Chapter 36 - Nutrition Flashcards
How does malnutrition affect healthcare?
- 35-50% of hospital patients are malnourished on admission.
- Illness, recovery, wound healing, infections are prolonged
Food and the Hospitalized Patient
- Intake of nutritious food is crucial for patients recovering from the effects of medical or surgical procedures.
- Patients who receive good nutrition may have shorter hospital stays, fewer post-operative complications and less need for drugs and other interventions
Obesity and the Hospitalized Patient
- 30.5% of the U.S. population is obese with a BMI > 30
- High number of hospitalized obese patients because obesity contributes to the etiology of diseases most often seen in hospitalized patients
- Obese patients stay an average of 1.5 days longer
- Wound healing impaired by obesity-related underlying disease, such as diminished tissue perfusion
- Obesity, as an independent risk factor, carries a nearly 6-fold increase in mortality rate
Carbohydrates
- Sugars and starches
- Classified as simple or complex sugars
- Organic compounds composed of carbon, hydrogen, and oxygen
- Most abundant and least expensive source of calories in the world
- 90% of carbohydrate intake is ingested
- Converted to glucose for transport through the blood
- Cells oxidize glucose to provide energy, carbon dioxide, and water
- 50 to 100 g of carbohydrates are needed daily to prevent ketosis
- RDA-intake be 50-60% of total calorie
- 1 gram = 4 Kcal
Protein
- Required for the formation of all body structures
- Labeled complete or incomplete, based on amino acid composition
- Animal proteins are complete; plant proteins are incomplete
- Protein tissues are in a constant state of flux
- RDA for adults is 0.8 g/kg of body weight (10% to 20% total calorie intake)
- 1 gram = 4 kcal
Fats/Lipids
-Insoluble in water and blood
-Composed of carbon, hydrogen, and oxygen
-95% of lipids in diet are triglycerides
-Most food fats contain mixtures of saturated (raise cholesterol levels) and unsaturated (lower cholesterol levels) fatty acids
-Most animal fats are saturated
-Most vegetable fats are unsaturated
Aids in the absorption of vitamins and provides insulation, structure, and temperature control
-Digestion occurs largely in the small intestine
-Most concentrated source of energy in the diet
-RDA not established, should be < 30% daily caloric intake
-1 gram = 9 kcal
Vitamins
- Organic compounds needed by the body in small amounts
- Most are active in the form of coenzymes
- Needed for metabolism of carbohydrates, protein, and fat
- Classified as water soluble or fat soluble
- Absorbed through the intestinal wall directly into bloodstream
Water Soluble Vitamins
- Vitamin C collagen formation, antioxidant, enhance iron absorption
- B Vitamins coenzyme in protein, fat, and carbohydrate metabolism
+Not stored so require replenishment frequently
+Deficiencies may occur with absorption problems
Fat Soluble Vitamins
- Vitamin A affects visual acuity, formation & maintenance of skin and mucous membranes, and immune function.
- Vitamin D affects calcium and phosphorous metabolism and stimulates calcium absorption.
- Vitamin E antioxidant, protects Vitamin A, heme synthesis
- Vitamin K synthesis of certain proteins necessary for blood clotting; K deficiency can cause bleeding gums, bruising, increased bleeding and longer wound healing time.
+Stored in liver and adipose
+Deficiencies can occur with malabsorption syndromes and pancreatic and biliary diseases
+Daily intake not imperative; deficiency symptoms may take prolonged time to develop
+Excessive intake of A and D are toxic
Minerals
- Organic elements found in all body fluids and tissues
- Some function to provide structure in body, others help regulate body processes
- Contained in the ash that remains after digestion
- Macrominerals include calcium, phosphorus, and magnesium
- Microminerals include iron, zinc, manganese, and iodine
Water
- Accounts for between 50% and 60% of adult’s total weight
- 2/3 of body water is contained within the cells (ICF)
- Remainder of body water is ECF, body fluids (plasma, intersititial fluid)
- Provides fluid medium necessary for all chemical reactions in body
- Acts as a solvent and aids digestion, absorption, circulation, and excretion
Factors Affecting Food Habits
- Physical: geographic, location, food technology, and income
- Physiologic: health, hunger, stage of development
- Psychosocial: culture, religion, tradition, education, politics, social status.
Developmental Considerations
- Growth: increases nutritional needs
- Activity: increases nutritional needs
- Age-related changes in metabolism and body composition
- Nutritional needs
- Fewer calories required in adulthood because of a decrease in basal metabolic rate
Risk Factors for Poor Nutritional Status
- developmental factors
- sex
- state of health (physical and mental)
- alcohol abuse
- medications
- megadoses of nutrient supplements
- chemotherapeutic agents decrease appetite
Factors that increase BMR
- growth
- infections
- fevers
- emotional tension
- extremem environmental temperatures
- elevated levels of certain hormones
