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APPLIED SKILLS MODULE The Principles of Nutrition Objectives • Outline why the science of nutrition is important • Briefly outline macronutrients & micronutrients • Outline the importance of hydration • Identify what is a balanced diet Nutrition • Most people grow well and stay healthy provided that they get enough of a variety of food to eat, wherever they live in the world • A knowledge of nutrition principles is important for all of us • The science of nutrition is the study of all processes of growth, maintenance and repair of the living body that depend upon the digestion of food, and the study of that food (Department of Health, 2012) Nutrition Food is any solid or liquid that, when swallowed can supply any of the following: • Material from which the body can produce movement, heat or other forms of energy • Material for growth, repair or reproduction • Substances necessary to regulate the production of energy or the processes of growth and repair The components of foods that have these functions are called nutrients (Department of Health, 2012) Nutrition The following types of nutrients may be present in foods: • Carbohydrates: which provide the body with energy; excess may also be converted into body fat • Fats: which provide energy in a more concentrated form than carbohydrates and may also be converted into body fat • Proteins: which provide materials (amino acids) for growth and repair. They can be converted into carbohydrates and used to provide energy As these are all needed in relatively large quantities they are often referred to as macronutrients (Department of Health, 2012) Nutrition • Vitamins and minerals are required to help regulate body processes and for growth and repair • Vitamins and minerals are needed only in small quantities and are sometimes referred to as micronutrients (Department of Health, 2012) Minerals The major minerals are: • Calcium • Iron • Magnesium • Phosphorus • Potassium • Sodium Zinc • • • Helps with the healing of wounds and is associated with the activity of a wide variety of enzymes Most people should be able to get all the zinc they need by eating a varied and balanced diet When supplements are taken advice is that taking no more than 25mg of zinc supplements per day and a higher dose should be under the supervision of a medical doctor Trace elements are essential nutrients that the body requires in order to function properly but are needed in smaller amounts Crab: Almost any kind of crab will be a great source of zinc Trace elements are found in small amounts in a variety of foods such as meat, fish, cereals, milk and diary foods, vegetables and nuts Roasted pumpkin and squash Seeds are a good source of zinc Vitamins Vitamins are used by the body everyday Water-soluble vitamins are not stored by the body and are the B vitamins and vitamin C such as: • Thiamin (vitamin B1) • Riboflavin (vitamin B2) • Niacin (vitamin B3) • Pyridoxine (vitamin B6) • Folate (vitamin B9) • Cobalamin (Vitamin B12) Fat soluble vitamins are the A vitamins • Vitamin A is essential for vision in dim light and necessary for the maintenance of healthy skin and surface tissues • Beta –carotene a good source of vitamin A • The yellow carotenes are responsible for the yellow or orange colours of many fruits and vegetables • The main food sources of Bcarotene are red, yellow and green (leafy) vegetables such as carrots, red peppers and spinach and yellow fruits such as mango and apricots Vitamin D Vitamin D helps to maintain bone mineralisation by ensuring an appropriate supply of calcium in the blood Most people should be able to get all the vitamin D they need by eating a healthy, balanced diet and getting some summer sun Infants and children who are deprived of vitamin D develop rickets with deformed bones In extreme cases, low levels of vitamin D resulting in low levels of calcium can cause heart failure Some adults are at risk from bone softening (osteomalacia) resulting in skeletal pain and bone fractures because they absorb too little calcium from a diet low in calcium and vitamin D Vitamin K Vitamin K is a group of compounds necessary for the normal clotting of blood Deficiency can occur in a very few newborn babies and so to counteract this are given a supplement of vitamin K at birth It also occurs in rare individuals who cannot absorb or utilise the vitamin What is Hydration? • From Hydrate – ‘cause to absorb or combine with water’ • Aim to avoid dehydration Caused by • Poor intake • GI losses e.g. diarrhoea, vomiting • Lung/skin losses • Excessive urine losses • Symptoms include – headache, mild confusion, postural hypotension, fatigue, thirst, dark urine, reduced skin turgor • Decreased skin turgor is a late sign in dehydration. It occurs with moderate to severe dehydration. Fluid loss of 5% of the body weight is considered mild dehydration, 10% is moderate, and 15% or more is severe dehydration Drink! • Humans are 50-70% water • Healthy adults should drink 1.5-3 litres (6-8 glasses) of liquid every day • More in hot weather and if physically active • Various sources (include non-caffeine fluids) How do we measure hydration? • Body weight Oedema • Fluid balance charts Intake – oral, IV, NG, IV drugs Output- urine, bowel, vomit, sweat • Urine colour • Blood results Sodium, Potassium and Urea levels BALANCED HEALTHY DIET The eatwell plate Fruit and vegetables Meat, fish, eggs, beans And other non dairy sources of protein Bread, rice, potatoes, Pasta and other starchy foods Milk and dairy foods Food and drinks high in fat and or sugar The food groups of the eatwell plate • Fruit and vegetables • Bread, rice, potatoes, pasta and other starchy foods • Milk and dairy foods • Meat, fish, eggs, beans and other non-dairy sources of protein. • Food and drinks high in fat and/or sugar Fruit and vegetables • One third of the diet should be made up of these foods • This group provides: – Dietary fibre; – Vitamins A, C; – Minerals; – Water or fluid Fruit and vegetables • Fruit and vegetables are good sources of dietary fibre, vitamins and minerals • Try to eat at least five portions a day • Eat a wide variety of different fruits and vegetables • These are high in dietary fibre which keeps the gut healthy • Fruit and vegetables are also low in energy and fat which can help to maintain a healthy weight Bread, rice, potatoes and pasta and other starchy foods. • One third of the diet should be made up of these foods. • This group provides: – Carbohydrate; – Dietary fibre; – B vitamins; – Minerals, e.g. iron and calcium Milk and dairy foods • A moderate amount of these foods are needed in the diet • This group provides: – Protein; – Calcium; – Vitamin A Milk and dairy foods • This group is made up of milk, yogurt and cheese, however should be lower fat varieties where possible • Children under the age of 2 should be offered whole or full fat products Meat, fish, eggs, beans and other non-dairy sources of protein • A moderate amount of these foods are needed in the diet • This group provides: – Protein; – Vitamins, e.g. A, B, D; – Minerals, e.g. iron Meat, fish, eggs, beans and other non-dairy sources of protein • This group is made up of meat, fish, eggs, and beans • Also, choosing lean meat and not adding fat when cooking will reduce the amount of fat in the diet Meat, fish, eggs, beans and other non-dairy sources of protein • Two portions of fish should be consumed twice a week, one of which should be oily • This is because oily fish contains omega 3 fatty acids and believed to be good for heart health • Examples of oily fish are salmon, herring and sardines Food and drinks high in fat and/or sugar • Foods from this group are not necessary for a healthy diet, but can be enjoyed occasionally. • These foods should be eaten in small amounts • This group provides: – Fat; – Carbohydrate (sugars) Food and drinks high in fat and/or sugar • This group is made up of food and drinks high in fat and/or sugar • There are many different types of these foods available. For example, – Foods high in fat: oil, chips, cake. – Foods high in sugar: sweets, cakes, and some carbonated drinks • These foods should only be eaten occasionally and in small amounts Salt • Salt does not appear on the eatwell plate • It is estimated that 75% of the salt we eat comes from the food we buy, such as bread and cereal products, meat products and some ready meals. It is important to check the labels when buying foods • Salt intake can be further reduced by not adding salt to food during cooking or at the table Fluid • The eatwell plate shows some fluids such as milk and fruit juice in food groups • Water, tea and coffee are not shown, but can form a large part of the body’s fluid intake • All food and drinks count towards fluid intake, except alcoholic drinks Fluid - alcohol • Alcohol does not feature on the eatwell plate, but those who drink there are recommendations – Males - no more than 3-4 units per day – Women - no more than 2-3 units per day • Over consumption of alcohol, or binge drinking should be avoided Healthy Eating Pyramid Foods high in fats and sugars: take only small amounts from this group Meat, fish and dairy: take something from this group Fruit and vegetables: take 5 portions a day from this group Carbohydrates: take most food from this group (rice, pasta, bread, potatoes) Summary To summarise the main points from this presentation: • A healthy diet is a balanced diet eating a variety of foods in the right proportions • Consuming the right amount of food and drink to achieve a healthy body weight References Department of Health (2012) Manual of Nutrition (12th Edition) Surrey: The Stationary Office National Patient Safety Agency (2008) Water: The Forgotten Nutrient Source [On-line] http://www.nrls.npsa.nhs.uk/resources/?entryid45=59826&cid= 898358&p=7 (Accessed 20th February 2013)