Nutrition
Nutrition plays a foundational role in maintaining health and preventing disease. A well-balanced diet that meets the body’s energy needs and supports proper metabolism is crucial for optimal functioning. Understanding the relationship between energy intake and energy expenditure, as well as how the body processes macronutrients, is key to promoting good health.
By the end of this section, you should know about:
- The importance of a balance between energy intake and energy requirements.
- The end products of carbohydrate, protein, and fat metabolism.
- The current dietary guidelines for the general population.
- The variance in nutritional requirements throughout growth and development.
Let’s take a closer look at them.
Test Your Knowledge
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Nutrition: Balance between Energy Intake and Requirements.
Nutrition is important for development, tissue repair, metabolism and organ function. Food security ensures that all household members have access to adequate, safe and nutritious food. Beyond the livelihood, food has a symbolic significance in social, cultural and religious events.
The Role of Nurses in Nutrition
Florence Nightingale emphasized the importance of nutrition in nursing. Today, medical nutrition therapy (MNT) plays an important role in handling diseases such as diabetes and high blood pressure. Special nutrition supports, such as enteral or parenteral Nutrition, are crucial to serious conditions.
Healthy People 2020 Nutrition Goals
The U.S. aims to promote health and reduce chronic diseases through nutrition-related objectives, including:
Increasing healthy weight and reducing obesity. Improving food choices, such as reducing saturated fats and sodium while increasing fruit, vegetables, and whole grains. Addressing iron deficiency and anemia. Expanding nutrition education and food security programs.
Scientific Knowledge Base
Nutrients and Energy
The body requires nutrients—carbohydrates, proteins, fats, water, vitamins, and minerals—for energy, metabolism, and maintenance. Energy balance determines weight changes.
Amino acid: Organic compounds that combine to form proteins, essential for growth, repair, and maintenance of body tissues.
Anabolism: The process of building up complex molecules from simpler ones, requiring energy, such as muscle growth or tissue repair.
Anorexia nervosa: A psychological disorder characterized by an intense fear of gaining weight, leading to restricted eating and excessive weight loss.
Anthropometry: The measurement of the human body, including height, weight, and body fat, used to assess nutritional status.
Basal metabolic rate (BMR): The rate at which the body burns energy at rest to maintain basic physiological functions such as breathing and digestion.
Body mass index (BMI): A measure of body fat based on height and weight. It helps categorize individuals into weight status categories like underweight, normal, overweight, or obese.
Bulimia nervosa: An eating disorder characterized by binge eating followed by purging, often through vomiting or excessive exercise, to prevent weight gain.
Carbohydrates: Organic compounds, including sugars, starches, and fibers, that provide energy to the body.
Catabolism: The process of breaking down complex molecules into simpler ones, releasing energy. This includes the breakdown of food during digestion.
Chyme: The semi-liquid substance formed in the stomach after food is broken down, which moves into the small intestine for further digestion.
Daily values: Reference amounts of nutrients that are used to help consumers understand the nutrient content in food, based on a daily intake of 2,000 calories.
Nutrition: The End Products
Carbohydrates
Carbohydrates (4 kcal/g) are the main energy source, classified as simple (sugars) or complex (starches, fiber). Fiber aids digestion but does not provide calories.
Proteins
Proteins (4 kcal/g) are essential for growth, repair, and maintaining nitrogen balance. Complete proteins (e.g., fish, poultry) contain all essential amino acids, while incomplete proteins (e.g., legumes) require pairing for full benefits.
Fats
Fats (9 kcal/g) are energy-dense and classified as saturated, unsaturated, or essential fatty acids. Healthy fats (unsaturated) support metabolism, while excessive saturated fat intake can lead to disease.
Water
Water is critical for cellular function, making up 60-70% of body weight. Fluid intake must balance output for optimal health.
Vitamins and Minerals
Vitamins: Organic compounds essential for metabolism, classified as fat-soluble (A, D, E, K) or water-soluble (C, B-complex). Minerals: Inorganic elements needed for biochemical reactions. Macrominerals balance pH, while trace elements aid various bodily functions.
Digestion and Absorption
Digestion breaks down food through mechanical and chemical processes, aided by enzymes that catalyze reactions, ensuring nutrient absorption.
Enzyme Function and Digestion
Enzymes have specific features and are the best feature of any pH levels. For example, in saliva, the amylase starch broke into sugar. The pH levels in the GI path are different: saliva is neutral, gastric juice is sour, and the secretion of the small intestine is alkaline. Digestion includes mechanical, chemical and hormonal processes. Enzymes work more efficiently when the food breaks mechanically. Hormones regulate digestive secretion, and parasimpic nervous system stimulates GI -activity.
The Digestive Process
The digestive starter begins by chewing in the mouth and the enzyme pitlin broke the starch. The food is swallowed, passes through the esophagus through peristalsis in the stomach. In the stomach, hydrochloric acid (HCL) begins as gastric secretions and enzymes such as papsin to break protein and fat. A mucus layer protects the abdominal liner, while substances such as alcohol and aspirin are directly absorbed. The food stays in the stomach for 1-7 hours before passing as a time in the small intestine.
Small Intestine and Absorption
Chyme enters the duodenum, where bile, pancreatic enzymes, and intestinal juices aid digestion. The hormones secretin and cholecystokinin (CCK) regulate the release of bicarbonate and digestive enzymes. Bile emulsifies fats for enzyme action. The small intestine is the primary site of digestion and absorption, with villi increasing the surface area. Nutrients are absorbed through passive diffusion, active transport, osmosis, and pinocytosis. The majority of water, electrolytes, and vitamins are absorbed in the small intestine and processed by the liver.
Metabolism and Nutrient Storage
Metabolism consists of anabolic (building) and catobolic processes. Anabolism produces body tissue, while the aspect breaks them, especially in hunger. Digestion is transported to tissue for nutrients for energy production and storage. The body mainly stores energy in the form of fat and glycogen. When needed, stored fat and proteins are converted into energy through processes such as gluconogenesis.
Elimination
The waste enters the large intestine, where the absorption of the waterfast fabric stool. Exercise, fiber and water intake regulates peristalsis and stool stability. The colon also absorbs minerals and helps synthesize vitamins and B complex vitamins before eliminating the stool.
Nutrition: Dietary Guidelines for the General Population.
Dietary Guidelines
The Dietary Reference Intakes (DRIs) outline nutrient recommendations based on age and gender. Guidelines suggest a balanced diet with nutrient-dense foods, limited fats and sugars, and reduced sodium intake. The ChooseMyPlate program provides visual guidance on healthy food proportions. The FDA established Daily Values on food labels to help consumers understand nutrient intake based on a 2000 kcal diet.
Malabsorption: A condition in which the body cannot properly absorb nutrients from the digestive tract, leading to deficiencies.
Malnutrition: A state of inadequate or imbalanced nutrition, which can result from insufficient intake or the body’s inability to absorb nutrients.
Medical nutrition therapy (MNT): A therapeutic approach to treating medical conditions through diet adjustments, often used in managing chronic diseases like diabetes.
Metabolism: The chemical processes in the body that convert food into energy, including both anabolism and catabolism.
Minerals: Inorganic nutrients, such as calcium and iron, that play essential roles in various bodily functions, including bone health and oxygen transport.
Monounsaturated fatty acids: A type of healthy fat found in foods like olive oil and avocados, known to improve heart health.
Nitrogen balance: The difference between nitrogen intake and nitrogen excretion. Positive balance indicates growth or healing, while negative balance may indicate malnutrition or illness.
Requirements of Nutrition Throughout Growth and Development.
Eating and drinking affected sociological, cultural, psychological and emotional factors. Food plays a role in traditions, rituals and emotional experiences, which affects how individuals buy food, cook and eat. It is necessary to understand these values to affect healthy food patterns. The requirement for nutrition varies depending on age, body structure, activity level, pregnancy and illness. Registered dietists estimate individual nutrition requirements when using future equations.
Factors Influencing Nutrition
Environmental Factors
Eating and drinking affected sociological, cultural, psychological and emotional factors. Food plays a role in traditions, rituals and emotional experiences, which affects how individuals buy food, cook and eat. It is necessary to understand these values to affect healthy food patterns. The requirement for nutrition varies depending on age, body structure, activity level, pregnancy and illness. Registered dietists estimate individual nutrition requirements when using future equations.
Developmental Nutritional Needs
Infants Through School-Age
Infants experience rapid growth, which requires high levels of protein, vitamins, minerals and fluids. Breastfeeding is recommended for the first six months due to health benefits. The infant formula provides important nutrients, but cow’s milk should be avoided in the first year due to digestive problems and potential allergies. The introduction of permanent food starts at about 4-6 months, with iron-dominated grains as the first choice. New foods should gradually be introduced to detect allergies.
Toddlers (1-3 years) require an increase in protein intake, but low kilocalis. They often develop food preferences and can become jam cucumber. Calcium and phosphorus are crucial to bone development, and excessive milk consumption can lead to iron deficiency. Some foods, such as nuts and raw vegetables, reduce the dangers of the knee.
Children of school age (6-12 years) grow continuously, enough protein and vitamins A and C. Poor eating habits require an alternative without food, and reduced physical activity contributes to overweight in children. Over the past 20 years, overweight in children has doubled and the teenager has three times in teens, which has increased the risk of type 2 diabetes and heart disease. Prevention efforts should focus on family training, balanced diet and increased physical activity.
Adolescents
Adolescents have increased the needs of energy and protein due to growth. Calcium supports bone development, and iron is important for muscle development and menstrual health. Factors affecting diet include concerns about body image, freedom, fast food, peer pressure and mania diet. Many teenagers, especially girls, are facing nutritional deficiencies due to dieting or contraception. Quick foods and high calorie food contribute to overweight, and leaving food leads to nutrient nutrients. Eating disorders such as anorexia and bulimia often appear in adolescence, which makes preliminary recognition and intervention important.
Adolescents and Exercise
Adolescents who engage in sports and regular exercise require dietary adjustments to meet increased energy demands. Carbohydrates should make up 55-60% of daily intake, while protein needs rise to 1-1.5 g/kg/day. Fat intake remains unchanged. Hydration is essential, especially in hot climates, to prevent dehydration. While supplements are unnecessary, iron-rich foods help prevent anemia. Parents play a key role in shaping dietary habits by promoting healthy snacks and limiting unhealthy food at home.
Adolescent Pregnancy and Nutrition
Pregnancy within four years of menarche poses risks due to physiological immaturity. Malnutrition in conception increases the health risk for both mother and fetus. Teen girls are often opposed to weight gain, which makes nutritional advice challenging. Calcium, iron and vitamins A and C are often deficient in diet. American College of Obstetricians and Gynecologists recommend professional vitamins to remove these deficiencies.
Young and Middle Adults
Nutritional needs decrease as growth slows, with a focus on energy, maintenance, and repair. Obesity becomes a concern due to lower physical activity and increased dining out. Women using oral contraceptives may need extra vitamins, while iron and calcium intake remain crucial.
Pregnancy Nutrition
Poor nutrition during pregnancy can lead to loss of birth and health risks for both mother and child. A well -balanced diet is needed, especially in the first trimester. Protein intake should reach 60 grams daily, with increased calcium requirements in the third quarter. The iron dose supports the expansion of blood volume, while folic acid prevents nerve pipe defects. Pregnant women should consume 400 mcg folic acid daily by increasing 600 mcg during pregnancy. Pramukt vitamins are usually recommended.
Lactation Nutrition
Lactating mothers require an additional 500 kcal/day and increased protein intake. Calcium needs remain unchanged, while vitamins A and C intake should increase. Water-soluble vitamins must be consumed daily for adequate breast milk composition. Caffeine, alcohol, and certain medications pass through breast milk and should be avoided.
Older Adults and Nutrition
More than 65 adults require less calories due to slow metabolism, but their vitamins and minerals remain the same. Age -related changes in taste, digestion and appetite can affect nutrition. Economic obstacles, health problems and mobility challenges contribute to food security. Poor oral health can lead to malnutrition, while some medications can lead to nutritional shortages. Large adults should avoid grapes, stay hydrated and consume high protein options such as cheese, eggs and peanut butter. Calcium and vitamin D are necessary for bone health and may require supplement.
Alternative Food Patterns
Many dietary habits are influenced by religion, culture, and personal beliefs. Special diets, including vegetarianism, can provide adequate nutrition if properly planned. Some religious restrictions affect food choices, such as fasting and prohibiting certain meats. Cultural beliefs around “hot” and “cold” foods influence dietary habits in various communities.
Vegetarian Diets
Vegetarian diets vary in restrictions, from ovolactovegetarians (who consume eggs and dairy) to vegans (who eat only plant-based foods). Proper planning ensures sufficient protein and essential nutrients, but strict diets like macrobiotic or fruitarian can lead to malnutrition. Vegetarian children need careful monitoring to prevent deficiencies, especially in vitamin B12.
Critical Thinking
Successful critical thinking in nutrition assessment requires integrating knowledge, experience, patient information, critical thinking attitudes, and professional standards. Clinical judgment involves anticipating information, analyzing data, and making informed decisions about patient care.
Nursing Process
Applying the nursing process helps in developing individualized care plans. A critical thinking approach ensures safe, patient-centered care, particularly when assessing nutritional status.
Assessment
A thorough assessment allows nurses to analyze findings and make informed clinical decisions. Early recognition of malnutrition or at-risk patients improves short- and long-term health outcomes. Malnourished patients are at higher risk of complications like arrhythmia, sepsis, and hemorrhage, leading to increased hospital readmission rates and costs.
Through the Patient’s Eyes
Gathering patient history helps assess nutritional status. Nurses play a key role in identifying signs of poor nutrition and initiating necessary interventions. Understanding patients’ food preferences, cultural values, family traditions, and attitudes about nutrition is crucial for effective care.
Screening
Nutrition screening is a quick and essential step in assessing malnutrition risk. Screening tools consider objective data such as height, weight, weight changes, primary diagnosis, and comorbidities, along with subjective symptoms like nausea, vomiting, and constipation. Identifying risk factors such as unintentional weight loss or dietary modifications requires further nutritional consultation.
Standardized Screening Tools
Different standardized equipment helps you assess nutritional status. Settlement Global Evaluation (SGA) evaluates the patient’s history, weight and physical evaluation to predict nutritional complications. Various care settings in the Mini Nutritional Evaluation (MNA) used for older adults include screening and evaluation components, indicating malnutrition in protein energy. These malnutrition screening tools (MSTER) measure effective nutritional problems in the health care system.
Assessing for Malnutrition
The risk of malnutrition is high in patients with conditions affecting their ability to swallow, digest or absorb nutrients. Factors such as congenital anomalies, gastrointestinal surgery and intravenous dextrosis infusion increase the possibility of nutritional deficiency. Chronic diseases, altimetable requirements and age (infants and old adults) are also important risk factor. Hardized equipment must be used, when possible, to assess nutritional risk.
Anthropometry
Anthropometry involves measuring body shape and structure, which begins with height and weight. These are usually measured by introduction, and if the patient cannot stand, the length is measured when flat. Weight measurements over time are more useful than single reading. Consistency in time, scale and clothing is important. Rapid weight changes can indicate fluid changes. Triceps Mid-Øvre Arm (Mac), Triceps provides insight into an additional measurement condition such as Skinfold (TSF) and Body Mass Index (BMI). BMI, calculated in the form of weight (kg), which is divided by height (mg), helps identify weight problems. The BMI area 25-30 suggests being overweight, indicating overweight over 30, increasing the health risk.
Laboratory and Biochemical Tests
No single laboratory test can diagnose malnutrition, but the tests for plasma proteins (albumin, transferin, percepumin, etc.) can provide valuable insight. These proteins respond to the nutritional status at different deadlines. Factors such as fluid balance, liver and renal functions affect the levels. The nitrogen balance calculated through protein intake and output is another important indicator of nutritional conditions.
Diet and Health History
A comprehensive dietary history is necessary to understand the nutritional needs of the patient. This includes food preferences, allergies, ability to reach food and information about illness or activity level. Nurses should ask specific questions about food intake, food time, part size, special diet and effects of medication. In outpatient settings, a food diary can be used, while in health services the number of calories is useful.
Dietary reference intakes (DRIs): Nutritional guidelines used to assess and plan the nutrient needs of healthy individuals, including recommended daily allowances (RDAs) and tolerable upper intake levels (ULs).
Dispensable amino acids: Amino acids that the body can synthesize on its own and do not need to be obtained through the diet.
Dysphagia: Difficulty swallowing, often seen in individuals with neurological disorders or after surgery.
Enteral nutrition (EN): The delivery of nutrients directly into the gastrointestinal tract via a feeding tube for patients who are unable to consume food orally.Enzymes: Proteins that catalyze biochemical reactions, including digestion of food.
Fat-soluble vitamins: Vitamins that are stored in the body’s fatty tissues and liver, such as vitamins A, D, E, and K.
Fatty acids: Organic acids that are key components of lipids, used for energy storage and cell function.
Fiber: A type of carbohydrate that the body cannot digest, helping with digestion and maintaining healthy blood sugar and cholesterol levels.
Food security: Having consistent access to sufficient, safe, and nutritious food for an active and healthy life.
Gluconeogenesis: The process of creating glucose from non-carbohydrate sources, such as proteins or fats, typically occurring in the liver.
Glycogenesis: The process of converting glucose into glycogen for storage in the liver and muscles.
Glycogenolysis: The breakdown of glycogen into glucose, which is used by the body for energy.
Hypervitaminosis: A condition resulting from the excessive intake of vitamins, particularly fat-soluble ones, leading to toxicity.
Ideal body weight (IBW): A weight range based on height and gender, used as a guideline for healthy weight.
Indispensable amino acids: Amino acids that the body cannot synthesize and must be obtained through diet.