Lecture Clinical procedures for medical assisting (4/e): Chapter 18 – Booth, Whicker, Wyman

CHAPTER

18
Nutrition and
Special Diets

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18­2

Learning Outcomes
18.1 Describe how the body uses food.
18.2 Explain the role of calories in the diet.
18.3 Identify nutrients and their role in health.
18.4 Recall the Dietary Guidelines for Americans.

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18­3

Learning Outcomes (cont.)
18.5 Explain how the Food Guide Pyramid can be
used to plan a nutritious, well-balanced diet
and healthy lifestyle.
18.6 Describe the test used to assess body fat.
18.7 Explain reasons why a diet may be modified.
18.8 Identify types of patients who require special
diets and the modifications required for each.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


18­4

Learning Outcomes (cont.)
18.9 Describe the warning signs, symptoms, and
treatment for eating disorders.
18.10Educate patients about nutritional
requirements.
18.11Document patient education about nutrition.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


18­5

Introduction
• Nutrition

• Medical assistant –
understand
– How the body
relationship between
takes in and utilizes
nutrition and health
food and nutrients
– Five-part process
•
•

•
•
•

Intake
Digestion
Absorption
Metabolism
Elimination

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


18­6

Daily Energy Requirements
• The body requires
nutrients
– To provide energy
– To build, repair, and
maintain body tissues
– To regulate body
processes

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


18­7

Metabolism

• The sum of all cellular processes that build,
maintain and supply energy to living tissue
• Phases
– Anabolism – nutrients are changed into more
complex substances that are used to build body
tissues
– Catabolism – complex substances are broken down
into simpler substances and converted to energy

• Metabolism affected by age, weight, activity,
state of health, and other factors

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


18­8

Calories
• Kilocalorie (calorie)
– Measurement of energy produced by food
– Amount 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 processes
– Excess calories stored as fat
– Count calories of food eaten and estimate
expenditure for activities

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

18­9

Apply Your Knowledge
1. 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.

2. 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.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


18­10

Nutrients
• Needed for
–
–
–
–

Energy

Growth
Repair
Basic processes

• Energy is only
provided by
– Proteins
– Carbohydrates
– Fats

• Nutrients are
provided by
–
–
–
–
–
–
–

Proteins
Carbohydrates
Fiber
Lipids
Vitamins
Minerals
Water
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18­11

Proteins
• Functions
– Building and repairing
cells and tissues
– Maintaining water
balance
– Antibody production
and disease
resistance
– Maintaining body heat

• 10% to 20% of total
caloric intake daily

• 1 gm = 4 calories
• Deficiency
– Weight loss/fatigue
– Malnutrition
– Lower resistance to
infection
– Interference with
normal growth
processes

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18­12

Proteins (cont.)
• Complete proteins
– Contain all 9 essential
amino acids
– Animal food sources
– Recommend lean
meats, low-fat or skim
milk

• Incomplete proteins
– Lack one or more
essential amino acids
– Plant sources
– Can be combined to
provide all 9 essential
amino acids
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


18­13

Carbohydrates
• Functions
– Provide 2/3 of daily
energy needs
– Provide heat
– Metabolize fats
– Preserve protein for
uses other than

energy production

• 50% to 60% of total
caloric intake daily

• 1 gm = 4 calories
• Deficiency
– Weight loss
– Protein loss
– Fatigue

• Excess contributes to
fat stores

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18­14

Carbohydrates (cont.)
• Simple sugars
– Fruits and some
vegetables
– Milk
– Table sugar

• Complex
carbohydrates

• Excess

– Stored in liver and muscles
cells as glycogen
– Converted into and stored as
fat

– Polysaccharides – long
chains of sugar units
– Types
• Starch – major source of
energy
• Fiber

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18­15

Fiber
• Does not supply
energy or heat
• Functions
– Increases and softens
the bulk of stool
– Absorbs wastes and
toxins
– Decreases the rate of
carbohydrate
breakdown and
absorption

• 20 – 30 gm per day
for adults

• Types
– Soluble
• Absorbs fluid and
swells when eaten
• Slows absorption
• Helps control blood
glucose
• Lowers cholesterol
– Insoluble – promotes
regular bowel
movements

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18­16

Lipids
• Concentrated source
of energy
• 1 gm = 9 calories
• Triglycerides
– Simple lipids
– 95% of dietary lipids

• Cholesterol
– Compound lipids

– 5% of dietary lipids

• Functions
– Provide a
concentrated source of
energy
– Transport fat-soluble
vitamins
– Store energy as body
fat – insulate and
protect organs
– Provide a feeling of
fullness

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18­17

Lipids (cont.)
• Saturated fats
– Primarily from
animal sources
– Solid at room
temperature

• Trans fats

• Unsaturated fats
– Liquid at room

temperature
– Types
• Polyunsaturated
• Monounsaturated

– Formed during
hydrogenation of
vegetable oils
– FDA recommends
zero consumption
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18­18

Lipids (cont.)
• Cholesterol
– Fat-related substance
produced by liver
– Animal-based food
sources
– Essential to health
• Part of cell membranes
• Structural basis for
steroid hormones and
vitamin D
• Component of bile

• Lipid levels
– High cholesterol

• Heart
disease/stroke
• Peripheral vascular
disease

– Lipoproteins
• Carry lipids
through the
bloodstream
• Low-density (LDL)
• High-density (HDL)
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


18­19

Vitamins
• Organic substances
– Essential for normal growth
and maintenance
– Essential for resistance to
infection
– Help the body use other
nutrients
– Assist with body processes

• Absorbed through
digestive tract

• Types

– Water soluble – not stored
by the body
– Fat-soluble – stored by the
body

• Well-balanced diet
usually minimizes
likelihood of vitamin
deficiency

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18­20

Minerals
• Natural, inorganic
substances
– Build and maintain
tissues
– Carry out life functions

• Major minerals –
needed in large
quantities

• Trace minerals – needed
in small amounts
• Absorbed in intestines
• Established RDAs

–
–
–
–

Calcium
Iodine
Magnesium
Selenium

Zinc
 Iron
 Phosphorus


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18­21

Water
• No caloric value
• 65% of body weight
• Functions
– Maintains fluid balance
– Lubricates moving
parts
– Dissolves chemicals
and nutrients
– Aids in digestion

– Transports nutrients
and secretions
– Flushes out wastes
– Regulates body
temperature

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18­22

Water (cont.)
• Fluid balance – intake should equal output
• Patient education
– Explain the importance
of water
– List sources of water

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Principal Electrolytes and Nutrients of Special
Interest
• Electrolytes
– Sodium
• Fluid and acid-base
balance
• Maintains normal
conditions inside and

outside of cells

– Potassium
• Muscle contraction
• Fluid and electrolyte
balance

18­23

– Chloride
• Fluid and electrolyte
balance
• Component of
hydrochloric acid

• Antioxidants – chemical
agents that neutralize
free radicals (by-products
of normal metabolism)

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


18­24

Apply Your Knowledge
Matching:

ANSWER:

F Bulk to stool
___

A. Cholesterol

C Tissue repair
___

B. Antioxidants

H Excess stored as glycogen or fat
___

C. Proteins

G Concentrated source of energy
___
A Produced by liver
___

D. Water

D No caloric value
___

F. Fiber

B Neutralizes free radicals
___

G. Lipids

E Formed during hydrogenation
___

H. Carbohydrates

E. Trans fats

S
U
P
E
R
J
O
B
!

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18­25

Dietary Guidelines
• Established to help people
– Get proper nutrition
– Reduce occurrence of disease
– Control weight

• Designed to encourage healthy eating
habits
• Suggest types and quantities of foods
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.