Chapter 13 Flashcards
Nutrition and Diet Therapy
Weight gain is a leading cause of nutrition related diseases along with genetics and the environment in which people live.
The number of calories each person needs varies by age, gender, and activity level.
If a person is engaged in performing manual labor, they may be considered ‘moderately active’.
The ‘very active’ people are engaging in high levels of exercise, combat, or similar tasks.
The Physical Fitness Assessment (OPNAVINST 6110.1 series, Physical Readiness Program)
Body Mass Index (BMI). BMI is calculated by dividing a person’s weight in kilograms (2.2# = 1 kg) by
the person’s height in meters squared (2.54 cm = 1 inch) or kg/m²
A normal weight BMI is
18.5 kg/m² to 24.9 kg/m². Persons below 18.5 kg/m² are considered underweight, persons with a BMI of 25.0 – 29.9 kg/m² are overweight, and persons with a BMI > 30 g/m² are considered obese.
There are six essential nutrients: water, carbohydrates, protein, fat, vitamins, and minerals.
Carbohydrates have four calories per gram, protein has four calories per gram, and fat has nine calories per gram
Water, vitamins, and minerals do not contain calories
Water is THE most important nutrient.
A person cannot survive for very long without water, an average of three days.
a male needs to consume 3.7 liters of water daily vice that of the 2.7 liters needed to be consumed daily by females.
Water toxicity, which can result in death, is quite possible with intakes above 8 liters.
Water needs may increase 2.5 to 4.5 liters per day based on sweat losses, temperature, activity level, and other water depleting factors
The human body is approximately 60% water.
a loss of 5 to 7% can lead to heat injury or death.
Plant sugar in its simplest form is called glucose, a monosaccharide.
Sugars are simple forms of carbohydrates.
Starches, glycogen, and fiber are polysaccharides
The body makes glycogen through the process of glycogenesis and stores it in the muscles and liver.
There is usually between 2000 and 3000 calories in body stores of glycogen.
Fiber is a non-digestible, non-essential, plant-based polysaccharide
Fiber can be further defined as soluble or insoluble.
The general recommendation for fiber intake is 25 grams for women and 37 grams for men;
Carbohydrates’ main role is to provide energy to the cells.
All carbohydrates (excluding fiber) contain 4 calories per gram. In times of stress, such as trauma or illness, carbohydrate utilization increases and allows protein to be spared and used in recovery.
Carbohydrates should consist of between 40 and 60% healthy person’s diet.
Another commonly used source of carbohydrate is dextrose. Usually used in intravenous fluids, dextrose has 3.4 calories per gram. One liter of D5 is a 5% dextrose solution.
proteins support growth and maintenance of the body, build enzymes, hormones, and antibodies to defend the body.
***Proteins are commonly referred to as the “building blocks” of the body.
Proteins contain 4 calories per gram.
Protein that is consumed can be qualified on a scale of high biological value; referred to as the protein digestibility corrected amino acid score (PDCAAS).
Egg whites have the highest value followed by beef, chicken, and other animal products to include milk
Proteins are made up of amino acids. There are 20 amino acids that make up all the proteins the body needs.
The recommended amount of protein for all adults is 0.8g/kg/day. For a person who weighs 176 pounds or 80 kg (pounds divided by 2.2), the person requires 64 g of protein per day.
Fruits contain virtually no protein.
Monounsaturated fats are generally healthy fats, but burn easily when used in cooking.
Polyunsaturated fats are used widely for frying foods
Fat serves in thermoregulation of the body, cushions the organs, is a source of the 4 fat soluble vitamins – vitamins A, D, E, and K,
Fat is calorically dense and at 9 calories per gram is more than double the calories per gram of both carbohydrates and protein
The most common phospholipid is bile which is made in the liver and allows fat to be digested in the body.
Fat soluble vitamins include vitamins A, D, E, and K.
Water soluble vitamins include vitamin C, thiamin, riboflavin, niacin, B6, B12, folic acid, pantothenic acid, and biotin.
A clear liquid diet is very common and is usually the first diet ordered for people who have not eaten in a few days or are recovering from surgery; it is used to determine a patient’s readiness for solid food.
A patient is not typically on a clear liquid diet for more than 2-3 days.
The full liquid diet does not consist of all five food groups, lacks meats and beans, and is inadequate in iron, niacin, B12, and thiamin. A full liquid diet can be used when a patient is tolerating a clear liquid diet, but may not be quite ready for a regular or modified diet. A full liquid diet is similar to a clear liquid diet; it is not intended for more than 2-3 days.
DENTAL LIQUID, BLENDERIZED LIQUID DIET.—A dental liquid diet is usually indicated with patients whose jaw is wired
Some patients may be able to drink from a cup while others may need to use of a 60cc catheter tip syringe with a 10-12” piece of tubing which is helpful to facilitate getting food past the dental wires.
SOFT OR BLAND DIET.—It is indicated in certain post-operative cases, patients with gastrointestinal disorders such as GERD (gastroesophogeal reflux disease), immediately following an acute illness, or patients who cannot tolerate spicy or highly seasoned foods.
A soft or bland diet is considered nutritionally complete since all five food groups would be represented.
A high calorie and/or high protein diet is most typically indicated with trauma, underweight, failure to thrive (at any age), burns, wound healing, and occasionally after major surgery.
A protein restricted diet is indicated in patients with renal disease or hepatic disease.
The main foods excluded or limited with a low protein diet are meat, milk, cheese, eggs, and at times grains and vegetables.
A low residue diet and or a low fiber diet may be ordered for patients with diverticulitis, active ulcerative colitis, irritable bowel syndrome (IBS) flare ups, or post gastrointestinal surgery.
A typical fiber restriction is approximately 10-15 grams per day.
A high fiber diet can also be helpful in the chronic management of many gastrointestinal diseases. Conditions such as diverticulosis and non-acute irritable bowel syndrome or ulcerative colitis usually benefit from a higher fiber diet.
A gluten free diet is used when a person has Celiac’s Disease, an inflammatory disease of the bowel.
