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Learn about the role of nutrition in promoting wellness and preventing diseases. Discover the importance of nutrients, such as carbohydrates, lipids, proteins, vitamins, minerals, and water. Understand the Dietary Reference Intakes for determining nutrient needs.
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1 The Role of Nutrition in Our Health
What Is Nutrition? • Food refers to plants and animals we eat • Nutrition is the science that studies food: • How food nourishes our bodies • How food influences our health
Why Is Nutrition Important? • Proper nutrition supports wellness • Wellness is more than the absence of disease • Physical, emotional, and spiritual health • Active process • Critical components of wellness • Nutrition • Physical activity
Why Is Nutrition Important? • Healthful diet can prevent disease • Poor nutrition causes deficiency diseases: scurvy, pellagra • Nutrition plays a role in osteoporosis and cancer • Nutrition is associated with chronic diseases: heart disease, stroke, and diabetes
Why Is Nutrition Important? Obesity is a growing problem: • Eating more calories than expended • Risk factor for heart disease, stroke, type 2 diabetes, and some forms of cancer
Why Is Nutrition Important? • Nutrition is a national goal to promote optimal health and disease prevention • Goals of Healthy People 2020 • Increase quality and years of healthy life • Eliminate health disparities
What Are Nutrients? • Nutrients are chemicals in foods that our bodies use for growth and function • Organic nutrients contain carbon, an essential component of all living organisms • Carbohydrates, lipids, proteins, vitamins • Inorganic nutrients: nutrients that do not contain carbon • Minerals and water
What Are Nutrients? • Macronutrients are nutrients required in relatively large amounts • Provide energy to our bodies • Carbohydrates, lipids, proteins • Alcohol is not considered a nutrient • Does not support the regulation of body functions or the building or repairing of tissues • Considered to be both a drug and a toxin
Carbohydrates • Primary source of fuel for the body, especially for neurologic functioning and physical exercise • Composed of chains of carbon, hydrogen, and oxygen • Found in grains (wheat, rice), vegetables, fruits, legumes (lentils, beans, peas), seeds, nuts, and milk products
Lipids • Insoluble in water • Include triglycerides, phospholipids, and sterols • Composed of carbon, hydrogen, and oxygen • Energy source during rest or low- to moderate-intensity exercise • Stored as adipose tissue (body fat) • Provide fat-soluble vitamins
Proteins • Proteins are found in many foods, primarily in meat, dairy, seeds, nuts, and legumes • Small amounts of proteins are also found in vegetables and whole grains
Vitamins • Vitamins are organic molecules that assist in regulating body processes • Critical in building and maintaining healthy bones and tissues • Support immune system • Ensure healthy vision • Do not supply energy to our bodies • Vitamins are micronutrients, required in smaller amounts
Minerals • Minerals are inorganic substances required for body processes • Regulate fluid and energy production. • Essential for bone and blood health • Remove harmful metabolic by-products • Our diets and bodies contain major minerals and trace minerals
Water • Water is an inorganic essential nutrient • Water is involved in many body processes: • Fluid balance and nutrient transport • Nerve impulses • Body temperature • Muscle contractions • Nutrient transport • Excretion of waste products
Determining Nutrient Needs • Dietary Reference Intakes (DRIs): updated nutritional standards • Expanded on the traditional RDA values • Set standards for nutrients that do not have RDA values • Dietary standards for healthy people only • Aim to prevent deficiency diseases and reduce chronic diseases
Determining Nutrient Needs Dietary Reference Intakes (DRIs) consist of: • Estimated Average Requirement (EAR) • Recommended Dietary Allowance (RDA) • Adequate Intake (AI) • Tolerable Upper Intake Level (UL) Dietary Reference Intakes (DRIs) Determination
Determining Nutrient Needs • Estimated Average Requirement (EAR) • The average daily intake level of a nutrient to meet the needs of half of the healthy people in a particular life stage or gender group • Used to define the Recommended Dietary Allowance (RDA) of a nutrient
Determining Nutrient Needs • Recommended Dietary Allowance (RDA) • The average daily nutrient intake level that meets the needs of 97% to 98% of healthy people in a particular category
Determining Nutrient Needs • Adequate Intake (AI) • Recommended average daily nutrient intake level • Based on observed and experimentally determined estimates of nutrient intake by a group of healthypeople • Used when the RDA is not available: calcium, vitamin D, vitamin K, and fluoride
Determining Nutrient Needs • Tolerable Upper Intake Level (UL) • Highest average daily nutrient intake level likely to pose no risk of adverse health effects to most people • Consumption of a nutrient at levels above the UL increases the potential for toxic effects and health risks increases
Determining Nutrient Needs • Estimated Energy Requirement (EER) • Average dietary energy intake to maintain energy balance in a healthyadult • Defined by age, gender, weight, height, and level of physical activity
Determining Nutrient Needs • Acceptable Macronutrient Distribution Ranges (AMDR) • Ranges of energy intakes from macronutrients that are associated with reduced risk of chronic disease while providing adequate intakes of essential nutrients • If nutrient intake falls outside this range, there is a potential for increasing our risk for poor health
Assessing Nutritional Status • Nutrition professional must have a thorough understanding of the client’s current nutritional status • Weight • Ratio of lean body tissue to body fat • Intake of energy and nutrients • Foundation of recommended dietary and lifestyle changes • Baseline for evaluation
Malnutrition • Nutritional status is out of balance:too much or too little of a particular nutrient or energy over a significant period of time • Undernutrition: too little energy or too few nutrients over time, causing weight loss or a nutrient-deficiency disease • Overnutrition: too much energy or too much of a given nutrient over time, causing obesity, heart disease, or nutrient toxicity
Physical Examinations • Physical exams are conducted by trained healthcare providers • Tests depend upon client’s medical history, disease symptoms, and risk factors • Typical tests include vital signs, lab tests, heart and lung sounds • Nutritional imbalances may be detected by examining hair, skin, tongue, eyes, and fingernails
Health History Questionnaire • Tool to assist in cataloging history of health, illness, drug use, exercise, and diet • Socioeconomic factors (education, access to shopping/cooking facilities, marital status, ethnic/racial background) • Energy and nutrient intake questionnaires
Dietary Intake Tools • Techniques to assess nutrient and energy intakes: • Diet history • Twenty-four-hour dietary recall • Food frequency questionnaire • Diet records • Strengths and limitations
Diet History • Information from interview or questionnaire: • Weight (current and usual weight, goals) • Factors affecting appetite and food intake • Typical eating pattern • Disordered eating behaviors (if any) • Education and economic status • Living, cooking/food purchasing arrangements • Medication and dietary supplements • Physical activity
Twenty-Four-Hour Dietary Recalls • Recalls all food and beverages consumed in the previous 24-hour period • Accurate recall includes serving sizes, food preparation methods, and brand names of convenience foods or fast foods • Limitations: • May not be typical intake • Relies on memory • Relies on ability to estimate portion sizes
Food Frequency Questionnaires • Determine typical dietary pattern over a predefined period of time • Include lists of foods with the number of times these foods are eaten • Some assess only qualitative information (typical foods without amounts) • Semiquantitative questionnaires assess specific foods and quantity consumed
Diet Records • List of all foods and beverages consumed over a specific time period (3−7 days) • Improved accuracy when: • Foods are weighed or measured • Labels of convenience foods and supplements are saved • Challenges to accuracy and sufficient detail
Anthropometric Assessment • Common measurements include height, body weight, head circumference in infants, and limb circumference • Require trained personnel and correct tools • Compare standards specific for age/gender • Assess trends in nutritional status/growth
Nutrition Deficiencies • Primary deficiencyoccurs when a person does not consume enough of a nutrient, a direct consequence of inadequate intake • Secondary deficiencyoccurs when: • A person cannot absorb enough of a nutrient in his or her body • Too much of a nutrient is excreted from the body • A nutrient is not utilized efficiently by the body
Deficiency Symptoms • Subclinical deficiency occurs in the early stages; few or no symptoms are observed • Covert symptoms are hidden and require laboratory tests or other invasive procedures to detect • Symptoms of nutrition deficiency that become obvious are overt
Scientific Method To ensure that certain standards and processes are used in evaluating claims, the researcher: • Makes an observation and describes a phenomenon • Proposes a hypothesis (educated guess) to explain the phenomenon • Develops an experimental design to test the hypothesis 4. Collects and analyzes data to support or reject the hypothesis