Medical assisting Administrative and clinical procedures (5e) Chapter 55 Nutrition and health

Nutrition is the process of how the body takes in and utilizes food and other sources of nutrients. It is a fivepart process that includes intake, digestion, absorption, metabolism, and elimination. This chapter gives you an understanding of how a wellplanned diet can lead to optimal health and wellbeing for your patients.

Nutrition and Health

55.1 Relate daily energy requirements to the

role of calories.

55.2 Identify nutrients and their role in health.

55.3 Implement a plan for a nutritious,

well-balanced diet and healthy lifestyle using the USDA's guidelines.

55.4 Describe methods used to assess a

patient’s nutritional status.

Learning Outcomes

55.5 Explain reasons why a diet may be

modified.

55.6 Identify types of patients who require

special diets and the modifications required

for each.

55.7 Describe the warning signs, symptoms,

and treatment for eating disorders.

55.8 Educate patients about nutritional

Learning Outcomes

between nutrition and health

Daily Energy Requirements

• The body requires nutrients

– To provide energy

– To build, repair, and

maintain body tissues – To regulate body

processes

• Build, maintain and supply energy

• Phases

– Anabolism ~ builds tissues

– Catabolism ~ forms energy

• Requires nutrients

– Monitor food intake ~ calories/day

– Calories burned during physical activity

Apply Your Knowledge

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.

– Lipids – Vitamins – Minerals – Water

Proteins (cont.)

• Functions

– Building and repairing cells and tissues

– Maintaining water balance

– Antibody production and disease

resistance – Maintaining body heat

– Lower resistance to infection

– Interference with normal growth processes

Proteins (cont.)

– Used to make proteins

– Plant and animal sources

– Three types

• Essential amino acids

• Nonessential amino acids

• Conditional amino acids

Carbohydrates (cont.)

• Converted to

glucose for energy

• Starch

• Fiber

• Functions

– Increases and softens the bulk of stool

– Absorbs wastes and toxins

– Decreases the rate of carbohydrate

breakdown and absorption

• 14 grams / 1000 calories

• Adequate water intake

• Soluble or insoluble

• Source of energy (1 gm = 9 calories)

• Triglycerides and compound lipids

• Functions – essential to growth and

metabolism

• 20% - 30% of daily calories

• Problems related to deficiency or excess

• Unsaturated fats

– Liquid at room temperature

– Vegetable oils

• Polyunsaturated

• Monounsaturated

• Constituent of bile

• Lipid levels

– Cholesterol and triglycerides

– Lipoproteins

• Low-density (LDL)

• High-density (HDL)

• Organic substances

– Essential for normal growth and

maintenance – Essential for resistance to infection

• Absorbed through digestive tract

• Water- or fat-soluble

• Natural, inorganic substances

– Build and maintain tissues

– Carry out life functions

• Major– needed in large quantities

• Trace – needed in small amounts

• Absorbed in the intestines

• RDAs

– Calcium ~ 800 to

1200 mg – Iron ~ 10 to 15 mg

• 55 mcg – women

• 10 mcg – men

– Transports nutrients and secretions

– Flushes out wastes – Regulates body

temperature

• Educate patients about

when to increase fluids

Principal Electrolytes and Nutrients of

Apply Your Knowledge

Matching:

_ 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

J O B

Dietary Guidelines

• USDA Dietary Guidelines

– Encourage people to eat a balanced diet

– Limit consumption of less nutritious foods

– Increase physical activity

– Consistently make good nutritional

decisions

• Key – balance food intake with physical activity

USDA Choose MyPlate Guidelines

American Cancer Society Guidelines

• Achieve and maintain a

health weight

• Adopt a physically active

lifestyle

• Consume a healthy

diet – plant foods

• Limit consumption of alcoholic beverages

Apply Your Knowledge

What is the purpose of the MyPlate initiative?

ANSWER: To remind Americans to eat healthfully

by

balancing calories and reducing portions

increasing fruits, vegetables and whole grains

and switching to fat-free or low-fat milk

Decreasing sodium and sugary drinks and

increasing water

Assessing Nutritional Levels

Assessing Nutritional Levels (cont.)

• Body mass index (BMI)

– Measure of body fat based on height

and weight – Body mass index

calculators

Assessing Nutritional Levels (cont.)

• Measurement of fat as a % of body weight

– Skinfold test – measurement of a fold of

skin with a caliper

– Optimal % differs between

men and women – Aging changes ratio

Apply Your Knowledge

What 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.

Well

– Prevent or treat illness

– High-calorie, protein diet

high-– High carbohydrate

Modified Diets

• Frequency and timing of meals

• Exclusion of certain foods

– Bland diets ~ diverticulosis

Patients with Specific Nutritional

– Vitamin intake – Encourage patient

to follow diet

Patients with Specific Nutritional

Needs (cont.)

• Diabetes

– Goal ~ control of blood glucose level

– Food exchange system

• Seven categories

• Portion sizes – Avoid skipping or delaying meals

– Fiber ~ helps to prevent sharp rise in

blood glucose after a meal

Patients with Specific Nutritional

Needs (cont.)

• Heart disease

– Reduce cholesterol

– Lose weight if needed

– Reduce consumption of fats

• Hypertension

  sodium,  potassium, adequate calcium

– Eliminate or reduce alcohol consumption

Patients with Specific Nutritional

Patients with Specific Nutritional

Specific Modified Diets (cont.)

Apply Your Knowledge

Matching

_ Eliminate foods from diet

_ Food exchange system

_ Hunger drives eating

_ Modification to a soft diet

_ Reduced sodium diet

Eating Disorders (cont.)

– Binge eating followed by purging

– Usually easier to treat than anorexia

– Goals of treatment

• Establish a healthy weight

• Establish good eating patterns

• Resolve psychosocial triggers

Eating Disorders (cont.)

• Getting help

– Rate of recovery poor

– Disorders can become chronic

• Remission and relapse

• May be fatal – Be alert for patient eating or activity

patterns during interviews

Apply Your Knowledge

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 fat.” What should you do?

ANSWER: Document the weight loss and report it to

the physician She may be suffering from an eating

disorder.

• Refer questions to dietitian about

– Meal patterns

– Food selections

Patient Education (cont.)

• Factors to consider

– Anything that affects food choices and

behaviors – Patient age and family circumstances

– Diseases and disorders

– Patient’s psychological condition

• Patient must understand the reasons for the

diet

Patient Education (cont.)

• Guidelines

– Teach patient as an individual

– Teach a small amount at a time

– Keep explanations at patient’s level of

understanding – Let patient be an active learner

– Provide a written diet plan

– Suggest support groups

Patient Education (cont.)

• Cultural considerations

– Influence

• Food purchases

• Like and dislikes

• Meal timing and frequency

• Attitude toward supplements

• Snacking

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!

In Summary

55.1 The body uses food for three major purposes: to

provide energy; to build, repair, and maintain body

tissues; and to regulate body processes Calories

provide energy for the body Calories are measured in

the foods we eat We also can estimate the amount of

calories used by the body during activity.

53.2 The body needs a variety of nutrients for energy,

growth, repair, and basic processes Several food

components provide nutrients These are proteins,

carbohydrates, fiber, lipids, vitamins, minerals, and

water.

In Summary (cont.)

53.3 Dietary guidelines suggest the types and quantities of

food that people should eat each day They also may

contain the recommendations about which types of

foods to limit and which types of foods to increase

MyPlate provides recommendations for eating a

variety of nutrients and maintaining physical activity

Using MyPlate recommendations promotes a

balanced diet and healthy lifestyle.

53.4 Calipers are used to perform a skinfold test that

determines the percentage of body fat BMI is the

body mass index Both measurements, along with

other factors, maybe used to assess a patient's

In Summary (cont.)

55.5 Dietary modifications may be used alone

or in combination with other therapies to

prevent or treat illness.

55.6 Patients with allergies, anemia, cancer,

diabetes, advancing age, heart disease, hypertension, lactose sensitivity, and obesity need special diets In addition

pediatric, pregnant, lactating, and debilitated

patients as well as those undergoing drug

In Summary (cont.)

55.7 You should now the signs and symptoms of

more common signs and symptoms for each include

• anorexia nervosa – unexplained weight loss, starvation, and fear of weight gain

self-• bulimia – eating large quantities of food in a short period of time, going to the bathroom immediately after eating, and using laxatives to excess

• binge eating – eating large quantities of food, not

In Summary (cont.)

55.8 Patients need to be educated about special diets

and how to implement dietary changes as instructed by physicians and dietitians Knowledge of basic nutritional principles and current nutritional

other health insurance companies.

End of Chapter 55

He that eats till he

is sick must fast till he is well.