NR228: Nutrition class notes

Health-is a state of complete physical, mental, and social well-being, emotional, spiritually, socially. Nut  Formal Education-School  Non-formal Education-American Heart Association or community wellness programs  Informal Education- occurs through daily activities  When a nurse chats with a patient regarding diet modification Carbs= fuel—Simple (sugar) Complex (starch, fiber-provides no Kcals, no energy Dietary Reference Intakes (DRI)- How much experts recommend you eat of something, the goal to help prevent the chronic development of illness.  Estimated Average Requirement (EAR)  Recommended Dietary Allowance (RDA)  Adequate Intake (AI)  Tolerable Upper Intake Level (UL)-how much of a nutrient you can have before you have negative effect.  Acceptable Macronutrient Distribution Ranges (AMDRs)- counting macros (proteins, carbs)  Fats 20-35%, Carbs 45-65%, Proteins 10-35%. Kilocalorie know the table below Males 2 drinks per is mod, 1 Food labels -1st thing to do is to read the serving size. o Free- Contains insignificant amount of fat (0.5 grams) o Reduced- 25% less calories o Light/Lite- 1/3 fewer calories, or 50% less fat o Organic vs Non-Organic-meat has to be no antibodies, no GMO, no synthesis fert., no pest control. chooseM  Requires 50% of grains should have whole grains.  Vegs 2 ½ cups/ per day  Fruit 2 cups/ day  Dairy= skim/low fat Plant base diet is recommended Best form of food is Fresh/ Raw vegs, then frozen, then canned foods. Exchange List  Created by the American Diabetes and the American Dietetic Association  Foods are divided into carbs, meats/meat subs, and fats.  Serving size provides similar amount of carbs, protein, fat, and kcal. Most effective way to evaluation a Pt’s diet is a FOOD JOURNAL. Carbs:  Carbs are made up of: organic compounds of carbon, hydrogen, and oxygen make up simple carbs  Simple: Monosaccharides (glucose, fructose) pass thought the GI easily.  Simple: Disaccharides [Sucrose (fructose + glucose)] Table sugar  Complex: Polysaccharides  Many units of monosaccharides held together by a chemical bond  Starch and fiber Lactose “milk Sugar” (glut galactose) Maltose (glu + glu) + fermentation = alcohol gluconeogenesis-turning glycogen into glucose Glycogenosis-turning glucose into glycogen  Primary job of Carb metabolism- Maintaining blood glucose (BG) levels  Blood glucose levels can be maintained by metabolizing  Carbs- easily broken down, and easily converted into glucose  Lipids – Gluconeogenesis (ketosis)-turning fat into glucose, byproduct of ketones.  Proteins- gluconeogenesis-turning glycogen into glucose, byproduct is ammonia, excess is turned into fat  BG levels are maintained through:  Carb metabolism  Fat metabolism  Ketones à Metabolic Acidosis  Stored Carbs  Glycogenosis-turning glucose into glycogen Nature Sources in the food supply  Sugar cane and sugar beets  Honey, dextrose, and molasses  Other sources, such as corn syrup and high-fructose corn syrup (HFCS) Sugar alcohols slower absorption effects:  Provide 2-3 kcals of energy  Occur naturally in fruits and berries  Sorbitol, Mannitol, and Xylitol Alternative sweeteners (artificial sweeteners) have no nutrient value:  Aspartame- found in diet sodas, 160-220% sweeter than sucrose. Phenylketonuria PKU Pt are not to eat this. Cannot process/ absorb Phenylalanine  Saccharin- Sweet N Low. 300x sweeter sucrose. Hx link to bladder cancer.  Sucralose- Splenda. 600x sweeter sucrose. Poorly absorb be the body and excrete in the urine.  Stevia- Stevia- 200 x sweeter sucrose. Fiber  25-38 g/day  Most Americans adults average 16 g/day  Most Americans eat high protein & high fat diets & drink high sugared beverages  Americans consume high amounts of refined grains  Race/ethnicity  Mexican-Americans: fiber consumption is the highest  African Americans: fiber consumption is the lowest  Fiber cannot be broken down by digestive juices  Fiber adds no nutritional value  Fiber creates bulk and eases the work of the GI muscles that regulate food movement  GI flora uses fiber as a medium for microbial fermentation for vitamin synthesis & formation short-chain fatty acids (SCFAs)  vitamin k, biotin, B12, folate, thiamin  SCFAs: used by the colon mucosa for energy (maintains the health of the colon epithelial cells) & increase fecal matter bulk Soluble Fiber: dissolves in fluids  Thickens substances  Pectin, mucilage, psyllium seed husk, guar gum, Insoluble Fiber: does not dissolve in fluids  Cellulose, hemicellulose  Foods are classified by type of fiber  Less soluble: whole wheat, bran, fruits and mature veggies  More soluble: oats, legumes, barley, apples, carrots  Some are known to reduce cholesterol (oats, barley bran) Refined Grains We lose -Bran- has cellulose (Fiber, Mg, Riboflavin, Thiamin, niacin -Germ- Protein, Zinc we keep endosperm- starch (energy) Protein, low niacin, thiamin, B6  Energy Food Sources: grains, legumes, & starchy root vegetables  Fiber: fruits, vegetables, & whole grains  Low in glycemic index