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Clinical nutrition
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basic concepts Health: The merging and balancing of five physical and psychological dimensions of health: physical, mental, emotional, social, and spiritual. Nutrition: The study of essential nutrients and the process by which nutrients are used and quality of nutrients Nutrients: Substances in food required by the body for energy, growth, maintenance and repair.
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Role of nutrition: Physical health of the body.depends on the quantity and quality of nutrients, Intellectual health relies on a well functioning brain and central nervous system, (iron deficiency . anemia affects intellectual health), Emotional health may be influenced by poor eating habits (hypoglycemia), Social health often centers around food-related occasions, and Spiritual health often has ties to food.
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Health promotion: increases the level of health of individuals, families, groups, and communities. Role of nutrition: Healthy people 2010, defines some objective nutrition as decreasing daily fat intake, and less total caloric intake.
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Wellness: is a lifestyle that enhance each of the five dimensions of health. Wellness nutrition approaches food consumption as a positive way to nourish the body. Consuming a diet based on lower fat/higher fiber and moderate caloric consumption is essential to convey competency to care for ourselves
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Disease prevention: Is the recognition of a danger to health that could be reduced or alleviated through specific actions or changes in life style behaviors. There are three levels of prevention, Primary: activities to avert the initial development of a disease or poor health, low fat and high fiber diet is important;
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Secondary: early detection to halt or reduce the effects of a disease or illness, sodium intake restriction may control HTN, and consequently avoid HD;
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Tertiary: to minimize further complications or to assist in the restoration of health. Direct treatments of many disorders have a dietary components (ulcer, coronary heart disease -Nutrition is consider as vital component in personal health care. -Promotion of health, and prevention of disease for all people, rests on whole food supply.
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-Human nutrition depends on attitudes toward food, and eating pattern through our life span, under influence of community, nation, and over all world. -We need nutrition for maintenance of growth, activity,and reproduction.
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-The body need energy to carry out vital function as breathing, and the people need energy to perform physical activity, that could be met by food.
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-Dietetics is the health profession,having primary responsibility of application of nutritional care, in various state of health, and disease, with assistance of nurse and physician.
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Definition of nutrition: -Nourishment that sustain life, it begins from the moment of conception until death. -The food people eat, and how it nourishes their bodies. Kinds of nutrients: 1- Macro nutrients : -Fats, carbohydrates ( CHO), proteins. -Supply energy, build tissue. 2- Micro nutrients : -Vitamins( vits ),minerals.
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NB:- water is the over all vital nutrients, enter in all of life process, -Metabolism: sum of chemical process in the body, to sustain life, and health. -Need in small amount. -Regulate, and control body process.
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-Source of energy: 1-Carbohydrates CHO : -Primary source of energy. -Sugar is simple CHO food, while starch is complex CHO food. -The quick source of energy is glycogen. -Each one gram of CHO, yield 4kilocalories. -50to60% of energy taken from CHO diet.
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2-Fats: -Comes from plants and animals. -Saturated fat from animals. -Unsaturated fat from vegetables, and oil products. -Each one gram of fat yield 9 kilocalories. -25to30% of energy taken from fat.
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3-Proteins: -The body take energy from protein, when there is insufficient amount of CHO, and fat. -Each one gram of protein yield 4kilo calories. -15to29%of total energy taken from protein. -The primary function of protein,are building and energy. NOTE: caloric is unit of heat used in the nutritional science, each 1000 calories equal 1 kilocalorie.
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*Tissue building 1-Protein the primary source: -Responsible for tissue building. -The necessary unit of building is called amino acid. 2-Minerals : -Calcium and phosphorus help in building, and maintain bone tissue. -Iron help in build of hemoglobin of red blood cell. 3-Vitamins: -Vit C build tissue, and prevent bleeding in tissue. 4-Fatty acid.
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-Metabolic regulation,and control: 1-Vitamines: -Many vits act as co-enzyme or cell enzyme, to govern chemical reactions in cell metabolism, example B-complex vits. 2-Minerals : -Act as co-enzyme factors of cell metabolism. Example: the trace element cobalt act with B12, to prevent occurrence of pernicious anemia,
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3-Water and fiber : -Regulate the passage of food through gastro intestinal tract (GIT), that help in absorption of different nutrient. -Remember : water is the fundamental agent for life, provide the basis of metabolic process.
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Nutritional assessment: Nutritional assessment is the process of determining nutritional status. It may reveal nutrient deficiencies or excesses. The deficiency may be primary due to inadequate intake or secondary as a result of body inefficient use of nutrients. We can use two levels: evaluating the dietary intake, and evaluating the intake besides considering how the body uses the nutrients.
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Diet Evaluation: 24-hour recall, usual food intake, a food record, a food frequency checklist, or a diet history. One the data collected, they can be analyzed.
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Assessment of nutritional status: 1. Clinical examination, observing eyes, mucous membranes, skin, hair, mouth, teeth, and tongue. 2. Biochemical analysis of body tissue, blood and urine tests, iron. 3. Anthropometric measurements, Ht, wt, limp circumference.
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Levels of nutritional status Ideal nutrition: Positive nutrition -Well developed body Ideal weight Good muscle development, and tone -The skin is smooth, and clear, hair is glassy -The eye clear, and bright.
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Posture is good. -Facial expression is alert. Appetite, digestion,and elimination are normal. mentally and physically alert Having essential nutrition, to resist infectious disease. - -Sleep well at nigh
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-Border line nutrition - -Poor eating habits, Whose living in stress environment, with low income. -Has no reservoir of nutrition. -At risk of physical illness
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3-Malnutrition : Nutrients energy are not enough to meet day to day needs.- Associated with poverty.-- Affect infants, children, pregnant women, and elderly. - Increase infant mortality rate, because of poverty, low income and, un-educated mother.
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- Children and pregnancy,develop anemia result in, Low resistance to infectious disease. Impaired learning ability. - Reduce activity level.- -Apathy. Elderly suffering of chronic disease.
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Over nutrition.- -Over weight and obesity. -Excess energy intake. Lead to chronic disease, as hyper tension, and DM. Note: * -Specific dietary factors lead to: -Coronary heart disease( CHD). - High blood pressure( HTN ).- - Stroke( CVA).- - Some type of cancer. - -DM. Obesity.
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Recommendation for good nutrition : Eat variety of food, Well balanced diet. - Maintain ideal weight. - -Avoid too much fat,saturated fat, and cholesterol. Eat food with adequate starch, and fiber.- -Avoid too much sugar. -Avoid too much sodium. Avoid alcohol intake.
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