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  • Nutrition is not just food it also includes fluids
  • The Healthy Eating Pyramid is a food selection guide developed by the Australian Nutrition Foundation Inc. (Nutrition Australia). It is without doubt the most successful and widely used guide ever produced in Australia. Its success is in its simplicity and its acceptance by a wide age range. The Healthy Eating Pyramid uses the idea of food groups and organises these according to the energy and the nutrients that they supply. It shows the proportions of one group of foods to another for our total food intake.


  • 1. Nutrition Provide Support to meet Personal Care Needs CHCICS301A Updated by Jo Lewis BHS
  • 2. What is nutrition?
    • Nutrition = all processes by which the body utilises food and fluids for energy, growth and maintenance
    • At all stages of the lifespan, we need good nutrition, to resist illness, repair tissue, regulate body functions and provide energy
  • 3. Characteristics of Nutrition
  • 4. Nutritional requirements
    • Nutritional requirements are considered in terms of essential and balanced nutrients (ie protein, fats, carbohydrates, vitamins etc), and energy (kilojoules)
    • Need foods from each of the basic food groups, in sufficient quantities (milk/dairy, meat/fish/eggs, fruit and veg, breads and cereals, fats, water)
  • 5. How should nutrients be distributed ??
    • Traditional model = Healthy Diet Pyramid
    • Other distributions ie diet consisting of 60% carbohydrate, 20% protein, and 20% fat often thought appropriate
    • Current trend towards lower carbohydrate and higher protein intake
    • Important to eat a variety of foods each day
    • Energy requirements – don’t need as much energy in older age as there is little growth
  • 6.  
  • 7. Compare - Nutrient Requirements
    • Younger adults (up to 65)
    • 1 serve meat, fish, eggs, legumes = 60-75gm
      • 3 serves red meat
      • 2 serves fish
      • 1 serve chicken/pork
      • 1 serve legumes
    • 2-3 serves diary foods
    • 2-3 serves fruit
    • 4-5 serves vegetables
    • 5 or more serves bread & cereals
    • 2 extras (indulgences)
    • 5 or more cups of fluids
    • Frail older adults
    • 2 serves meat, fish, eggs, legumes = 120-150gm/day
    • 3-4 serves dairy foods
    • 2-3 serves fruit
    • 4-5 serves vegetables
    • 5 or more serves bread & cereals
    • 2 extras (indulgences)
    • 5 or more cups of fluid-includes milk, soups as well as tea, coffee & other drinks
  • 8. Nutrients
    • The essential nutrients are:
    • Carbohydrates Water
    • Fibre Vitamins and minerals
    • Proteins Proteins
    • Lipids (fats)
    • Nutrients are the chemical substances in food that provide energy, build and maintain cells and regulate body processes
  • 9. Carbohydrates
    • Provide energy
    • Before being used are converted from food we’ve eaten into glucose
    • Also assist in metabolism of fat
    • Add bulk to intestinal contents aiding peristalsis
    • Found in vegetables, cereals and pastas, fruits, honey, milk
  • 10. Proteins
    • Compounds composed of amino acids
    • Proteins build and repair tissue, or supply energy
    • Major sources of protein are meat, fish, eggs, cheese, milk, poultry, lentils, legumes and nuts
  • 11. Lipids
    • Fat supplies energy and forms adipose tissue which supports and protects some organs
    • Adipose tissue also insulates the body to prevent heat loss and is a reserve store of fuel
    • Fats also supply the fat soluble vitamins A,D,E,K
    • Major food sources of fats are animal (meat, butter, oil, cream, egg yolk, cheese, fish oil) or vegetable (present in cocoa and oils like olive, safflower, peanut etc)
  • 12. Water & Fibre
    • Water obtained from food and fluid’s we eat and drink as a result of metabolism
    • Necessary for digestion, absorption and metabolism of food, to produce secretions, and maintain body fluids
    • Fibre is fibrous part of foods not digested or absorbed
    • Excreted in stool (BA) , and provides bulk
    • Thought to help in prevention of some disorders constipation, diverticular disease, gallstones, intestinal ca
  • 13. Vitamins & Minerals
    • Vitamins generally obtained from food we eat
    • Essential for metabolic function - either fat or water soluble
    • Minerals important in metabolism, maintenance of BP, cardiac function, and regulation of body processes ( homeostasis )
  • 14. Vitamin D
    • Essential to maintain strong, healthy bones & assist prevention of fractures, along with calcium
    • In Australia 68-86% of elderly in Res. Care have low Vit D levels
    • Residents require 1-3hrs sun exposure (face & hands) every week – if unable, require supplements
    • Vitamin D is diminished by sunscreen
    • Cannot be obtained through glass
  • 15. Who is at risk for poor nutritional status?
    • Physically inactive
    • Alcohol, drug or nicotine dependent
    • Pregnant or breastfeeding
    • Elderly
    • People unaware of nutritional principles
    • Strict vegetarians/vegans, or following ‘fad’ diets
    • People experiencing certain physical or emotional disorders
  • 16. What influences individual eating patterns?
    • Availability of food
    • Economic status
    • External influences, such as the family or advertising
    • Food fads and fallacies
    • Beliefs, values, religious and cultural heritage
  • 17.
    • Social and emotional aspects of food
    • Physical status – including allergies, food intolerance, difficulty chewing or swallowing, medical or surgical disorders which interfere with digestion, absorption or cause loss of nutrients, level of mobility and independence
    • Psychologic status – anxiety, depression
  • 18. How is nutritional status assessed?
    • Nutritional history
    • Clinical signs
    • Height/weight tables
    • Calculation of body mass index
    • Laboratory values
    • Other measurements, ie skinfold testing
  • 19. Effects of poor nutrition and hydration
    • Loss of strength for daily activities
    • Reduced mobility and independence
    • Risk of falls
    • Increased fatigue
    • Increased risk of illness and infection
    • Increased risk of pressure areas/ulcers
    • Poor wound healing or recovery from illness
    • Constipation
    • Confusion and sensory changes/loss
  • 20. What affects nutritional status of older people?
    • Physiologic and physical changes – loss of teeth, loss of smell and taste, decreased saliva, decreased peristalsis, reduction in appetite, reduced dexterity
    • Social changes – loneliness, depression
    • Perceptions of food
    • Availability of food – changes in ability to shop, prepare and eat food, low income
    • Medication interactions
  • 21. Malnutrition
    • Consequence of continued poor nutrition – defective in either quantity or quality
    • Is not a specific term – could refer to either over- or under- nutrition
    • Malnourishment usually termed to mean that intake and utilisation of nutrients is reduced, in relation to body requirements
  • 22. Who is at risk for malnutrition?
    • Clients experiencing increased metabolic demands, or extensive loss of nutrients – infection, burns, vomiting, physical trauma, major wounds, prolonged fever
    • Clients not consuming oral food/fluids for more than a few days
    • BMI less than 20, or recent loss of 10% of usual body weight
  • 23.
    • Alcohol or drug dependent
    • Clients on medications which work against or block nutrients
    • Clients with deficient ability to utilise nutrients, ie Crohn’s disease
    • NB – need early identification of those at risk
  • 24.
    • Common in older patients
    • Worse with illness - CVA, MND, MS, PD
    • Poor nutrition increases risk of:
      • Pressure sores
      • Delayed healing
      • Prolonged recovery
      • Psychological response to illness
  • 25. Obesity
    • Excess of body fat, r/t either excessive kJ intake, or inadequate energy expenditure, or both
    • Serious consequences = cardiovascular disease, breathing difficulties, hypertension, diabetes mellitus, gallbladder disease, mobility problems, reproductive problems
    • Psychosocial problems
  • 26. Treatment of Obesity
    • Supervised regulation of food intake
    • Exercise
    • Behaviour modification
    • ?? Medication - appetite suppressants or fat-blockers
    • Surgical intervention for morbid obesity, ie gastric banding
  • 27. Bariatric
    • Bariatric – defined as BMI greater than 30
    • Their weight far exceeds the recommended guidelines
    • Body size restricts – mobility, health, access to available services
    • Their weight increases risk of further health complications & death
    • Causes numerous care challenges
  • 28. Dietary Guidelines for Older Australians
    • Enjoy a wide variety of nutritious foods
    • Keep active to maintain muscle strength and a healthy body weight
    • Eat at least three meals per day
    • Care for your food: prepare and store it correctly
    • Eat plenty of vegetables (including legumes) and fruit
    • Eat plenty of cereals, breads and pastas
  • 29.
    • Eat a diet low in saturated fat
    • Drink adequate amounts of water and/or other fluids
    • If you drink alcohol, limit your intake
    • Choose foods low in salt and use salt sparingly
    • Include foods high in calcium
    • Use added sugars in moderation
    • Developed by National Health and Medical Research Council 1999
  • 30. Activity – What about Molly?
    • Breakfast
      • Cornflakes, milk & sugar
      • 1 slice white toast, butter, jam
      • White tea
    • Morning tea
      • White tea, sweet biscuit
    • Lunch
      • Roast lamb, potato, pumpkin, peas, gravy
      • Rice pudding, white tea
    • Afternoon tea
    • White tea & cake
    • Tea
    • Soup
    • Ham sandwich
    • Peaches & cream
    • Supper
    • Milk & Milo
    • Sweet biscuit