Download Williams` Basic Nutrition & Diet Therapy

FOOD, NUTRITION, AND HEALTH
HEALTH PROMOTION
Definitions
 Health Promotion – Active involvement in
behavior or programs that advance positive well-being
 Nutrition – the sum of all processes involved in taking
in nutrients and assimilating and using them to maintain
body tissue and provide energy, a foundation for life and
health
 Nutritional science – the body of science,
developed through control research that relates to the
process involved in nutrition: international, community, and
clinical
HEALTH PROMOTION
Definitions
 Dietetics – management of diet and the use of food;
the science concerned with the nutritional planning and
preparation of foods
 Registered Dietitian – a professional dietitian,
accredited with an academic degree of undergraduate or
graduate study program who has passed required
registration examinations administered by the American
Dietetic Association
 Health – a state of optimal physical, mental, and social
well – being; relative freedom from disease or disability
HEALTH PROMOTION
Definitions
 Metabolism – the sum of all chemical changes
that take place in the body by which it maintains
itself and produces energy for its functioning.
 Glycogen – A polysaccharide, the main storage
form of carbohydrate, largely stored in the liver
and to a lesser extent in muscle tissue
 Kilocalorie – the general term calorie refers to
a unit of heat measure and is used alone to
designate the small calorie
HEALTH PROMOTION
Health
Good
and Wellness
nutrition essential
to good health
Wellness is the full
development of potential.
Balance
and a positive
dynamic state
HEALTH PROMOTION

Wellness Movement and National
Health Goals
Rooted in 1970
 Response to medical care’s emphasis

 On
illness an disease
 Increasing healthcare costs

“Holistic” health
 Focus
on lifestyle
 Personal choices related to health
HEALTH PROMOTION
 Traditional
 Attempts
Health Approach
of change only when
s/s of disease or illness exist
 Seek a cure
 Little value for lifelong good
health
HEALTH PROMOTION
Preventive
 Identifies
Health Approach
a person’s risk factors for
development of health problems
 Encourages person to choose
behaviors that will decrease risk of
developing health problems
HEALTH PROMOTION
 Importance
of a balanced diet
 Food
is a necessity of life
 Important
Maintain
good health
In recovery from illness
 Balanced
diet extends a person’s
years of normal functioning
HEALTH PROMOTION
Signs of Good Nutrition








ALERT EXPRESSION
SHINY HAIR
CLEAR COMPLEXION
GOOD COLOR
BRIGHT CLEAR EYES
PINK GUMS
FIRM MUSCLES
NORMAL WEIGHT FOR
PATIENT






ERECT POSTURE
EMOTIONAL STABILITY
GOOD STAMINA
HEALTHY APPETITE
NORMAL SLEEP
PATTERNS
NORMAL ELIMINATION
Body Mass Index =
Steps
Example: 150 lbs & 5’6’’
1. Convert weight in lbs to Kg by dividing 150 lbs ÷ 2.2=68.18
by 2.2
2. Convert height in feet to inches
5’6’’=66 inches
3. Convert height to meters. Multiple
68 inches x 2.54=167.64
167.64/100=1.68
4. Multiply height (in meters)
by itself
1.68 x 1.68 = 2.82
5. Divide your weight (Step1)
by height (Step 4)
68.18/2.82=24.18
height in inches by 2.54; then divide by
100
BMI=24.2
HEALTH PROMOTION
Signs of poor nutrition
 APATHY
 DULL
HAIR
 GREASY COMPEXTION
 DULL EYES
 SWOLLEN ABDOMEN
 FLABBY MUSCLES
 SLUMPED POSTURE
 CONSTIPATION OR DIARRHEA
FUNCTIONS OF NUTRIENTS
IN FOOD
 Provide
Energy – Carbohydrates,
proteins, and lipids
 Tissue
building- Proteins, lipids,
vitamins, minerals, and water
 Regulation
and control- Proteins,
lipids, vitamins, minerals, and water
FUNCTIONS OF
NUTRIENTS IN FOOD
Individual
nutrients have many
specific metabolic functions
including primary and
supporting roles
No Nutrients ever work alone
FUNCTIONS OF
NUTRIENTS IN FOOD
Energy sources
Carbohydrates –
 Dietary
carbohydrates (starches and
sugars) provide the bodies primary source
of fuel
 Fuel is needed for heat and energy
 Glycogen is animal starch and is a bodies
store of quick energy
 Each gram of carbohydrate yields 4kcal of
body energy
 45 % - 65 % of our diet
FUNCTIONS OF
NUTRIENTS IN FOOD
Energy
Fats –
Secondary
sources
form of energy
Each gram of fat yields 9 kcal of body
energy
20 % - 35 % of our diet 2/3 should be
from plant source not animal source
FUNCTIONS OF
NUTRIENTS IN FOOD
Energy sources
ProteinsEnergy
can be from proteins if not
carbohydrates or fats
Each gram of protien yields 4 kcal of
body enerty
10 % - 35 % of our diet
FUNCTIONS OF
NUTRIENTS IN FOOD
 Tissue building
Proteins –The primary function of protein is
tissue building. Protein provides amino acids
which are the building blocks necessary for
repair and construction of body tissue
 Other nutrients

Vitamin C- Vitamin C is needed to create the
cementing intercellular ground substance. The
ground substance is called collagen
 Calcium and phosphorus-help build and maintain the
bone tissue
 Iron – helps build oxygen carrier hemoglobin in red
blood cells
 Fatty acids-come from fat metabolism they help
build the central fat substance of cell
 walls and promote the transport of fat soluble
materials across the cell wall

FUNCTIONS OF
NUTRIENTS IN FOOD

Regulation and control
The body is an amazing organ
 Keeps all the body functions in alignment
 Makes sure all functions are running smoothly
 Vitamins – May function as co enzymes which
are components of cell enzymes , they assist
with cell metabolism- most b complex vitamins
 Minerals- Function as co enzymes which assist
in cell metabolism, also against pernicious
anemia
 Other nutrients – Water and fiber. Water is
necessary for life itself. Fiber helps maintian
the passage of food through the GI tract and
influences the absorption of all nutrients

GOOD NUTRITION
Optimal nutrition is a person who receives
and uses substances that are obtained from
a varied diets in ideal amounts for that
specific individual
 Undernutrition One who receives less than
the desired amounts of nutrients effects
immune system and mental activities
 Malnutrition Nutritional reserves are depleted
 Overnutrition More than desired amounts of
nutrients are taken in over the course of time
producing a gross or morbid obesity

NUTRIENTS AND FOOD GUIDES
FOR HEALTH PROMOTION


United States standards: Dietary
Reference Intakes (DRIs) – a system of
reference values that can be used for
assessing and planning diets for healthy
populations and many other purposes.
Recommended Dietary Allowances (RDAs)
recommended daily allowances of nutrients
and energy intake for population group
according to age and sex with defined
weight and height.
AIM
 Aim
 Be
for a healthy weight
physically active each day
BUILD
 Let
the pyramid guide your food choices
 Choose
a variety of grains daily, especially
the whole grain
 Choose
daily
 Keep
a variety of fruits and vegetables
food safe to eat
CHOOSE
 Choose
a diet that is low in saturated fat
and cholesterol and moderate in total fat
 Choose
beverages and foods to moderate
your intake of sugars
 Choose
 If
and prepare food with less salt
you drink alcoholic beverages, do so in
moderation
NUTRIENTS AND FOOD GUIDES
FOR HEALTH PROMOTION

Individual Needs

Person-Centered Care
 Food
patterns are specific to an individual
 Depends on the needs, habits, culture,
environment, tastes, and energy demands

Changing Food Environment
 Changing
rapidly
 More processed food of questionable
nutritional value
 More plentiful food supply but still
malnourished
NATURE OF CARBOHYDRATES
Definitions
 Photosynthesis– Process by which plants
containing chlorophyll are able to manufacture carbohydrate by
combining CO 2 from air and water from soil

Saccaride– Chemical name for sugar molecule

Simple carbohydrate– Sugars with a simple structure of

Complex carbohydrate – Large complex molecules
one or two single sugar units
of carbohydrates composed of many sugar units
NATURE OF CARBOHYDRATES
Definitions
 Sugar Alcohols– Nutritve sweeteners that
provide 2 – 3 Kcal per gram, sorbitol, mannitol and
xylitol
 Sorbitol– Sugar alcohol formed in mammals
from glucose and converted to fructose

Enzyme– Specific proteins produced in cells that
digest or change specific nutrients in specific
chemical reactions with out being changed
themselves in the process
 Brush Border – Cells that are located on the
microvilli within the lining of the intestinal tract
NATURE OF CARBOHYDRATES
 Basic
fuel source
Photosynthesis is a process by which plants
manufacture carbohydrate by combining CO2
from the air and water from the soil. Sunlight
is used as energy and chlorophyll is the
catalyst
 6 CO2 + 6 H2O + Energy + Chlorophyll =
C6H12O6 + 6 O2

 Relation
Energy is necessary for life. Need fuel for
energy.
Basic fuel source
 Sugars and starches are main source of energy


to Energy
NATURE OF CARBOHYDRATES
 Energy-Production
 Digest
System
carbohydrates and change it
to glucose
 Glucose transported via circulation
 Released through process of
metabolism
 Carbohydrates called “quick energy”
NATURE OF CARBOHYDRATES
 Classes
of Carbohydrates
Monosaccharides-
one sugar, simple
sugar or simple carbohydrate- building block for all
carbohydrates, requires no further digestion. Corn syrup
Disaccharides
–
two sugars, simple sugars
or simple carbohydrate, double, CHO, table sugar, sugar
cane, molasses, milk, starch digestion,
Polysaccharides-
Complex carbohydrate
has large complex compound of many polysaccharides
units in long chains, grains, cereal, bread, crackers, rice,
cord, legumes, potatoes, liver, muscle meats, animal
tissue
NATURE OF CARBOHYDRATES
Monosaccharide

Glucose-

Fructose-

Galactose-
metabolism
Basic sugar in body
Found in fruits or in
honey. Sweetest if the simple sugarsamount of sugar in fruit depends on its
ripeness
Comes in digestion
of milk sugar or lactose
NATURE OF CARBOHYDRATES
Disaccharides
Sucrose
–
Lactose
–
fructose combined
table sugar glucose and
Sugar found in milk glucose
and galactose combined- lactose stays in body
longer and creates formation of useful
bacteria. Cows milk is 4.8 % lactose as human
milk is 7 % lactose
Maltose-
derived from intermediate
break down of starch, used as a sweetner in
processed foods
NATURE OF CARBOHYDRATES
 Polysaccharides
 Starch-Most significant polysaccharide in the diet.
Found in grains, legumes and other vegetables. Break
down slowly. Supply energy over a period of time.45 %
65 % of total Kcal are from starch.
 Whole grain – Food products such as flour, bread,
and cereals that still retain its outer bran layer and the
inner germ endosperm and nutrients (see page 19)
 Glycogen – It is not a significant source of
carbohydrate. It is formed in body tissues. It is found
in liver and muscles where it is constantly recycled.
Stored form of carbohydrate and is stored in liver
Kernel of wheat showing bran
layers
NATURE OF CARBOHYDRATES
 Dietary
fiber
–
Humans lack the enzymes to
digest dietary fiber.
 Cellulose – Mostly from plants. Undigested in the GI
tract and provides bulk to the diet. Main source is stems
and leaves of vegetables.
 Noncellulose polysaccharides- Hemicelluloses,
pectin's, gum and mucilage's They all absorb water
and swell to a larger bulk
 Lignin – Woody part of plants Binds with bile acids
and cholesterol to prevent their absorption
NATURE OF CARBOHYDRATES
 Other
sweeteners – sugar alcohols and
alternative sweeteners are often used
as sugar replacement.
 a. Nutritive sweeteners- Sorbitol,
mannitol xylitol are the alcohol form of
sucrose
 b. Nonnutritive sweeteners- aspartame
and saccharin
FUNCTIONS OF
CARBOHYDRATES
 Basic
fuel supply- 4 Kcal/g
 Fuel
for the body
 Burn in the body to meet energy needs
 Reserve
fuel supply
 Glycogen
reserves=supply backup fuel
 Amount of glycogen and blood sugar in
body relatively small (supply ½ day
energy)
 Carbohydrates must be taken daily to
prevent breakdown of fat and tissue
FUNCTIONS OF
CARBOHYDRATES
 Special
 Liver
tissue functions
–
 Glycogen
reserves in the liver and muscle –
create reserves to protect cells form depressed
metabolic function and resulting in injury
 Protein
and fat-
Regulates protein and fat production Proteins are broken down for source of
energy if no carbohydrates
 Ketones are the by product - The Ketones are
strong acids and creates acidosis. This upsets
the acid base balance

FUNCTIONS OF
CARBOHYDRATES
 Special
 Heart
tissue functions
–
Fatty acids are the preferred fuel for the heart
muscle
 Glycogen is used in emergency situations may
cause cardiac disorder and angina

 Central
nervous system
 Constant
carbohydrates stores required for
nerve function
 Brain does not store glucose-depends on
minute to minute supply
 Sustained low blood sugar-may cause brain
damage and death
FOOD SOURCES OF
CARBOHYDRATES

Starches
Fundamental complex carbohydrate foods for
slowly available glucose
 Sustained energy sources of rapidly available
glucose (RAG)
 Required for balance diet
 Source of fiber and other nutrients


Sugars
Not the villain in the story of health
 Too much sugar lead to health problems-obesity,
dental caries (cavities)
 Average American consumes 1/3 lb a day
 Moderation is the key

DIGESTION OF
CARBOHYDRATES
 Digestion
chemical
is mechanical and
 Mechanical
or muscle action is the
breakdown food mass into smaller
particles (mastication)
 Chemical is with specific enzymes
that break down food nutrients into
still smaller usable metabolic
products
DIGESTION OF
CARBOHYDRATES
 Mouth
 Mixes
with saliva and salivary amylase
(ptyalin) secreted by the parotid gland,
located under ear and in back of jaw
 Stomach
Stomach- peristalsis wave like action of
muscles fibers of the stomach wall
 Hydrochloric acid in the stomach stops the
secretions of the parotid glands

DIGESTION OF
CARBOHYDRATES

Small intestine
Carbohydrate digestion is complete in the small
intestines by enzymes secreted by the pancreas  Pancreatic secretions are pancreatic amylase
which breaks down disaccharides and
monosaccharides
 Intestinal secretions

Brusch border (microvilli)
 sucrase, lactase, and maltase they act in their
respective disaccharide to create glucose, galactose and
fructose
 Lactose intolerance is the inability to breakdown lactose
into its monosaccharide units (glucose and galactose)

1. Some starch is broken down by
salivary amylase to maltose.
2. Salivary amylase in inactivated by
strong acid
3. Enzymes (amylase) from pancreas
break down starch into maltose
4. Enzymes in wall of small intestine
break down diaccharides sucrose,
lactos and maltose into
monosaccjarides glucose, fructose,
and galactose
5. Absorption of glucose, fructose and
galactose into blood stream to be
taken to the liver
6. Some soluble fiber is fermented into
various acid and gases by bacteria in
the large intestines
7. Insoluble fiber is excreted in feces,
but little other dietary carbohydrate is
present.
Ethnicity and Lactose
Intolerance
 African
American and Native American
suffer from lactose intolerance more
than Caucasian.
 100% of Native Americans endure
some form of lactose intolerance
 95 % of African American suffer with
some form of lactose intolerance
 12 % Caucasian suffer from lactose
intolerance
BODY NEEDS FOR
CARBOHYDRATES
 Dietary
Reference Intakes (DRIs)
 Energy
needs listed as total kilocalories
 45 % - 65 % 225 TO 325 g of
carbohydrates for a 2000 kcal diet
 U.
S. Dietary Guidelines
 General
guidelines to promote health
 Not specific as to where calories should
come from
 Advises “let the Pyramid guide your food
choices”