NURSING 001 Chapter 19 Nutritional Concepts and Related Therapies Already Graded A
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Course
Nursing
Institution
Nursing
Ch 19 Nutritional Concepts and Related Therapies
Wednesday pg 485-508 ch 6 box 6-4 pg 101-105/ Thursday test 508-532 and CH 22 p 676-684
Nutrition: sum of all processes involved in taking in nutrients and using them to maintain body tissue and provide
energy (one of the foundation of life); Good...
Ch 19 Nutritional Concepts and Related Therapies
Wednesday pg 485-508 ch 6 box 6-4 pg 101-105/ Thursday test 508-532 and CH 22 p 676-684
Nutrition: sum of all processes involved in taking in nutrients and using them to maintain body tissue and provide
energy (one of the foundation of life); Good nutrition is essential for optimal health throughout all stages of life
Role of the nurse in promoting nutrition: Pt look at nurse for more information
● responsible for assisting pt to eat, record intake, observe signs of poor nutrition and communicating about
dietary concerns to hcp
● Nurse needs knowledge of nutrition to help pt
Basic nutrition: Diet planning guides
Guidelines started as farmers bulletin more than 100 yrs ago and then evolved into basic 7, basic four, the food guide
pyramid,Mypyramid, and currently MyPlate
MyPlate: Developed by USDA in 2011
● Image of round plates divided into 4 different color selection
○ Vegetables, fruit, grain, protein and a seperate group dairy
● USDA suggest ppl balance calories by reducing portions; increase intake of fruit and vegetables
● Reduce amount of sodium and sugary foods in the diet
Dietary guidelines for americans: the latest of these guidelines and include recommendation for the general
population
● Help choose overall healthy diet
● This guide balances calories: consuming more fruits, vegetables, whole grains, increasing fat-free or low-fat
dairy and seafood; consuming low sodium, saturated fat, trans fat, cholesterol, added sugars, and refined grains
● Dietary guidelines for americans affects: food stamps, WIC, school breakfast and lunch programs
○ The government developed these guidelines to address adequate nutrition, avoid overnutrition and
chronic disease
Dietary Reference intakes (DRI): refers to a set of nutrients based values that serve for both assessing and planning
diet
● DRI replace and expand on recommended dietary allowance (RDA) have been around for more than 50 years
● Purpose of the DRI is to help provide individuals optimize their health, prevent disease, and avoid consuming
too much of a nutrient
Essential nutrients: Basic functions
A nutrient: a chemical compound or element in food that is necessary for good health
Essential nutrient: nutrients that the body cannot make in the amounts essential for good health; therefore, it is
necessary to obtain these nutrients through a diet
○ 6 classes of essential nutrients: carbohydrates, fats, proteins, vitamins, minerals, and water
○ Each necessary for life
○ 3 major functions of nutrients: 1) providing energy 2) building and repairing tissue 3) regulating body
processes
Providing energy
● Kilocalorie(kcal): is a measurement of energy, much as a pound is measured in weight
○ The more kcal a food has the more energy it will provide
● Of the 6 essential nutrients only 3 provide energy: carbohydrate, fats, and proteins
○ Carbs and proteins provide approximately 4 kcal/g, Fats provide 9 kcal/g, Alcohol supplies 7 kcal/g
, ● Caloric distribution: Obtain 45-65% of daily kcal from carbs, 20-35% from fats, 10-35% from protein
Building and repairing tissue
● Protein is the nutrient that places the most important role in building and repairing
○ It contains amino acids
● Calcium and phosphorus are minerals that are necessary nutrients in bone structure, iron, another mineral
makes up a large part of hemoglobin in RBC
Regulating body processes
● Metabolism: combination of all chemical processes that take place in living organisms
○ Processes of building up and breaking down tissue
○ Nutrients play a role in metabolism and help regulate certain body processes
■ The presence of carbs is required for fat to be used correctly
■ Vitamin B are necessary for the body to derive energy from food
■ Water is an integral part of almost all chemical reactions in the body
● By studying how the body uses nutrients scientist have found 2 important facts
○ Individual nutrients have many functions in the body
○ No nutrient works alone
Carbohydrate: organic compounds containing carbon, hydrogen, and oxygen
● Main function to provide energy
● Also needed in adequate amounts to keep protein from being used as energy
● Made up of saccharides (sugar units)
● Classified as simple or complex carbohydrates
○ Simple carbohydrates: include monosaccharides and disaccharides
■ Monosaccharides have one unit of sugar require no digestion
■ Fructose (monosaccharide) found in fruits and glucose (blood sugar)
■ Disaccharides are made up of two sugar units bonded together
● Once they go into the body hydrolysis breaks them down into monosaccharides
● Ex. table sugar (sucrose) and milk (lactose)
● DRIs relating to carbohydrates indicates that 45%-65% of adult calories should be a form of carbohydrates
○ Added sugar should be no more than 8% (40g)
○ Simple sugars are found in milk and fruits
● Complex carbohydrates: polysaccharides made of long chains of glucose units
○ All break down into simple sugars when digested
○ 3 types of complex carbohydrate are
■ Starch- found in plant foods such as grains, legumes, and vegetables (breaks down more slowly
b/c its larger
■ Glycogen: (animal starch) made of simple sugars, stored in liver used when body glucose is low
■ Dietary fiber: humans cannot digest, fiber consumed secreted in feces has no nutritional value
● It can lower cholesterol and blood glucose level and assist in weight loss
● Insoluble fiber: found in wheat bran, vegetables, whole grains and some fibrous fruit
● Water-soluble fiber: fruits, oats, barley, and legumes
Daily requirements of Carbohydrates
● Fiber intake 21 and 38g/day
, ● MyPlate recommends increasing fruits and vegetables, and consuming at least half of grains as whole grains
NOT refined
● Increase in fiber can cause gas, bloating and constipation, too much can lead to osteoporosis and anemia
● 8 glasses of water per day
Digestion and metabolism of carbohydrates
All carbohydrates broken down in digestive tract into monosaccharides before absorbed and converted to glucose
except fibers
● Extra carbohydrates are stored as glycogen
Fats (lipids): organic substances of a fatty nature that are insoluble in water and necessary for good health
○ Both fats and cholesterol are lipids
● They provide the most concentrated source of energy of all nutrients; need 9 kcal/g
● Dietary fats provide Satiety (a feeling of fullness and satisfaction from food)
○ Adds aroma to foods and provides the body with essential fatty linoleic acids and linolenic acid
○ Dietary fats also carry fat soluble vitamins: A,D,E, and K
● Composed of carbon, hydrogen and oxygen just like carbohydrates
● Lipids also contain fatty acid and glycerol; b/c of this they may be called glycerides or triglyceride
○ Fatty acids are the building blocks of fat
● Classified as either saturated or unsaturated
○ Saturated fatty acid: chemical bonds are completely filled or saturated with hydrogen
■ Are generally of animal origin and solid at room temp
■ Have a long shelf life because the fat is strong so it takes long to spoil
■ Tend to increase blood cholesterol, increasing the risk of atherosclerosis
■ 7% of total daily calories
○ Unsaturated fatty acid: one or more places where hydrogen is missing on its chemical chain (called
points of unsaturation)
■ A fatty acid with only one point of unsaturation is called monounsaturated fatty acid
■ Fatty acids with 2 or more points of unsaturated fats are polyunsaturated
Fatty acid class Food contributing significant amounts to the diet
Saturated Coconut, palm and palm kernel oils
Fat in and on meats and poultry
Egg yolk, butter, cream, milk fat, cocoa butter,
olive oil,olives
Monounsaturated Canola oil, peanuts and peanut oil
Most other nuts
avocados
Trans Partially hydrogenated plant and fish oil, stick
margins, shortening, commercial fats used for
frying, baking
, Hydrogenated fats: Hydrogenation is a process in which hydrogen is added to a fat of vegetable origin (unsaturated) in
order to make it more saturated or solid
● Most oils such as corn oil have been hydrogenated to some extent
Trans fatty acid: are unsaturated fatty acids that have been completely hydrogenated
● Synthetic trans fatty acids are produced during hydrogenation and can be found in some deep-fried restaurant
foods, packaged cookies, crackers, and other
● Trans fatty acids are like saturated fats and tend to increase cholesterol levels
Cholesterol: is a lipid belonging to a class of chemical substances called sterols
● Is a building block for cell membrane and for hormones such as estrogen and testosterone
● Found in animal origin foods: meats, egg yolk, seafood, poultry, and dairy products
● Plant sterols sometimes decrease cholesterol levels in the blood
● Recommended intake is no more than 30mg/day
Digestion and metabolism of fats:
● In order for fats to be digested they have to be broken down into smaller globules
● Bile is necessary to emulsify fat (bile is stored in gallbladder and dispensed to duodenum when fat is present)
● When fat is emulsified the body is able to break down and absorb it
● Lipids are packaged as lipoproteins(molecules made of lipids surrounded by protein)
○ Body makes 4 types of lipoproteins
○ 1)chylomicrons 2)high-density lipoproteins HDLs 3) low-density lipoproteins LDLs 4)very low-density
lipoproteins VLDLs
■ Higher the protein content of lipoproteins the greater the density
○ LDLs (bad cholesterol) and HDLs (good cholesterol) are important in cardiovascular disease
■ Both carry cholesterol to bloodstream
○ Recommended that serum cholesterol levels stay below 200 mg/dL
Classification of LDL, total ,and HDL cholesterol 19-3
LDL cholesterol
<100 mg/dL Optimal
100-129 mg/dL Near or above optimal
130-159 mg/dL Borderline high
160-189 mg/dL High
≥190 mg/dL Very high
Total cholesterol
<200 mg/dL Desirable
200-239 mg/dL Borderline high
≥240 mg/dL High
HDL Cholesterol
<40 mg/dL for men Low
<50 mg/dL for women
Protein: another nutrient vital to the human body, provide building blocks for blood and bone and are part of every cell
● Contains 1000s of different proteins all essential for tissue growth, repair, and wound healing
● Collagen a vital connective tissue is made of protein
● Some hormones such as thyroxine and insulin are proteins
● Enzymes are proteins produced by living cells
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