NUTRITION & DIET THERAPY

Basic Concepts of Nutrition and Diet Therapy

HEALTHCARE PROVIDERS IN HEALTHCARE DELIVERY

NUTRITION
• It is the science of food and its relationship to health. Registered Nurse
• Involves the process of taking in and utilizing o the first team member to interview the client
nourishment, which includes natural and artificial and communicate important nutritional
feeding. information – client’s response to food,
• Pre-disposing = non-modifiable factors like age, race intake, and tolerance. They also provide
etc. nutritional information to clients.
• Precipitating = modifiable factors like lifestyle, food, Registered Dietitians
nutrition, exercise. o together with the physicians, they are
responsible for meeting the client’s
nutritional needs. They interpret the
ROLE OF NUTRITION physician’s diet order in terms of client’s
food habits and food choices, calculate
client’s nutritional requirements, evaluate
• Nutrition can contribute to the prevention of disease: client’s response therapeutic diets,
recommend the best route for
PRIMARY administration, and provide in-depth
• implementation of practices that are likely to avert nutrition education and counseling to
the occurrence of disease. patients.
• Strategy: Physicians
o Motivating people to change their behavior o are responsible for the diagnosis and
and maintain a healthy body weight. treatment of medical conditions. They manage
medical care, order laboratory tests, and
SECONDARY prescribe medications and diets.

• the institution of monitoring techniques to discover NUTRIENTS

incipient diseases early enough to enhance the
opportunity to control their effects. • Are the chemical substances supplied by food that
• Strategy: the body needs for growth maintenance and
o Risk for Diabetes in Pre-diabetes stage. repair?
o Testing blood sugar levels, non- invasive
CLASSES AND ESSENTIALITY OF NUTRIENTS
treatments such as weight loss and diet
modification. • Carbohydrates (CHO)
• Fats (Lipids)
TERTIARY
• Proteins
• the use of treatment techniques after a • Minerals
disease has occurred to prevent complications • Vitamins
or to promote maximum adaptation. • Water
• Strategy:
o Patients with swallowing disorders –
nourishments that can avoid choking.
 CLASSIFICATION OF NUTRIENTS
• Function
o those that form tissues in the body are
body-building nutrients while those that
furnish heat and energy are fats,
carbohydrates, and proteins.
• Chemical properties
o nutrients are either organic or
inorganic.
• Essentiality
o nutrients are classified based on their
significant contribution to the body’s
physiological functioning.
• Concentration
o nutrients are either in large amounts or
little amounts.
TYPES OF NUTRIENTS
• Essential Nutrient
o one that the human body requires but
cannot manufacture in sufficient
amounts to meet bodily needs. Must be
supplied by foods in the diet.
o Ex. Vit A, Vit C, and Calcium….
• Non-essential Nutrient
o are not needed in the diet because the
body can make them from other
substances.
o Ex. Alanine
• Conditionally Essential Nutrients
o are those that a healthy body can
manufacture in sufficient quantities.
The body cannot produce in optimal
amounts in certain situations of
physiological status or disease.
o Ex. Tyrosine
LIFE SUSTAINING FUNCTION OF NUTRIENTS
• Serve as a source of energy or heat.
• Support the growth and maintenance of tissue.
• Aid in the regulation of basic body processes.
SOURCES OF ENERGY
ENERGY
• Capacity to do work.
• It cannot be seen, heard, or felt.
• Exists in variety of forms: electric, thermal (heat),
chemical, mechanical, etc.
• Note: All food enters the body in chemical energy
and is converted into other energy forms.
• Energy Nutrients: Carbohydrates, Fats, and Proteins.
• Kilocalories – unit of measure of the energy in food
and in the body. (Kcal)
MACRONUTRIENTS
•
• Required in large amounts
• Contribute to the bulk energy needed for the
metabolic system.
MICRONUTRIENTS
• Required in small amounts
• Help various functions of the body, growth, and
disease prevention.
DIGESTION, ABSORPTION, & METABOLISM
DIGESTION
• The breakdown of food in the body in preparation for
absorption.
o Mechanical Digestion: food is broken up by
teeth and moved along GI tract by peristalsis
o Chemical Digestion: Carbohydrates, Proteins,
and Fats are broken down into nutrients
tissues can absorb and use.
• Chemical changes occur through hydrolysis (the
addition of water and breaking down of food
molecules).
• Enzymes act on food substances, causing them to
break down into simple compounds.
o An enzyme can act as a catalyst, which
speeds up the chemical reactions
without itself being changed in the
process.
  ABSORPTION
• The passage of nutrients into the blood or
lymphatic system.
- Nutrients must be in their simplest form
o Carbohydrates: simple
sugars
o Proteins: amino acids
o Fats: fatty acids and glycerol
• Most absorption occurs in the small intestine;
some occurs in the large intestine.
• Water is absorbed in the stomach, small SMALL INTESTINE
intestine, and large intestine.
• Hormones released
PARTS OF THE DIGESTIVE SYSTEM
MOUTH
• Digestion begins here
• Enzyme (salivary amylase) acts on starch
• Starch is a complex carbohydrate
• Teeth break-up food; food mixes with saliva
• “Bolus” formed
• Length of time food is in mouth is brief
• Small amounts of carbohydrates changed.
ESOPHAGUS
• Food travels through this muscular tube
• Connects mouth to stomach
• Peristalsis and gravity act to move bolus
• Cardiac Sphincter opens at lower end of
esophagus to allow passage of bolus into stomach
STOMACH
• Temporary storage of food
• Mixing of food with gastric juices
• Regulation of a slow, controlled emptying of food
into the intestine
• Secretion of the intrinsic factor for vitamin B12
• Destruction of most bacteria inadvertently
consumed.
• Hydrochloric acid prepares the gastric area for
enzyme action
• Pepsin breaks down proteins
• In children, rennin breaks down milk proteins
• Lipase acts on emulsified fats
• 3 Parts of Stomach
o Fundus: upper portion of the
stomach
o Body of the stomach: middle area
o Pylorus: end of stomach near small
intestines
o Chyme: semi-liquid mass of food and
gastric juices
o Pernicious anemia: lack of intrinsic
factor
o Secretin causes pancreas to release
sodium bicarbonate to neutralize
acidity of chyme
o Cholecystokinin triggers gallbladder to
release bile.
• Bile: emulsifies fat after it is secreted into small
intestine.
• Enzymes are found in the pancreatic juice that is
secreted into small juices.
o Pancreatic proteases (trypsin,
chymotrypsin, carboxypeptidases): split
proteins.
o Pancreatic amylase: converts starches
(polysaccharides) to simple sugars
o Pancreatic lipase: reduces fats to fatty
acids and glycerol
• Produces enzymes
• Prepares foods for absorption
• Lactase, maltase, sucrase convert lactose,
maltose, sucrose to simple sugars.
• Peptidases reduce proteins to amino acids
• Twenty-two feet long
• Villi, hairlike projections, increase surface area
for maximum absorption
• The small intestine is divided into three sections
– The Duodenum is the first section, Jejunum is
the middle section, and the Ileum is the last
section.
LARGE INTESTINE ENERGY

• Colon walls secrete mucus to protect against • Needed for involuntary and voluntary activity
acidic digestive juices in chyme. • Involuntary Activity: maintenance of body tissue,
• Major tasks of the large intestine: temperature, growth
o Absorb water
Voluntary Activity: walking, swimming, eating, reading,
o Synthesize some B vitamins and vitamin
K typing
o Collect food residue
3 GROUPS OF NUTRIENTS PROVIDES ENERGY
METABOLISM
• The use of food by the body after digestion
• Carbohydrates – primary source of energy
• Results in energy
• Proteins
• Occurs after digestion and absorption; nutrients
• Fats
are carried by the blood to the cells of the body.
• The unit to measure the energy value of foods is
OXIDATION the kilocalorie.
• Kcal:
o amount of heat needed to raise the
• Nutrients combine with oxygen
temperature of 1 kilogram of water 1
• Carbohydrates reduce to carbon dioxide and
degree Celsius.
water
• Kcal is commonly calorie
• Protein to carbon dioxide, water, and nitrogen
• Equivalent of grams
• Also known as aerobic metabolism
o 1 gram of carbohydrate yields 4kcal
• Aerobic Metabolism – Energy is released as o 1 gram of protein yields 4kcal
nutrients are oxidized o 1 gram of fat yields 9kcal
• Anaerobic Metabolism – reduces fats without o 1 gram of alcohol yields 7kcal
the use of oxygen
• The complete oxidation of carbohydrates, BASAL METABOLIC RATE
proteins, and fats is commonly called the Krebs • The rate at which energy is needed for body
cycle. maintenance
• Anabolism is the process of using energy from • The energy necessary to carry on all involuntary
oxidation to create new compounds vital processes while the body is at rest.
• Catabolism is the breakdown of compounds • Also known as resting energy expenditure (REE).
during metabolism FACTORS AFFECTING BMI
• Controlled primarily by hormones secreted by
the thyroid gland: Triiodothyronine (T3) and • Lean body mass
thyroxine (T4) • Body size
• Hyperthyroidism: metabolism speeds up and • Sex
the body metabolizes its food too quickly, • Age
weight is lost. • Heredity
• Hypothyroidism: metabolism slows down, and • Physical condition
the body metabolizes its food too slowly; • Climate
patient tends to become sluggish and • BMR is greater in men than women
accumulate fat. • BMR increases during growth and fever
• BMR decreases with age and during
starvation.
 CALCULATING BMR CONCLUSION

HARRIS-BENEDICT EQUATION • Food is broken down through the processes

of mechanical and chemical digestion into
nutrients that can be absorbed.
• Used by dietitians for persons over age 18 • Enzymes act to break down nutrients.
• Uses height, weight, and age • Absorption occurs mostly in the small
FEMALE BMR intestines
• During metabolism, carbohydrates and
• 655 + (9.6 X weight in kilograms) + (1.8 x height proteins are combined with oxygen in a
in cm) – (4.7 x age) process called oxidation.
• Energy released during oxidation is
• NOTE:
o To convert pounds to kg measured by the
o POUNDS / 2.2 = kg
MALE BMR

• 66 + (13.7 x weight in kg) = (5x height in cm) –

(6.8 x age)

ESTIMATED BMR

• Convert body weight from pounds to

kilograms
• Multiply kilograms by 24 (hours per day)
• Multiply the answer obtained by 0.9 for a
woman and by 1.0 for a man

110 POUND WOMAN

• 110 pounds / 2.2 (pounds per kg) 50 kg

• 50 kg x 24 hours a day = 1,200 kcal
• 1,200 kcal x 0.9 = 1,080 kcal

170 POUND MAN

• 170 pounds / 2.2 (pounds per kg) = 77.27 kg

• 77.27 kg x 24 hours a day = 1,854