NUTRITION AND METABOLIC PATTERN

What is Nutrition?
The study of foods and nutrients and their effect on health, growth and development of the individual.
Nutrition is the good we get from all the food we eat and it helps our bodies work.
Nutrients are the substances found in the food that is essential requirement for body functioning.
Body needs adequate food intake with balanced essential nutrients.

Essential Nutrients
water
carbohydrates
proteins
lipids
vitamins and
minerals.

Carbohydrates
Preferred source of energy
Include simple and complex carbohydrates
Promote fat metabolism, spare protein and enhance lower GI function
Major good sources milk, grains, fruits and vegetables
Inadequate carbohydrates intake affects metabolism

Carbs metabolism
Carbohydrates breaks into glucose
Some glucose circulate in the blood to maintain blood level and source of energy.
Reminder stored
Insulin enhances transport of glucose into cells

Proteins
Made of carbon, hydrogen, oxygen and nitrogen
Each protein molecule is made of amino acids
Essential: must supplied from diet and are necessary for tissue growth and maintenance.
Nonessential: body makes it and mix it with dietary protein to make new protein molecules

Classification of proteins
Complete proteins
Contains all essential and some non essential amino acids.
Found in animal, dairy, eggs

Incomplete proteins
Missing one or more essential amino acids.
Derived from vegetables
Balanced combination of food can provide essential amino acids e.g. maize and beans.
Protein metabolism

Three activities
Anabolism ( building)
Catabolism (breaking down)
Nitrogen balance (balance N intake = N output)

Lipids
Contains carbon, hydrogen and oxygen but more hydrogen than carbohydrates
Greasy, insoluble in water but soluble in alcohol
Fats are lipids that are solid at rtp
Oils are lipids that are liquid at rtp
Structured with fatty acids described as saturated and unsaturated fatty acids. (saturated, unsaturated fat)
Meat, butter, milk, coconut are saturated fat
Fish, oil, cereal, legumes (maize oil), breast milk are unsaturated fat.
Enzyme lipase converts fat into usable energy

Micronutrients
Vitamin are not manufactured by the bodies and needed to catalyze metabolic processes.
Fat soluble vitamins ( A, D, E and K)
Water soluble vitamins ( C, B-complex)
Minerals ( calcium, phosphorus, sodium, potassium, iron, iodine)

Energy Balance
Is the relationship between the energy derived from food and the energy used by the body.
Body obtains energy in the form of calories form carbohydrates, fat, protein and uses energy for daily voluntary and involuntary activities like walking, breathing.
Energy intake thru calorie value.
BMR by which body metabolizes food to maintain the energy requirements at awake and at rest.



Balanced Diet
Provides appropriate amounts of all nutrients in the correct proportions to meet body requirements which is achieved by eating variety of foods.
Any nutrient eaten in excess or deficient can affect health. (obesity, anemia)
Is important in maintaining a healthy body weight and can be assessed by body mass index (BMI)
Check out: wt kg divided ht squared (18.5---24.9)
Example: weight 60 kg ÷ height (1.52)² meters = 26 is the BMI.
http://www.cdc.gov/nccdphp/dnpa/healthyweight/assessing/bmi/index.htm


Young children


(one serving )
Grain group 1 slice of bread, 1/2 cup of cooked rice or pasta, 1/2 cup of cooked cereal,
Vegetable group 1/2 cup of chopped or raw vegetables, or 1 cup of raw leafy vegetables.
Fruit group 1 piece of fruit or melon wedge, 3/4 cup of 100% fruit juice, 1/2 cup of canned fruit, or 1/4 cup of dried fruit.
Milk group 1 cup of milk or yogurt or 2 ounces of cheese.
Meat group 2 to 3 ounces of cooked lean meat, poultry or fish, 1/2 cup of cooked dry beans, substitute 2 tablespoons of peanut butter or 1 egg for 1 ounce of meat.

Elder’s:


NUTRITION AND METABOLIC PATTERN

Tuft's University adjusted the food pyramid for those over age 70 to include:
8 glasses of water a day and plenty of fiber to help manage constipation.
Calcium, vitamin D, and B12 supplements.



Fancy pyramid food possible in Africa?





Factors affecting nutrition
Accessibility
Affordability
Food safety
Traditions
Lifestyle
Medications and therapy
Health
Alcohol consumption
Psychologic factors


Assessment
ABCD
Anthropometric Data: Ht, wt, waist circumference, BMI

Biochemical Data: Hemoglobin, serum albumin

Clinical: Skin, Hair and nails, mucus membrane

Dietary Data: 24-hour food recall, food diary

Nursing Diagnosis
Imbalanced nutrition: Less than body requirements/intake of nutrients insufficient to meet metabolic needs

Imbalanced nutrition: More than body requirements related to excess intake and decreased activity expenditure

Low self-esteem related to obesity

Risk for infection related to immunosuppresion secondary to insufficient protein intake.

Therapeutic Diets
Clear liquid diet
Full liquid diet
Soft diet
Bland diet
Low residue/low fiber diet
High fiber diet
Fat controlled diet
High calorie diet
Sodium restriction diet
Protein restriction diet
High protein diet
Low calcium diet
High calcium diet
Low purine diet
High iron diet
Carbohydrate controlled diet

References
Carpenito, J.L. (2002). Nursing diagnosis: Application to clinical practice (9th edition) Philadelphia: Lippincott.
Kozier & Erb. (2008). Fundamentals of Nursing (8th edition) New Jersy: Pearson.
Ross and Wilson. (2006). Anatomy and physiology (10th edition) Churchill Livingstone.
Savage King and Burgess. (1993). Nutrition for developing countries (2nd edition) Oxford.
Images: google images