Nutrition Flashcards
What is nutrition?
“the science of food, the nutrients and the substances therein, their action, interaction, and balance in relation to health and disease, and the process by which the organism ingests, absorbs, transport, utilizes, and excretes food substances” The Council on Food and Nutrition of the American Medical Association
What are essential nutrients?
Essential Nutrients are either not synthesized in the body naturally or are made in insufficient amounts.- these must be provided in the diet or through the use of supplements
Essential nutrients must: (3)
Have at least one specific biological function of the nutrient in the body must be identified.
Omission of the nutrient from the diet must lead to a decline in certain biological functions, such as production of blood cells.
Replacing the omitted nutrient in the diet before permanent damage occurs, will restore those normal biological functions
The six classes of nutrients, and what they do
Nutrients that supply energy
Carbohydrates
Lipids
Proteins
Nutrients that regulate body processes
Vitamins
Minerals
Water
Poor diet and sedentary lifestyle are risk factors for:
chronic diseases: Disease of the heart (29% of all deaths) Cancer (22%) Cerebrovascular disease (~7%) Diabetes (3%) Accounts for ~2/3 of all deaths
Describe carbohydrates
Sugars and starches
Organic compounds composed of carbon, hydrogen, and oxygen
Most abundant and least expensive source of calories in the world
Classified as simple or complex sugars
Energy yielding (~4 kcal /gm)
90% of carbohydrate intake is ingested
Converted to glucose for transport through the blood
50 to 100 g of carbohydrates are needed daily to prevent ketosis
USDA and DHHS recommend 45-65% of total calories come from complex carbohydrates.
Describe proteins
Composed of carbon, hydrogen, oxygen, nitrogen
Structural material
Required for the formation of all body structures
Labeled complete (high quality) or incomplete (low quality), based on amino acid composition
Animal proteins are complete; plant proteins are incomplete
Needed for tissue growth
Added needs during illness
T or F:
Red meat is an incomplete protein.
False. It is a complete protein.
Describe lipids
Insoluble in water and blood Composed of carbon, hydrogen, and oxygen 95% of lipids in diet are triglycerides Contain mixtures of saturated (raise cholesterol levels) and unsaturated (lower cholesterol levels) fatty acids -Most animal fats are saturated -Most vegetable fats are unsaturated Digestion occurs largely in the small intestine Most concentrated source of energy in the diet RDA not established, should be no more than 20% to 35% total calorie intake
describe trans fats/ Hydrogenation of fatty acids
A partially hydrogenated oil
Makes oil solid
Describe vitamins
Composed of various elements and are needed by the body in small amounts. Enable chemical reactions
Fat soluble
Water soluble
Yield no energy
Fat soluble vitamins
A D E K
Water soluble vitamins
C some B
Describe minerals
Inorganic substances
Function in cellular processes, nervous system, water balance, structural systems
During cooking / soaking can cause a loss of minerals
Trace minerals
Major minerals
Electrolytes
Yield no energy
Describe Water
Accounts for between 50% and 60% of adult’s total weight
Two-thirds of body water is contained within the cells (ICF)
Remainder of body water is ECF, body fluids (plasma, interstitial fluid)
Provides fluid medium necessary for all chemical reactions in body
Acts as a solvent and aids digestion, absorption, circulation, and excretion
Describe phytocemicals
A chemical found in plants
Not considered essential nutrients
Provide significant health benefits
Found in fruits and vegetables
The food guide pyramid
Translates science into practical terms
Helps people meet nutritional needs
For carbohydrate, protein, fat, vitamins, & minerals
Suggests a pattern of food choices
Incorporates foundations of healthy diet:
Variety, balance, moderation
Using the pyramid
Choose low-fat/non-fat options Include plant proteins several times a week Include dark green vegetable every day Include vitamin C-rich food every day Choose whole-grain products Include plant oils daily Eat fish at least twice a week
Factors affecting BMR
Males have a higher BMR due to larger muscle mass
BMR is about 1 cal/kg of body weight per hour for men
BMR is about 0.9 cal/kg of body weight per hour for women
Factors that increase BMR
Growth, infections, fever, emotional tension, extreme environmental temperatures, elevated levels of certain hormones
Factors that decrease BMR
Aging, prolonged fasting, and sleep
Age, sleep, infections, fasting, trauma, burns
On the average- (after age 20) BMR decreases ___ per decade…
2%
Factors affecting food habits
Physiologic and physical factors
Stage of development, state of health, medications
Physical, sociocultural, and psychosocial factors influencing food choices
Economics, culture, religion, tradition, education, politics, social status, food ideology
Developmental considerations
growth, activity, age-related changes, nutritional needs
Growth
infancy, adolescence, pregnancy, and lactation increase nutritional needs
Activity
increase nutritional needs
Age related changes
in metabolism and body composition
nutritional needs
level off in adulthood
Fewer calories required in adulthood because of decrease in BMR
Risk factors for poor nutritional status
Developmental factors Gender State of health Alcohol abuse Medications Megadoses of nutrient supplements
Components of nutritional assessment
History taking Dietary, medical, socioeconomic data Physical assessments Anthropometric and clinical data Laboratory data Protein status, body vitamin, mineral, and trace element status
What would you look for in lab data specifically?
albumin: low-poor nutrition
Prealbumin: more reliable than albumin looks at short term changes faster
BMI
Underweight = BMI < 18.5 Healthy weight = BMI 18.5-24.9 Overweight = BMI 25-29.9 Obese = BMI 30-39.9 Severely obese = BMI >40 *A high BMI may not reflect overweight or fatness. Extra muscle tissue can result in a BMI greater than 25.
Describe types of Dietary data
24-hour recall method
Food diaries/calorie counts
Food frequency record
Diet history
Factors to Assess for Nutritional Status
Usual dietary intake Food allergies or intolerance Food preparation and storage Dietary practices Eating disorder patterns
T or F: According to the MyPyramid Food Guide, the average person should consume 2½ cups of vegetables daily.
True
According to the MyPyramid Food Guide, the average person should consume 2½ cups of vegetables daily.
Dietary nursing interventions
Screening patients at home for nutritional risk
Observing intake and appetite
Evaluating the patient’s tolerance
Assisting the patient with eating
Administering enteral and parenteral feedings
Consulting with the dietitian and physician
Addressing potential for drug–nutrient reactions
Obtaining more food or snacks for the patient if appropriate
Monitoring food brought in by visitors
Participating in nutrition education efforts
Enteral
GI tract
Parenteral
Usually IV
Monitoring nutritional status
Stimulating the appetite
Assisting with eating
Providing nutrition in special situations
Describe Liquid diets
Clear- foods that are clear at room temperature (water, tea, broth, clear juices, gelatin)
Describe full liquids diet
contain additional items such as milk drinks, pasteurized eggs, vegetable juices…
*Commonly used with patients with dysphagia
Describe soft diets
(AKA bland/low fiber) low in fiber- lightly seasoned
Descrive mechanical soft diet
diet that this modified texture and allows minimal chewing before swallowing
Describe vegan diets
range from avoidance of red meat to complete elimination of animal products.
NPO
Nothing by mouth
Describe enteral nutrition
(tube feeding) less than 4 week duration -Levine, Salem Sump, Dobhoff (stylet)
Describe Peg
(Percutaneous endoscopic gastrostomy), Low profile Pegs
Describe parental nutrition
nutrition support via IV route. Can be given through a
- CVC or TPN
- Peripherally –PPN through a short term IV access device (less concentrated).
PICC
Peripherally interted centeral catheter
Length ranges from 40 to 65 cm
Chest x-ray to determine placement (tip rests in the SVC)
Complications of TPN
Insertion problems Infection and sepsis Metabolic alterations (hyperglycemia) Fluid, electrolyte, and acid–base imbalances Phlebitis Hyperlipidemia
PICC
Peripherally inserted central catheter
Length ranges from 40 to 65 cm
Chest x-ray to determine placement (tip rests in the SVC)
CVC
central venous catheter
