Chapter 001

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  • Ask students to name some recent nutrition discoveries or topics in the news pertaining to nutrition.Discuss the scientific process with the students and how scientists build on previous research to discover new findings. 
  • Ask students to identify uses of food other than to satisfy hunger.Highlight the integral role nutrition plays in a patient’s plan of care and recovery.
  • Give an example of how decreased health costs result from preventive care. (Healthy weight reduces risks for chronic diseases.)Give an example of a disease process directly related to nutritional status. (Iron-deficiency anemia or osteoporosis)
  • Emphasize that the benefits of living well today are seen over time, just as the detriments of not living well today are seen over time.
  • Ask students to name lifestyle choices that promote nutritional health.Ask students to name lifestyle choices that reduce nutritional health.
  • Ask students why so many people are focused mainly on eating to relieve hunger or satisfy their appetite and not as supplying their body with all the components of proper nutrition. 
  • Ask students to explain why good nutrition is important in healing from disease or injury.
  • Using these seven signs of proper nutrition, discuss signs of malnutrition. 
  • Explain blood glucose and its role as the body’s main energy source.Provide an example of nutrients that work together. (Iron and vitamin C, fat-soluble vitamins and fats)Ask students to give examples of diseases that result from a mineral deficiency or other nutrient deficiency, or from a nutrient excess.
  • Give examples of simple and complex carbohydrates. 
  • List plant and animal sources of fats.Explain the importance of fat as an energy source.Explain that men and women usually store fat in different parts of the body; have the students determine where these sites are located. (Men: abdomen; Women: hips)
  • TALKING POINT:Of what are proteins composed? (Amino acids)
  • TALKING POINTS:Ask students to list foods high in vitamin C, calcium, phosphorus, and iron.Explain that the bones act as a reservoir for calcium; when calcium levels drop in the blood, calcium is taken from the bones and must be replenished by dietary intake. 
  • TALKING POINT:Explain why fat is important for infant brain development.
  • Which do students think are more susceptible to degradation or destruction: vitamins or minerals? (Vitamins)
  • Explain that more than 60% of the human body is composed of water and explain how water is lost in urine, feces, sweat, and respiration.
  • Discuss some ways health professionals promote variety and moderation.
  • Discuss some of the social developments that lead to overnutrition.
  • What federal programs address undernutrition? (WIC, EFNEP [Coop Extension], Head Start)What local programs address this issue? (Food banks, homeless shelters)
  • Discuss the idea of “if some is good, more is better” and how moderation relates to this.
  • What are some of the organizations throughout the world that set these standards? 
  • Explain the role of the National Academy of Sciences and who actually convenes to determine the DRIs.
  • Explain that these four categories are under the umbrella of DRIs, and draw a diagram if necessary.
  • Draw a graph of a bell curve to illustrate both the RDA and EAR.
  • Emphasize the difference between the RDA and AI.Discuss how the UL refers to total daily intake from food, fortified food, and nutrient supplements.
  • How might sources of some nutrients, such as protein, differ from country to country?
  • Have students think about a practical approach for M.R. to manage his meal plan and a practical easy tool to fit into his busy life- style.
  • Can MyPlate be taught to children?Ask students to list a sample diet that reflects the recommendations in MyPlate. 
  • Have students list components that M.R. would need to enter in order to generate a personalized plan including:AgeGenderWeightHeightActivityDirect them to the Web site: http://www.choosemyplate.gov
  • Ask students whether the MyPlate method would be a practical approach for M.R. and the reasons why.Is there a better tool?
  • Ask students how environment might affect food choices and physical activity levels.Explain the change that occurred in many households across the United States in the 1950s and 1960s that led to a change in food patterns.Talk about the process of collecting scientific research to form a guideline.
  • Ask students how often they eat fast, processed, or prepackaged foods per week.Ask students to explain why Americans suffer from malnutrition with such an abundant food supply.Give some examples of fast food restaurants that have health-conscious alternatives: (McDonald’s, Arby’s, Chili’s)If the students look at nutrition labels, what do they look for first? Explain that the food label can be deceiving if the portion size is not considered. For example, bottled beverages often contain 2 or more servings, ice cream is labeled to be served in ½ cup portions, and 2 to 3 snack cookies equal a serving.
  • Utilizing the 4 Key Recommendations, discuss options for M.R.Key Recommendations: Balancing Calories to Manage WeightPrevent and/or reduce overweight and obesity through improved eating and physical activity behaviors. Example: use Choose MyPlateControl total caloric intake to manage body weight. For people who are overweight or obese, this means decreasing calories from foods and beverages. Example: use vegetable-based oil such as olive oil in place of solids, still considering overall decrease in fat and sugars.Increase physical activity and reduce time spent in sedentary behaviors. Example: personalize calorie limits and use Choose MyPlate ToolMaintain appropriate calorie balance during each stage of life—childhood, adolescence, adulthood, pregnancy and breast-feeding, and older age. Example—do what is appropriate—e.g., 10 min of activity at a time, etc., being sure to comply with the plan of care
  • Chapter 001

    1. 1. Williams' Basic Nutrition & Diet Therapy Chapter 1 Food, Nutrition, and Health Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 1 14th Edition
    2. 2. Lesson 1.1: Health Promotion and Essential Nutrients 1. Optimal personal and community nutrition is a major component of health promotion. 2. Certain nutrients in food are essential to our health and well-being. Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 2
    3. 3. Health Promotion (p. 1)  Basic definitions  Nutrition: Food people eat and how their bodies use it  Nutrition science: Scientific knowledge of food requirements for maintenance, growth, activity, reproduction, lactati on  Dietetics: Health profession that applies nutrition science to promote health and treat disease  Registered dietitian: Nutrition authority on the health-care team Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 3
    4. 4. Health Promotion (cont’d) (p. 1)  Health and wellness  Health: more than just absence of disease  Includes meeting basic needs  Recognizes individual as a whole  Considers internal and external environments  Wellness seeks full development of potential Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 4
    5. 5. Health Promotion (cont’d) (p. 2)  National health goals  Continue focus on wellness  Emphasize lifestyle and personal choice  Healthy People 2020 Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 5
    6. 6. Health Promotion (cont’d) (p. 2)  Traditional and preventive approaches to health  Preventive approach: identify and minimize risk factors  Traditional approach: attempts change when symptoms of illness or disease appear Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 6
    7. 7. Health Promotion (cont’d) (p. 3) Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 7
    8. 8. Health Promotion (cont’d) (p. 2)  Importance of a balanced diet  Six essential nutrients • Carbohydrates • Protein • Fat • Vitamins • Minerals • Water Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 8
    9. 9. Health Promotion (cont’d) (p. 2)  Importance of a balanced diet (cont’d)  Health-care plan includes: • Assessing patient’s nutritional status • Identifying nutrition needs Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 9
    10. 10. Health Promotion (cont’d) (p. 3)  Signs of good nutrition  Well-developed body  Ideal weight for height and body composition  Good muscle development  Smooth and clear skin  Glossy hair  Clear and bright eyes Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 10
    11. 11. Functions of Nutrients in Food (p. 3)  Basic functions of food  Provide energy  Build tissue  Regulate metabolic processes Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 11
    12. 12. Functions of Nutrients in Food (cont’d) (p. 4)  Energy sources  Carbohydrates • Primary source of fuel for heat and energy • Maintain body’s backup store of quick energy as glycogen • Should provide 45% to 65% of total kilocalories Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 12
    13. 13. Functions of Nutrients in Food (cont’d) (p. 4)  Energy sources (cont’d)  Fats • Animal and plant sources • Secondary (storage) form of heat and energy • Should provide no more than 20% to 35% of total kilocalories Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 13
    14. 14. Functions of Nutrients in Food (cont’d) (p. 4)  Energy sources (cont’d)  Proteins • Primary function is tissue building • Should provide 10% to 35% of total kilocalories • Source of energy when supply from carbohydrates and fats is insufficient Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 14
    15. 15. Functions of Nutrients in Food (cont’d) (p. 4)  Tissue building  Proteins • Provide amino acids • Necessary for building and repairing tissues  Vitamins and minerals • Vitamin C for tissue building • Calcium and phosphorus for building and maintaining bone Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 15
    16. 16. Functions of Nutrients in Food (cont’d) (p. 5)  Tissue building (cont’d)  Iron: essential part of hemoglobin in the blood  Fatty acids: build central fat substance of cell walls Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 16
    17. 17. Functions of Nutrients in Food (cont’d) (p. 5)  Regulation and control  Vitamins • Function as coenzyme factors • Components of cell enzymes in governing a chemical reaction during cell metabolism  Minerals • Also serve as coenzyme factors Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 17
    18. 18. Functions of Nutrients in Food (cont’d) (p. 5)  Regulation and control  Water: essential base for all metabolic processes  Fiber: regulates passage of food material through gastrointestinal tract Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 18
    19. 19. Nutritional States (p. 5)  Optimal nutrition  Varied and balanced diet  Includes appropriate amounts of: • Carbohydrates • Fats • Proteins • Minerals • Vitamins • Water Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 19
    20. 20. Nutritional States (cont’d) (p. 5)  Malnutrition  Improper or insufficient diet  Includes undernutrition and overnutrition  Increases risk for illness  Limits work capacity, immune system, and mental activity Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 20
    21. 21. Nutritional States (p. 5)  Undernutrition  Nutritional reserves are depleted  Insufficient intake to meet daily needs or added stress  Especially affects most vulnerable  Can occur in hospitals Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 21
    22. 22. Nutritional States (p. 6)  Overnutrition  Excess nutrient and energy intake over time  Produces harmful gross body weight  Excessive amounts of nutrient supplements over time Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 22
    23. 23. Lesson 1.2: Planning a Balanced Diet  Food and nutrient guides help us plan a balanced diet according to individual needs and goals. Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 23
    24. 24. Nutrient and Food Guides for Health Promotion (p. 6)  Nutrient standards  Most countries have established minimum standards  Vary by country  In U.S., known as Dietary Reference Intakes (DRIs) Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 24
    25. 25. Nutrient and Food Guides for Health Promotion (cont’d) (p. 6)  U.S. standards: dietary reference intakes (DRIs)  National Academy of Sciences sets since 1941  Recommended Dietary Allowances (RDAs)  U.S. and Canadian scientists developed DRIs  Includes recommendations for each gender and age group Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 25
    26. 26. Nutrient and Food Guides for Health Promotion (cont’d) (p. 6)  U.S. standards: Dietary Reference Intakes (DRIs) (cont’d)  Encompass four interconnected categories of nutrient recommendations • Recommended Dietary Allowance (RDA) • Estimated Average Requirement (EAR) • Adequate Intake (AI) • Tolerable Upper Intake Level (UL) Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 26
    27. 27. Nutrient and Food Guides for Health Promotion (cont’d) (p. 7)  U.S. standards: Dietary Reference Intakes (DRIs) (cont’d)  Recommended Dietary Allowance (RDA) • Daily intake of nutrients that meet needs of almost all healthy individuals  Estimated Average Requirement (EAR) • Intake level that meets needs of half the individuals in a specific group Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 27
    28. 28. Nutrient and Food Guides for Health Promotion (cont’d) (p. 7)  U.S. standards: Dietary Reference Intakes (DRIs) (cont’d)  Adequate intake (AI) • Used when not enough evidence to establish the RDA  Tolerable upper intake level (UL) • Sets maximal intake unlikely to pose adverse health risks Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 28
    29. 29. Nutrient and Food Guides for Health Promotion (cont’d) (p. 7)  Other standards  Canadian and British similar to U.S.  Other countries may use standards set by: • Food and Agriculture Organization • World Health Organization Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 29
    30. 30. Case Study  M.R., a 45-year-old white male, has been referred by his physician to the Registered Dietitian to assist with a practical approach to healthy eating  His nutritional assessment reveals that he is in good health Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 30
    31. 31. Case Study (cont’d)  M.R. would like to lose about 10 pounds and be more active with his daily exercise  He works in an office setting for 8 hours  His wife is also working and they have two children, ages 9 and 11  M.R. is involved with little league three times a week with his son and daughter Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 31
    32. 32. Nutrient and Food Guides for Health Promotion (cont’d) (p. 7)  Food guides and recommendations  My Plate • USDA released in 2005 • Promotes variety, proportionality, gradual improvement, physical activity • Participants can personalize at Web site Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 32
    33. 33. Case Study (cont’d)  How can M.R. personalize his meal plan? Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 33
    34. 34. Case Study (cont’d)  Would the MyPlate method be a practical approach for M.R.? Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 34
    35. 35. Nutrient and Food Guides for Health Promotion (cont’d) (p. 8) Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 35
    36. 36. Nutrient and Food Guides for Health Promotion (cont’d) (p. 10)  Food guides and recommendations  Dietary Guidelines for Americans • Result of growing public concerns in the 1960s • Based on chronic health problems of an aging population • Relate current scientific thinking to America’s health problems  Other recommendations from American Cancer Society and American Heart Association Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 36
    37. 37. Nutrient and Food Guides for Health Promotion (cont’d) (p. 10)  Individual needs  Person-centered care • Food patterns vary with needs, tastes, habits, living situations, energy needs  Changing food environment • Shift to fast, processed, prepackaged foods • Malnutrition persists in all segments of population • Society beginning to recognize relation between food and health Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 37
    38. 38. Case Study (cont’d)  Using the 2010 Dietary Guidelines, how could you incorporate the 4 key Recommendations into a healthy life style plan for M.R.? Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 38

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