The Nurse's Role in Therapeutics: Evaluating the Evidence Flashcards
Nutrition
The science of foods and the nutrients and other substances they contain, and of their ingestion, digestion, absorption, transport, metabolism, interaction, storage, & excretion
- A broader definition includes the study of the environment & of human behaviour as it relates to these processes
Food Guides
Diet-planning tools that sort foods of similar origin and nutrient content into groups and then specify that people should eat certain numbers of servings from each group
1950’s
Majority of immigrants from Europe
1999
- 1/3 of immigrants from Asian countries
- 15% from India, Pakistan, & Sri-Lanka
2006
- more than 200 ethnic groups identified
- 15% Chinese, 10% East Indian, 34% European
Mostly settle in large urban centres
- Toronto, & Vancouver, montreal
- Proportion of population that identifies as visible minority
2016
1 in 5 Canadian residents were born outside of Canada
Primary determinants of healthy eating (3)
- access to information
- availability of healthy & acceptable foods
- Poverty
How do you sift through the health claims around you? What is the problem?
- limitations of media to present important facts
- Findings are controversial, scientists may disagree
- Preliminary findings are used by the media and by commercial promotors
- Promotors know consumers like to try new products and treatments
How can you tell what claims to believe?
- Was the study a properly designed scientific experiment? Can findings be replicated?
- Are findings based solely on personal testimonials?
- Are findings generalized for all people?
- is the journal a respected journal? Has it been peer-reviewed?
Beware of:
- quick and easy fixes
- Personal testimonials
- One product does it all
- Natural
- Time-tested or latest innovation
- Satisfaction guaranteed
- Paranoid accusations
- Meaningless medical jargon
- Too good to be true
Social Learning Theory: Three sets of motivating factors
- physical motivators
- social incentives
- cognitive motivators
Transtheoretical model of Change: Precontemplation stage
an individual does not see a health problem, or does not have any intention of changing or modifying it in the foreseeable future
Transtheoretical model of Change: Contemplation stage
an individual has an awareness of a problem, and is considering making a change. The person remains ambivalent and lacks a strong commitment
Transtheoretical model of Change: Preparation stage
a person begins to take small steps towards changing difficult health related habits. The individual is not fully committed to consistent action
Transtheoretical model of Change: Action Stage
an individual has a strong commitment to change and is making consistent, definitive actions to make behavioural change
Transtheoretical model of Change: Maintenance stage
an individual stabilizes, gains achieved during the action stage are consolidated
Self-Efficacy
a personal belief in one’s ability to execute the actions required to achieve a goal
SMART Goals
Specific
Measurable
Achievable
Relevant
Time bound
Benefits of a motivation framework
- Behaviour change is based on a person’s values, beliefs and preferences
- Fits well with concepts of client-centered care
- Emphasizes an individual’s capacity to take charge of his or her personal health and to control lifestyle factors that impact health
- Can be more effective than other approaches, as the client chooses his or her actions
Food Consumption Surveys
surveys that measure the amounts and kinds of food people consume (using diet histories), estimate and nutrient intakes, & compare them with a standard such as the DRI
Nutritional Status Surveys
Surveys that evaluate people’s nutrition status using nutrition assessment methods
Dietary Reference Intakes (DRI):
a set of values for the dietary nutrient intakes of healthy people in the United States & Canada. These values are used for planning and assessing diets
Recommended Dietary Allowances (RDA) = 99.9% of population
Set of values reflecting the average daily amounts of nutrients considered adequate to meet the known nutrient needs of practically all healthy people; a goal for dietary habits
Adequate Intake (AI)= approximate
Value that is used as a guide for nutrient intake when scientific evidence is insufficient for determination of an RDA
Tolerable Upper Levels (UL) = safest upper level tested
Suggested upper limits of intakes of potentially toxic nutrients. Intakes above the UL are likely to cause illness from toxicity.
Estimated Average Requirments (EAR) = 50% of the population
Population-wide average nutrient requirements for nutrition research & policy making; the basis upon which RDA values are set. Better used to evaluate group nutritional need
Using Nutrient Recommendations
- vary by age
- based on healthy populations
- RDA and AI are best used for individuals
- EAR is best for groups
- Daily intakes will vary - meant to be average intake
Estimated Energy Requirement (EER)
The dietary energy intake level that is predicted to maintain energy balance in a healthy adult of a defined age, gender, weight, and physical activity level consistent with good health
6 classes of Nutrients
- water
- carbohydrates
- fats
- proteins
- vitamins
- minerals
Macro-nutrients
- Fats
- Proteins
- Carbs
Micro-nutrients
- Vitamins
- Minerals
- Water
Organic Nutrients
Carbon containing. The four organic nutrients are carbohydrate, fat, protein, and vitamins
Inorganic Nutrients
Do no contain carbon or pertain to living things
Essential Nutrients
Nutrients that the body cannot make and therefore must be obtained from food
Carbohydrate
4kcal/g
Protein
4kcal/g
Fat
9kcal/g
Alcohol
7kcal/g
Kcalorie
- the energy it takes to raise the temperature of 1 kg of water by 1 c
- 1000 calories equal 1 kilocalories
- The scientific use of “kcalorie” is the same as the popular use of the term “calorie”
Density: what is energy density?
“a measure of the energy a food provides relative to the amount of food”
- high calorie count for the nutrients
Density: What is nutrient density?
“a measure of the nutrients a food provides relative to the energy it provides. The more nutrients and the fewer kcalories, the higher the nutrient density”
Acceptable Macronutrient Distribution Ranges (AMDR)
The following proportion of macronutrients provides energy & nutrients and reduces risk of chronic disease
- Protein 10-35%
- Carbohydrate 45-65%
- Fat 20-35%
Ingredients list
in descending order of predominance by weight
serving size
all labels for given product use same serving size. Need to be aware that serving size may differ from actual quantity eaten!
Daily Values
reference values developed by the FDA specifically for use on food labels
- set adequacy standards for desirable nutrients
- set moderation standards for nutrients that must be limited
Daily Values
reference values developed by the FDA specifically for use on food labels
- set adequacy standards for desirable nutrients
- set moderation standards for nutrients that must be limited
Nutrition Facts
presented in quantities and % of daily values
Nutrient Claims
describe contents of a product, eg. free, zero, light, reduced
Health Claims
Characterize the relationship between a nutrient or other substance in food and a disease or health-related condition
Structure-function claims
describe how a product may affect a structure or function of the body; for example,
Concepts of Meal Planning
An adequate and balanced diet is one that meets all the nutritional needs of an individual for maintenance, repair, the living processes, and growth or development
Concepts of Meal planning
- Adequacy
- Balance
- kCalorie (energy) control
- Nutrient density
- Moderation
- Variety
