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BASIC NUTRITION Nutrition All of the processes involved in consuming and utilizing food for energy, maintenance, and growth. 2 Physiology of Nutrition Five processes are involved in the body’s use of nutrients: Ingestion. Digestion. Absorption. Metabolism. Excretion. 3 Ingestion The taking of food into the digestive tract, generally through the mouth. 4 Digestion The mechanical and chemical processes that convert nutrients into a physically absorbable state. Digestion includes: Mastication (chewing). Swallowing. Peristalsis (coordinated, rhythmic, serial contractions of the smooth muscles of the GI tract). 5 Absorption The process by which the end products of digestion pass through the small and large intestines into the blood or lymph systems. 6 Metabolism The body’s conversion of nutrients into energy. Basal metabolism is the amount of energy needed to maintain essential physiologic functions when a person is at complete rest, both physically and mentally. 7 Excretion The process of eliminating or removing waste products from the body. 8 The Six Essential Nutrients Water Carbohydrates Fats Proteins Vitamins Minerals 9 Water The Most Important Nutrient. Daily requirements: 1,000mL of water to process 1,000kcal eaten. 10 Functions of Water Solvent (dissolves Lubricant (aids in substances to form providing smooth solutions). movement for joints). Transporter (carries Component of all cells. nutrients, wastes, etc. Hydrolysis (breaks apart throughout the body). substances, especially in Regulator of body metabolism). temperature. 11 Classification & Sources of Water Liquids consumed (water, coffee, juice, tea, milk, soft drinks). Foods consumed (especially fruits and vegetables). Metabolism (produces water when oxidization occurs). 12 Water: Digestion, Absorption and Storage Water is not digested. It is absorbed and used by the body as we drink it. It cannot be stored by the body. The body loses water in four ways: Urine. Feces. Sweat. Respiration. 13 Water: Signs of Deficiency Abnormal water losses include profuse sweating, vomiting, diarrhea, hemorrhage, wound drainage (burns), fever, and edema. A deficiency of water is called dehydration. Prolonged dehydration results in death. 14 Carbohydrates The chief source of energy for the body. Made up of carbon, hydrogen, and oxygen. They are the major source of food for all people. Daily requirements: 50% to 60 of an individual’s kcal intake per day. 15 Functions of Carbohydrates CHO are... The primary source of energy for the body. Spares proteins from being used for energy, thus allowing them to perform their primary function of building and repairing body tissues. Needed to oxidize fats completely and for synthesis of fatty acids and amino acids. 16 Carbohydrates: Classification and Sources CHO may be simple or complex. Simple are single or double sugars. Complex are composed of many single sugars joined together (starch, dietary fiber, glycogen). 17 Carbohydrates: Classification and Sources Digestion of cooked starches begins in the mouth. Little digestion occurs in the stomach. CHO digestion completed in the small intestine. CHO are used completely, leaving no waste for the kidneys to excrete. 18 Carbohydrates: Signs of Deficiency Mild deficiency can result in weight loss and fatigue. Serious deficiency can result in ketosis. 19 Fats The most concentrated source of energy in the diet. An essential nutrient, but too much can be a health hazard. Daily requirements: should not exceed 25% to 30% of an individual’s caloric intake per day. 20 Functions of Fats Provides concentrated source of energy. Assists in absorption of fat-soluble vitamins. Is a major component of cell membranes and myellin sheaths. (See figure1) Improves flavor of foods and delay’s stomach’s emptying time. Protects and hold organs in place. Insulates body, thus assisting in temperature maintenance. 21 Myellin sheaths. Figure1 22 Classification of Fats Triglycerides (true fats). Phospholipids (lipoids, composed of glycerol, fatty acids, and phosphorus). Cholesterol. 23 Sources of Fats Animal (lard, butter, milk, cream, egg yolks, and fat in meat, poultry , and fish). Plant (oils from corn, safflower, peanut سوداني, palm , etc., as well as nuts and avocado). 24 نبات العصفر Safflower لعصفر مادة ملينة ومدرة للبول .وكان شاي العصفر يعطى لألطفال والكبار في الحمى والحصبة والطفح الجلدي .وتوضع عجينته من الدقيق لعالج الدمامل .وتتناول الزهور كسفوف أو خليط مع زيت الزيتون لعالج الشريان التاجي والجلطات ومشاكل العادة الشهرية ونزول الطمث واليرقان وآالم البطن بعد الوالدة .ويعالج الكدمات وآالم الجلد والتهابه والجروح وآالم المفاصل وتيبسها.ويقلل تجلط الدم .يستخرج من العصفر صبغات تستعمل في إنتاج مواد التجميل .كذلك تستخدم بذور العصفر إلنتاج الزيت في الوقت الحاضر. 25 Digestion, Absorption and Storage of Fats No chemical breakdown of fats occurs in the mouth and very little in the stomach. Digestion occurs in small intestine. Fats not immediately needed by the body are stored as adipose tissue. 26 Fats: Signs of Deficiency and Excess Deficiency occurs when fats provide less than 10% of daily kcal requirement. Gross deficiency may result in eczema, retarded growth, and weight loss. Excess fat consumption can lead to overweight and heart disease. 27 Proteins The only nutrient that can build, repair, and maintain body tissues. Daily requirements: determined by size, age, gender, and physical and emotional conditions. Daily protein requirement for average adults is 0.8g for each kilogram of weight. 28 Functions of Proteins To provide amino acids necessary for synthesis of body proteins, used to build, repair, and maintain body tissues. To assist in regulating fluid balance. Used to build antibodies. Plasma proteins help control water balance between the circulatory system and surrounding tissues. In event of insufficient stores of carbohydrates and fats, protein can be converted into glucose and used for energy. 29 Classification & Sources of Proteins Complete proteins contain all 9 essential aminoacids. (All animal fats, except for gelatin, are complete. Only plant fat that is complete is soybeans). Incomplete proteins have one or more essential amino acids missing (plant proteins). 30 Classification of aminocides Essential Phenylalanine 47 Valine 32 Threonine 27 Tryptophan 7 Methionine Leucine 55 Isoleucine 25 Lysine 51 Histidine 18 Nonessential جرام بروتين/الرقم يعني مليجرام 31 Digestion, Absorption and Storage of Protein Digestion begins in the stomach. Most digestion takes place in the small intestine. Amino acids not used to build proteins are converted to glucose, glycogen, or fat and are stored. 32 Signs of Deficiency and Excess of Protein Muscle wasting. Edema (swelling). Lethargy and depression. Excess can result in heart disease, colon cancer, osteoporosis. 33 Vitamins: Essential organic compounds that regulate body processes and are required for metabolism of fats, proteins, and carbohydrates. Needed in very small amounts. 34 Foundations of Vitamins Unique to each individual vitamin. 35 Classification and Sources of Vitamins Grouped according to solubility (fatsoluble or water-soluble). Sources are foods and vitamin supplements. 36 Digestion, Absorption and Storage of Vitamins Do not require digestion. Fat-soluble vitamins (KAED) absorbed into lymphatic system; water-soluble vitamins absorbed into circulatory system. Excess fat-soluble vitamins stored in the liver and adipose tissue. Excess water-soluble vitamins are excreted through urine. 37 Water-soluble vitamins B-complex vitamins and vitamin C are water-soluble vitamins that are not stored in the body and must be replaced each day. These vitamins are easily destroyed or washed out during food storage and preparation. The B-complex group is found in a variety of foods: cereal grains, meat, poultry, eggs, fish, milk, legumes and fresh vegetables. Citrus fruits are good sources of vitamin C. Using megadoses of multivitamins or supplements is not recommended. 38 Signs of Deficiency and Excess of Vitamins Vitamin deficiencies commonly afflict alcoholics, the poor, incapacitated elders, clients with serious disease that affect appetite, mentally retarded persons, and neglected children. Vitamins consumed in excess can be toxic. 39 Minerals Inorganic compounds that help regulate Body processes and/or serve as structural components of the body. Daily requirements: Amounts greater than 100 mg/day. Trace minerals less than 100 mg/day. 40 Functions of Minerals Unique to each individual mineral. 41 Classification & Sources of Minerals Classified as major minerals or trace minerals. Found in water and in natural foods, as well as supplemental minerals. 42 Digestion, Absorption & Storage of Minerals Influenced by Three Factors: Type of food (minerals from animal foods more readily absorbed than those from plant foods). Need of body (a deficiency will result in more absorption). Health of absorbing tissue. 43 Signs of Deficiency and Excess of Minerals Too much mineral intake can be toxic. Excessive amounts of minerals can result in hair loss and changes in the blood, muscles, bones, hormones, blood vessels, and nearly all tissues. 44 Four Food Groups (Historical) For many years, a plan to help people construct a well-balanced diet, with food choices from milk, meat, fruit/vegetable, and bread/cereal groups. 45 Food Guide Pyramid Fats, oils & sweets Use sparingly Milk, Yogurt & Cheese Meat, poultry, fish, dry beans, eggs & nuts 2-3 servings Vegetables & Fruits (2-5 servings) Bread, cereal, rice & pasta (6-11 servings) 46 Dietary Guidelines for Americans Eat a variety of foods. Maintain healthy weight. Choose a diet low in fat, saturated fat, and cholesterol. Choose a diet with plenty of vegetables, fruits, and grain products. Use sugars, salts, and sodium only in moderation. Drink alcoholic beverages only in moderation. 47 Factors Influencing Nutrition Culture. Religion. Socioeconomics. Fads. Superstitions. 48 Nutritional Needs During the Life Cycle Affected by: Nutritional status Height and weight Meal and snack pattern Adequacy of intake based on food guide pyramid Food allergies Physical activity Cultural, ethnic, and family influences Use of vitamin/mineral supplements 49 Nutritional Diseases Primary Nutritional Disease: occurs when nutrition is cause of the disease (scurvy) spongy gum, bleeding fatigue, rickets,beriberi is a disease caused by a deficiency of thiamine (vitamin B1) that affects many s ystems of the body, including the muscles, , anemia. Secondary Nutritional Disease: complication of another disease or condition. heart, nerves, and digestive system 50 Weight Management Maintaining weight at a desired level can be very difficult for some people. Overweight: 11% to 19% above desired weight. Obesity is 20% or more. Underweight: 10% to 15% below desired weight. 51 Safety of Food Depends upon: Proper Storage. Proper Sanitation. Proper Cooking. 52 Food Allergies Occurs when the immune system reacts to a food substance, usually a protein. When such a reaction occurs, antibodies form and cause allergic symptoms. 53 The Nursing Process: Assessment Two types of data: Subjective. Objective. 54 Subjective Data 24-Hour Recall. Food-Frequency Questionnaire. Food Record. Diet History. 55 Objective Data Body Mass Index. Skinfold Measurement. Other Measurements (e.g. Abdominal- Girth, Mid-Upper-Arm). Laboratory Tests. 56 Diet Therapy The treatment of a disease or disorder with a special diet. Dietary prescriptions include: Nothing by Mouth. Standard Diets (general, or regular; soft; clear-liquid; full-liquid; edentulous (tooth loss); pureed (soft or thick liquid). Special Diets (low-residue, high-fiber, liberal bland (regular diet with the omission of foods known to cause gastrointestinal discomfort), fat- controlled, sodium-restricted). 57 Assistance with Meals Preparing the client. Preparing the environment. Serving the tray. Assisting with eating. 58 Nutritional Support Two delivery Routes for adults: Enteral nutrition: The ingestion of food orally and the delivery of nutrients through a GI tube. Parental nutrition: Nutrients by passing the GI system and entering the blood directly. 59 60