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Module 14 Nutrition The Concept of Nutrition Normal nutrition Nutrition ( the science of the intake of nutrients and their actions in the body functioning Food choice Individuals base food choice on many factors ( see Table 14-1 FACTORS AFFECTING FOOD CHOICE, p. 924 Food habits affect choice Food convenience Food packaging Emotions have a role in food choice Body image Perceived health benefits Portion size Food safety In U.S., each year 48 million people get food-borne illness Over 31 pathogens are linked to food-borne illnesses Nutritional status The physical result of the balance between nutrient intake and nutritional requirements Healthy People 2020 has goals for nutritional intake Food allergy ( 5 of children 4 of adults Milk, eggs, peanuts are most common Food intolerance ( lactose intolerance is most common Satiety ( the feeling of fullness and satisfaction Food insecurity ( reduced eating due to lack of resources Nutrients ( substances found in food that the body needs for growth, maintenance, and repair USDA publishes Dietary Guidelines for Americans USDAs MyPlate plan outlines suggested food intake by food groups Carbohydrates ( organic compounds of food that supply energy in the form of calories to the body Primary sources are plant foods containing sugars and starches Monosaccharides glucose, fructose, galactose Disaccharides sucrose, lactose, maltose Fiber ( polysaccharide carbohydrate Lipids ( fats Dissolve in alcohol but not in water Contain carbon, hydrogen, and oxygen Secondary source of fuel for the body Three categories triglycerides, phospholipids, sterols Fat is useful in protecting the body Some fat is essential for the digestion, absorption, and transportation of fat-soluble vitamins Proteins ( naturally occurring substances that consist of amino acids Essential components of all living organisms, contain nitrogen Complete proteins ( contain all nine essential amino acides Incomplete proteins ( do not contain all essential amino acids Vitamins ( micronutrient compounds that are involved in regulating body functioning Fat-soluble vitamins (A, D, E, K) are found in fats and oils of foods and require bile for absorption Stored in the liver and tissues until needed Water-soluble vitamins (B complex, C) are absorbed with water in the GI tract Minerals ( salts dissolved in water Carry an electrical charge ( called electrolytes Work with other nutrients to maintain fluid balance Most abundant mineral is calcium Water ( comprises 60 of adult body weight and 75 of infant weight Considered an essential nutrient Transports nutrients and wastes Regulates metabolic processes Serves as a solvent for vitamins, minerals, glucose, and amino acids Acts as a lubricant and as a cushion Regulates body temperature Maintains blood volume Assists in maintaining a healthy weight Digestion and metabolism The digestive process Begins in the mouth ( teeth, salivary enzymes, creating food bolus Esophagus ( no digestion takes place Stomach ( digestive enzymes create chyme Small intestine ( cells recognize and absorb nutrients needed by the body Colon ( absorbs fluid Metabolism ( chemical process that enables the body to use the energy extracted from ingested food Liver is primary organ responsible for metabolic processes Genetic and lifespan considerations Genetic factors Genetics play a role in nutritionally related disorders such as lactose intolerance Genetically engineered crops Relationship among genetic variation, nutrient metabolism, and energy balance is being studied Nutrition for infants and children Unique nutritional requirements due to rapid physical and functional changes associated with growth and development Encourage breastfeeding for all infants Nutrition for adolescents Nutrition needs increase especially for protein, calcium, iron, and overall caloric intake Bone health in adulthood depends on bone density acquired in adolescence Growth spurts ( nutritional needs increase significantly Struggles over food choices occur in most households Social pressure to be thin Obesity in adolescence is a worldwide problem Nutrition for adults 34 of adults in U.S. are obese Food choices affect weight Nutrition for older adults Lower calorie needs due to declining physical activity But vitamin and mineral intake should not decline some should even increase Variety of factors affect food choice ( xerostomia, loss of teeth, dental caries, ill-fitting dentures, thirst dysregulation, decreased number of taste buds, cognitive impairment, constipation, polypharmacy Obesity is a concern Alterations to nutrition See CONCEPTS RELATED TO NUTRITION, p. 935 Alterations and manifestations Undernutrition ( insufficient food intake and being hungry 16.7 million children in U.S. live in households where they are unable to consistently access enough nutritious food for a healthy lifestyle Increases risk of development of infections, slower bone development, learning disabilities Failure to thrive See MULTISYSTEM EFFECTS OF UNDERNUTRITION, p. 937 Overnutrition Worldwide transition to refined foods and increased intake of animal protein and fats are resulting in significant increase in diseases linked to overnutrition Prevalence has doubled in children and adolescents in the past 30 years See ALTERATIONS AND THERAPIES NUTRITION, p. 938 Prevalence More than one third of U.S. adults are obese Obesity-related conditions include heart disease, stroke, type 2 diabetes, certain types of cancer In 2008, medical costs associated with diabetes were estimated at 147 billion Obesity now affects 17 of children and adolescents in the U.S. Genetic considerations and nonmodifiable risk factors Many health interruptions respond positively to changes in food intake Nonmodifiable risk factors include age, food allergies Case Study Part 1 ( Stacy Carpenter is a 9-year-old Hispanic female who is seen in the pedicatric clinic today for a well-child checkup , p. 939 Prevention Modifiable risk factors Nutritional intake is a modifiable risk factor for atherosclerotic vascular disease, osteoporosis, age-related macular degeneration, hypertension, and some cancers Screenings Identify need for further evaluation School systems screen for BMI Assessment Nursing assessment History See ASSESSMENT INTERVIEW NUTRITION, p. 940 See Mini Nutritional Assessment, p. 941 Anthropometric data Height Weight Body mass index Waist-to-hip circumference Skinfold thickness Physical examination See NUTRITION ASSESSMENT, p. 943 Lifespan and cultural considerations Nutritional needs change across the life span See LIFESPAN CONSIDERATIONS Nutrition, p. 944 Obesity disproportionately affects minorities and low socioeconomic groups See FOCUS ON DIVERSITY AND CULTURE Nutrition, p. 945 Culture can impact food choices, food preparation, and consumption Diagnostic tests Lipids Complete blood count Serum glucose Serum albumin Total protein Case Study Part 2 ( Stacy returns to the clinic 6 months later with complaints of feeling tired and having a sore throat , p. 945 Interventions and therapies Independent Educated clients on impact of nutritional status Discuss food choices and portion sizes Weekly weigh-ins and diet evaluation Collaborative Dietitians Enteral and parenteral nutrition Pharmacologic therapy Many can be purchased OTC See MEDICATIONS NUTRITION, p. 947 Surgery Surgery for certain diseases, such as Crohn disease, can affect absorption Surgery can reverse conditions, such as pyloric stenosis, that affect feeding Bariatric surgery can be performed of those with morbid obesity Nonpharmacologic therapy Dietary supplements Review The Concept of Nutrition Relate Link the Concepts Ready Go to Companion Skills Manual Refer Go to Nursing Student Resources Reflect Case Study Part 3 ( Stacy comes to see the nurse in the clinic at her school , p. 950 2015 by Education, Inc. 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