unit 8

Slide1: 

UNIT 8 EFFECTS OF NUTRITION Basic Nutrition Therapeutic Diets

Slide2: 

Upon completion of this unit, the student will: Identify and explain the significance of healthy nutritional practices in the overall plan for healthy living Name the four functions of food Name the five basic nutrients and explain how they maintain body function understand the rationale for therapeutic diets

Slide3: 

TIME: 2 weeks

Slide4: 

NEW TERMS: vitality - ability of an organism to go on living nutrients - substances that nourish the body resistance - ability of the body to protect itself from disease protein - complex compound (amino acid) found in plant and animal tissues; essential for heat, energy and growth vitamins - substances necessary for normal functioning and maintenance of health minerals - inorganic elements that occur in nature that are essential to every cell

Slide5: 

metabolism - the body’s process of using food to make energy and use nutrients hemoglobin - complex chemical in the blood that carries oxygen and carbon dioxide fecal - pertaining to feces, a solid waste product edema - swelling or abnormal or excessive collection of fluid in the tissues colitis - inflammation of the colon ileitis - inflammation of the lower three-fifths of the small intestine hypertension - high blood pressure

Slide6: 

Diabetes mellitus - condition that develops when the body cannot change sugar into energy; there is an insufficient amount of insulin, leading to an increased amount of sugar in the blood lactation - process of producing milk to feed a newborn

Slide7: 

People enjoy food and like to discuss it. Most people know that there is an important relationship between food and good health. However, many people do not know what nutrients are needed or why they are necessary. Therefore, it is important for every health care worker to have a solid understanding of basic nutrition.

Slide8: 

Nutrition includes all body process relating to food. These include digestion, metabolism, circulation, and elimination. These processes allow the body to use food for energy, maintenance of health, and growth. Nutritional status refers to the state or condition of one’s nutrition. The goal is, of course, to be in a state of good nutrition or to maintain wellness, a state of good health with optimal body function. To do this, one must choose foods that are needed by the body, and not just because they taste good.

Slide9: 

Nutrition plays a large role in determining height, weight, strength, skeletal and muscular development, physical agility, resistance to disease, appetite, posture, complexion, mental ability, and emotional and psychological health. The immediate effects of good nutrition include a healthy appearance, a good attitude, proper sleep and bowel habits, a high energy level, enthusiasm, and freedom from anxiety. In addition, the effects of good nutrition accumulate throughout life and may prevent or delay certain diseases or conditions.

Slide10: 

Some conditions that can be prevented or delayed by good nutrition: hypertension - high blood pressure; an excess of salt in the diet seems to be one cause; can lead to diseases of the heart, blood vessels, and kidney atherosclerosis - condition in which arteries are narrowed by the accumulation of fatty substances on their inner surfaces; thought to be caused by a diet containing large amounts of saturated fats and cholesterol; can lead to heart attack or stroke

Slide11: 

osteoporosis - condition in which bones become porous and break easily; one cause is long-term deficiencies of calcium, magnesium, and vitamin D malnutrition - is the state of poor nutrition and may be caused by poor diet or illness. Symptoms include fatigue, depression, poor posture, overweight or underweight, poor complexion, lifeless hair, and irritability. It can cause deficiency diseases, poor muscular and skeletal development, reduced mental abilities, and even death.

Slide12: 

Basic Nutrition The functions of food are: to provide heat to promote growth to repair tissue to regulate body processes

Slide13: 

Essential nutrients are composed of chemical elements that are found in food. They are used by the body to perform many different functions. As the body uses the elements, they are replaced by the food one eats. The essential nutrients are divided into six groups: carbohydrates fats proteins vitamins minerals water

Slide14: 

Carbohydrates - the basic source of energy for body heat and body activities

Slide15: 

Carbohydrates are commonly called starches or sugars. Carbohydrates are a cheaper source of energy than proteins or fats. They are easily digested, grow well in most climates, and keep well without refrigeration. They are made of carbon, hydrogen, and oxygen. The main sources of carbohydrates are breads, cereals, noodles or pastas, crackers, potatoes, corn, peas, fruits, sugar, and syrups. Cellulose is the fibrous, indigestible form of carbohydrate. It is important because it provides bulk in the digestive tract and causes regular bowel movements. Its best sources are bran, whole grain cereals, and fibrous fruits and vegetables.

Slide16: 

Fats - provide fatty acids for normal growth and development, provide energy, and carry vitamins A and D to cells

Slide17: 

Fats (lipids) are also made of carbon, hydrogen, and oxygen, but they contain more oxygen than carbohydrates. They provide the most concentrated form of energy, but they are a more expensive source of energy than carbohydrates. Fats also maintain body temperature by providing insulation, cushion organs and bones, aid in the absorption of fat-soluble vitamins, and provide flavor to meals. The main sources include butter, margarine, oils, cream, fatty meats, and egg yolks. Fats are also classified as saturated or polyunsaturated. Saturated fats are usually solid at room temperature and include the fats in meats, eggs, whole milk, cream, butter, and cheese. Polyunsaturated fats are usually soft or oily and include vegetable oils, margarines, and other products made from vegetable oils, fish, and peanuts.

Slide18: 

Cholesterol is a fatty substance found in body cells and animal fats. It is essential to life, but an excess is believed to contribute to atherosclerosis. It is advisable to limit the intake of foods containing fats from animal sources.

Slide19: 

Protein - an amino acid that builds and renews body tissues and provides heat energy

Slide20: 

Proteins are the basic components of all body cells. They are essential for building and repairing tissue, regulating body functions, and providing energy and heat. They are made of carbon, hydrogen, oxygen, and nitrogen, and some contain sulfur, phosphorus, iron, and iodine. Proteins are made up of 22 ‘building blocks’ called amino acids. Nine of these amino acids are essential to life. The proteins that contain these nine are called complete proteins. The best sources of complete proteins are animal foods such as meat, fish, milk, cheese, and eggs. Proteins that contain any of the remaining 13 amino acids and some of the 9 essential amino acids are called incomplete proteins. Sources of incomplete proteins are usually vegetable foods such as cereals, soybeans, dry beans, peas, and peanuts.

Slide21: 

Vitamins are organic compounds that are essential for normal metabolism, growth and body development. They allow the body to use the energy provided by carbohydrates, fats, and proteins. Only small amounts of vitamins are required and a well-balanced diet will usually provide the required vitamins. An excess amount of vitamins or a deficiency of vitamins can cause poor health. Vitamins are classified as water soluble or fat soluble. Water soluble vitamins dissolve in water, are not normally stored in the body, and are easily destroyed by cooking, air, and light. Fat soluble vitamins dissolve in fat, can be stored in the body, are not easily destroyed by cooking, air, and light.

Slide22: 

Vitamin A - fat soluble found in apricots, cantaloupe, milk, cheese, eggs, meat organs, fortified margarine, butter, fish-liver oils, dark green and deep yellow vegetables essential for growth, health of eyes, and structure and functioning of the cells of the skin and mucous membrane

Slide23: 

B Complex Vitamins - water soluble B1 - Thiamine found in whole grains, meats, dry beans and peas essential for carbohydrate metabolism, promotes normal appetite and normal function of the nervous system B2 - Riboflavin found in milk, cheese, eggs, meat, whole grains, dark green vegetables essential for carbohydrate, fat, and protein metabolism, health of mouth tissue, and healthy eyes

Slide24: 

B3 - Niacin found in meats, especially organ meats, poultry and fish, enriched breads and cereals, peanuts essential for carbohydrate, fat, and protein metabolism, healthy skin, nerves, and digestive tract B12 found in liver, kidney, muscle meats, milk, cheese, eggs essential for metabolism, healthy red blood cells, maintains nerve tissue

Slide25: 

Vitamin C - Ascorbic Acid - water soluble found in fresh, raw citrus fruits and vegetables - oranges, grapefruit, tomatoes, raw onions, cabbage, peppers, dark green vegetables essential for healthy gums, aids in wound healing, aids in absorption of iron Vitamin D - fat soluble - provided by fortification of certain foods such as milk and margarine, also fish liver oils and eggs. Sunshine is also a source of Vitamin D essential for growth, regulates calcium and phosphorus metabolism, builds and maintains bones and teeth

Slide26: 

Vitamin E - fat soluble found in vegetable oils, butter, margarine, peanuts, egg yolk, dark green leafy vegetables essential for protection of cell structure, especially red blood cells, inhibits breakdown of some unsaturated fatty acids Vitamin K - fat soluble found in spinach, kale, cabbage, liver, soybean oil, cereals essential for normal clotting of blood

Slide27: 

Folic Acid (Folacin) - water soluble found in green leafy vegetables, citrus fruits, organ meats, liver, whole grain cereals, yeast essential for protein metabolism and maturation of red blood cells

Slide28: 

Minerals are inorganic elements found in all body tissues. They regulate the activity of the heart, nerves, and muscles and build and renew teeth, bones and other tissues

Slide29: 

Calcium - found in milk and milk products, most dark green vegetables, canned salmon. Calcium aids in the development and maintenance of bones and teeth, helps in the clotting of blood, maintains normal heart and muscle action, and is responsible for nerve irritability.

Slide30: 

Phosphorus - found in milk and cheese, meat, poultry, and fish, nuts, legumes, and whole grain cereals. Phosphorus helps to develop and maintain bones and teeth, maintains blood acid-base balance, aids in the metabolism of carbohydrates, fats, and proteins, and is a constituent of body cells

Slide31: 

Magnesium - found in meat and seafood, nuts, milk, cereal grains, and fresh green vegetables. Magnesium is a constituent of bones, muscles, and red blood cells, helps maintain health of muscles and nerves, and aids in metabolism. Sodium - found in salt, meat and fish, poultry and eggs, milk, and cheese. Sodium aids in fluid balance, acid-base balance, regulates muscles and nerves, and aids in glucose absorption.

Slide32: 

Potassium - found in meat, milk, vegetables, oranges, bananas, prunes, and cereals. Potassium aids in fluid balance, regular heart rhythm, cell metabolism, and proper nerve function. Chlorine (chloride) - found in salt, meat, milk, and eggs. Chlorine aids in fluid balance, acid-base balance, and the formation of hydrochloric acid. Copper - found in liver, organ meats, nuts, legumes, and whole grain cereals. Copper aids in the utilization of iron, and is a component of enzymes

Slide33: 

Iron - found in eggs, meat, especially liver and kidney, deep yellow and dark green vegetables, potatoes, dried fruits, whole grain products, enriched flour, bread, breakfast cereals. Iron is responsible for the formation of hemoglobin on red blood cells, is part of cell enzymes, and aids in the production of energy.

Slide34: 

Iodine - found in fish (obtained from the sea), some plant foods grown in soils containing iodine, table salt fortified with iodine (iodized). Iodine is responsible for the formation of hormones in the thyroid gland.

Slide35: 

Flourine - found in flouridated water, fish and meat. Flourine is essential for healthy teeth and bones.

Slide36: 

Water: Water is found in all body tissues. It is essential for the digestion of food, makes up most of the blood plasma, helps body tissues absorb nutrients, helps regulate body temperature, and helps move waste material through the body. Although water is found in almost all foods, the average person should still drink six to eight glasses of water each day to provide the body with the water it needs.

Slide37: 

FIBER Although not an essential nutrient, fiber is important in the diet. It helps prevent bowel and colon diseases and constipation by providing bulk to the diet. Fiber is found in greens, kale, cabbage, celery, vegetable salads, raw and cooked fruits, whole grains and cereals.

Slide38: 

Before the body is able to use nutrients, it must break down the foods that are eaten to obtain the nutrients and then absorb them into the circulatory system. These processes are called digestion and absorption. The actual use of the nutrients by the body is called metabolism. Digestion is the process by which the body breaks food down into smaller parts, changes the food chemically, and moves the food through the digestive system. There are two types of digestive action - mechanical and chemical. During mechanical digestion, food is broken up by the teeth and moved through the digestive tract by peristalsis. During chemical digestion, food is mixed with digestive juices secreted by the mouth, stomach, small intestine, and pancreas. The digestive juices contain enzymes which break down the food chemically so the nutrients can be absorbed into the blood.

Slide39: 

After the food is digested, absorption occurs. Absorption is the process where blood capillaries pick up the digested nutrients. The nutrients are then carried by the circulatory system to every cell in the body. Most absorption occurs in the small intestine, but water, salts, and some vitamins are absorbed in the large intestine.

Slide40: 

After nutrients have been absorbed and carried to body cells, metabolism occurs. This is the process in which nutrients are used by the cells for building tissue, providing energy, or regulating various body functions. During this process, nutrients are combined with oxygen, and energy and heat are released. Energy is required for voluntary work, such as swimming or running, and for involuntary work such as breathing and digestion. The rate at which the body uses energy just for maintaining its own tissue, without doing any voluntary work, is called the basal metabolic rate (BMR). The body needs energy constantly, so it stores nutrients for future use. These stored nutrients are used to provide energy when food intake is not adequate for energy needs.

Slide41: 

Foods vary in the amount of energy they contain. For example, a candy bar provides more energy than an apple - but not necessarily great nutrients! When the body metabolizes nutrients to produce energy, heat is also released. The measurement of the amount of heat produced during metabolism is the way the energy content of food is measured. This heat is measured by a unit called a kilocalorie, or just calorie. The number of calories in a certain food is known as that food’s caloric value.

Slide42: 

An individual’s caloric requirement is the number of calories needed by the body during a 24-hour period. Caloric requirements vary from person to person, depending on activity, age, size, sex, physical condition, and climate. Usually the amount of physical activity or exercise is the main factor determining caloric requirements because energy used must be replaced. An individual who wants to gain weight can decrease activity and increase caloric intake. An individual who wants to lose weight can increase activity and decrease caloric intake.

Slide43: 

A general guideline for weight loss or gain is that one pound of body fat equals about 3,500 calories. To lose one pound, a decrease of 3,500 fewer calories is required, either by consuming 3,500 fewer calories or by using 3,500 calories through increased exercise. To gain one pound, an increase of 3,500 calories is required. A general guideline to maintain weight is that a person consume 15 calories per pound per day. If a person weighs 120 pounds, maintaining the weight would require a daily intake of 15 X 120 or 1,800 calories a day. By decreasing caloric intake by 500 calories per day for a total of 1,300 calories, a person would lose 1 pound per week. It is important to note that increasing or decreasing exercise along with controlling calorie intake is essential.

Slide44: 

Good health is everyone’s goal and good nutrition is the best way of achieving and maintaining it. Normally, this is accomplished by eating a balanced diet in which all of the required nutrients are included in correct amounts. The simplest guide for planning healthy meals is the U.S. Department of Agriculture Food Guide, which classifies foods into major food groups. Foods are arranged in groups containing similar nutrients, and portion sizes will vary according to the caloric requirements of individuals. Although the major food groups are a key to healthy meal plans, variety, taste, color, aroma, texture, and general food likes and dislikes must also be considered.

Slide46: 

HOW POOR NUTRITION AFFECTS THE BODY anemia - a decreased number of red blood cells or a decreased amount of hemoglobin anorexia nervosa - refusing to eat or drastically reducing intake of food bulimia - intervals of food craving and bingeing and then purging constipation - infrequent, difficult defecation of fecal material dull hair and eyes mental slowness

Slide47: 

Obesity - results when a person takes in more calories than the body uses, resulting in increased fatty tissue osteoporosis - bones become porous due to inadequate calcium intake or absorption poor skin

Slide48: 

THERAPEUTIC DIETS Therapeutic diets are modifications of the normal diet used to improve specific health conditions. Normally, they are prescribed by the doctor and planned by a dietitian. These diets may change the nutrients, caloric content, and/or texture of the normal diet. They may seem strange and even unpleasant to patients. In addition, the patient’s appetite may be affected by weakness, loneliness, illness, self-pity, and other factors. It is essential that the health care worker use patience and tact to convince patients to eat foods on the special diets.

Slide49: 

Purposes of Therapeutic Diets Regulate the amount of food in metabolic disorders Prevent or restrict edema by restricting sodium intake Assist body organs to regain or maintain normal function Aid in digestion by avoiding irritating foods Increase or decrease body weight

Slide50: 

REGULAR DIET A regular diet is a balanced diet usually used for the ambulatory patient. At times, it has a slightly reduced calorie content. Foods such as rich desserts, cream sauces, salad dressings, and fried foods may be decreased or omitted.

Slide51: 

LIQUID DIETS Liquid diets include both clear liquids and full liquids. All foods served must be liquid at body temperature. Both are nutritionally inadequate and should only be used for short periods of time. Foods included on a clear liquid diet are mainly carbohydrates and water, including apple juice, fat-free broths, plain gelatin, fruit ice, ginger ale, and tea or black coffee. The full liquid diet includes all clear liquids plus strained soups and cereals, custard, ice cream, pudding, sherbet, and eggnog. A basic rule is that if you can see through it, it is a clear liquid! Liquid diets may be used after surgery or a heart attack, for patients with acute infections, digestive problems, and before some X-rays of the digestive tract.

Slide52: 

SOFT DIET A soft diet is similar to the regular diet but foods must require little chewing and be easy to digest. Foods to avoid include meat and shellfish with tough connective tissue, coarse cereals, spicy foods, rich desserts, fried foods, raw fruits and vegetables, nuts, and coconut. This diet may be used following surgery, or for patients with infections, digestive disorders, or chewing problems.

Slide53: 

DIABETIC DIET A diabetic diet is used for patients with diabetes mellitus. In this condition, the body does not produce enough insulin to metabolize carbohydrates. Patients frequently take insulin by injection. The diet contains exchange lists that group foods according to type, nutrients, and caloric content. Patients are allowed a certain number of items from each exchange list according to their individual needs. Usually sugar-heavy foods such as candy, soft drinks, desserts, cookies, syrup, honey, condensed milk, chewing gum, and jams and jellies are avoided.

Slide54: 

CALORIE CONTROLLED DIETS Calorie controlled diets include both low calorie and high calorie diets. Low calorie diets are frequently used for patients who are overweight. High calorie foods are avoided or very limited. Examples include butter, cream, whole milk, cream soups or gravies, sweet soft drinks, alcoholic beverages, salad dressings, fatty meats, candy, and rich dessert. High calorie diets are used for patients who are underweight or have anorexia nervosa, hyperthroidism, or cancer. Extra proteins and carbohydrates are included. High bulk foods such as green salads, watermelon, and fibrous fruits are avoided because they fill the patient up too soon. High fat foods such as fried foods, rich pastries, and cheese cake are avoided because they digest slowly and spoil the appetite.

Slide55: 

LOW CHOLESTEROL DIET A low cholesterol diet restricts foods containing cholesterol. It is used for patients with atherosclerosis and heart disease. Foods high in saturated fat such as beef, liver, pork, lamb, egg yolks, cream cheese, and whole milk are limited, as are coconut and palm oil products.

Slide56: 

FAT RESTRICTED DIET Fat restricted diets are also called low fat diets. Examples of foods to avoid are cream, whole milk, cheese, fats, fatty meats, rich desserts, chocolate, nuts, coconut, fried foods, and salad dressing. Fat restricted diets may be used for obese patients or those with gallbladder and liver disease or atherosclerosis.

Slide57: 

SODIUM RESTRICTED DIETS Sodium restricted diets are also called low salt diets. Frequently patients use low sodium diet lists similar to the carbohydrate controlled lists used by diabetic patients. Patients should avoid or limit adding salt to food, smoked meats or fish, processed foods, pickles, olives, sauerkraut, and some processed cheeses. This diet reduces salt intake for patients with cardiovascular diseases such as hypertension or congestive heart failure, kidney disease, and edema.

Slide58: 

PROTEIN DIETS Protein diets include both low protein and high protein diets. Protein rich foods include meats, fish, milk, cheese, and eggs. These foods would be limited or decreased in low protein diets and added in additional amounts in high protein diets. Low protein diets are ordered for certain kidney diseases and for allergic conditions. High protein diets may be ordered for children and adolescents if growth is delayed, pregnant and lactating women, before and after surgery, and for patients suffering from burns, fevers, or infections.

Slide59: 

BLAND DIET A bland diet consists of easily digested foods that do not irritate the digestive tract. Foods to be avoided include coarse foods, fried foods, highly seasoned foods, pastries, candy, raw fruits and vegetables, alcoholic and carbonated beverages, smoked or salted meats and fish, nuts, olives, avocados, coconut, whole grain breads and cereals, and usually coffee and tea. It is used for patients with ulcers and other diseases of the digestive tract.

Slide60: 

LOW RESIDUE DIET A low residue diet eliminates or limits foods that are high in bulk and fiber. Examples include raw fruits and vegetables, whole grain breads and cereals, nuts, seeds, beans and peas, coconut, and fried foods. It is used for patients with digestive and rectal diseases such as colitis or diarrhea.

Slide61: 

OTHER DIETS Other therapeutic diets that restrict or increase certain nutrients may also be ordered. The health care worker should always check the prescribed diet and ask questions if foods seem incorrect. Every effort should be made to include foods that patients like if they are allowed on a particular diet.

Slide62: 

Types of Therapeutic Diets clear liquid - replaces fluids lost from vomiting or diarrhea, or used post-op (nutritionally inadequate) full liquid - for those with trouble chewing or swallowing or with gastrointestinal disturbances (deficient in iron) soft - for those with trouble chewing or post-op (nutritionally inadequate) bland - to soothe GI tract, avoid irritation in ulcers or colitis restricted residue (or low residue) - to reduce the normal work of the intestine in rectal disease, colitis, ileitis low-carbohydrate - to match food intake with insulin uptake and nutritional requirements for patients with diabetes mellitus

Slide63: 

Low-fat - for gallbladder and liver disease, obesity and heart conditions (deficient in fat-soluble vitamins) low-cholesterol - for patients with coronary disease or atherosclerosis low calorie - for overweight patients or those with arthritis or cardiac conditions high calorie - patients with anorexia nervosa and hyperthyroidism low sodium - for patients with kidney disease, cardiovascular disorders, edema, and hypertension high protein - during pregnancy, lactation, postsurgical, during illness

Slide64: 

Review this presentation, your textbook, and the Self Check you completed. Your instructor will give you the test for this unit.