Transcript Nutrition

Nutrition
N1037
Introduction
Key term: nutrition
 Integrated Pan-Canadian Healthy
Living Strategy goals:
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Healthy eating
 Physical activity
 Healthy weight
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Eating well with
Canada’s Food Guide
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Food groups:
Vegetables and fruit
 Grain products
 Milk and alternatives
 Meat and alternatives
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Dietary Guidelines
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Directional statements:
Have vegetables and fruit more often
than juice
 Eat at least one dark green and one
orange vegetable every day
 Have at least half of daily grain products
intake from whole grain
 Have meat alternatives such as beans,
lentils and tofu often
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Dietary Guidelines
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Directional statements:
Eat at least two food guide servings of
fish every week
 Satisfy thirst with water
 Drink skim, 1% or 2% milk each day –
drink fortified soy beverages if you do
not drink milk
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Dietary Guidelines
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Directional statements:
Reduce the total amount of fat in the
diet, especially saturated and trans fats,
however, a small amount of unsaturated
fat is recommended each day (30-45 ml
for an adult)
 Lower salt and sugar intake
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Dietary Guidelines
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Directional statements:
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Achieve and maintain a healthy body
weight by enjoying regular physical
activity - adults should get 30 to 60
minutes of moderate physical activity
every day and children should get 90
minutes
Dietary Guidelines
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Directional statements:
All women who could become pregnant
should take 400 µg (0.4 mg) of folic acid
a day to avoid neural tube defects in the
unborn fetus
 All adults over 50 years of age should, in
addition to following the Food Guide,
take a daily vitamin D supplement of 10
µg (400 IU) a day
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Nutrients
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Nutrients are the substances found in food
that are nourishing and useful to the body.
Carbohydrates
Protein
Fats,
Vitamins and minerals
Water
Nutrients
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Carbohydrates
Supply energy and fibre
 45% to 60% of daily caloric intake
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Nutrients
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Proteins
Supply nine essential amino acids
 Repairs body tissues, maintain osmotic
pressure, component of antibodies, and
an ultimate source of energy.
 10% to 35% of daily caloric intake
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Nutrients
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Fats
Saturated, monounsaturated
 Cholesterol, high-density lipoproteins,
low-density lipoproteins, omega fatty
acids, trans fats, triglycerides
 Part of the structure of all cells
 20% to 35% of total caloric intake
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Nutrients
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Vitamins
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Organic substances
Maintain body functions
Fat-soluble and water-soluble
Minerals
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Inorganic substances
Help build body tissues and regulate body
processes.
Macrominerals and microminerals
Nutrients
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Water
Makes up 50% to 60% of body weight
 Average adult needs 6–8 240 mL glasses
of water/day
 Signs of dehydration?
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Nutrition Through
the Life Cycle
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Anticipatory guidance
Infant Feeding Guidelines
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Assess reflexes—sucking, rooting,
swallowing
Rapid growth and development
Breastfeeding is preferred for first 12
months
Assess physical development to
determine readiness for solid
food
Infant Feeding Guidelines
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Introduction of solids
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6 – 9 months
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Iron containing foods
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Cereals
Meats and Egg Yolk
Vegetables and Fruit
Dairy : Cheeses, Yoghurt (Whole Cow’s milk after 9
months)
9 months +
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Introduction of finger foods, increased textures
(mashed and soft)
Infant Feeding Guidelines
Introduce foods one at a time
 Begin with foods that are least
allergenic
 Avoid egg whites and honey in infants
under 12 months
 No peanuts, nuts, or fish until age
three
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Nutritional Assessment
of Infants
Breastfed? How often? How long?
 Bottle-fed? How often? How much?
 Formula preparation? Storage?
 How does the infant respond to eating?
 Constipation? Diarrhea?
 Is the infant ever put in bed with a
bottle?
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Nutritional Guidelines
for Toddlers
Physical growth slows
 Increased independence
 Small portions
 Offer one new food at a time
 No peanuts, nuts, or fish until age
three
 Routine mealtimes
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Nutritional Guidelines
for Preschoolers
Independence
 May become a picky eater
 Offer food choices
 Offer small servings
 Finger foods
 Routine mealtimes
 Discuss need for healthy snacks
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Nutritional Guidelines for
School-Age Children
Erratic growth and eating
patterns
 Strong food preferences
 Encourage a balanced diet
 Limit highly sweetened
snacks and foods
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Nutritional Assessment
of Young Children
Concerns with child’s eating?
 Child’s food preferences?
 Involvement in sports? Physical
activity?
 Child’s meal schedule?
 Balanced diet?
 Intake of beverages with added
sugar?
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Nutritional Guidelines
for Adolescents
Period of rapid growth and change
 Fluctuating nutritional needs
 Concerns with body image
 Risks for eating disorders
 Adjustment portion quantity
based on physical activity level
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Nutritional Assessment
of Adolescents
Participation in physical
activity?
 Adhere to a specific diet
or meal plan?
 Skip meals?
 Satisfaction with current
weight?
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Nutritional Assessment
of Adolescents
Ever induced vomiting, used
laxatives, diuretics, or diet pills to
control weight?
 Consumption of snacks?
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Nutritional Guidelines for Young and
Middle-Aged Adults
Growth and caloric needs stabilize
 Eating habits may be influenced by
activity levels, life stressors
 Obesity often seen in this age group
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Nutritional Guidelines for
Young and Middle-Aged Adults
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Consideration of diseases
Atherosclerosis - Coronary
artery disease
 Osteoporosis
 Type II diabetes
 Metabolic syndrome
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DASH Diet
Nutritional Guidelines for
Pregnant and Lactating Women
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Role of proper nutrition in development of
healthy infant
Target weight gain for pregnancy
Adequate caloric intake
Increased fluid consumption
Prenatal vitamins
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Iron supplements
Calcium
Folic Acid
Nutritional Assessment
of Pregnant Women
Prepregnancy weight?
 Activity level?
 Use of supplemental vitamins?
 Consumption of caffeine, artificial
sweeteners, alcohol?
 Presence of constipation, nausea,
vomiting, or heartburn?
 Presence of food cravings?
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Nutritional Guidelines
for the Older Adult
Decreased caloric requirements
 Encourage to eat in a sitting
position
 Encourage adequate fluid
intake and high-fibre diet
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Nutritional Guidelines
for the Older Adult
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Nutritional risk factors
Difficulty chewing or swallowing
 Decreased appetite
 Decreased taste and smell
 Decreased ability to self-feed
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Nutritional Assessment
of Older Adults
Presence of physical limitations that
affect eating?
 Difficulty chewing or swallowing?
 Presence of dental problems?
 Difficulty obtaining or preparing
foods?
 Do you eat alone?
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Cultural Differences in
Nutrition
Cultural beliefs related to the
consumption of food
 Religious beliefs related to the
consumption of food
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Food restrictions
 Periods of fasting
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Components of a
Nutritional Assessment
Nutritional history
 Physical assessment
 Anthropometric
measurements
 Laboratory data
 Diagnostic data
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Nutritional History
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General diet information
Adherence to particular diet
 Food preferences
 Consumption of fast foods
 Ability to obtain and prepare foods
 Changes in past 12 months
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Nutritional History
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Food intake history
24-hour recall
 3-day diary
 Direct observation
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Evaluation of adequacy of diet
Physical Assessment
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Assess for subjective and objective
signs and symptoms of poor
nutritional status
Signs and Symptoms of
Poor Nutritional Status
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Subjective data
Fatigue
 Delayed wound healing
 Brittle hair, nails
 Mouth sores
 Changes in appetite
 Mood changes
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Signs and Symptoms of
Poor Nutritional Status
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Objective data
Weight changes
 Dry, rough, scaly skin
 Edema
 Dry, cracked lips
 Swollen, bleeding gums
 Decreased muscle tone
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Anthropometric Measures
Height
 Weight
 Ideal body weight, percent IBW
 Percent weight change
 Body mass index
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Anthropometric Measures
Waist to hip ratio
 Skinfold thickness
 Mid-arm circumferences
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Kwashiorkor
 Marasmus
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Laboratory Data
Hematocrit and hemoglobin
 Cholesterol, LDL-C, HDL-C, total
cholesterol:HDL-C ratio, triglycerides
 Transferrin, TIBC, iron
 Total lymphocyte count
 Antigen skin testing
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Laboratory Data
Albumin and prealbumin
 Glucose
 Creatinine height index
 Nitrogen balance
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Diagnostic Data
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Radiographic studies
X Rays
 Dual-energy X-ray Absorptiometry
(DEXA) scan
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Activities
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Review your 24 hour food recall –
compare to Canada Food Guide
Do health teaching depending on what
you assess.
 Do Calcium calculator
 Do initial physical assessment
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Complete Self – Assessment Tool
Interactive Food Label
Available athttp://www.hc-sc.gc.ca/fn-an/label-
etiquet/nutrition/cons/inl_main-eng.php
Contents:
1. Nutrition Facts Table
2. Specific Amount of Food
3. % Daily Value
4. Core Nutrients
5. Nutrition Claims
6. List of Ingredients
Nutrition Facts Table
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Whole Kernel Corn
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The Nutrition Facts table
includes Calories and 13
nutrients: Fat, Saturated
fat, Trans fat, Cholesterol,
Sodium, Carbohydrate,
Fibre, Sugars, Protein,
Vitamin A, Vitamin C,
Calcium and Iron.
Specific Amount of Food
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The specific amount may be indicated by:
A phrase such as: a slice, one egg, two cookies, followed by
the metric measure.
Familiar household units such as mL, cups, tablespoons,
or a fraction or unit of food (e.g., 1/4 pizza), followed by the
metric measure (g, mL) (e.g., 175 g yogourt).
Whole Wheat Bread
% Daily Value
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Use the % Daily Value to make food comparisons.
The % Daily Value provides a quick overview of the
nutrient profile of the food, allowing product
comparisons based on more than one nutrient. It puts
nutrients on the same scale (0% - 100% Daily Value).
You can quickly identify the strengths and weaknesses
of a food product.
Sirloin
Burger VsChicken
Chicken
Burger
Sirloin Burger
Burger
Calories and Core Nutrients
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Calories and the same core nutrients are always listed in the
same order. A consistent look makes the Nutrition Facts table
easy to find and use.
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Information on core nutrients available on Health Canada
Website
Nutrition Claims
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The Government has rules in place that must be met
before a nutrition claim can be made on a label or
advertisement. The rules for nutrition claims apply to
all foods, prepackaged and not prepackaged, no
matter where they are sold.
A manufacturer can choose whether or not to include
nutrition claims on the label or in the advertisement of
a food.
Many products will have nutrition claims as these
claims highlight a feature of interest to consumers.
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Source of Fibre
Low Fat
Cholesterol Free
Sodium Free
Reduced Calories
Light
Ingredients List
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Bran Cereal
Ingredients: Whole wheat, wheat bran,
sugar/glucose-fructose, salt, malt (corn
flour, malted barley), vitamins (thiamine
hydrochloride, pyridoxine hydrochloride,
folic acid, d-calcium pantothenate),
minerals (iron, zinc oxide).
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Case Study
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Questions
References
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Interactive Nutrition Label: http://www.hcsc.gc.ca/fn-an/labeletiquet/nutrition/cons/inl_main-eng.php
Canada’s Food Guide :http://www.hc-sc.gc.ca/fnan/food-guide-aliment/index-eng.php
Estes, M.E., (2006). Health Assessment and
Physical Examination. (3rd edition). Clifton
Park,NewYork: Thomson Delmar Leaning.
Estes, M.E., Buck, M. (2009). Health Assessment
and Physical Examination. (1st Canadian edition).
Toronto, Ontario: Nelson Education Ltd.