Download NUTRITION - Linda C. Hansen

NUTRITION
Objectives
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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
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Morbidity and mortality are linked to a
poor diet and a sedentary lifestyle
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Almost 2/3 of Americans are overweight
> 50% do not get enough activity
Nutrition is:
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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
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Decreased risk of chronic diseases
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Type 2 diabetes
Hypertension
Certain cancers
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Colon
Breast
Uterine
Kidney
Esophagus
Decreases risk of overweight and obesity
Decreased risk of being micronutrient deficient
Type 2 Diabetes
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Attributed to obesity
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Usually diagnosed in adults
Increased incidence in kids/teens
Increased incidence in some cultures
Native Americans
 African Americans
 Hispanic-Latino Americans
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Good nutrition
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Includes:
variety
moderation
balance
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Is a diet that has
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Decreased
Decreased
Decreased
Decreased
Decreased
Decreased
saturated fats
trans-fats
cholesterol
added sugars
salt
alcohol intake
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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
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Activity
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increase activity to decrease risk of chronic
diseases
Moderation
Personalization
Proportionality
Variety
Gradual improvement
RDA means
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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
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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
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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
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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
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Nutrition information helpful for
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Your own nutritional requirements
Serving sizes
 Special diets
 low sodium
 low fat
 low potassium
 high fiber
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“Healthy People 2010” goals
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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”
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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
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“Hype or hope”
Health in a bottle
Cancer studies
Function of many
have not been fully
established
Organic compounds
necessary to maintain
life
Vitamins
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Fat soluble vitamins are
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Water soluble vitamins are
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A, D, E, K
C, thiamine, niacin
B vitamins – riboflavin
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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
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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
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Vitamin B
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B6, B12, Folate
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B6 protein metabolism
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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
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B12 deficiency syndrome is anemia of folate deficiency
Vitamin D
functions as a hormone with intestines, kidney,
bones
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Lipid soluble
Important in metabolism of calcium and
phosphorus
Promotes calcium absorption and bone
mineralization
Vitamin D
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can be obtained through dietary sources or sun
exposure
Dietary sources
 Decreased absorption
 fortified foods – milk
from Sun Exposure
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fatty fish
egg yolks
beef liver
cheese – not
frequently fortified –
Swiss is best
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Obesity
Decreased sun
Clouds
Pollution
GI bypass
Preventative maintenance
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A healthy diet has more of an impact on reducing cancer
risks than vitamins
These vitamins have not shown to decrease risk of
cancer
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COQ10
Vitamin C
Vitamin E
Beta-Carotene
Minerals
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Inorganic – major
Provide structure and
fluid balance
Body >5gms
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Calcium
Phosphorus
Potassium
Sulfur
Sodium
Chloride
Magnesium
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Trace
Body < 5gms
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Iron
Zinc
Copper
Manganese
Iodine
Selenium
Dietary Supplements
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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
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Calcium supplements –
most abundant mineral in
body
Antioxidants
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Beta-carotene
Lutein
Selenium
Vitamins A, C, E
Botanicals
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Valued for medicinal
properties – herbs
FDA (Good manufacturing
practice) regulations
Concern with safety and
sanitation vs consistent
quality
Macronutrients
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Nutrients in your diet that are the key sources of
energy, growth, metabolism and body function:
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Protein
Carbohydrates
Fats
Water
Macro-minerals
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Calcium
Chlorine
Magnesium
Phosphorus
Sodium
Sulfur
Macronutrients
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Soluble – decrease GI
empty time, delays
glucose absorption
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Fiber
Fruits
Oats
Barley
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Insoluble – increase
GI time, delays
glucose absorption,
can affect absorption
of drugs by time in
colon
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Whole grains
vegetables
Micronutrients
“small amounts necessary”
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Vitamins
Minerals
Phytochemicals
Children’s Nutrition
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Diet habits influenced
by :
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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
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“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
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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
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Amount per day varies based on age
Essential for normal growth and
development
Most important vitamins and minerals
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Vitamin A
Vitamin C
Folate
Calcium
Iron
zinc
BMI
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Children and adolescents have gender
specific BMI
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Determined by BMI-for-age growth charts
GROWTH CHART FOR BOYS
GROWTH CHART FOR GIRLS
BMI
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< 5th percentile – underweight, under BMI
for age
85th percentile to < 95th percentile at risk
for overweight
> 95th percentile overweight
Maintaining Weight
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Goal for children and adolescents is to
maintain weight
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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
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Most common nutritional disorder
Monitor for secondary complications of
being overweight
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Hypertension
Increased blood lipids
Insulin resistance
Adolescent Nutrition
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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
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Loss of taste buds
Decreased gastric
secretions
Decreased gastric
motility
Food requirements
change as we age
Nutrition and Aging
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Decreased metabolic
rate
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Decreased muscle
mass
Decreased bone mass
Increased body fat
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Health issues
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Osteoporosis
cancer prevention
Cardiovascular disease
Food pyramid recommendation for
older adults – modified pyramid
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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
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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
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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
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Multivitamins are most commonly used
dietary supplement for women in the
United States
More women than men use dietary
supplements
Reproductive Years
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Important to be healthy before conception
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Impacts fetal and maternal outcomes
Many women lack sufficient quantities of
many vitamins and minerals
Monitor use of
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Weight loss products
Herbals
Vitamins and minerals
Vitamins and minerals during
pregnancy
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Folic acid
Vitamin A
Calcium
Omega 3 fatty acids
Vitamin D
Iron
Folic Acid
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Water soluble B complex vitamin
Available in folate rich foods
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Legumes
Green leafy vegetables
Citrus fruits and vegetables
Enriched breads and cereals
Required for DNA synthesis and cell
division
Prevents neural tube defects
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Spina bifida
anencephaly
Vitamin A
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Essential for
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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
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Vitamin D
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Important during pregnancy and lactation
Prevents rickets
Iron
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Needs double during pregnancy
Populations at risk for being
folic acid deficient
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Hispanic women
Obese women
Poorly controlled diabetics
Women with seizure disorders
Women with a history of neural tube defects
 Recommended
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Daily Intake
400 IU pre-conception
600 IU during pregnancy
Caloric Needs During Pregnancy
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Dependent on weight and activity level
Typically 2200 – 2900 kcals/day
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Increase by 340 kcals/day in second trimester
Increase by 452 kcals/day for third trimester
Breast Feeding
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Usually need an extra 500kcal/day
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Dependent on activity level and weight of mom
Fluid intake
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Moms can produce 750-800 ml milk
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My Pyramid.gov can be a reference
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Calcium intake 1000mg
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Spinach and broccoli
Dairy products
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Yogurt
cheese
Menopause
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Health threats for post menopausal
women
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Heart disease
stroke
Osteoporosis
Breast cancer
Bone and muscle loss
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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
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Vitamin D
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essential for calcium absorption
anti cancer agent
Vitamin B – esp. folic acid
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decrease levels of homocystine
Menopausal symptom prevention
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Micronutrients and phytochemicals
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Many products available
Vitamin E
 Black cohosh
 Soy
 Red clover
 Flax
 Other herbals
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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
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Diets/fads
Calories of food
Burning calories
Use of a food diary
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Can help to recognize
behaviors and food
eating patterns to
make changes and
increase weight loss
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3 components
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Variety
Moderation
balance
How portion size has changed
Aim for a Healthy Weight
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Making healthy choices
Replacements for high calorie or high fat
foods
Food diaries
Lifestyle changes
Weight Loss Programs
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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
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Increased risk for chronic diseases
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diabetes type 2
Hypertension
Stroke
Cancers
metabolic syndrome
Ethnocentric Nutrition
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Cultural factors
Socio economic status
Religious beliefs
Ethnicity in geographic locations
Health Promotion Goal
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Teach people of different cultures how to
incorporate their lifestyle into the food
pyramid to eat more healthfully
Health risks
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Risk of obesity for
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Caucasian adults – 25%
Blacks and Latinos 30-50%
Native Americans – 60%
Health promotion
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focus on education because morbidity and
mortality are directly related to lifestyle
and eating habits
Importance of Fruits and
Vegetables
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Diets high in fruits and vegetables significantly
reduce the risks of
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Stroke
Heart disease
Several types of cancer
Parents as Teachers
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Improving Diet Habits
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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
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WIC Nutrition Education
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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
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Goal
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Increasing healthful behaviors in WIC families
WIC Strategies
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Developed a statewide vision statement
Learner centered activities
Team approach
WIC continued
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Transtheoretical Model
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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
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not enough training
rural areas
Norway Study
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Trend for adolescent obesity increasing
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Socioeconomic status
Limited education
Sedentary lifestyle
Skipping breakfast
Latinos in Brooklyn, New York
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Understanding food practices
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Poverty
Government assistance for food
Parents’ body shape
Availability food in neighborhood
Cooking styles
Food as a reward or to console
“Cookin’ Up Health”
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Rural Appalachian Women
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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
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help women learn to cook healthier foods
from their own culture
Teach women about diet to modify their risks
reading abilities
“Cookin’ Up” Program
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Computer program accessed at local
health clinic
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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”
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Social Support Theory
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Need for support from others
Health Belief Model
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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
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Difficult for women to change the way
they grew up eating
Food used as a reward or to console
Cost
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Usually bought food in bulk – less availability
of healthy food in bulk
Belief that healthy food costs more
Healthy Nutrition
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As nurses, it is important to teach our
clients about the benefits of healthy
nutrition and an active lifestyle keeping in
mind cultural diversity.