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NR228: Nutrition class notes

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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...

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  • May 12, 2022
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NR228: Nutrition
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.

,chooseMyplate.gov
 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

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