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Introduction to

Nutrition

Gian Carlo Sy Torres RN

Nutrition

Study of food in relation to health of an individual,


community or society and the process through which food
is used to sustain life and growth

Study of essential nutrients & the processes by which


nutrients are used by the body

Study of the processes by which an organism ingests,


digests, absorbs, transports, utilizes and excretes food
substances

Foundation of Good Health- right kind & amount of food


eaten at the right time.

Nutrition is the cornerstone of each health


dimension
Physical

Health:

Dependent

on the quality & quantity of


nutrients available to the body

Intellectual
relies

health:

on a well functioning brain &


nervous system
Nutritional imbalance e.g. iron deficiency
anemia affects intellectual health.

Emotional

health:

May

be affected by poor eating habits.


When we miss a meal, feelings of anxiety,
confusion & trembling may occur
Social

health:

Social

health situations often center on food


related occasions. Nutritional status is
sometimes affected by the quality of our
relationships with family & friends.

Spiritual
Several

Health:

religions prohibit the consumption


of specific foods

Role of Nutrition
Wellness
A

lifestyle that enhances each of the five


dimensions of health.

Wellness
An

Nutrition

approach to food consumption as a


positive way to nourish our body
Organize our lives so we can more easily
follow a healthy eating pattern.

Nutrition Education
Utilized

to promote positive behavior


changes:
Assortment

eating variety of food from every

food group
Balance Provide food from all food groups in
quantities so essential nutrients are consumed
in proportion to each other
May

be:

Formal
Non

Formal
Informal

Functions of Nutrition in Relation to Nursing


Function
Nutrition
1. To sustain life

Nurse
1. To sustain and support
persons thru times of
dependence and need

2. To promote
2. To promote personal growth
growth
and restore health
3. To replace loss 3. To replace the loss of selfcare and help maintain a sense
of personal wholeness
4. To provide
energy

4. To help provide emotional


strength to cope with the total
experience of illness

Dietetics

combined science
and art of regulating
the
planning,
preparing and serving
of
meals
to
individuals or groups
according
to
principles of nutrition
and
management
with
due

Diet Therapy

branch of dietetics
specialized in the
use of food for the
treatment
of
disorder or disease
Planned diet must
be
eaten
to

Food

Any substance, organic or


inorganic when ingested or eaten
nourishes the body by:
1.
2.
3.

Building and repairing tissues


Supplying heat and energy
Regulating bodily/metabolic
processes

Sustains life

Food Selection
Food

Preferences

Foods

chosen to be eaten when all foods


are available at the same time

Food

Choice

Specific

foods that are convenient to


choose when we are actually ready to eat

Food

Liking

Foods

we really like to eat

Meaning of food
Food

likes:

Security

foods, reward foods


fetish foods , show off foods
grown up foods, advertised foods
Food

dislikes

Cultural

taboo foods, religious taboo


familial and individual taboo foods

Meaning of food
Pleasurable/Unpleasurable

association foods
Familiarity

on food preparation
easy/hard to prepare
Sanitary/Filthy sources
Allergies
Agreeable/

properties

Disagreeable sensory

Spoiled/Unspoiled
Color,odor,

taste, texture and


temperature

Qualities of Good Food


It

is nourishing or nutritious
It has satiety value
Prepared under sanitary
conditions, aesthetically and
scientifically
It is free from toxic agents
Its palatability factors satisfy
the customers
Offers variety & planned within
the socio-economic context

Calorie (Kcal)
Unit

of energy measurement
Amount of heat required to raise the
temperature of 1 kg of water by 1 C
1 g of carbohydrates = 4 calories
1 g of protein = 4 calories
1 g of fat = 9 calories

Nutrient:
Chemicals

or substances in food
required by the body for energy,
growth , maintenance & repair

some

are manufactured in the body


thru biosynthesis, others are
manmade
Essential nutrients are:
Water
CHO
CHON

Fats
Vitamins
Minerals

Essential Nutrients
Carbohydrates

(CHO)

Major

source of fuel
Simple white sugar, fruits and milk
Complex cereals, grains, pastas,
vegetables
Proteins

(CHON)

Performs

extensive range of functions


aside from being a source of energy
Contains essential and non essential
amino Acids

Fats/Lipids
Densest

form of energy
Roles in hormone production and
padding for body organs.
Triglycerides, phospholipid and sterols.
Vitamins
Indirectly

assists other nutrients in


various body processess
Fat Soluble and Water Soluble vitamins

Minerals
Structural

purposes
Body functions and activities
Major and trace minerals
Water
Major

part of every tissue in the body


Comprises 60-70% of total body weight

Nutrient Classification:
according

to function
according to chemical nature
according to essentiality
according to concentration

Nutrient Classification
According
Body

to Function:

Building

form

tissues or are structural component of


the body
Water - 2/3 of body weight
CHON - 20%,
CHO - 1%
Fats- 20%, Minerals - 4%
Energy
CHO,

giving

Fats & CHON

Regulate
all

body processes

nutrients

Nutrient classification
According

to Chemical nature:

Organic

- CHON, CHO, Fat & vitamins


Inorganic - minerals & water
According
Dietary

to Essentiality

essential

cannot

be made by body, must be provided


by food

Non-essential
Body

can make on its own

Nutrient Classification
According

to Concentration

MACRONUTRIENTS
>

0.005% of body weight (>50PPM)


CHON, CHO, Fats, Ca, P, K, Na
MICRONUTRIENTS
<

0.005% of body weight (<50PPM)


vitamins, Fe, Iodine, Flourine

Enzymes
Organic catalysts
that are protein in
nature and are
produced by living
cells
Hastens chemical
reactions without
itself undergoing
change
Ends in ase
e.g. maltase,

Hormones
Organic substances
produced by special
cells in the body
discharged into the
blood stream to be
transported to specific
organs and tissues
remote from the point
of manufacture
Regulate vital
processes which are
highly specific

Examples of hormones with


direct involvement to nutrition
Posterior

pituitary - Vasopressin
Anterior pituitary - Lipotropin
ParathyroidParathyroid
hormone, calcitonin
Thyroid Thyroxine
Pancreas - Insulin, glucagon
G.I. gastrin, secretin,
cholecystokinin

Nutritional Status (Nutriture)


Condition of the body resulting from the
utilization of essential nutrients
Optimum or Good Nutrition
body has adequate amount of essential nutrients that
are efficiently utilized such that growth and good health
are maintained at the highest possible level

Malnutrition
condition of the body resulting from lack of one or more
essential nutrients (nutritional deficiency) or excessive
nutrient supply to the point of creating harmful effects
(overnutrition)

Causes of Malnutrition
Secondary
Factors

Primary
Factor

Refers

to faulty diet
Inadequate intake
Poverty
Ignorance
Poor

food habits
Limited food supply
Poor distribution of
food
Cultural taboos

Refers

to all conditions
within the body that
reduce the nutrient
supply of the cells
Inefficient use of the
nutrients
Digestion
Absorption
Metabolism

and

Utilization
Increased excretion

Pathogenesis of
Nutritional Deficiency Disease
Dietary
Deficiency
(Primary
Factor)
Nutritional
Deficiency

Tissue
Depletion
Depletion of
Nutrient
Reserves

Biochemical
lesions or
changes

Functional Changes

Conditioning Factors
(Secondary Factors)

Anatomic Changes

principles in the
promotion of good
nutrition

1.The body requires food to:


Provide energy for organ function,
movement and work
Maintain body temperature
Provide raw materials for enzyme
function, growth, replacements of cells
and repair

2. The processes of
digestion, absorption
and metabolism work
together to provide all
body cells with energy
and nutrients

3. Mans energy
requirements vary and
is influenced by many
factors such as:
age
body size
gender
climate
sleep

physiological stress
(pregnancy/lactation)
pathological disorders
(diabetes)
activity/occupation
lifestyle

4. Foods are described


according to the density
of their nutrients.
Nutrient Density - the proportion of
essential nutrients to the number of
calories.

5.

Nutrient content is
variable
Enrichment
Fortification

Enrichment:
The

addition of vitamin/ and or minerals


to the food at a concentration level in
excess of the amounts naturally
present in food
Example

rice enriched with thiamin

Fortification:
The

food is used as a vehicle to carry the


added nutrients which are absent
originally in that food
Example

fortified vitamin rice

6. When energy
requirements are
completely met by
caloric intake, people
maintain their activity
level without weight
change.

7. An adequate
diet is the
foundation of
good
nutrition and
it should
consist of a
wide variety
of foods.

8. Measures for
improvement of
nutritional status are:
nutrition education
abundant food
supply
use of various
resources

9.

Malnutrition is
brought about by faulty
diet &/conditioning
factors

10.

Study of nutrition is
interrelated with arts &
sciences

Nutritional Assessment
Process

of determining Nutritional

Status
With 4 Components (A,B,C,D)
Anthropometry
Biochemical

tests
Clinical Examinations
Dietary Surveys

Assessing Nutritional Status

Physical/Instrumental Method
(Anthropometry)
1.

Weight - reflects body mass

Weight for age

used in under-5 year old children, as in Operation Timbang

Helpful in diagnosing acute undernutrition


(wasting) & chronic undernutriton (stunting)

Gomez

classification of nutritional
status based on percentage of
expected body weight
Formula:

% of EBW = ABW/EBW
Classification:

> 110% of EBW


91-110 %
76-90 %
61-75 %
60 % or less

=
=
=
=
=

overweight
normal
1st degree undernut.
2nd degree
3rd degree

Weight for height


used for adults, useful in assessing acute malnutrition
(obesity & wasting)
Body Mass Index

weight(kg.) / (height in m) 2

20 25%

Normal

27.5 30%

Mild obesity

30-40%

Moderate obesity

Above 40%

Severe obesity

Hamwi Method:
1. Ideal weight based on height:
Men: 106 pounds for the first 5 feet of
height & 6 pounds for each additional inch
Women: 100 pounds for the first 5 feet of
height & 5 pounds for each additional inch
Add or subtract 10% depending on body
frame.

2.

Height for age


reflects skeletal growth for age; also
used in young children, helpful in
diagnosing chronic undernutrition

3. Mid upper arm


circumferenceestimates muscle mass hence
the protein & energy reserves
at the mid-arm area; used
only in 1-4 year old age
group. For rapid screening.
13 cm. or more = normal
Less than 13 cm. =
wasting

4. Triceps skin fold


measures the amount of
subcutaneous fat; used for
adults only. Normal value is 1
inch

Assessing Nutritional Status


Biochemical

tests

Blood

- Hgb. & Hct, serum albumin,


transferrin,
Urine - creatinine excretion
Clinical

detects physical symptoms associated with


malnutrition

hair, skin, eyes, tongue, etc.

Medical

examination -

history-

reveal secondary factors to malnutrition

Assessing Nutritional Status


Dietary

survey - evaluates primary


factor of nutritional inadequacy
Food

recall
Food record
Food inventory/ diary
Dietary history

1.

24-hour food recall


-

recall all food and beverages the client


consumes during a typical 24-hour
period
usually gathered in a personal
interview or by telephone
evaluated according to the Food Guide
Pyramid

2. Food Frequency Record


-

checklist that indicates how often general


food groups or specific foods are eaten
may be categorized as times/day,
times/week, times/month, or frequently,
seldom, never
helps to focus on groups of foods that are
either deficient or excessive

3. Food Diary / Periodic Food Records


-

detailed record of measured


amounts (proportion sizes) of all
food and fluids a client consumes
during a specified period, usually 3
to 7 days
helpful for assessing food patterns

4. Diet History
-

comprehensive time-consuming assessment of


a clients food intake that involves an
extensive interview by a nutritionist or dietitian
includes characteristic of foods usually eaten
as well as the frequency and amount of food
consumed
may include a 24-hour recall, a food frequency
record, and a food diary
data are gathered through interviews or
questionnaires

GOOD DAY!!!

Be ready for a quiz


next meeting!!!

Basic tools in Nutrition:


Dietary

Reference Intakes

Standards

used to :

Review

scientific data on a specific nutrient


Assess functions of nutrients to reduce chronic
diet related conditions
Evaluate current data on nutrient consumption

Dietary

Standards:

Provide

a guide to adequate nutrient intake


levels against which to compare the
nutrient values of food consumed.

Basic tools in Nutrition:


Dietary

Requirement:
Is the minimum amount of nutrient
needed to provide for basic physiological
functioning of our bodies.
Recommended Dietary Allowance (RDA):
Is the minimum requirement plus a
safety factor or margin of safety to
account for variations in individual needs
Level of nutrient intake sufficient to meet
the needs of almost all healthy
individuals

Basic tools in Nutrition:


Adequate

Intake (AI)
Approximate level of an average
nutrient intake with in a sample
population
Tolerable Upper Intake levels (UL)
Level of Nutrient intake that should
not be exceeded to prevent adverse
health risks

Basic tools in Nutrition:


Food

exchange lists:

Is

a system of grouping of common foods


that have practically the same amount of
CHON, CHO,and fat.

Food

composition tables (FCT):

Lists

the chemical composition of a food


whether of plant or animal origin
With variations according to kind, breed,
part ,soil fertility and uncontrollable factors.

Basic tools in Nutrition:


Food

group/Food Guide Pyramid:

Food

containing high levels of certain


nutrients are grouped together and the
serving portions are stated in household
measures for the laymen to understand.

FOOD GUIDE PYRAMID


Fats, Oils & Sweets
USE SPARINGLY

Milk, Yogurt, & Cheese Group


2 3 SERVINGS

Meat, Poultry, Fish,


Dry Beans, Eggs, &
Nuts Group
2 3 SERVINGS

Vegetable Group
3 5 SERVINGS

Fruit Group
2 4 SERVINGS

Bread, Cereal, Rice &


Pasta Group
6 11 SERVINGS

Nutrient

Density:

Relative

measure of nutrients in food in


proportion to its caloric content
A nutrient that carry out one function is
equally essential as a nutrient with 3
functions
INQ (Index of Nutrient Quality)
= % RDA of the Nutrient
% Energy requirement

If INQ is 1 or more for at least 4 nutrient &


INQ of 2 or more for at least 2 nutrient = food
is considered nutritious
Example

lean liver & lean chicken meat liver is


more iron dense than chicken

USE

OF COMPUTERS:

Nutrition

education
Record keeping jobs
Dietary analysis
Diagnosis
Information storage & retrieval
Prediction & forecasts
Robotics
Etc.

NUTRITIONAL LABELLING
Label should have the
ff. format:
Calories
CHON
CHO
Fat
Vit. C & A
Thiamin
etc

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