Transcript MDA Ch16
Nutrition Chapter 16 Copyright © 2005 by Elsevier Inc. All rights reserved. Introduction You probably have heard the expression, “You are what you eat.” This is true because food is used to build and repair the body. Food choices must therefore be based on sound information and knowledge. Malnutrition during these crucial periods may result in physical or mental disabilities. Well-nourished persons are usually better able to heal and ward off infections than poorly nourished individuals. Copyright © 2005 by Elsevier Inc. All rights reserved. Introduction-cont’d The study of nutrition includes all the processes involved in the selection, intake, and utilization of nutrients. Nutrients are the components in food that supply the elements necessary to meet the bodies requirements for energy, growth, maintenance, and well-being. Copyright © 2005 by Elsevier Inc. All rights reserved. The Role of the Dental Assistant • As a dental assistant, you will be discussing nutrition and food choices with patients in a variety of circumstances including: – Counseling patients about the prevention of tooth decay – Counseling patients regarding their diet following oral surgery or other dental procedures – Performing dietary analysis with patients – Counseling patients who have orthodontic appliances on their teeth regarding food choices Copyright © 2005 by Elsevier Inc. All rights reserved. Fig. 16-1 The dental assistant discusses nutrition with the patient. Copyright © 2005 by Elsevier Inc. All rights reserved. Recommended Dietary Allowances (RDA) • The RDAs are the levels of essential nutrients that are needed by individuals on a daily basis. • The RDAs are based on scientific knowledge about each nutrient. • The RDAs are determined by the Food and Nutrition Board of the National Academy of Sciences. • The RDAs are reevaluated and reissued approximately every 4 years to keep up with emerging research. Copyright © 2005 by Elsevier Inc. All rights reserved. Food Guide Pyramid • The Food Guide Pyramid is designed to reflect the new dietary guidelines that call for more consumption of grains and less consumption of meat, sweets, and fats. • The pyramid is divided into six sections. – Two symbols, a circle and a triangle, are used on the pyramid. The circle indicates fat that occurs naturally or is added, and the triangle indicates sugar that is added. Copyright © 2005 by Elsevier Inc. All rights reserved. Fig. 16-2 The Food Guide Pyramid (From U.S. Dept. of Agriculture and U.S. Dept. of Health and Human Services, 1996.) Copyright © 2005 by Elsevier Inc. All rights reserved. Key Nutrients • Carbohydrates • Proteins • Lipids (fats) • Water • Vitamins • Minerals Copyright © 2005 by Elsevier Inc. All rights reserved. Carbohydrates • Carbohydrates – Simple sugars – Complex carbohydrates – Dietary fiber Copyright © 2005 by Elsevier Inc. All rights reserved. Cariogenic Foods (Causing Decay) • Any food that contains sugars or other carbohydrates that can be metabolized by bacteria into plaque is said to be cariogenic. • Refined carbohydrates, such as candy and other sweets, are cariogenic because their sugars are readily available. • A major factor in determining the cariogenicity of a carbohydrate depends on how long the food stays in the mouth. Copyright © 2005 by Elsevier Inc. All rights reserved. Cariogenic Foods-cont’d • Sugary liquids, such as soft drinks, leave the mouth quickly and are not as cariogenic as sticky foods, such as raisins or caramels. • Foods such as crackers, although not sweet, are cariogenic because they stick to the teeth and remain in the mouth long enough to be broken down into sugars. • Another important factor in determining the cariogenicity is whether the food stimulates the flow of saliva. Copyright © 2005 by Elsevier Inc. All rights reserved. Sources of Carbohydrates • Cereal grains – Wheat, corn, oat, rice, barley, and buckwheat • Sweets – Table sugar, honey, maple and corn syrups • Vegetables – Green leafy vegetables, dried beans, and peas Copyright © 2005 by Elsevier Inc. All rights reserved. Proteins • Proteins are composed of amino acids, which are materials our bodies use in the building and repair process. • There are 20 amino acids, of which 8 are essential in the adult for normal growth and maintenance of tissues. – These 8 essential amino acids must come from food. • A complete protein is one that contains a wellbalanced mixture of all 8 essential amino acids. Copyright © 2005 by Elsevier Inc. All rights reserved. Sources of Proteins • Complete proteins – Meat, fish, poultry, eggs, and dairy products • Partially complete proteins – Grains and vegetables • Incomplete proteins – Corn and gelatin Copyright © 2005 by Elsevier Inc. All rights reserved. Fats • Fats are important sources of energy. • Fats provide essential fatty acids. • Fats transport vitamins. • Fats provide heat insulation. • Fats are components of cell membranes and myelin, which is the covering around nerve fibers. • Fat forms protective cushions around the body organs. Copyright © 2005 by Elsevier Inc. All rights reserved. Cholesterol • Cholesterol is a fat commonly found in saturated fats (from animal sources). • The fat in the body is divided into two categories: – Good fat is high-density lipoprotein (HDL). – Bad fat is low-density lipoprotein (LDL). • The recommendation is that cholesterol be limited to less than 250 mg per day, which is the amount in one egg yolk. Copyright © 2005 by Elsevier Inc. All rights reserved. Antioxidants • The antioxidant vitamins, E and C, and betacarotene can prevent cholesterol from oxidizing and damaging arteries. • Many fruits, vegetables, and certain seasonings contain naturally occurring antioxidants. Copyright © 2005 by Elsevier Inc. All rights reserved. Vitamins • Vitamins are organic substances that occur in plant and animal tissues. • They are essential in minute amounts for the human body to maintain growth and good health. • Vitamins do not supply energy, but they are needed to release energy from the carbohydrates, fats, and proteins. • To date, 13 vitamins have been discovered. – Four are fat soluble. – Nine are water soluble. Copyright © 2005 by Elsevier Inc. All rights reserved. Minerals • Minerals are inorganic substances that make up about 4% of the body weight. • There are 14 essential minerals. • The minerals present in the largest quantities include sodium, potassium, calcium, chlorine, phosphorus, and magnesium. • The trace elements include iron, zinc, copper, selenium, chromium, manganese, iodine, and fluorine. Copyright © 2005 by Elsevier Inc. All rights reserved. Water • Approximately two thirds of the body weight is water. • Often called the forgotten nutrient, water helps to: – Build tissue – Aids in regulating body temperature – Acts as a lubricant for joints and mucous membranes Copyright © 2005 by Elsevier Inc. All rights reserved. Diet Modification • A dental assistant may be called upon to assist a patient with modifying his or her diet. • The normal diet can be modified according to: – Consistency: Sticky or chewy foods should be avoided when temporary restorations have been placed. Soft foods are recommended for patients with orthodontic appliances on their teeth. Copyright © 2005 by Elsevier Inc. All rights reserved. Diet Modification-cont’d • Caloric level: An adequate number of calories is necessary for proper healing following oral surgery. • Spiciness: Foods that are too spicy can irritate the oral tissues following dental procedures. • Levels of one or more nutrients: A properly balanced diet promotes all forms of healing. • It is helpful to have special instructions written out for the patient to take home. Copyright © 2005 by Elsevier Inc. All rights reserved. Dietary Analysis • A dietary analysis can be used to help a patient understand the role of nutrition in his or her dental and general health. • The patient must keep a diet diary for about 3 days. • The patient must record every food eaten, including the amount, how it was prepared, and when it was eaten. • The dental team then reviews the completed diary with the patient using a dietary analysis form. Copyright © 2005 by Elsevier Inc. All rights reserved. Fig. 16-3 Sample dietary analysis form Copyright © 2005 by Elsevier Inc. All rights reserved. Reading Food Labels • Every food label must contain the following information: – Individual serving size – Number of servings per container – Total calories – Calories derived from fat content – Percentage of daily value (% of RDA) Copyright © 2005 by Elsevier Inc. All rights reserved. Fig. 16-4 Nutritional facts label Copyright © 2005 by Elsevier Inc. All rights reserved. Nutrient Claims • Examples of nutrient claims include: – “Low fat” – “High fiber” – “Reduced calories” – “Cholesterol free” Copyright © 2005 by Elsevier Inc. All rights reserved. Fig. 16-5 Comparative versus absolute nutrient claims (From Kinn ME, Woods M: The medical assistant: administrative and clinical, ed 8, Philadelphia, 1999, Saunders.) Copyright © 2005 by Elsevier Inc. All rights reserved. Organic Foods • Foods with the organic label must have been grown without the use of any chemical pesticides, herbicides, or fertilizers. • The use of hormones in seed preparation is prohibited. • Organic milk must have no added vitamins or chemicals and preparation is closely monitored. Copyright © 2005 by Elsevier Inc. All rights reserved. Eating Disorders • Influences of the media, food industry, and society have led to a preoccupation with being thin. Such influences have contributed to a society of weightconscious adolescents and adults and an increase in eating disorders. • Eating disorders have serious medical, oral, and psychological implications and can be life threatening. Copyright © 2005 by Elsevier Inc. All rights reserved. Eating Disorders-cont’d. • Eating disorders commonly occur during adolescence and adulthood and include anorexia nervosa, bulimia (the two most common), and other disorders such as binge eating, compulsive overeating, female athlete triad, and chronic dieting syndrome. • Most of those who suffer from eating disorders are 14 to 25 years old, white, and affluent. The occurrence of eating disorders is more common in females; the ration of females to males is 10:1. Copyright © 2005 by Elsevier Inc. All rights reserved. Eating Disorders • The two most serious eating disorders seen today are anorexia nervosa and bulimia. – Bulimia is often referred to as a bingeing and purging disorder. – Anorexia nervosa is characterized by self-starvation. Copyright © 2005 by Elsevier Inc. All rights reserved. Female Athlete Triad • This term refers to young female athletes with an eating disorder that includes restrictive dieting, overexercising, weight loss, and a lack of body fat. • It results in osteoporosis (bone thinning) and amenorrhea. • Dental risks include enamel decalcification, increased caries, and increased periodontal and soft tissue inflammation. Copyright © 2005 by Elsevier Inc. All rights reserved. Managing Eating Disorders • Anorexia nervosa and bulimia are considered psychiatric diseases with serious medical, dental, and nutritional complications. • Dental professionals are often the first health care providers to diagnose an eating disorder. • In addition to providing dental care and education, the dentist is obligated to assist the patient in obtaining psychotherapy and medical care. Copyright © 2005 by Elsevier Inc. All rights reserved. Managing Eating Disorders-cont’d. • Successful management of these disorders requires a team approach including psychiatrists, psychologists, physicians, nurses, dietitians, social workers, and dentists. • The road to recovery is often long and expensive. Copyright © 2005 by Elsevier Inc. All rights reserved. Healthy Habits • Eat right. Consume five servings of fruits and vegetables daily, plus generous portions of grain, beans, and dairy products. • Keep bones strong. Include sufficient calcium in your diet. Take a daily supplement for vitamin D, which helps your body absorb more calcium effectively. • Protect immune system. Be sure to eat whole grains, green leafy vegetables, seafood, lean meats, and moderate amounts of vegetable oils to receive vitamins E and B6 and the trace mineral zinc. They help your body to fight infection and chronic disease. Copyright © 2005 by Elsevier Inc. All rights reserved. Healthy Habits-cont’d. • Maintain body weight. Excess fat can hasten the onset of diabetes, heart disease, arthritis, and other problems. • Exercise. Combine aerobic exercises such as walking and running with simple stretch training to strengthen your muscles. Copyright © 2005 by Elsevier Inc. All rights reserved.