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Delmar Learning Copyright 2003 Delmar Learning, a Thomson Learning company Nutrition and Diet Therapy 8th Edition by Ruth Roth and Carolynn Townsend Slide 2 Delmar Learning Copyright 2003 Delmar Learning, a Thomson Learning company Nutrition and Diet Therapy PowerPoint Presentation Written by Susan L. Robson, MSN, RNP-c Slide 3 Copyright 2003 Delmar Learning, a Thomson Learning company Section 1 Fundamentals of Nutrition Slide 4 Copyright 2003 Delmar Learning, a Thomson Learning company Chapter 1 The Relationship of Food and Health Slide 5 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company5 Objectives Name the six classes of nutrients and their primary functions Recognize common characteristics of well-nourished people Recognize symptoms of malnutrition Slide 6 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company6 Objectives Describe ways in which food and health are related List the four basic steps in nutrition assessment Slide 7 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company7 Nutrients Chemical substances necessary for life Functions Provide energy Build and repair tissue Regulate body processes Slide 8 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company8 Nutrients Six classes Carbohydrates Fats (lipids) Proteins Vitamins Minerals Water Slide 9 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company9 Nutrients Organic Contains carbon, hydrogen, oxygen Carbon is found in all living things Example: carbohydrates, fats, proteins, vitamins Inorganic In simplest form when ingested Function: regulate body processes Example: water, minerals Slide 10 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company10 Carbohydrates Provides major source of energy Examples: cereal grains, vegetables, fruits, nuts, and sugars Slide 11 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company11 Fats (lipids) Provides energy Highest kilocalorie value Sources of fat: meats, milk, cream, butter, cheese, egg yolks, oils, nuts Slide 12 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company12 Protein Builds and repairs body tissues Provides energy Only one of the six nutrients that contains nitrogen Sources of protein: meats, fish, poultry, eggs, milk, cheese, corn, grains, nuts, and seeds Slide 13 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company13 Vitamins Organic compounds Regulate body processes Examples: vitamins A, B, C, D, E and K Slide 14 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company14 Minerals Inorganic compounds Regulate body processes Examples: calcium, phosphorus, potassium, sodium, chloride, iron, magnesium, zinc Slide 15 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company15 Water Major constituent of all living cells Composed of hydrogen and oxygen Slide 16 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company16 The Six Essential Nutrients and Their Functions Organic NutrientsFunction CarbohydratesProvide energy FatsProvide energy ProteinsBuild & repair tissues VitaminsRegulate body processes Inorganic NutrientsFunction MineralsRegulate body processes WaterRegulates body processes Slide 17 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company17 A client is at home recovering from surgery. You ask the client what they have eaten over the past 24 hours. The client states the following: Breakfast: 2 doughnuts, orange juice Lunch: lettuce salad with oil & vinegar, soda Snack: pretzels, soda Dinner: spaghetti with tomato sauce, garlic bread; wine Slide 18 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company18 Discuss the answers to the following questions: What nutrients are missing in the clients diet? Why are these nutrients important for this client? Slide 19 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company19 The client is missing protein and water in the diet. Protein is needed to build and repair body tissues after surgery. Water is needed to prevent dehydration. Slide 20 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company20 Characteristics of Nutritional Status GoodPoor Alert expressionApathy Shiny hairDull, lifeless hair Clear complexionGreasy, blemished complexion Good colorPoor color Slide 21 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company21 Characteristics of Nutritional Status GoodPoor Bright, clear eyesDull, red-rimmed eyes Pink, firm gums and well-developed teeth Red, puffy, receding gums, and missing or cavity-prone teeth Firm abdomenSwollen abdomen Firm, well-developed muscles Underdeveloped, flabby muscles Slide 22 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company22 Characteristics of Nutritional Status GoodPoor Well-developed bone structure Bowed legs, pigeon breast Normal weight for height Over- or underweight Erect postureSlumped posture Emotional stabilityEasily irritated, depressed, poor attention span Slide 23 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company23 Characteristics of Nutritional Status GoodPoor Good staminaEasily fatigued Seldom illFrequently ill Healthy appetiteExcessive or poor appetite Healthy, normal sleep habits Insomnia at night, fatigued during the day Normal eliminationConstipation or diarrhea Slide 24 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company24 Divide into groups of 2. Assess your partner for signs of good nutrition. Identify common characteristics associated with good nutrition exhibited in your partner. Slide 25 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company25 Shiny hair Clear skin Clear eyes Erect posture Alert expressions Firm flesh on well-developed bone structures Pink gums and well-developed teeth Normal weight for height Slide 26 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company26 Malnutrition Overnutrition Excess energy or nutrient intake Undernutrition Deficient energy or nutrient intake Overnutrition is a larger problem in the United States than undernutrition. Slide 27 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company27 Identify at least 5 signs of malnutrition present in this child. Courtesy of the Centers for Disease Control and Prevention, Public Health Image Library Slide 28 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company28 Poor quality hair Mottled complexion Dull expression Spindly arms and legs Bloated abdomen Slide 29 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company29 Relation of Food to Health Cumulative Excess nutrients over time Examples: atherosclerosis, obesity, hypertension, diabetes, gallbladder disease, some cancers Deficiencies Nutrients lacking for extended period Examples: iron deficiency, beriberi, scurvy, osteomalacia, osteoporosis, rickets, goiter Slide 30 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company30 Deficiency Diseases Deficiency Disease Iron deficiency Iron-deficiency anemia Beriberi Night blindness Goiter Kwashiorkor Marasmus Nutrients Lacking Iron Thiamin Vitamin A Iodine Protein All nutrients Slide 31 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company31 Deficiency Diseases Deficiency DiseaseNutrients Lacking OsteomalaciaCalcium, vitamin D, phosphorus, magnesium, and fluoride OsteoporosisCalcium and vitamin D Slide 32 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company32 Deficiency Diseases Deficiency Disease Pellagra Rickets Scurvy Xerophthalmia (blindness) Nutrients Lacking Niacin Calcium and vitamin D Vitamin C Vitamin A Slide 33 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company33 Nutritional Assessment Anthropometric measurements Clinical examination Biochemical tests Dietary/social history Slide 34 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company34 Anthropometric Measurements Height Weight Head circumference (children) Upper arm measurement Skinfold Slide 35 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company35 Anthropometric Measurements Height Weight Slide 36 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company36 Anthropometric Measurements Head circumferenceTriceps skinfold Slide 37 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company37 Clinical Examination Clinical SignsPossible Deficiencies Pallor, blue half circles beneath eyes Iron, copper, zinc, B12, B6, biotin EdemaProtein Bumpy goosefleshVitamin A Lesions at corner of mouth Riboflavin GlossitisFolic acid Slide 38 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company38 Clinical Examination Clinical SignsPossible Deficiencies Numerous black and blue spots and tiny, red pin prick hemorrhages under the skin Vitamin C EmaciationCarbohydrates, proteins; kcal Slide 39 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company39 Clinical Examination Clinical SignsPossible Deficiencies Poorly shaped bones or teeth or delayed appearance of teeth in children Vitamin C Slow clotting time of blood Vitamin K Slide 40 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company40 Clinical Examination Clinical SignsPossible Deficiencies Unusual nervousness, dermatitis, diarrhea in same patient Niacin TetanyCalcium, potassium, sodium GoiterIodine EczemaFat Slide 41 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company41 Biochemical Tests Serum albumin level Measures main protein in blood Determines protein status Serum transferrin level Indicates iron-carrying protein in blood indicates iron stores low indicates body lacks protein Slide 42 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company42 Biochemical Tests Blood urea nitrogen (BUN) may indicate renal failure, insufficient renal blood supply, or blockage of the urinary tract Serum creatinine indicates amount of creatinine in blood used to evaluate renal function Slide 43 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company43 Biochemical Tests Creatinine excretion indicates amount of creatinine excreted in urine over a 24-hour period used in estimating body muscle mass muscle mass depleted, as in malnutrition; level will be low Slide 44 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company44 Biochemical Tests Other tests Hemoglobin (Hgb) Hematocrit (Hct) Red blood cells (RBCs) White blood cells (WBCs) Lipid profile (high & low-density lipoprotein, serum triglycerides) Urinalysis Slide 45 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company45 Dietary/Social History Evaluation of food habits. 24-hour recall: Client interviewed by the dietitian and asked to give types, amounts, and preparation of all foods eaten in past 24 hours Food diary: written record of all food and drink ingested in a specified period Computer diet analysis to determine nutrient deficiencies or toxicities Slide 46 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company46 Dietary/Social History Social history Consideration of financial resources to obtain needed food, and properly store and cook food Food-drug interactions that can lead to malnutrition Slide 47 Chapter 1Copyright 2003 Delmar Learning, a Thomson Learning company47 Conclusion Nutrition and health are directly related. Effects of poor nutrition are cumulative. There are six essential nutrients: carbohydrates, fats, proteins, minerals, vitamins, and water. Nutritional assessment is the best way to determine deficiencies that may result from lack of nutrients.