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Transcript
NUTRITION Objectives The viewer will list the six food groups of the food pyramid and describe the correlation between food and exercise. Given a food label, the viewer will list the carbohydrate/protein/fat/calories of a serving size of a specific food. The viewer will describe how portion sizes have changed over the last 20 years and the increased caloric intake resulting from that change. The viewer will have fun while learning about nutrition by participating in learning activities. Nutrition is important to good health Morbidity and mortality are linked to a poor diet and a sedentary lifestyle Almost 2/3 of Americans are overweight > 50% do not get enough activity Nutrition is: The “study of materials that nourish an organism and the manner in which the separate components are used for maintenance, repair, growth and reproduction.” Nutrients necessary for human life are: Proteins Vitamins Carbohydrates Minerals Fats water Benefits of a Healthful Eating Plan Decreased risk of chronic diseases Type 2 diabetes Hypertension Certain cancers Colon Breast Uterine Kidney Esophagus Decreases risk of overweight and obesity Decreased risk of being micronutrient deficient Type 2 Diabetes Attributed to obesity Usually diagnosed in adults Increased incidence in kids/teens Increased incidence in some cultures Native Americans African Americans Hispanic-Latino Americans Good nutrition Includes: variety moderation balance Is a diet that has Decreased Decreased Decreased Decreased Decreased Decreased saturated fats trans-fats cholesterol added sugars salt alcohol intake Food Pyramid Developed to serve as a guideline to healthy eating to promote health and decrease risk for chronic diseases Guidelines are reviewed every 5 years Apply to people over two years of age The New Food Pyramid Anatomy of My Pyramid Activity increase activity to decrease risk of chronic diseases Moderation Personalization Proportionality Variety Gradual improvement RDA means Recommended daily allowance - Average daily dietary intake level that is sufficient to meet the nutrient requirements of 9798% of healthy individuals in each age and gender group Recommended Daily Allowances (RDA’s) for a 2000 calorie diet Grains – 6 ounces Fruits - 2 cups vegetables – 2 ½ cups Dairy products- 3 cups Meats/beans – 5 ½ ounces One size does not fit all The needs of one client may not be the same as another Culture, ethnicity, religious practices, and economic status need to be considered when educating others Serving sizes Serving Sizes The Healthy Dinner plate for portion control Food Labels Food Labels Important for nutrition information – typically based on 2000 calorie diet Nutrient standards by which foods can be evaluated American Heart Association Developed criteria for “heart healthy” diet from the basis of this criteria Food Labels Nutrition information helpful for Your own nutritional requirements Serving sizes Special diets low sodium low fat low potassium high fiber “Healthy People 2010” goals Increase the number of healthy weight adults (BMI >18.5 < 25) Decrease obesity from 23% to 15% Increase fruits and vegetables people eat on a daily basis Eliminate differences in a healthy lifestyle based on socio-economic status Leading health indicators for “Healthy People 2010” Physical activity Overweight and obesity Tobacco use Substance abuse Responsible sexual behavior Mental health Injury and violence Environmental quality Immunizations Access to health care Vitamins, minerals, and organic compounds “Hype or hope” Health in a bottle Cancer studies Function of many have not been fully established Organic compounds necessary to maintain life Vitamins Fat soluble vitamins are Water soluble vitamins are A, D, E, K C, thiamine, niacin B vitamins – riboflavin Don’t require fat for absorption Excreted when in excess to prevent toxic build-up Circulate freely in blood Vitamin A plays a role in vision, bone growth, reproduction, cell division, and cell differentiation Fat soluble People with the Found in fruits and vegetables following conditions Leafy greens need a supplement carrots ETOH Found in foods that come from animals Celiac Eggs Crohn’s disease Liver Antioxidant Dairy products chronic diseases Protects cells Vitamin B B6, B12, Folate B6 protein metabolism Decrease homocystine levels Builds RBC’s and HGB Increases the amount of oxygen they can carry Red blood cell metabolism Nervous and immune system B12 requires protein to aide absorption B12 deficiency syndrome is anemia of folate deficiency Vitamin D functions as a hormone with intestines, kidney, bones Lipid soluble Important in metabolism of calcium and phosphorus Promotes calcium absorption and bone mineralization Vitamin D can be obtained through dietary sources or sun exposure Dietary sources Decreased absorption fortified foods – milk from Sun Exposure fatty fish egg yolks beef liver cheese – not frequently fortified – Swiss is best Obesity Decreased sun Clouds Pollution GI bypass Preventative maintenance A healthy diet has more of an impact on reducing cancer risks than vitamins These vitamins have not shown to decrease risk of cancer COQ10 Vitamin C Vitamin E Beta-Carotene Minerals Inorganic – major Provide structure and fluid balance Body >5gms Calcium Phosphorus Potassium Sulfur Sodium Chloride Magnesium Trace Body < 5gms Iron Zinc Copper Manganese Iodine Selenium Dietary Supplements any vitamin, mineral, herb, amino acid or dietary substitute intended to supplement the diet, contains one or more dietary ingredient, taken by mouth Dietary Supplements – per Dietary Guidelines (2005), nutrient needs should be meet through consuming foods. Dietary supplements are not required to be standardized Dietary Supplements Calcium supplements – most abundant mineral in body Antioxidants Beta-carotene Lutein Selenium Vitamins A, C, E Botanicals Valued for medicinal properties – herbs FDA (Good manufacturing practice) regulations Concern with safety and sanitation vs consistent quality Macronutrients Nutrients in your diet that are the key sources of energy, growth, metabolism and body function: Protein Carbohydrates Fats Water Macro-minerals Calcium Chlorine Magnesium Phosphorus Sodium Sulfur Macronutrients Soluble – decrease GI empty time, delays glucose absorption Fiber Fruits Oats Barley Insoluble – increase GI time, delays glucose absorption, can affect absorption of drugs by time in colon Whole grains vegetables Micronutrients “small amounts necessary” Vitamins Minerals Phytochemicals Children’s Nutrition Diet habits influenced by : Family food preparation eating behaviors Eating habits Poor eating habits develop in childhood 60% of kids eat more than RDA of fat < 20% of kids eat RDA of fruits and vegetables Balance “Childhood nutrition should be a balance between high energy and nutrient content required for growth and development, and physical exercise which can seek to control body weight and promote good health.” (Shepherd, 2008) Kcal/day requirements vary based on age and gender Boys Age Age Age Age 4-6 7 – 10 11-14 15-18 1715 1970 2220 2755 Girls 1545 1740 1845 2110 Activity is important to maintain a healthy weight Studies show that lack of physical activity during childhood may lead to health problems in adulthood like obesity, heart disease, and Diabetes type 2 Vitamins and Minerals for children and adolescents Amount per day varies based on age Essential for normal growth and development Most important vitamins and minerals Vitamin A Vitamin C Folate Calcium Iron zinc BMI Children and adolescents have gender specific BMI Determined by BMI-for-age growth charts GROWTH CHART FOR BOYS GROWTH CHART FOR GIRLS BMI < 5th percentile – underweight, under BMI for age 85th percentile to < 95th percentile at risk for overweight > 95th percentile overweight Maintaining Weight Goal for children and adolescents is to maintain weight be more physically active spend less screen time eat family meals eat a healthy breakfast avoid sugary drinks eat more fruits and vegetables eat less salty or sugary snacks CHILDHOOD OBESTIY Most common nutritional disorder Monitor for secondary complications of being overweight Hypertension Increased blood lipids Insulin resistance Adolescent Nutrition Relationship between health education at school and nutrition and physical activity Knowledge about nutrition improves with taking quizzes about nutrition Teaching children and teens about healthy lifestyles Nutrition and Aging Loss of taste buds Decreased gastric secretions Decreased gastric motility Food requirements change as we age Nutrition and Aging Decreased metabolic rate Decreased muscle mass Decreased bone mass Increased body fat Health issues Osteoporosis cancer prevention Cardiovascular disease Food pyramid recommendation for older adults – modified pyramid Bright colored vegetables Deep colored fruit Low-fat and non-fat dairy products Dry beans, nuts, fish poultry, lean meat and eggs Liquid vegetable oils and soft spreads low in saturated and trans fats Physical activity Frozen fruits and vegetables ok – have a longer shelf life, may be cheaper Adequate amounts of fiber rich foods such as whole grains May need supplemental nutrients Fluids Regular physical activity An ancient adage from Chinese medicine A doctor would rather treat 10 men than one woman.” “ A quote from “Better Nutrition” by S. Sellman Women’s Nutrition Special circumstances: Pregnancy Breastfeeding Menopause Women’s Nutrition Multivitamins are most commonly used dietary supplement for women in the United States More women than men use dietary supplements Reproductive Years Important to be healthy before conception Impacts fetal and maternal outcomes Many women lack sufficient quantities of many vitamins and minerals Monitor use of Weight loss products Herbals Vitamins and minerals Vitamins and minerals during pregnancy Folic acid Vitamin A Calcium Omega 3 fatty acids Vitamin D Iron Folic Acid Water soluble B complex vitamin Available in folate rich foods Legumes Green leafy vegetables Citrus fruits and vegetables Enriched breads and cereals Required for DNA synthesis and cell division Prevents neural tube defects Spina bifida anencephaly Vitamin A Essential for Proper visual functioning Fetal growth Reproduction Immunity Epithelial tissue integrity Crosses the placenta High levels can cause miscarriages, birth defects Recommended amounts 700 REA (retinol activity equivalents) to a maximum of 3000 REA Vitamins and minerals Vitamin D Important during pregnancy and lactation Prevents rickets Iron Needs double during pregnancy Populations at risk for being folic acid deficient Hispanic women Obese women Poorly controlled diabetics Women with seizure disorders Women with a history of neural tube defects Recommended Daily Intake 400 IU pre-conception 600 IU during pregnancy Caloric Needs During Pregnancy Dependent on weight and activity level Typically 2200 – 2900 kcals/day Increase by 340 kcals/day in second trimester Increase by 452 kcals/day for third trimester Breast Feeding Usually need an extra 500kcal/day Dependent on activity level and weight of mom Fluid intake Moms can produce 750-800 ml milk My Pyramid.gov can be a reference Calcium intake 1000mg Spinach and broccoli Dairy products Yogurt cheese Menopause Health threats for post menopausal women Heart disease stroke Osteoporosis Breast cancer Bone and muscle loss From mid 30’s women lose ¼ pound muscle each year Gain that much in fat 1% bone loss - rapid during the first 5-7 years after menopause Prevention of health threats Vitamin D essential for calcium absorption anti cancer agent Vitamin B – esp. folic acid decrease levels of homocystine Menopausal symptom prevention Micronutrients and phytochemicals Many products available Vitamin E Black cohosh Soy Red clover Flax Other herbals Weight control Maintaining weight - Your weight will stay the same when the calories you eat and drink equal the calories you burn. Losing Weight - You will lose weight when the calories you eat and drink are less than the calories you burn. Gaining Weight - You will gain weight when the calories you eat and drink are greater than the calories you burn. Dieting Diets/fads Calories of food Burning calories Use of a food diary Can help to recognize behaviors and food eating patterns to make changes and increase weight loss 3 components Variety Moderation balance How portion size has changed Aim for a Healthy Weight Making healthy choices Replacements for high calorie or high fat foods Food diaries Lifestyle changes Weight Loss Programs WOW Web sites give information on how to chose a program http://win.niddk.nih.gov Aim for a Healthy Weight website www.nblbi.nih.gov/health/public/heart/ obesity/lose_wt/. Gym memberships Personal trainers Obesity Increased risk for chronic diseases diabetes type 2 Hypertension Stroke Cancers metabolic syndrome Ethnocentric Nutrition Cultural factors Socio economic status Religious beliefs Ethnicity in geographic locations Health Promotion Goal Teach people of different cultures how to incorporate their lifestyle into the food pyramid to eat more healthfully Health risks Risk of obesity for Caucasian adults – 25% Blacks and Latinos 30-50% Native Americans – 60% Health promotion focus on education because morbidity and mortality are directly related to lifestyle and eating habits Importance of Fruits and Vegetables Diets high in fruits and vegetables significantly reduce the risks of Stroke Heart disease Several types of cancer Parents as Teachers Improving Diet Habits Sponsored by the National Cancer Institute called the High 5, low fat program Target: low income black families Goal: parental role modification ChallengesPoverty decreases opportunities for education and access to health insurance Increased stress Poor nutritional habits WIC Nutrition Education WIC – Women, Infants, Children (federal, state, and local agencies) Lacked in providing education to the families it served Wanted to develop a plan to include education Felt that all staff needed to be educated A relationship needs to exist between staff and clients Goal Increasing healthful behaviors in WIC families WIC Strategies Developed a statewide vision statement Learner centered activities Team approach WIC continued Transtheoretical Model readiness for change assessed if ready for change, support from administration was necessary some agencies were not ready for change and program was not implemented Barriers to change not enough training rural areas Norway Study Trend for adolescent obesity increasing Socioeconomic status Limited education Sedentary lifestyle Skipping breakfast Latinos in Brooklyn, New York Understanding food practices Poverty Government assistance for food Parents’ body shape Availability food in neighborhood Cooking styles Food as a reward or to console “Cookin’ Up Health” Rural Appalachian Women High incidence of heart disease among these women Limited reading abilities Help women learn to cook healthier foods from their own culture Teach women about diet to modify their risks Goals help women learn to cook healthier foods from their own culture Teach women about diet to modify their risks reading abilities “Cookin’ Up” Program Computer program accessed at local health clinic Interactive, user friendly Tips given on health and nutrition Variety of recipes based on user defined information (age and number of people she was cooking for) Focus was to increase fruits and vegetables in diet rather that eliminate foods Models for Health Promotion used in “Cookin’ Up Health” Social Support Theory Need for support from others Health Belief Model Designed recipes to be quick and easy based on findings that the group needed to have foods more healthful based on cardiovascular risk but concerns over time constraints and cost Barriers to Change Difficult for women to change the way they grew up eating Food used as a reward or to console Cost Usually bought food in bulk – less availability of healthy food in bulk Belief that healthy food costs more Healthy Nutrition As nurses, it is important to teach our clients about the benefits of healthy nutrition and an active lifestyle keeping in mind cultural diversity.