Principles of Nutrition.NUTRITION FOR ALL

FOR STUDENTS

1. Principles of Nutrition

2. Objective Definition of main concepts Functions and importance of Food Chemical elements that make up food Nutrition related diseases

3. Definition of Key Terms Food:any solid or liquid which when swaloed and absorbed in the blood stresm will provide the body with one or more nutrients. Nutrtion:the study of food and their relation to the food an dthe body Nutrients:chemical substances found in food example,vitamins , carbohydrates,proteins and minerals. They help keep the body healthy Nutritional status:individuals personal health conditions which reflects their need for nutrients and their use of them.

4. Nutritional value of food:quantity ,range and quality of the chemical substances found in food and its effect to the body.

5. Nutrition Related Health Problems Malnutrition:Incorrect or unbalanced intake of nutrients calorie:the amount of energy needed to raise temperature of one gram of water by one degree celcious

6. Essential nutrients Proteins Fats Carbohydrates Vitamins Minerals water

7. Main Nutritional disordrs Obesity Starvation Kwashiorkor Marasmus Anorexia nervosa Bulimia nervosa Vitamin deficiency Trace element deficiency

8. Obesity Defined as an excess of adipose tissue that impacts health risk Etiology Genetic predisposition Diets largely derived from carbohydrates and fats Hypothyroidism,cushings syndrome insulinoma and hypothalamic disorders

9. Pathophysiology Obesity is associated with increased adiose stores in the subcutaneous tissue,skeletal muscles,internal organs such as kidney, heart,liver,and fatty liver is also common in obese individuals. There is increase in both sizes and number if adi [oocytes and there is hypertrophy as well as hyperplasia.

10. Metabolic changes Hyper insulinemia Non –insulin dependant diabetes Hypertension Hyper lipoteinaemia Artherosclerosis Coronary artery disease Cholelithiasis Cancer osteoarthritis

11. Serious health hazards of obesity Stroke Coronary artery disease Hypertension Fatty liver Diabetes Arterosclerosis Hyperlipidemia osteoarthritis

12. Management of obesity Nutritional therapy Behavior modification MEDICAL MANAGEMENT Drug therapy-appetite suppressing drugsphentermine , diethylpropion SURGICAL MANAGEMENT Vertical banded gastroplasty Adjustable gastric bannding

13. starvation State of overall deprivationof nutrients Etiology Deliberate fasting Famine conditions in a country or community Secondary under nutrition such as chronic wastingdiseases , cancerse.t.c

14. Signs and symptoms DRY and scary skin Muscular weakness Anaemia Increased susceptibility to infections Loss of appetite Wound healing delay Loss of hair Brittle nails deprsession

15. Nursing mnx Health promotion Acute intervention Health education Try to maintain an optimal body weight

16. Protein deficiency malnutrition Kwashiokor which is related to protein deficiency through calorie intake may be sufficient Mrasmus is starvation in infants occurring due to overall lack of calories

17. Kwashiorkor v/s marasmus Clinical features Occurs in children btn 6 months to 3 years Growth failure Wasting muscle but preservedadipose tissue Edema localized or generalized present Enlarged fatty liver Serum proteins low Anaemia presnt Alternate bands of dark and light hair Moonface with little interest in surrounding area Swollen abdomen Flaky appearance of skin Clinical features Growth failure Wasting of all tissues includingmuscles and adipose tissue Edema present Nohepatic ellargement Serum protein low Anemia present Normal hair Very underweight body Thin limbs withlittle muscle/fat Old man appearance

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19. Marasmus Diagnostic evaluation Severe hypochromic anaemia is generally diagnosed .the plasma protein levels is usually lowered unless hemo concentration is present

20. Pathophysiology marasmus Adequate calories are not ingested to fulfillthe metabolic needs of the body ,reserve food elementssuch as proteins and fats in the tissues are used to sustain life.this may be caused by: An inadequate diet or faulty eating habits Congenital anomalies Disease process that interfere with assimilation of ood Infections Loss of food intake via diarrhea an d vomiting Food allergy Emotional problems such as disturbed mother child relations

21. Nursing managent Providing a nutrional intake that is rich in the essential nutrients to correctthe dietary insufficiency and to promote normal growth and development Parenteral fluid therapy to correct the electrote imbalance and dehydration Oral feeding Additional vitains and minerals and blood transfusion Maintaining normal body temperature Providing periods of rest and appropriate activity and stimulation Record input and out period

22. Daily weighing and turning, prevention of infection of mouth, skin,respiratory and genitourinary tract

23. Prevention of marasmus Parent education Prompt treatment of congenital defects Prevent emotional disturbances

24. Prevention of marasmus Parent education Prompt treatment of congenital defects Prevent emotional disturbances

25. kwashiorkor Pathophysiology When inadequate aminoacids are not provided,not absorbed normaly or abnoramally lost protein undernutrion occurs. May occur in children with chronic diarrhea, nephrosis , haemorrhage , burns,or infection. Nutritional edema results when body lackingsufficient intake or sustaining a loss of high quantity proteins burns its own tissues and destroys the plasma protein so that the level of plasma albumin becomes low

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27. Protein content foods Eggs Cows milk Cheese Meat cooked Fish cooked Rice cooked Soy beans

28. Nursing management Management includes replacement of missing nutrients nd treatment for any acute problems such as diarrhea renal failure and shock. Dietary intake of proteins and calorie is increased gradually, skim milk,synthetic aminoacids can be given to supplement Vitamins and minerals especially vit 4, magnesium and potassium are added to correct any deficiencies Iron and folic to correct anaemia Treat infections

29. prevention Prevention is by providing a diet containing an adequate quality of protein of high biologic quality. Educating parents on nutritional needs of afamily Adequate amount of food to be provided t children and infants

30. Anorexia nervosa An eating disorder in which the person experiences hunger but refuses to eat because of a distorted body image,leading to a self perception of fatness Usually seen in adolescent girls and young women ,but als in middle aged men and women

31. Etiology of eating disorders Although the cause of eating disorders is not certin several factores have been pointed,this include Sociocultural and environmentall factors including media and peer influences, Family factors including parental discord Biological factor – genetics,neurotransmitter regulation,hormonal functioning Negetive affect-low self esteem

32. Clinical manifestation Weight loss Dry sin Pallor Bradycardia Hypotension Intorelance to cold Constipation amenorrhoea

33. pathophysiology Similar to those seen in starvation Limited calory intake causes the body to adapt by using bodys fat stores and sparing nitrogen stores. With prolonged starvation significant shifts in fluid nad electrolyte balance can occurv The hypothalamus responds to the lack of nutrient intakebwith changes in pituitary function resulting in amenorrhoe and infertility. The exetent of malnutrition will determine the pathophysiologic changes observed

34. Bulimia nervosa An eating disorder characterized by uncontrollable binge eating alternating with vomiting or dieting Clients with this tend to maintain relatively normal weight but go through periods of excessivelyeating and vomiting

35. Clinical manifestations Episodes of binge eating followed by self induced vomiting Vomiting episodes occur mostly in the afternoon and evening and are done in secret Abuse of laxatives and diuretics Depression related like personality characteristics

36. How bulimia nervosa affects the body

37. Vitamin A(RETINOL) PHYSIOLOGICAL FUNCTIONS Maintainance of normal visionin reduced light Maintainance of structure and function of specialized epithelium Mainatinance of normal cartilaginous bone growth

38. Deficiences of vit A Night blindness Occular lesions Cutaneous lesions Bitot spot xerophthalmia

39. Sources of Vit A LIVER Dairy products Eggs Dark green leafy vegetables Recommended intake 5000iu for men and 4000iu women

40. Vitamin D[ Calciferol ]  Functions Vitamin D is of almost importance in the regulation of calcium and phosphorous metabolism in the body . It serves to maintain proper blood levels of calcium and phosphorous by promoting their intestinal absorption and by mobilizing these minerals from the skeleton when needed. Mineralization of the skeleton and teeth requires an adequate supply of vitamin D.

41. Sources Exposure to straight, fortified foods, fish lives oil are good sources of vitamin D natural foods are poor sources at vitamin D although small amounts are present in egg yolk, liver, and fish such as herring, sardines, tuna and salmon . Recommended dietary allowances Vitamin D is now considered more as a pro hormone than a vitamin . Exposure to sunlight even for 5 minutes per day. A specific recommendation of a daily supplement of 400 IU is made.