids)
Fuel Factor
1 gm = 9 kcal
Fats are a greater source of energy. Fats yield 9 Calories per gram. Of course when those Calories aren’t burned, the Calories will be stored as body fat, making fat a less than desirable nutrient. Fats are also called lipids, because of their composition. Cholesterol is a lipid, as are triglycerides and trans fats.
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22. Nutrition Fats (Lipids)
1 Tbsp olive oil weighs 14 gm. How many kilocalories?
1 tablespoon of olive oil weighs 14 gm. How many Calories is that? Answer = 126 Calories. Because fats contain more Calories per gram, they are said to be calorically dense.
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23. Nutrition Macronutrient Fats (Lipids) Good Fats? Bad Fats?
Good fats? Bad fats? Many of you have heard about saturated fats, polyunsaturated fats, and trans fats. The body needs some fats. Polyunsaturated fats are better than saturated fats. Trans fats are never good. Saturated fats and trans fats raise cholesterol levels, posing a threat for high blood pressure, heart attacks, and strokes. Later, in Unit II, you’ll learn more about the composition of these fats and perhaps have a better understanding as to why cholesterol poses these health risks.
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24. Nutrition Macronutrients – The Energy Providers Proteins Fuel Factor
1 gm = 4 kcal
Protein, the buiding blocks of life. Everyone needs protein and, yet, even too much protein can be a bad thing. Proteins have the same energy value as carbohydrates: 4 Calories per gram.
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25. Nutrition Proteins 1 egg weighs 6 gm. How many kilocalories in 3 eggs?
A typical egg weighs 6 grams. How many calories in 3 eggs? Answer: 4 * 6 * 3 =72 kcal.
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26. Nutrition Macronutrient Proteins Good Proteins? Bad Proteins?
Meat proteins, especially red meats, may also contribute to high blood cholesterol levels. That’s because most meats have a lot of fat. Meat proteins, especially red meats, may also contribute to high blood cholesterol levels. Most meats have a lot of fat.
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27. This 450-gram breakfast delivers 500 Kcalories.
Nutrition
Energy Density
Energy or caloric density is a proportion of kilocalories per weight of food. Why does the breakfast on the right have the same amount of Calories as the breakfast on the left?
LOWER ENERGY DENSITY
HIGHER ENERGY DENSITY
This 450-gram breakfast delivers 500 Kcalories.
This 144-gram breakfast also delivers 500 kcalories.
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28. Macronutrients Provide Energy
Nutrition
Macronutrients Provide Energy
The macronutrients provide energy in the form of Calories. It is important to remember that excess, unused Calories, even those obtained from carbohydrates and proteins, will eventually be stored as fat.
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29. Nutrition The Tissue Builders Proteins Example – Amino Acids
Nutrients that are essential to life but do not provide energy are called Micronutrients. Protein is both a macronutrient and a micronutrient, though it’s usually thought of as one of the 3 macronutrients. Protein provides the amino acids necessary for cell structure.
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30. Nutrition The Tissue Builders Vitamins Example – Vitamin C Collagen
Vitamins also contribute to tissue growth. An example is Vitamin C which helps to form collagen. Collagen fibers give firmness to skin tissue. As we age, we lose collagen and the tissue ‘collapses,’ forming wrinkles.
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31. Nutrition The Tissue Builders Minerals Example – Iron Hemoglobin
Minerals are also micronutrients that help to build tissue. Iron is an important mineral that is essential in forming hemaglobin, the oxygen carrying components of the red blood cell.
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32. Cell Wall – Structure and Transport
Nutrition
The Tissue Builders
Fatty Acids
Cell Wall – Structure and Transport
Fatty acids, though found in fats and oils, are essential for optimal health. Fatty acids help to transport oxygen in the blood, help to build strong cells and tissues, and even help the body to get rid of excess cholesterol. Omega-3 is a fatty acid. Because fatty acids regulate body functions as well as provide tissue and cell structure, fatty acids also act as regulators.
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33. Example – Coenzyme Factors
Nutrition
The Regulators
Vitamins and Minerals
Example – Coenzyme Factors
Vitamins and minerals act as regulators as well. Although Vitamin C doesn’t produce energy, it is essential to the capture and release of energy that occurs in the body. Potassium and Calcium are required for muscle contraction. So fatty acids, vitamins, and minerals are important in building cells and tissues and also in maintaining cellular and body functions.
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34. Nutrition The Regulators Non-Nutrients Water Fiber 4/24/2017 6:22 AM
In addition to the macronutrients and the micronutrients, there are two very important non-nutrients. These are water and fiber. Water makes up about 60% of the body weight, water carries the nutrients to the cells, and every system is dependent upon water. Typically, a person needs 8 glasses of water per day. Fiber isn’t actually digested. The sole purpose of fiber is to help solid waste move through the colon. The healthy body needs fiber everyday.
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35. Nutrition Discussion A single nutrient for each single food?
Good nutrients vs bad nutrients?
Too much of anything can be not good. If the body doesn’t have enough potassium, a state called hypokalemia, then the heartbeat will become erratic and the person will die. Too much potassium, hyperkalemia, and the heart will stop beating altogether, also resulting in death. With few exceptions, there are no good nutrients vs bad nutrients. There might be some foods that are more or less beneficial than others, but there are no bad nutrients. If it were bad for you, it wouldn’t be a nutrient. Having said that, any nutrient taken in excessive quantities can be harmful if not fatal.
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36. Nutrition Achieving Optimum Nutrition Malnutrition Overnutrition
Undernutrition
So, what’s the goal here? The goal is to achieve optimum nutrition, or the best possible nutrition.
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37. Nutrition Achieving Optimum Nutrition Malnutrition 4/24/2017 6:22 AM
We usually think of malnutrition as being too little food. In fact, malnutrition can be too little food, too little calories, too little of one or more nutrients, or even too much. Sailors often developed scurvy, a disease caused by insufficient Vitamin C. Once the link between Scurvy and Vitamin C was found, large quantities of limes were loaded into the ships for the men to consume at sea. Hence, the sailors were called ‘limeys.’ Osteoporosis results from the undernutrition of calcium. Heart disease can result from too much fat, especially choleseterol and trans fats, so a person who eats too many fats may be malnourished.
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38. Nutrition Achieving Optimum Nutrition Overnutrition 4/24/2017 6:22 AM
Overnutrition is the result of ingesting too many Calories. What the body doesn’t burn, the body eventually stores as fat.
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39. Nutrition Achieving Optimum Nutrition Undernutrition 4/24/2017 6:22 AM
An undernourished state results from too little food or too few nutrients. Most of the time undernutrition is synonymous with poverty, but it can also be associated with insufficient knowledge, mental illness, the aging process, chronic illness, and prolonged hospitalization.
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40. Nutrition Community Health Care Setting Setting 4/24/2017 6:22 AM
We’ll start Unit I by looking at how we can become a better informed consumer. A nurse who is an informed consumer can help patients and clients maintain wellness. We’ll end Unit I by looking at how nurses can help patients and clients in the hospital and long term care settings achieve better nutrition. First, let’s look at your nutrition.
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41. Nutrition Home Work Assignment – Food Log
Go to
Find YOUR Pyramid Plan
Explore the Nutricalc CD that comes with your Nutrition Book.
Calculate your Ideal Body Weight (IBW) and Body Mass Index (BMI) /
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42. Nutrition Home Work Assignment – Food Log (cont.)
Keep a daily log of all the foods you eat for 2 days
Be as specific as possible
Include all condiments
Include all beverages including water
Bring this log to the next class
Homework assignment
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