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Faculty of Medicine
Introduction to Community Medicine Course
(31505201)
Unit 2 Nutrition and Nutrition Assessment and Diet
Introduction and Terminology used in nutrition
By
Hatim Jaber
MD MPH JBCM PhD
25-09-2016
Presentation outline
Time
Introduction to unit 2
12:00 to 12:10
Nutrition in Health and Medicine
12:10 to 12:20
The Nutrients & their Categories.
12:20 to 12:40
Food Pyramid
12:40 to 12:50
Unit 2 Nutrition
Learning objectives
• Understand and Describe the relation between
nutrition and health
• Name nutrient categories according to their
physiologic roles, and outline the ecology of
malnutrition with differential characterization of the
various types and classes of nutritional disorders.
• Identify nutrition-risk groups by application of proper
criteria and suggest ideas for the prevention and
control of nutrition-related diseases.
• List the scientific reasons that justify the launching of
public campaigns that target at the promotion of
breast feeding practice for infants
Unit 2 Nutrition
Unit contents
•
•
•
•
•
•
•
•
•
Introduction and Terminology used in nutrition.
The Nutrients & their Categories.
Nutritional Allowances & Requirements
Spectrum of public nutrition problems: Malnutrition &
its Ecology
Assessment of Nutritional Status.
Anthropometric Assessment
Common nutritional disorders in Jordan
Formula feeding
Breast feeding & Breast milk.
PERSPECTIVES ON NUTRITION
• To scientists, nutrition is the
study of:
– The nutrients found in foods
– The body’s handling of
nutrients to maintain health
• Nutrients (some of which
provide energy for processes
in the body) are substances
that can promote:
– Growth
– Maintenance
– Repair
For many, nutrition is all
about losing
weight!
Nutrition definition
• “The science/study of nutrients (that come from
food), their action, interaction, and balance in
relation to health and disease; and the process
by which the organism (body) ingests, digests,
absorbs, transports, utilizes and execrates food
substances”
• .. Science of food and its relationship to health…
• .. Is a dynamic process in which the food that is
consumed is utilized for nourishing the body..
NUTRITION AND HEALTH
• Health professionals agree that the overall composition of
the diet has an important effect on health.
• Eating too much fat, sat. fat and cholesterol and not eating
enough vegetables, fruits, and fiber has been linked to an
increase in heart disease and other cancers.
• The federal government constantly revises its official U.S.
Dietary Guidelines for Americans to help consumers choose a
healthy diet.
• These guidelines make Recommendations for Americans 2
years of age and older.
Diet, Dietetetics and Good nutrition
– Diet: a mixture of foodstuffs, which are selected to
satisfy the daily nutritional requirements of the
body…. The foods one consumes: The quality of which
affects the risk of chronic diseases
• Dietetetics:.the practical application of principles of
nutrition: ht includes the planning of meals for the well
and the sick.
• Good nutrition : “ maintaining a nutritional status that
enables us to grow well and enjoy good health”
Adequate nutrition is characterized by:
1-Daily intake of
nutrients, which are
(quantitatively and qualitatively).
2-Adequate nutrition should consider
physiological status and pathological
disorders.
3- Normal digestion, absorption,
metabolism, excretion.
FOOD
• Is a composite mixture of various nutrients in
a varying proportion, together with water
Classifications of foods
FOOD LABELS
• Food labels provide the following
information:
– Common name of product.
– Name and address of manufacturer,
packer or distributor.
– Net contents (wt, measure or count).
– Nutrient content of product
– Serving size
– Servings per container
– Calories/calories from fat
– Nutrient amounts and percentages of
Daily Values
– Daily values and calories/gram
reminder
– Ingredients
Food label
HOW MUCH FOOD DO WE NEED?
RDA (recommended dietary allowances)
• Primary nutrient intake standards for US for many
years.
DRI (dietary reference intake)
• Recently replaced RDA as primary standards
• Expands on RDAs
Food security and safety
• Food security: availability of the right quality and
quantity of food to supply the recommended
daily nutrients to maintain good health and
prevent malnutrition.
• Food safety: reflection of food sanitation and is
related to safeguarding from the immediate or
late health hazards resulting from biological,
chemical , or physical contamination of food (
production, transport, distribution, processing,
and subsequent use are properly handled )
CLASSIFICATION OF FOODS
•
Classification by origin:
- Foods of animal origin
- Foods of vegetable origin
•
Classification by chemical composition:
- Proteins
–
–
–
–
Fats
Carbohydrates
Vitamins
Minerals
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Background definitions
• Nutrients: “Chemical substances in food that
nourish the body by providing energy, building
materials, and factors to regulate needed
chemical reactions.”
• Essential nutrients: Must be provided by food
because the body does not produce them in
sufficient quantities or can not make them at all.
• Nonessential nutrients: Healthy, well-nourished
bodies can make them in sufficient quantities to
satisfy their needs.
CLASSIFICATION BY PREDOMINANT
FUNCTION
• Body building foods:
• -meat, milk, poultry, fish, eggs, pulses etc
• Energy giving foods:
• -cereals, sugars, fats, oils etc.
• Protective foods:
• -vegetables, fruits, milk, etc
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MORE FOOD RELATED FACTS
….
• Vitamins - only organic nutrient that
does not supply energy but is needed to
get energy from foods.
• Essential nutrient - body cannot make
enough of and must get from food.
• Some dietary and lifestyle practices
(smoking, inactivity, drinking alcohol) are
risk factors for many health conditions.
• Substances (non-nutrients) in foods are
phytochemicals that give foods the
characteristic taste and smell.
Definitions and concepts
• Food is a composite mixture of various
nutrients in a varying proportion,
together with water.
• Nutrients are chemical substances,
which are required in grams (e.g.
macronutrients) or in milligrams or
micrograms (e.g. micronutrients).
Food Constituents Macronutrients & Micronutrients
• Protein
• Carbohydrates
• Fat -Water Soluble Vitamins
• Fat Soluble Vitamins
• Minerals
• Trace elements Water
Foods are grouped on the basis of their predominant
function into:
1-Energy yielding foods (carbohydrates and fats).
2-Body building foods (Protein) .
3-Maintenance and regulation of tissue functions
(vitamins and minerals)
2.1. Formation of Cells.
Required Nutrients: mainly protein.
2.2. Building and Maintenance of Bones and Teeth:
Required Nutrients:
• Calcium and phosphorus are the basic nutrients.
• Vitamin D for absorption and metabolism of calcium
and phosphorus.
• Fluorine
teeth.
for healthy decay - resistant enamel of
2.3. Formation of Blood Cells
a) Red cells are formed in the bone marrow.
Haemopoictic nutrients are:
• Iron and protein, to form hemoglobin.
• Vitamin B12 and folic acid, for development and
maturation of red cells in the bone marrow.
• Vitamin C helps absorption of iron.
• Copper helps absorption of iron, and
synthesis of hemoglobin.
b)
White
nutrition.
cells
also
need
adequate
3- Protective (Vitality) foods:
For maintenance and regulation of tissue functions:
Required nutrients are.
• B-vitamins.
• Vitamin A:
Iodine:
• Others: cytochrome (intracellular iron), vitamin K,
calcium, phosphorus
4- Water.
Adequate diet provides the basic food
nutrients (protein, carbohydrates, fat,
vitamins, essential elements, water) and
energy.
NUTRIENTS
• Organic and inorganic complexes contained in
food are called nutrients. They are broadly
divided in to:
• Macronutrients:
• -proteins
• -fats
• -carbohydrates
• Micronutrients:
• -vitamins
• -minerals
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The Nutrients
Copyright 2005 Wadsworth Group, a division of Thomson Learning
The 6 Essential Nutrients
•
•
•
•
•
•
Water
Carbohydrates
Protein
Fat
Vitamins
Minerals
©2002 Learning Zone Express
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Energy-Yielding
Nutrients
• Calories
and
kilocalories
Copyright 2005 Wadsworth Group, a division of Thomson Learning
Water
• Inorganic
• Not energy-yielding
• Essential
Copyright 2005 Wadsworth Group, a division of Thomson Learning
Eating Pattern for Longevity
• Healthy habits of the Okinawans
• Enough is enough
• Moderation & a healthful lifestyle are key
cultural values
• Psychological & spiritual health matters
FOOD CHOICES
• Select foods to provide adequate amounts of nutrients and
energy!
• When humans eat, foremost in their minds is that they are
consuming foods, not nutrients!
•
•
•
•
•
•
•
•
The following influence food choices:
• Personal Preference
Advertising
• Positive Associations
Availability
• Geographical location
Convenience
Economy
• Social Pressure
Comfort
• Values and beliefs
Ethnicity
• Body weight
Habit
• Nutritional Value
Understanding Our Food Choices
•
•
•
•
•
•
Hunger vs. appetite
Availability
Income, food prices, & convenience
Advertising & the media
Social & cultural factors
Personal values or beliefs
Variables which affect
nutrient needs:
1. Age
2. Gender
3. Activity Level
4. Climate
5. Health
6. State of nutrition
Aim for Fitness
1. Aim for a healthy
weight
2. Be physically active each day
Build a Healthy Base
3. Let the pyramid guide your
choices
4. Choose a variety of grains
daily, especially whole grains
5. Choose a variety of fruits
and vegetables daily.
6. Keep food safe to eat.
Choose Sensibly
7. Choose a diet that is low in
saturated fat and cholesterol and
moderate in total fat
8. Choose beverages and foods
to moderate your intake of
sugars
9. Choose and prepare food with less
salt
10. Individuals over 21 who
drink alcoholic beverages
should do so in moderation
FOOD PYRAMID::
diagram that represents a healthy diet by placing food
groups ina pyramid according to the number of servings
from each group to be eaten every day.
Food Guide Pyramid
Daily exercise and weight control
Clinical Nutrition
(Medical Nutrition Therapy)
Purpose
– To achieve or maintain good nutritional
status.
Patient Care: Team Approach
(Interdisciplinary)
• Physician
• Registered Dietitian
• Registered Nurse, Licensed Vocational Nurse,
Certified Nursing Assistant
• Pharmacist
• Speech Therapist
• Occupational Therapist
• Social Worker
The Nutrition Care Process
• Identifying and meeting a person’s nutrient and nutrition
education needs. Five steps:
1. Assess Assessment of nutritional status
2. Analyze Analyze assessment data to determine nutrient
requirements
3. Develop Develop a nutrition care plan to meet patient’s
nutrient and education needs.
4. Implement: Implement care plan
5. Evaluate: Evaluate effectiveness of care plan: ongoing
follow-up, reassessment, and modification of care plan.
Illness
Example : Cancer
Altered
Food Intake
Examples: Loss
of appetite,
altered food
likes/dislikes,
difficulty chewing
and swallowing,
reduced saliva
secretion
Altered
Digestion and
Absorption
Examples:
radiation enteritis,
surgical resection
of GI tract,
diarrhea
Altered
Metabolism
Example:
increased energy
needs due to
altered energy use
in cancer
Malnutrition
Altered
Nutrient
Excretion
Examples: fecal
loss of fat-soluble
vitamins and
calcium in clients
with cancers that
affect enzyme
secretion or bile
salt production
What is a vegetarian diet?
• one that does not include meat (including
fowl) or seafood, or products containing those
foods
– The American Dietetics Association
• Includes: fruits, vegetables, beans, legumes,
cereal grains, nuts, and seeds, with or without
dairy products and eggs
Other Forms of Vegetarian Diets
• Vegan-excludes meat, dairy, eggs, honey
• Lacto – excludes meat, eggs (but includes
dairy products and honey)
• Ovo – excludes meat, dairy products (but
includes eggs and honey)
Why?
 A vegetarian diet may be chosen for:
 Ethical
 Health
 Environmental
 Religious
 Political
 Cultural
 Aesthetic
 Economic
 …or other reasons
Health Advantages
• Vegetarian diets have been associated with the
following when compared to nonvegetarian diets:
–
–
–
–
–
–
–
Lower LDL cholesterol levels
lower risk of death from ischemic heart disease
lower blood pressure
lower rates of hypertension
type 2 diabetes
lower body mass index
lower overall cancer rates
Vegan Food Pyramid
(Adapted from J Am Diet Assoc.
2003;103:771-775)
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The Student Diet ‫صحة وهنا‬
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