Energy needs –Assessment & Required.pptx

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1. Energy needs – A ssessment & Requirement Dr.Sowmya M

2. Defining nutritional status Nutritional status is a current body status of a person (or) A population group related to their state of nourishment. Refers to the degree of balance between nutrient intake & nutrient requirement.

3. This balance is affected by many factors including physiologic, psychical, developmental, cultural & economic It determined by a complex interaction between internal/ Constitutional factor & external environment factors. Internal- age, sex, nutrition, behavior, physical activity & diseases. External – food safety, cultural, social & economic circumstances .

4. Optimal nutritional :- Sufficient nutrients are consumed to support day to day needs & any increased metabolic demands( growth, illness, pregnancy). Under nutrition :- Nutrient intake is inadequate to meet day to day need or add metabolic demand. Vulnerable groups :- Infants, pregnant women, low incomes, hospitalized people, aging adults—This group are at risk for impaired growth & development, lowered resistance to infection & disease, delay wound healing, longer hospital stay & higher health care cost.

5. Over nutrition :- Consumption of nutrient in excess of body need. A major nutritional problem today – can leads to obesity & its risk for heart disease, type 2 DM, HTN, stroke, GB disease, sleep apnea & osteoarthritis.

6. Developmental care Infants & children - Birth -4month- most rapid period of growth in the life cycle. The infant double birth weight by 4 month & triple by 1 year. Breastfeeding is recommended for full term infants for the 1 st year of life because breast milk is ideally formulated to promote normal infant growth & development & natural immunity. infants increase their length by 50% during the first year of life & double it by 4 years of age.

7. Adolescence : Characterized by rapid physical growth & endocrine & hormonal change. Calorie & protein requirement increase to meet this demand & to meet demand of bone growth & increasing muscle mass & in the girls the onset of menarche calcium & iron requirement increased. In generally boys grow & have less body fat than girls.

8. Adulthood:- Growth & nutrient needs stabilize most adult are relatively good health. This time is important for health education because life style factors such as smoking, stress, lack of exercise, diet high in fat, sugar & low in fiber result – risk of HTN< DM, obesity, cancer & osteoporosis.

9. Old age : older adults have increased rik for under nutrition or over nutrition. Risk factor: poor physical or mental health, social isolation, limited functional ability, poverty & diseases. Normal physiology changes:- affect the nutritional status, poor dentition, decreased visual acuity, decreased saliva production, slowed gastrointestinal absorption, diminished olfactory & taste sensitivity.

10. Nutritional assessment A comprehensive analysis of a person’s nutrition status that uses historical information, food intake, anthropometric measurements, physical examination & biochemical. Purposes & components of nutritional assessment Identify individuals who are malnourished or are at risk for developing malnutrition. Provide data for designing a nutrition plan of care to prevent or minimize development malnutrition. Establish baseline data for evaluating the efficacy of nutritional care.

11. Nutrition screening The first step in assessing nutritional status, is required for all patient in all health care setting within 24 hours of admission. Parameters used for nutrition screening typically include weight & height, history of condition associated with increased nutritional risk, diet information & laboratory.

12. It need to assess risk of becoming malnourished & over nourished. Assessment of nutritional in Two methods Direct – A B C D Methods Indirect – Economic factor, Ecological variables, cultural & social habits.

13. Nutritional assessment is the interpretation of anthropometric, biochemical (laboratory), clinical and dietary data to determine whether a person or groups of people are well nourished or malnourished (over-nourished or under-nourished). Nutritional assessment can be done using the ABCD methods. These refer to the following: A-Anthropometry B-Biochemical/biophysical methods C-Clinical methods D-Dietary methods.

14. A-Anthropometry Measurement of human dimensions Anthropos = human Metrikos = measuring Technique of measuring people Measure Index Indicator Reference Information

15. Measurement of body height, weight & proportions. They indicate the nutritional status in general but not used too identify specific nutritional deficiencies. To evaluate both under & over nutrition. It indicates nutritional status – Body mass index (BMI) this is associated with type 2 DM, CVS disorder.

16. B-Biochemical/biophysical methods- routine laboratory test . C-Clinical methods D-Dietary methods – diet history

17. Energy requirements Energy requirement  is the amount of food energy needed to balance energy expenditure- - in maintain body size, body composition and a level of necessary and desirable physical activity consistent with long-term good health. Energy requirement includes the energy needed for The optimal growth and development of children. The deposition of tissues during pregnancy, and The secretion of milk during lactation consistent with the good health of mother and child.

18. Energy & requirement

19. Sources- Energy for the metabolic & physiological functions – derived from the chemical energy bound in found like carbohydrate, protein & fats. Components of energy requirements 1. Basal metabolism – series of functions that are essential for life– cell functions, replacement, synthesis , secretion & metabolism of enzymes & hormones—To maintain body temperature, uninterrupted work of cardiac, respiratory muscle & brain functions—energy use for this is called as Basal Metabolism Rate .

20. BMR is Depending on age, lifestyle, body size, gender. 45-75 % - Total energy expenditure 2. Metabolic response of food- Eating requires energy for the ingestion & digestion of food, for the absorption, transport, inter-conversion, oxidation & deposition of nutrients –This processes increase heat production & oxygen consumption, this is know as Dietary induced thermo genesis, specific dynamic action of food & thermic effect of feeding. 10% Total energy required

21. 3. Physical activity- After BMR this is a second largest component of daily energy expenditure. 4. Growth – it having 2 components Energy needed to synthesize growing tissue The energy deposited in those tissue. Total energy requirement in different age groups 35% - 1-3 months 5% - 3-12 months 3% - Till adolescence age Later Negligible

22. 5. Pregnancy- during pregnancy extra energy is needed for the growth of the fetus, placenta, various maternal tissues like uterus, breasts, fat stores, change in maternal metabolism & increased in maternal effort at rest & during physical activity. 6. Lactation- The energy cost of lactation has 2 components The energy content of the milk screated Production of milk.