Download Slide 2

CHAPTER 26
Concepts of Basic Nutrition and Cultural
Considerations
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 2
Learning Objectives
Theory
1) Review the structure and function of the gastrointestinal
system.
2) Use the components of the USDA MyPlate website to
assist patients in planning their diets.
3) List medical conditions that may occur as a result of
protein, calorie, vitamin, or mineral deficiency or
excess.
4) Identify patients at risk for nutritional deficits.
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 3
Overview of the Gastrointestinal System
• Structures involved in
the digestive system
• Mouth
• Teeth
• Tongue
• Accessory organs
• Salivary gland
• Liver
• Gallbladder
• Pancreas
• Pharynx
• Esophagus
• Stomach
• Small intestine
• Large intestine
• Anus
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 4
Effects of Aging on GI Tract
• Dental caries and tooth loss
• Decrease a person’s ability to chew food
• Decreased gag reflex
• Increases the risk of aspiration
• Decreased sense of taste
• May lead to loss of appetite
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 5
Effects of Aging on GI Tract (cont’d)
• Decreased muscle tone at sphincters
• Increases risk of esophageal reflux
• Decreased gastric secretions
• May interfere with digestion of food
• Decreased peristalsis
• Increased risk of constipation
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 6
Metabolism
• Process in which large molecules are broken down into
smaller molecules
• Makes energy available to the organism
• Enables absorbed nutrients to enter bloodstream
following digestion
• Digestion converts food into chemical substances such as proteins
and simple sugars to be used by the body for energy production
and cellular metabolism
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 7
Dietary Guidelines
• USDA MyPyramid
• Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat
milk and milk products
• Includes lean meats, poultry, fish, beans, eggs, and nuts
• Is low in saturated fats, trans fats, cholesterol, sodium, and added
sugars
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 8
Protein
• Constant supply essential for rebuilding and replacing
body tissues
• Plays a role in hormone production, fluid balance,
antibody production, and transportation of nutrients
• Supplies approximately 4 calories/g
• Composed of amino acids
• 9 essential
• 11 nonessential
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 9
Food Sources: Protein
• Animal sources
• Red meat, eggs, milk and milk products, poultry, fish
• Complete, or high-quality proteins
• Plant sources
• Grains, legumes, and most vegetables
• Incomplete, or low-quality proteins
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 10
Food Sources: Protein (cont’d)
• Average DRI is 46 to 56 g of protein per day for the
healthy adult
• Protein intake should be 10% to 15% of the total daily
calories
• May vary depending on activity level, state of health, and
availability of protein food sources
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 11
Proteins
• Protein deficiency
• Marasmus
• A form of protein energy and nutrient malnutrition
• Occurring chiefly in the first year of life, characterized by growth
retardation and wasting of subcutaneous fat and muscle
• Kwashiorkor
• A condition occurring in infants and young children soon after weaning
from breast milk
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 12
Proteins (cont’d)
• Protein excess
• Stressful to the liver and kidneys
• Kidneys must rid the body of excess waste products
• Liver function is strained with the excess load of protein to metabolize
• Can lead to excess fat in the diet
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 13
Vegetarian Diets
• Lacto-ovo-vegetarian
• Dairy products, eggs, and plant foods included in the diet
• Lactovegetarian
• Eggs are excluded; dairy products and plant foods included
• Vegan
• All animal food sources are excluded, including honey
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 14
Vegetarian Diets (cont’d)
• Well-planned vegetarian diets offer health benefits
• Decreased risk of heart disease, hypertension, diabetes, and
obesity
• Vegans may have a diet deficient in
• Vitamin B6, vitamin B12, iron, zinc, riboflavin, and vitamin D
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 15
Learning Objectives
Theory
4) Discuss the function of proteins, carbohydrates, fats,
vitamins, minerals, and water in the human body.
5) Identify food sources of proteins, carbohydrates, fats,
vitamins, and minerals.
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 16
Carbohydrates
• The body’s main source of energy
• Should make up 50% to 60% of the daily diet
• Supply 4 calories/g
• Regulate protein and fat metabolism, fight infection, and
promote growth of body tissues
• Three main types:
• Simple, complex, and fiber
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 17
Carbohydrates (cont’d)
• Simple carbohydrates
• Glucose is the metabolized form of sugar found in the body and is
found in:
• Table sugar (sucrose), the major sweetener found in foods
• Fruit sugar (fructose)
• Milk sugar (lactose)
• Quickly absorbed into the bloodstream
• Cause a quick rise in serum glucose
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 18
Carbohydrates (cont’d)
• Complex carbohydrates
• Breads, pasta, cereals, and rice
• Broken down into simple sugars for use by the body
• Provide a more consistent serum glucose level than simple sugars
provide
• Recommended that 85% to 95% of consumed carbohydrates are
complex carbohydrates
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 19
Carbohydrates (cont’d)
• Fiber
• The portion of the carbohydrate that cannot be broken down during
digestion
• Passes through the intestine undigested
• Increases bulk in the stool
• Aids in elimination
• May decrease absorption of fat
• Recommended intake 21 to 38 g/day
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 20
Food Sources: Fiber
• Fruits
• Apples, bananas, oranges, grapefruits
• Cantaloupe, strawberries
• Vegetables
• Green beans, broccoli, cauliflower, celery
• Corn, potato (with skin), sweet potato
• Grains and cereals
• Breads, All Bran, oatmeal, Shredded Wheat
• Legumes (cooked)
• Beans: kidney, pinto, lima; black-eyed peas
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 21
Fats
• An essential nutrient
• Supplies a concentrated form of energy
• Supplies 9 calories/g consumed
• Provides source of fatty acids
• Adds flavor to foods and contributes to texture
• Dissolves and transports fat-soluble vitamins and fat-soluble
•
•
•
•
•
phytonutrients (carotenoids)
Insulates and controls body temperature
Makes food smell appetizing
Cushions and protects body organs
Facilitates transmission of nerve impulses
Gives feeling of fullness after eating
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 22
Fats (cont’d)
• Made up of fatty acids and glycerol
• Fatty acids are classified as saturated or unsaturated
• Fatty liquids at room temperature are called oils
• Oils containing unsaturated fats:
• Corn oil, safflower oil, canola oil
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 23
Fats (cont’d)
• Omega-3 fatty acids
• The most unsaturated form of fatty acid
• Found in salmon, halibut, sardines, tuna, canola oil, soybean oil,
chicken, eggs, and walnuts
• Should be added to the diet as sources of unsaturated fats
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 24
Vitamins
• Essential nutrients that must be taken in through
food sources or supplements
• Water-soluble vitamins
• Easily absorbed into the bloodstream for use by the body
• B-complex vitamins and vitamin C
• Fat-soluble vitamins
• Absorbed in the small intestine the same as other fats by
action of bile in the duodenum and stored in the liver
• A, D, E, and K
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 25
Minerals
• Inorganic substances found in animals and plants
• Essential for metabolism and cellular function
• Major minerals
• Calcium, magnesium, sodium, potassium, phosphorus, sulfur,
chlorine
• Trace minerals
• Iron, copper, iodine, manganese, cobalt, zinc,
molybdenum, selenium, fluoride, chromium
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 26
Water
• Water is the most essential of all nutrients
• Adult body is 50% to 69% water
• Water requirement is 1 mL/calorie of intake
• Used in every body process, from digestion to absorption
to elimination or secretion; large amount must be stored in
the body
• General rule: intake needs to be equal to recorded output
plus 500 mL
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 27
Factors Influencing Nutrition
• Age: infants, toddlers, preschool, school-age,
adolescents, adults, older adults
• Illness
• Emotional status
• Economic status
• Religion: Islam, Judaism, Seventh-Day Adventist
• Culture: African American, Hispanic, Asian
• Assessment, Nursing Diagnosis, Planning
• Implementation, Teaching
• Evaluation
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 28
Nutritional Needs Through the
Life Span: Infants
• Should double birth weight by 6 months and triple weight
by 1 year
• Breast milk recommended
• AAP recommends breast milk for first full year
• Formulas
• Modified form of cow’s milk, made more digestible with added
carbohydrate and fat content
• Solids introduced in diet at 4 to 6 months
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 29
Nutritional Needs Through the Life Span:
Toddlers and Preschool
• Ages 2 to 5 years
• Consume less milk and increase intake of solids
• Provide small servings
• Offer foods that are easy to chew
• Avoid combination foods
• Toddlers prefer single-item foods that do not touch each other on
the plate
• Try colorful foods (e.g., peas, carrots)
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 30
Nutritional Needs Through the Life Span:
Toddlers and Preschool (cont’d)
• Provide a pleasant environment at mealtimes
• Provide plates and utensils in a size that can be easily
handled by a small child
• Use dishes that are colorful and/or contain pictures of
favorite characters
• Avoid forcing a child to eat
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 31
Nutritional Needs Through the Life Span:
School-Age Children
• May desire sweet, non-nutritive foods such as soda,
candy, cake, and ice cream
• Provide well-balanced breakfast before school
• Provide nutritious after-school snacks
• High-calorie, high-sodium preferences may predispose to
obesity
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 32
Nutritional Needs Through the Life Span:
Adolescents
• Tend to consume many fast foods, either from restaurants
or vending machines
• During growth spurt the body requires more calories as
well as nutrients
• Adolescent females require increased levels of iron after
the menstrual cycle begins
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 33
Nutritional Needs Through the Life Span:
Adulthood
• Rely on fast foods and convenience foods
• Obesity and hypertension prevalent
• Have increased fat and sodium intake
• Have increased sugar intake
• Lack exercise
Copyright © 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.