Presentation on theme: "Nutrition and Special Diets"— Presentation transcript:
1Nutrition and Special Diets Chapter 49Nutrition and Special DietsPowerPoint® presentation to accompany:Medical AssistingThird EditionBooth, Whicker, Wyman, Pugh, Thompson
2Learning Outcomes49.1 Explain why a medical assistant needs to understand the role of diet in health.49.2 Describe how the body uses food.49.3 Explain the role of calories in the diet.49.4 Identify the seven basic food components and explain the major functions of each.49.5 List the Dietary Guidelines for Americans.
3Learning Outcomes (cont.) 49.6 Explain how the Food Guide Pyramid can be used to plan a nutritious, well-balanced diet.49.7 Describe the test used to assess body fat.49.8 Identify types of patients who require special diets and the modifications required for each group.49.9 Identify specific modified diets that may be ordered to treat or prevent certain conditions.
4Learning Outcomes (cont.) 49.10 Describe the warning signs, symptoms, and treatment for eating disorders.49.11 Describe techniques the medical assistant can use to effectively educate different types of patients about nutritional requirements.49.12 Explain the medical assistant’s role in educating patients about nutrition and describe the proper documentation of patient education.
5Introduction Nutrition Medical assistant How the body takes in and utilizes food and nutrientsFive-part processIntakeDigestionAbsorptionMetabolismEliminationMedical assistantMust understand relationship between diet and healthMust recognize signs of illness related to diet
6Role of Diet in Health Food Body’s source of nutrients needed to function properlyCertain foods are needed to maintain or regain healthSome conditions require special dietsMedical team works together to ensure that patients understand the role of diet in healthRegistered dietitian (RD) – designs diets that are therapeutic and realistic for patients
7Daily Energy Requirements The body requires nutrientsTo provide energyTo build, repair, and maintain body tissuesTo regulate body processes
8Daily Energy Requirements: Metabolism The sum of all cellular processes that build, maintain and supply energy to living tissuePhasesAnabolism – nutrients are changed into more complex substances that are used to build body tissuesCatabolism – complex substances are broken down into simpler substances and converted to energyMetabolism affected by age, weight, activity, state of health, and other factors
9Daily Energy Requirements: Calories Kilocalorie (calorie)Measurement of energy produced by foodAmount of energy needed to raise the temperature of 1 kg of water by 1°C.Used to measure the energy expended during activities and metabolic processesExcess calories stored as fatCount calories of food eaten and estimate expenditure for activities
10Apply Your Knowledge Correct! What is the role of diet in health? ANSWER: Food is the source of nutrients the body needs to function properly. Sometimes a special diet is needed to stay healthy or regain health, and some conditions require special diets.What is the difference between anabolism and catabolism?ANSWER: Anabolism converts nutrients into complex substances needed to build body tissues. Catabolism converts complex substances into simpler forms and converts them into energy.Correct!
11Nutrients Nutrients are provided by Needed for ProteinsCarbohydratesFiberLipidsVitaminsMineralsWaterNeeded forEnergyGrowthRepairBasic processesEnergy is only provided byProteinsCarbohydratesFats
12Nutrients: Proteins Functions 10% to 20% of total caloric intake daily Building and repairing cells and tissuesMaintaining water balanceAntibody production and disease resistanceMaintaining body heat10% to 20% of total caloric intake daily1 gm = 4 caloriesDeficiencyWeight loss / fatigueMalnutritionLower resistance to infectionInterference with normal growth processes
13Nutrients: Proteins (cont.) Complete proteinsContain all 9 essential amino acidsAnimal food sourcesRecommend lean meats, low-fat or skim milkIncomplete proteinsLack one or more essential amino acidsPlant sourcesCan be combined to provide all 9 essential amino acids
14Nutrients: Carbohydrates FunctionsProvide 2/3 of daily energy needsProvide heatMetabolize fatsPreserve protein for uses other than energy production50% to 60% of total caloric intake daily1 gm = 4 caloriesDeficiencyWeight lossProtein lossFatigueExcess contributes to fat stores
15Nutrients: Carbohydrates (cont.) Complex carbohydratesPolysaccharides – long chains of sugar unitsTypesStarch – major source of energyFiberSimple sugarsFruits and some vegetablesMilkTable sugarExcessStored in liver and muscles cells as glycogenConverted into and stored as fat
16Nutrients: Fiber Does not supply energy or heat Functions Increases and softens the bulk of stoolAbsorbs wastes and toxinsDecreases the rate of carbohydrate breakdown and absorption20 – 30 gm per day for adultsTypesSolubleAbsorbs fluid and swells when eatenSlows absorptionHelps control blood glucoseLowers cholesterolInsoluble – promotes regular bowel movements
17Nutrients: Lipids Concentrated source of energy 1 gm = 9 calories TriglyceridesSimple lipids95% of dietary lipidsCholesterolCompound lipids5% of dietary lipidsFunctionsProvide a concentrated source of energyTransport fat-soluble vitaminsStore energy as body fat – insulate and protect organsProvide a feeling of fullness
18Nutrients: Lipids (cont.) Saturated fatsPrimarily from animal sourcesSolid at room temperatureTrans fatsFormed during hydrogenation of vegetable oilsFDA recommends zero consumptionUnsaturated fatsLiquid at room temperatureTypesPolyunsaturatedMonounsaturated
19Nutrients: Lipids (cont.) CholesterolFat-related substance produced by liverAnimal-based food sourcesEssential to healthPart of cell membranesStructural basis for steroid hormones and vitamin DComponent of bileLipid levelsHigh cholesterolHeart disease / strokePeripheral vascular diseaseLipoproteinsCarry lipids through the bloodstreamLow-density (LDL)High-density (HDL)
20Nutrients: Vitamins A E D B12 C B6 Organic substances Essential for normal growth and maintenanceEssential for resistance to infectionHelp the body use other nutrientsAssist with body processesAbsorbed through digestive tractTypesWater soluble – not stored by the bodyFat-soluble – stored by the bodyWell-balanced diet usually minimizes likelihood of vitamin deficiency
21Nutrients: Minerals Natural, inorganic substances Build and maintain tissuesCarry out life functionsMajor minerals – needed in large quantitiesTrace minerals – needed in small amountsAbsorbed in intestinesEstablished RDAsCalcium ZincIodine IronMagnesium PhosphorusSelenium
22Nutrients: Water No caloric value 65% of body weight Functions Maintains fluid balanceLubricates moving partsDissolves chemicals and nutrientsAids in digestionTransports nutrients and secretionsFlushes out wastesRegulates body temperature
23Nutrients: Water (cont.) Fluid balance – intake should equal outputPatient educationExplain the importance of waterList sources of water
24Nutrients: Principle Electrolytes and Nutrients of Special Interest SodiumFluid and acid-base balanceMaintains normal conditions inside and outside of cellsPotassiumMuscle contractionFluid and electrolyte balanceChlorideFluid and electrolyte balanceComponent of hydrochloric acidAntioxidants – chemical agents that neutralize free radicals (by-products of normal metabolism)
25Apply Your Knowledge S U P E R J O B ! Matching: ___ Bulk to stool A. Cholesterol___ Tissue repair B. Antioxidants___ Excess stored as glycogen or fat C. Proteins___ Concentrated source of energy D. Water___ Produced by liver E. Trans fats___ No caloric value F. Fiber___ Neutralizes free radicals G. Lipids___ Formed during hydrogenation H. CarbohydratesANSWER:FCHGADBE
26Dietary Guidelines Established to help people Get proper nutritionReduce occurrence of diseaseControl weightDesigned to encourage healthy eating habitsSuggest types and quantities of foods
27Dietary Guidelines: USDA and U.S. Dept. of Health and Human Services RecommendationsEat a balanced dietLimit consumption of less nutritious foodsIncrease physical activityBe consistent with good nutritional choicesFood safetyDisinfect food surfacesWash handsCook foods to safe temperatureRefrigerate foodsAvoid raw eggs and meats and unpasteurized milk or juices
30Dietary Guidelines: American Cancer Society Eat more high-fiber foodsFive or more servings of fruits and vegetables dailyLimit consumption of processed and red meatsAdopt a physically active lifestyleAchieve and maintain a healthy weightLimit consumption of alcoholic beverages
31Apply Your Knowledge Very Good! ANSWER: Match food group to appropriate color:VegetablesOilsMeat and beansGrainsFruitsMilk productsGreenOrangeVery Good!BluePurpleRedYellow
32Assessing Nutritional Levels AgeHealth statusHeight / weightBody frameBody circumference% of body fatNutrition and exercise patternsEnergy needsAlsoCultureBeliefsLifestyleEducation
33Assessing Nutritional Levels (cont.) Measure fat as % of weightSkinfold testMeasurement of the thickness of a fold of skin with a caliperTotal % of fatOptimal % differs between men and womenAging changes ratio – fat replaces muscle tissue
35Modifying Diets Modifications Restriction of certain foods Emphasis on particular foodsChange in daily caloric intakeChange in the amount of a specific nutrientChange in the texture of foodsAlteration in the number of daily mealsChange in variables such as bulk or spiciness
36Modifying Diets: Patients with Specific Nutritional Needs Food allergiesWheat, milk, eggs, and chocolateEliminate from dietAnemiaIron supplementsDietary ironCancerIncrease caloric intakeAdequate protein intakeDiabetesFood exchange systemDiabetes food pyramidElderlyEnergy and metabolic requirements decreasePhysical difficultiesMedicationsSocial factorsEconomic factors
37Modifying Diets: Patients with Specific Nutritional Needs (cont.) Heart diseaseReduce cholesterolLose weight if neededReduce consumption of fatsHypertensionDecrease sodium / increase potassium / adequate calciumEliminate or reduce alcohol consumptionLactose sensitivityLactase not present to break down lactoseOverweightDietary modificationBehavior modificationMotivation and education
38Modifying Diets: Patients with Specific Nutritional Needs (cont.) Children1st yearBreast milk or commercial formulaCow’s milk inadequateNutritional needs changeGrowth spurtsMaturationIncreasing activityHunger regulates intakePregnantAdditional proteinCalciumIronFolic acidFiberLactatingAdditional calories and proteinFolic acid and calcium
39Specific Modified Diets For treatment or prevention of certain conditionsModifications include changes inTextureLiquid or softHigh-fiberNutrient levelLow sodiumReduced calorieFrequency and timingThree smaller mealsTiming in relation to a procedureExclusions – for food intolerances
40Specific Modified Diets (cont.) Supplements and parenteral nutritionOral – specially formulated to provide adequate nutrientsParenteral – given IV to bypass the digestive systemDrug therapyDrugsChange in food intakeChange in absorptionFoodsInterfere with metabolism and action of a drug
41Apply Your KnowledgeWhat factors does the physician consider when assessing a patient’s nutritional status?ANSWER: The physician considers a patient’s age, health status, height and weight, body frame and circumference, percent of body fat, eating and exercise patterns, and energy needs. Culture, beliefs, lifestyle, and educational level should also be considered during the assessment.
42Apply Your Knowledge Yippee! 2 for 2! ANSWER: Matching ___ Eliminate foods from diet A. Change in texture___ Food exchange system B. Children___ Decreased metabolism C. Food allergies___ Hunger drives eating D. Parenteral nutrition___ Modification to a soft diet E. Diabetes___ Reduced sodium diet F. Elderly___ Bypasses GI tract G. Drug therapy___ May alter food intake and absorption H. Change in nutrient levelCEYippee! 2 for 2!FBAHDG
43Eating Disorders Extremely harmful eating behavior Anorexia nervosa Self-starvationTreatmentRestore normal nutritionPsychotherapyEducation of nutrition conceptsChronic condition – can be fatal
44Eating Disorders (cont.) BulimiaBinge and purge by vomiting, diuretics, laxativesUsually easier to treat than anorexiaTreatmentMedicationPsychotherapyGoalsEstablish a healthy weightEstablish good eating patternsResolve psychosocial triggers
45Eating Disorders (cont.) Getting help – be alert to patient report ofSkipping at least two meals per dayUncontrolled eating of large amounts of foodUsing laxatives or other purges to control weightAvoiding social situations that interfere with diet or exerciseFeeling disgust, depression, and guilt after bingeFeeling that food controls life
46Apply Your Knowledge Right! A young female patient arrives at the clinic showing a 15 pound weight loss in the last two months. Her weight is 10 pounds under the average weight for her height. She states she “feels great.” What should you do?ANSWER: Document the weight loss and report it to the physician. She may be suffering from anorexia nervosa or bulimia, two types of eating disorders that require medical care and psychotherapy.Right!
47Patient Education Reinforce nutrition instructions Teach patient Role nutrition plays in preventing illnessesHow to be wise consumers by reading food package labelsFactorsPatient likes and dislikesPatient age and family circumstancesDiseases and disordersPatient’s psychological condition
48Patient Education (cont.) GuidelinesTeach patient as an individualTeach a small amount at a timeKeep explanations at patient’s level of understandingReinforce good eating behaviorLet patient be an active learnerProvide a written diet planSuggest support groups
49Patient Education (cont.) Cultural considerationsInfluenceFood purchasesLike and dislikesMeal timing and frequencyAttitude toward supplementsSnackingAdjust diet and recipes accordinglyOutside resourcesPatient education materialsExamplesAmerican Diabetes AssociationAmerican Dietetic AssociationAmerican Heart AssociationOvereater Anonymous (OA)
50Excellent! Apply Your Knowledge What do you need to consider when teaching patients about nutrition?ANSWER: You need to consider patient likes and dislikes, age and family circumstances, diseases and disorders, and the patient’s psychological condition. In addition, you need to incorporate cultural considerations into nutritional education.Excellent!
51In Summary Nutrition – complex, technical topic Medical assistant Knowledge of basic nutritional principlesMake good nutrition understandable and achievableEducate patientsRecognize eating disorders
52End of ChapterEnd of Chapter 49He that eats till he is sick must fast till he is well. ~English Proverb