Unit 1

Introduction to Nutrition

Anita A. Cabezon RN, MPH

Nutrition
Study of food in relation to health
Study of essential nutrients & the processes by
which nutrients are used by the body
Study of the processes by which an organism
ingests, digests, absorbs, transports, utilizes and
excretes food substances
Foundation of Good Health- right kind & amount of food
eaten at the right time.

Nutrition is the cornerstone of each health dimension

Physical Health:
Dependent on the quality & quantity of nutrients
available to the body

Intellectual health:
Nutritional imbalance e.g. iron deficiency anemia
affects intellectual health since it relies on a well
functioning brain & nervous system.

 Emotional health:
May be affected by poor eating habits.
When we miss a meal, feelings of anxiety, confusion &
trembling may occur

Social health:
Social health situations often center on food related
occasions. Nutritional status is sometimes affected by
the quality of our relationships with family & friends.

Spiritual Health:
Several religions prohibit the consumption of specific
foods

Functions of Nutrition in Relation to Nursing

Function
Nutrition
1. To sustain life

2. To promote
growth

Nurse
1. To sustain and support
persons thru times of
dependence and need
2. To promote personal growth
and restore health

3. To replace loss 3. To replace the loss of selfcare and help maintain a sense
of personal wholeness
4. To provide
energy

4. To help provide emotional

strength to cope with the total
experience of illness

Dietetics

Diet Therapy

combined science and

art of regulating the
planning, preparing and
serving
of
meals
to
individuals
or
groups
according to principles of
nutrition
and
management with due
consideration
to
economic,
social
and
psychological factors.

branch
of
dietetics
specialized in the use of
food for the treatment
of disorder or disease
Planned diet must be
eaten
to
maximize
effectiveness

Food
Any substance, organic or
inorganic when ingested or eaten
nourishes the body by:
1. Building and repairing tissues
2. Supplying heat and energy
3. Regulating bodily/metabolic
processes

Sustains life

Food Selection
Food Preferences
Foods chosen to be eaten when all foods
are available at the same time

Food Choice
Specific foods that are convenient to
choose when we are actually ready to eat

Food Liking
Foods we really like to eat

Meaning of food
Food likes:
Security foods, reward foods
fetish foods , show off foods
grown up foods, advertised foods

Food dislikes
Cultural taboo foods, religious taboo
familial and individual taboo foods

Pleasurable/Unpleasurable association foods

Agreeable/ Disagreeable sensory properties

Meaning of food
Pleasurable/Unpleasurable association foods

Familiarity on food preparation

easy/hard to prepare
Sanitary/Filthy sources
Allergies

Agreeable/ Disagreeable sensory properties

Spoiled/Unspoiled
Color, odor, taste, texture and temperature

Qualities of Good
It is nourishing or nutritious
Food
It has satiety value
Prepared under sanitary
conditions, aesthetically and
scientifically
It is free from toxic agents
Its palatability factors satisfy
the customers
Offers variety & planned within
the socio-economic context

Calorie (Kcal)
Unit of energy measurement
Amount of heat required to raise the
temperature of 1 kg of water by 1 C
1 g of carbohydrates = 4 calories
1 g of protein = 4 calories
1 g of fat = 9 calories

Nutrient:
Chemicals in food required by the body for
energy, growth , maintenance & repair
some are manufactured in the body thru
biosynthesis, others are manmade
Essential nutrients are:
Water
CHO
CHON

Fats
Vitamins
Minerals

Nutrient Classification:
according to function
according to chemical nature
according to essentiality
according to concentration

Nutrient Classification
According to Function:
Body Building

form tissues or are structural component of the body

Water - 2/3 of body weight
CHON - 20%,
CHO - 1%
Fats- 20%,
Minerals - 4%

Energy giving
CHO, Fats & CHON

Regulate body processes

all nutrients

Nutrient classification
According to Chemical nature:
Organic CHON, CHO, Fat & vitamins
Inorganic - minerals & water

According to Essentiality
Dietary essential
cannot be made by body, must be provided by food

Non-essential
Body can make on its own

Nutrient Classification
According to Concentration
MACRONUTRIENTS
> 0.005% of body weight
CHON, CHO, Fats, Ca, P, K, Na

MICRONUTRIENTS
< 0.005% of body weight
vitamins, Fe, Iodine, Flourine

Enzymes
Organic catalysts that
are protein in nature
and are produced by
living cells
Hastens chemical
reactions without itself
undergoing change

Ends in ase
e.g. maltase, amylase

Hormones
Organic substances
produced by special cells in
the body discharged into the
blood stream to be
transported to specific organs
and tissues remote from the
point of manufacture
Regulate vital processes
which are highly specific
Some are protein in nature
others lipid-related

Examples of hormones with direct

involvement to nutrition
Posterior pituitary - Vasopressin
Anterior pituitary - Lipotropin
Parathyroid- Parathyroid
hormone,
calcitonin
Thyroid Thyroxine
Pancreas Insulin, glucagon
G.I. gastrin, secretin,
cholecystokinin

Nutritional Status (Nutriture)

Condition of the body resulting from the
utilization of essentials nutrients
Optimum or Good Nutrition
body has adequate amount of essential nutrients that
are efficiently utilized such that growth and good health
are maintained at the highest possible level

Malnutrition
condition of the body resulting from lack of one or more
essential nutrients (nutritional deficiency) or excessive
nutrient supply to the point of creating harmful effects
(overnutrition)

Causes of Malnutrition
Primary
Factor

Refers to faulty diet

Poverty
Ignorance
Poor food habits
Limited food supply
Poor distribution of
food
Cultural taboos

Secondary
Factors

Refers to all conditions

within the body that
reduce the nutrient
supply of the cells
Digestion
Absorption
Metabolism and
Utilization
Increased excretion

Pathogenesis of
Nutritional Deficiency Disease

Dietary
Deficiency
(Primary
Factor)
Nutritional
Deficiency

Tissue
Depletion
Depletion of
Nutrient
Reserves

Biochemical
lesions or
changes

Functional Changes

Conditioning Factors
(Secondary Factors)

Anatomic Changes

principles in the
promotion of good
nutrition

1.The body requires food

to:
Provide energy for organ function,
movement and work
Maintain body temperature
Provide raw materials for enzyme
function, growth, replacements of cells
and repair

2. The processes of
digestion, absorption
and metabolism work
together to provide all
body cells with energy
and nutrients

3. Mans energy
requirements vary and
is influenced by many
factors such as:
age
body size
gender
climate
sleep

physiological stress
(pregnancy/lactation)
pathological disorders
(diabetes)
activity/occupation
lifestyle

4. Foods are described

according to the density
of their nutrients.
Nutrient Density - the proportion of
essential nutrients to the number of
calories.

5. Nutrient content is
variable
Enrichment
Fortification

 Enrichment:
The addition of vitamin/ and or minerals to the
food at a concentration level in excess of the
amounts naturally present in food
Example rice enriched with thiamin

Fortification:
The food is used as a vehicle to carry the added
nutrients which are absent originally in that
food
Example fortified vitamin rice

6. When energy
requirements are
completely met by
caloric intake, people
maintain their activity
level without weight
change.

7. An adequate
diet is the
foundation of
good
nutrition and
it should
consist of a
wide variety
of foods.

8. Measures for
improvement of
nutritional status are:
nutrition education
abundant food
supply
use of various
resources

 9. Malnutrition is brought
about by faulty diet
&/conditioning factors
10. Study of nutrition is
interrelated with arts &
sciences

Assessing Nutritional Status

Physical/Instrumental Method (Anthropometry)

1. Weight - reflects body mass

Weight for age

used in under-5 year old children, as in Operation Timbang

Helpful in diagnosing acute undernutrition (wasting)

& chronic undernutriton (stunting)

 Gomez classification of nutritional status

based on percentage of expected body
weight
Formula:
% of EBW = ABW/EBW

Classification:
> 110% of EBW
91-110 %
76-90 %
61-75 %
60 % or less

=
=
=
=
=

overweight
normal
1st degree undernut.
2nd degree
3rd degree

Weight for height

used for adults, useful in assessing acute malnutrition
(obesity & wasting)
Body Mass Index

weight(kg.) / (height in mt.) 2

20 25%

Normal

27.5 30%

Mild obesity

30-40%

Moderate obesity

Above 40%

Severe obesity

Hamwi Method:
1. Ideal weight based on height:
Men: 106 pounds for the first 5 feet of height & 6
pounds for each additional inch
Women: 100 pounds for the first 5 feet of height & 5
pounds for each additional inch
Add or subtract 10% depending on body
frame.

 2. Height for age

reflects skeletal growth for age; also

used in young children, helpful in
diagnosing chronic undernutrition

 3. Mid upper arm circumference estimates muscle mass hence the protein & energy
reserves at the mid-arm area; used only in 1-4 year
old age group. For rapid screening.
13 cm. or more = normal
Less than 13 cm. = wasting
4. Triceps skin fold
measures the amount of subcutaneous fat; used for
adults only. Normal value is 1 inch

 3. Mid upper arm circumference estimates muscle mass hence the

protein & energy reserves at the midarm area; used only in 1-4 year old
age group. For rapid screening.
13 cm. or more = normal
Less than 13 cm. = wasting
4. Triceps skin fold
measures the amount of subcutaneous
fat; used for adults only. Normal
value is 1 inch

Assessing Nutritional Status

Biochemical tests
Blood - Hgb. & Hct, serum albumin, transferrin,
Urine - creatinine excretion

Clinical examination detects physical symptoms associated with

malnutrition
hair, skin, eyes, tongue, etc.

Medical history reveal secondary factors to malnutrition

Assessing Nutritional Status

Dietary survey - evaluates primary factor of
nutritional inadequacy

Food recall
Food record
Food inventory/ diary
Dietary history

1. 24-hour food recall

- recall all food and beverages the client
consumes during a typical 24-hour period
- usually gathered in a personal interview or
by telephone
- evaluated according to the Food Guide
Pyramid

2. Food Frequency Record

- checklist that indicates how often general food
groups or specific foods are eaten
- may be categorized as times/day, times/week,
times/month, or frequently, seldom, never
- helps to focus on groups of foods that are
either deficient or excessive

3. Food Diary / Periodic Food Records

- detailed record of measured amounts
(proportion sizes) of all food and fluids a
client consumes during a specified period,
usually 3 to 7 days
- helpful for assessing food patterns

4. Diet History
- comprehensive time-consuming assessment of a
clients food intake that involves an extensive
interview by a nutritionist or dietitian
- includes characteristic of foods usually eaten as well
as the frequency and amount of food consumed
- may include a 24-hour recall, a food frequency
record, and a food diary
- data are gathered through interviews or
questionnaires

GOOD DAY!!!

Be ready for a quiz next

meeting!!!