Chapter 49 - Nutrition and special diets. This chapter gives you an understanding of how a well-planned diet can lead to optimal health and well-being for your patients. After completing this chapter, students will be able to: Describe how the body uses food, explain the role of calories in the diet, identify nutrients and their role in health, recall the dietary guidelines for Americans,...
CHAPTER 49 Nutrition and Special Diets © 2011 The McGraw-Hill Companies, Inc All rights reserved 492 Learning Outcomes 49.1 Describe how the body uses food 49.2 Explain the role of calories in the diet 49.3 Identify nutrients and their role in health 49.4 Recall the Dietary Guidelines for Americans © 2011 The McGraw-Hill Companies, Inc All rights reserved 493 Learning Outcomes (cont.) 49.5 Explain how the Food Guide Pyramid can be used to plan a nutritious, well-balanced diet and healthy lifestyle 49.6 Describe the test used to assess body fat 49.7 Explain reasons why a diet may be modified 49.8 Identify types of patients who require special diets and the modifications required for each © 2011 The McGraw-Hill Companies, Inc All rights reserved 494 Learning Outcomes (cont.) 49.9 Describe the warning signs, symptoms, and treatment for eating disorders 49.10Educate patients about nutritional requirements 49.11Document patient education about nutrition © 2011 The McGraw-Hill Companies, Inc All rights reserved 495 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 496 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 497 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 498 Calories • Kilocalorie (calorie) – Measurement of energy produced by food – Amount of energy needed to raise the temperature of 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 499 Apply Your Knowledge 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 © 2011 The McGraw-Hill Companies, Inc All rights reserved 4910 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 © 2011 The McGraw-Hill Companies, Inc All rights reserved 4941 Apply Your Knowledge Matching ANSWER: _ C Eliminate foods from diet E Food exchange system _ F Decreased metabolism _ Yippee! for 2! A Change in texture B Children C Food allergies B Hunger drives eating _ A Modification to a soft diet _ D Parenteral nutrition H Reduced sodium diet _ F Elderly D Bypasses GI tract _ G Drug therapy G May alter food intake and absorption _ H Change in nutrient level E Diabetes © 2011 The McGraw-Hill Companies, Inc All rights reserved 4942 Eating Disorders • Extremely harmful eating behavior • Anorexia nervosa – Self-starvation – Treatment • Restore normal nutrition • Psychotherapy • Education of nutrition concepts – Chronic condition – can be fatal © 2011 The McGraw-Hill Companies, Inc All rights reserved 4943 Eating Disorders (cont.) – Bulimia • Binge and purge by vomiting, diuretics, laxatives • Usually easier to treat than anorexia • Treatment – Medication – Psychotherapy • Goals – Establish a healthy weight – Establish good eating patterns – Resolve psychosocial triggers © 2011 The McGraw-Hill Companies, Inc All rights reserved 4944 Eating Disorders (cont.) • Getting help – be alert to patient report of – Skipping at least two meals per day – Uncontrolled eating of large amounts of food – Using laxatives or other purges to control weight – Avoiding social situations that interfere with diet or exercise – Feeling disgust, depression, and guilt after binge – Feeling that food controls life © 2011 The McGraw-Hill Companies, Inc All rights reserved 4945 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 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 © 2011 The McGraw-Hill Companies, Inc All rights reserved 4946 Patient Education • Reinforce nutrition instructions • Teach patient – Role nutrition plays in preventing illnesses – How to be wise consumers by reading food package labels • Factors – Patient likes and dislikes – Patient age and family circumstances – Diseases and disorders – Patient’s psychological condition © 2011 The McGraw-Hill Companies, Inc All rights reserved 4947 Patient Education (cont.) • Guidelines – Teach patient as an individual – Teach a small amount at a time – Keep explanations at patient’s level of understanding – Reinforce good eating behavior – Let patient be an active learner – Provide a written diet plan – Suggest support groups © 2011 The McGraw-Hill Companies, Inc All rights reserved 4948 Patient Education (cont.) • Cultural considerations – Influence • • • • • Food purchases Like and dislikes Meal timing and frequency Attitude toward supplements Snacking – Adjust diet and recipes accordingly © 2011 The McGraw-Hill Companies, Inc All rights reserved 4949 Apply Your Knowledge What 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! © 2011 The McGraw-Hill Companies, Inc All rights reserved 4950 In Summary 49.1 The body uses food for three major purposes: to provide energy; to build, repair, and maintain body tissues; and to regulate body processes 49.2 Calories provide energy for the body Calories are measured in the foods we eat We can also estimate the amount of calories used by the body during activity 49.3 The body needs a variety of nutrients for energy, growth, repair, and basic processes There are several food components that provide nutrients These are proteins, carbohydrates, fiber, lipids, vitamins, minerals, and water © 2011 The McGraw-Hill Companies, Inc All rights reserved 4951 In Summary (cont.) 49.4 Dietary guidelines suggest the types and quantities of food that people should eat each day They may also contain recommendations about which types of foods to limit and which types of foods to increase 49.5 The Food Guide Pyramid provides recommendations for eating a variety of nutrients and maintaining physical activity Following the Food Guide Pyramid recommendations promotes a well-balanced diet and healthy lifestyle 49.6 Calipers are used to perform a skinfold test that determines the percentage of body fat © 2011 The McGraw-Hill Companies, Inc All rights reserved 4952 In Summary (cont.) 49.7 Dietary modifications may be used alone or in combination with other therapies to prevent or treat illness 49.8 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 therapy, need modifications to their diet © 2011 The McGraw-Hill Companies, Inc All rights reserved 4953 In Summary (cont.) 49.9 You should now the signs and symptoms of eating disorders in order to evaluate for these disorders during the patient interview Some of the more common signs and symptoms for each include: – anorexia nervosa – unexplained weight loss, selfstarvation, and fear of weight gain – 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 – not followed by purging and weight gain © 2011 The McGraw-Hill Companies, Inc All rights reserved 4954 In Summary (cont.) 49.10 You may play a major role in educating patients about special diets and in helping them to implement dietary changes as instructed by physicians and dietitians Knowledge of basic nutritional principles and current nutritional findings will help you perform these tasks with confidence and competence 49.11 Documenting nutritional education is part of preventative health care practice and is required to help ensure payment by managed care and other health insurance companies © 2011 The McGraw-Hill Companies, Inc All rights reserved 4955 End of Chapter 49 He that eats till he is sick must fast till he is well. ~English Proverb © 2011 The McGraw-Hill Companies, Inc All rights reserved ... activity needs • Color coded – – – – – – Orange – grains Green – vegetables Red – fruits Yellow – oils Blue – milk products Purple – meats/beans • Action figure – physical activity Food Pyramid... Growth Repair Basic processes • Energy is only provided by – Proteins – Carbohydrates – Fats • Nutrients are provided by – – – – – – – Proteins Carbohydrates Fiber Lipids Vitamins Minerals Water... 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