Hosa Nutrition

 3 macros
 Vitamins and minerals
 Water (fluids and electrolyte balance)
 Life span nutrition
 Digestion, absorption, metabolism
 Cultural and religious influences
 Food related illnesses and allergies
 Medical nutrition therapy
o Diabetes
o Cardiovascular disease
o Renal disease
o Gastrointestinal disease
o Cancer
o Clients with special needs


CH. 1 Food Nutrition and Health
Health Promotion
Basic Definitions
Nutrition and Dietetics
 Nutrition: food people east and how their bodies use it
 Nutrition science: body of scientific knowledge governing nutrient requirements
 Dietetics: applying nutrition science to promote human health
 Registered dietitian (RD): nutrition authority on health care team
Health and Wellness
 Wellness seeks full development of a person. Health is absence of disease
National Health Goals
 Healthy People 2020 (US Dept of Health and Human Services, part of Healthy People Series):
“Ultimate vision in which all people live long, healthy lives”
Traditional and Preventative Approaches to Health
 Preventative health care approach: identifying risk factors for a disease, and then choosing diet
based on that
 Traditional health care approach : changing symptoms that already exist
Importance of Balanced Diet
Signs of Good Nutrition
 Smooth skin, glossy hair, clear eyes
Food and Health
 Essential nutrients: carbs/fats/proteins/vitamins/minerals/water
 Nonessential nutrients: can be made in body

,Functions of Nutrients in Food
 Principle of nutrient interaction:
o Individual nutrients have primary and secondary functions
o No nutrient works alone
 Nutrients provide energy, build tissue, and regulate metabolism
Energy Sources
 Energy-yielding nutrients: carbs/fat/protein
o Alcohol not nutrient; no function in body (7kcal/gram)
 Carbs: 45-65% diet
 Fat: 20-35% (mostly from plants) (10% or less from saturated fat)
 Protein: 10-35%
Tissue Building
 Main function of proteins, vitamin C (collagen), calcium and phosphorous (bone), iron
(hemoglobin), fatty acids (cell membrane)
Regulation and Control
 Vitamins and Minerals - function as coenzymes (components of cell enzymes)
 Water and Fiber - fiber regulates passage of food and absorption of nutrients
Nutritional States
 Optimal nutrition
 Malnutrition (under and over nutrition): average American diet is suboptimal
o Undernutrition can be caused by hospitalization
Nutrient and Food Guides for Health and Promotion
Nutrient Standards
 Food insecurity: uncertain availability of adequate and nutritious food; independent of social
status
 Dietary reference intake: reference values for the nutrient intake needs of healthy individuals for
each gender and age group
US Standards: Dietary Reference Intakes
 Recommended Dietary Allowances (RDAs): minimum amount of nutrients necessary to protect
against risk for nutrient deficiency (established after WW2)
 Original goal – preventing deficiency disease (RDAs)
 New goal – maintaining optimal health (DRIs)
 DRIs contain
o RDA: daily intake of a specific age group and gender; need research to back up
o Estimated Average Requirement: intake level that meets needs of ½ of individuals in
specific group
o Adequate Intake: guide when insufficient scientific research available to establish RDA
o Tolerable Upper Limit: maximum intake that is unlikely to pose health problems
Other Standards
 Canadian, European, and US standards same

,  Food and Agriculture Organization (FAO) and WHO sets standards for poor countries
Food Guides and Recommendations
 My plate
 Dietary Guidelines for Americans: new statement issued every 5 years
 DRIs
Other Recommendations
 Disease organizations (ex. American Cancer Society) modeled upon Dietary Guidelines for
Americans
Individual Needs
Changing Food Environment
 Americans pickier on what they eat due to fad diets. Most fads can provide overall balanced diet


CH. 2 Carbohydrates
Nature of Carbs
Relation to Energy
Energy Production System
 Carbs is basic fuel. Glucose is the refined fuel

Dietary Importance
 Carbs are widely available, low in cost, and easily stored

Classes of Carbs
Monosaccharides
 Glucose: also called dextrose
 Fructose
o Fruits (as fruit ripens, more starch broken down to fructose)
o Honey (honey is sugar itself; not sugar substitute)
o Sweetest of simple sugars
o High fructose corn syrups: glucose changed into fructose in cornstarch
 Galactose: product of lactose digestion

Disaccharides
 Lactose: milk sugar formed by mammary glands
o Not in plants
o Remains in intestines longer, creating useful bacteria
o Promotes absorption of calcium and phosphorous
 Maltose: dimers released during starch breakdown

Polysaccharides
 Starch
o Cooking starch softens starch cells, so it’s easier to digest
o Whole grain: food products (flours, breads, cereals) produced from unrefined grain,
which retains the bran layers, endosperm, and germ and thus the nutrients inside
o Enriched grains: refined grain products where some of the nutrients were added back
o Fortified foods: nutrients added that were not originally present

,  Glycogen
 Dietary Fiber
o Soluble Fiber: primarily lowers blood cholesterol (ex. Pectin, Gum, Mucilage, B-Glucans,
Algal polysaccharides)
o Insoluble Fiber: primarily helps constipation (ex. Cellulose, Hemicellulose, Lignin)
 Cellulose
o Adds bulk to diet by holding water, moving food mass along, soft feces
o Stems and leaves of veggies and coverings of seeds and grains
 Lignin: only non-carbohydrate type of fiber
o Woody parts of plants
o Binds to cellulose in plants
 Noncellulose polysaccharides: hemicellulose, pectin, gum, mucilage, and algal substances
o Add bulk, slow emptying, reduce cholesterol
 Excessive fiber reduces mineral absorption by chelation

Drug Nutrient Interaction: Phytic Acid and Mineral Absorption
 Phytic acids bind to minerals (chelator), decreasing absorptivity. Diets high in fiber containing
phytic acid coupled with low intake of iron may cause iron deficiency anemia
o Chelator: ligand that binds to metal to form metal complex

Other Sweeteners
 Sugar Alcohols: have calories, thus considered nutritive sweeteners. (ex. Sorbitol, Mannitol,
Xylitol)
o 2-3 calories (chewing gum)
o Sorbitol: sucrose substitute
o Absorbed more slowly, lower risk for dental caries, can cause diarrhea
 Nonnutritive/alternate sweeteners: have no calories, much sweeter than sucrose than nutritive

Functions of Carbs
Basic Fuel Supply
Reserve Fuel Supply
 100g glycogen in liver (maintains blood glucose and brain function), 300-400g in muscles

Special Tissue Functions
Liver
 Glycogen prevents cells from depressed metabolic function

CNS
 Brain depends of glucose; low blood sugar may cause brain damage

Protein and Fat Sparing
 Carbs provide an Antiketogenic effect: prevents rapid breakdown of fat, which produces ketones,
which upsets acid/base balance in body

Digestion of Carbohydrates
Mouth
 Chewing (mastication) breaks down the food, mixing it with saliva.