Module 1:
Introduction to Nutrition
NUTRITION
An interdisciplinary science focused on the
study of how foods, nutrients, and other food
constituents affect health.
It is the study of food and how the body makes
use of it.
It refers to the food people eat and how it
nourishes their body.
NUTRITION
It is the science of food, the nutrients and other
substances therein, their action, interaction
and balance in relation to health and disease
and the processes by which an organism
ingests, digests, absorbs, transports, utilizes
and excretes food substances.
Principles of the Human Nutrition
1. Food is a basic need of humans.
Part of Maslow’s hierarchy of needs
Human need enough food to live and the right assortment of
foods for optimal health.
“FOOD SECURITY” – enough food
“FOOD INSECURITY” – limited or uncertain
> availability of safe, nutritious foods, or the ability to acquire
them in socially acceptable ways is limited or uncertain.
E.g. 14.3 % of US Households
7.7% Canadian Households
Principles of the Human Nutrition
2. Foods provide energy (calories), nutrients, and
other substances needed for growth & health.
People eat food for many different reasons:
CALORIE – a unit of measure of the amount of
energy supplied by food
> Transferred from food to the body
NUTRIENTS – chemical substances in food that the
body uses for a variety of functions
PHYTOCHEMICALS/ PHYTONUTRIENTS – pigments
that act as antioxidants in the body
Principles of the Human Nutrition
3. Health problems related to nutrition originate
within cells.
Nutrient functions at cellular level
The functions of each cell are maintained by the
nutrients it receives – state of OPTIMAL CELLULAR
NUTRIENT CONDITIONS supports hemostasis (BODY)
Disruption in the availability of nutrients or the
presence of harmful substances in the cell’s
environment ---- initiate disease & disorders that
eventually affect tissues, organs and system
Principles of the Human Nutrition
4. Poor nutrition can result from both inadequate
and excessive levels of nutrient intake.
Intake levels below & above this range are associated
w/ impaired cellular functions
“DEFICIENCY” – inadequate NI (Depletion of tissue
reserves of the nutrient)
“TOXICITY” – excessive NI (Saturation of TR of the
nutrient)
Results to physical signs & symptoms
Long term impairment of health
Principles of the Human Nutrition
5. Humans have adaptive mechanisms for
managing fluctuations in food intake.
Conserve nutrients when dietary supply is low
Eliminate nutrients when excessively high amounts
are present
o E.g. Iron, Calcium
Absorption is regulated so that the amount absorbed
changes in response to the body’s need for these
nutrients
o Iron, Calcium, Vitamin A, STORED within the body for
Vitamin B12 (Dietary later use
surplus)
Excess is ELIMINATED
o Vitamin C & Water (Low through urine & stools
storage capacity)
Body down-regulates its
o Low caloric intake & need for energy by Low
Body Temp & Capacity for
significant body weight is Physical Work
lost
Extra is converted to FAT &
o Energy intake exceeds to lesser extent to
need GLYCOGEN later use
Principles of the Human Nutrition
6. Malnutrition can result from poor diet, disease
state, genetic factor, or combinations of these
causes.
Results from either inadequate or excessive availability
of energy or nutrients w/in the cells
PRIMARY Malnutrition
SECONDARY Malnutrition
NUTRIENT-Gene Interaction (Nutrigenomics)
Examples of Effects of Nutrient-Gene
Interaction on Health:
o High alcohol intake during o The fetuses of other
pregnancy in some women women w/ different
increases the risk for FAS genetic traits are NOT
AFFECTED by high alcohol
intake
o Regular intake of green
tea reduces the risk of o Whereas in others, it
prostate cancer in certain does NOT
individuals with
PARTICULAR genetic traits
Examples of SINGLE-gene Disorders that
affect Nutrient Needs
DISOR DER EFFECT
PKU (Phenylketonuria) Causes build up of
Lack of enzyme Phenylalanine phenylalanine in the blood
Hydroxylase High levels during growth
lead to MR & poor growth
GALACTOSEMIA Inability to use galactose to
Interferes w/ the utilization of produce energy
sugar galactose found in MUST AVOID all milk
lactose containing galactose for life
HEMOCHROMATOSIS Absorb more Fe than normal
Produce CHON that controls Excessive levels have toxic
how much Fe is absorbed effects on tissues (liver, heart)
from food Medication, low Fe & Vit. C
Principles of the Human Nutrition
7. Some groups of people are at higher risk of
becoming inadequately nourished than others.
GREATER NEED FOR NUTRIENTS:
Pregnant women or BF mothers
Children
People who are ill
Frail elderly persons
HIGHEST RISK FOR NUTRITIONAL INSULTS:
Poor people
COMPROMISED THE SOONEST & THE MOST
Cases of food shortages (War or Natural Disaster)
Principles of the Human Nutrition
8. Poor nutrition can influence the development of
certain chronic diseases.
Low nutrient intake (Vegetables, Fruits & Whole Grains)
Excessive nutrient intake (Calories & Sugars)
Associated with the development of CHRONIC
INFLAMMATION & OXIDATIVE STRESS
Contribute to the development of more than one
disease & produce disease by more than one
mechanism (YEARS to become APPARENT)
Principles of the Human Nutrition
9. Adequacy, variety, balance, moderation and
nutrient density are key characteristics of a
healthy diet.
Healthy dietary patterns are:
o Plant-based food (REGULAR consumption: V, F&DB)
o Fish & seafood
o Low fat dietary products
o Poultry & lean meat
o Nuts & seeds
o Whole grains
Principles of the Human Nutrition
10. There are no “good” or “bad” foods.
Hotdogs, ice cream, candy, bacon, French fries
Vegetables, fruits & whole grains
People tend to classify foods as good or bad
NO FOOD can be firmly labeled as good or bad
All foods can fit into a healthful diet as long as nutrient
needs are met at calorie-intake levels that maintain a
healthy body weight.
Why is nutritional science
applied to nursing?
The recognition of the role of nutrition in
preventing diseases or illness.
The concern for adapting food patterns of
individuals to their nutritional needs within the
framework of their cultural, economic and
psychological situation.
The awareness of the need in specified disease
states to modify nutritional factors for
therapeutic purpose.
FOOD
ANY SUBSTANCE, organic or inorganic, when
ingested or eaten nourishes the body by:
supplying heat and energy
building and repairing tissues
regulating body processes.
FOOD
In any article, whether simple, mixed or
compound, which is used as a drink or food,
confectionary or condiment. It includes
articles used as component for such.
(Food and Drug Administration)
Factors Influencing
Food Selection:
Food Availability Ethnic
Food Palatability Heritage/Tradition
Cost and Food Industry &
Convenience Media
Social Factors
Psychological
Factors
Nutritional factors
NUTRIENT CLASSIFICATION
1. According to FUNCTION:
Energy-giving nutrients – energy source for
metabolism
Structural/body building – support
structural components of cells and tisues
Regulatory – maintains homeostasis &
speeds up metabolism
NUTRIENT CLASSIFICATION
2.According to CHEMICAL NATURE:
Organic – CHO, CHON, Fats, Vitamins
Inorganic – Minerals, Water
NUTRIENT CLASSIFICATION
3.According to ESSENTIALITY:
Essential – Required in the diet bec. it
cannot be synthesized by
the body
Non-essential – present in food but do
not have to be part of the diet
NUTRIENT CLASSIFICATION
4. According to CONCENTRATION:
Macronutrients – needed in LARGE amount,
provide energy in the form of kcal
Micronutrients – needed in SMALL amount,
needed for other important functions
of the body
NUTRITIONAL STATUS
Nutritional status or Nutriture - individual’s
physiological need for nutrients is being met
by the food he is eating --- a state of balance
in the individual between the nutrient intake
& nutrient expenditure or need.
Optimum or good nutrition - body has
adequate supply of essential nutrients that
are efficiently utilized such that growth and
good health are maintained at the highest
possible level.
NUTRITIONAL STATUS
Malnutrition or poor nutrition is a
condition that results from lack of one
or more essential nutrients or it may
be due to excessive nutrient supply to
the point of creating harmful or toxic
effects
FORMS OF MALNUTRITION
Undernutrition is pathologic process
resulting from the consumption of
inadequate quantity of food over an
extended period of time.
Overnutrition is a pathological state
resulting from the consumption of an
excessive quantity of food over an
extended period of time
NUTRITIONAL STATUS
Nutritional deficiencies may be caused by a
primary factor or secondary (conditioning
factors).
Primary factor - refers to faulty diet
Secondary factors - all conditions within the
body that reduce the ultimate supply of
nutrients to the cells
FORMS OF MALNUTRITION
Specific Deficiency - is a pathological
state resulting from a relative or
absolute lack of an individual nutrient.
Imbalance - is a pathological state
resulting from a disproportion among
the essential nutrients
Nutrition Problems in the Philippines
2015 Updating of the Nutritional Status of Filipino Children by Food
and Nutrition Research Institute (FNRI)
Philippines - facing the worst chronic malnutrition rate among
children aged 0-2 years old at 26.2% in the last 10 years.
Overall chronic malnutrition or stunting rate for children under-5
years old has significantly increased to 33.5% from 30.5 in 2013.
Reduction of acute malnutrition or wasting, where a child suffered
starvation & illness, there has been almost no progress in the
national data.
“The latest national data also show that children born to the
poorest mothers are thrice likely to suffer from stunting. This
means that we need to double our efforts to ensure that nutrition-
related policies and programs reach the most vulnerable.”
1.Protein-Energy Malnutrition
Kwashiorkor
Undernutrition – consuming adequate energy & insufficient
high quality CHON
Depigmentation of the hair and skin, edema in the limbs
and flabby moonlike face, growth failure, skin lesions,
apathy & low resistance to infection
Often develops in a child, after weaning from breast, on the
birth of next sibling is given a diet consisting mainly of
starchy foods or sugar-water. Hence, child may get calories
but not protein
KWASHIORKOR
1.Protein-Energy Malnutrition
Marasmus
Characterized by a shrunken, wizened “old man’s face”
or “monkey face”, living skeleton with skin and bone
Lacking in calories (protein, fats & carbohydrates)
From the Greek word “wasting”
Due to inadequate breastfeeding or improper
(diluted)milk formula
MARASMUS
2.Vitamin A Deficiency
XEROPHTHALMIA
Results to poor eyesight in extreme cases,
blindness, low body resistance to diseases and
skin will become rough and dry
Vitamin A-deficiency
3. Anemia (IRON Deficiency)
• Common among infants 3 months to 2 years of age
• In toddlers, anemia is traced to slow chronic
unsuspected bleeding brought about by intestinal
parasites
Parasites
• interfere with nutrient utilization by competing with
their host for their own food needs.
• It can also be found to a school child, adolescent,
adult and aged people.
4. GOITER (Iodine Deficiency)
Findings of the Department of Health revealed
that this country has the most goiter cases in
Southeast Asia.
5.Excessive of Nutrition
Obesity
Causes of Malnutrition:
– Poverty
– Faulty food intake
– Large family size
– Low level of education
(Household members)
– Intra-familial food
distribution
– Urbanization
– Widespread incidence of
infectious diseases &
parasitism (poor
sanitation)
– Low food expenditure
– Poor distribution of food
supply
Effects of Malnutrition
Increased susceptibility to infections
Impaired physical and mental development
Impaired national development (social & economic
burdens)
In health, additional burden of medical services,
hospitalization, etc.
In education, more school absences, dropouts,
etc. thereby reducing the number and
quality of our manpower potentials
In agriculture and industry, losses through
performance, absenteeism & accident
processes
In socio-political context, it means greater unrest
and disorder
NURSES
Vital link between the client & other HCP.
(physician, pharmacist, dietician)
In a unique position to recognize alterations
related to inadequate intake, disorders of
digestion, or absorption & overeating.
Critical role both for the implementation of
nutritional support & for ongoing assessment.
(Nurse administers, monitors nutritional
therapies & evaluate)
THE NURSING PROCESS
Diagnosis Evaluation
Implementation
Serves Client
Assessment Nutrition therapy &
framework as outcomes
Community- Client teaching
for the plan of were
level care. Increase/decrease achieved:
Individual Planning: Limit/avoid Partially-
level Reduce/encourage met
Give client the
opportunity to Modify/maintain or Not
actively achieved at
participate in all
goal-setting
NUTRITIONAL ASSESSMENT
Community-Level Assessment
Identify a population status using broad nutrition &
health indicators
Targets community’s “state of nutritional health”
Uses:
Existing vital statistics data
Seeking opinion of target group members & local
health experts
Making observation
Assessment of Nutriture
(Operation Timbang)
Through a nationwide survey malnourished children
are identified and located in the community.
Weights of children under five years old (0 – 72 months
old) are taken & classified as to their nutritional status.
Usually done after/before massive deworming.
Twice in a year by local Barangay Nutrition Scholars.
RLE: CHN
Community Health Diagnosis (CDx)
Identify key nutrition concerns & issues
Used to develop community-wide programs addressing
specific problem areas
E.g.
Childhood Malnutrition
Iron Deficiency Anemia
Presence of other health-related disease
NUTRITIONAL ASSESSMENT
Individual-Level Assessment
Provides the baseline for anticipatory guidelines &
nutrition intervention
Four major components:
Clinical/ Physical Examination
Dietary Assessment
Anthropometric Assessment
Biochemical Assessment
ASSESSMENT OF NUTRITIONAL STATUS
1. Clinical/ Physical Examination
Visual inspection of a person by a qualified
profession to note features that may be R/T
malnutrition or suggest nutrition-related problems
Physical characteristics are nonspecific indicators
but can support other findings
ASSESSMENT OF NUTRITIONAL STATUS
2. Dietary Assessment
2. Dietary Assessment
24-Hour Recall & Record
Completed by clients
Estimate the person’s overall
diet quality – intake of specific
nutrients
Identify strengths &
weaknesses
Multiple days is needed to
obtain a reliable estimate of
food groups, calories &
nutrients
2. Dietary Assessment
Dietary History
Require an interview by a trained
professional
24˚ recall modified to represent
usual intake - careful deliberation
over food types & portions
Cross-checked frequency
questionnaire that confirms 24˚
usual dietary intake information
2. Dietary Assessment
Food Frequency Questionnaire
Used to estimate food
nutrient intake of groups of
people
Force people into describing
food intake based on limited #
of food choices & portion
sizes
Relatively expensive to
administer & tabulate
2. Dietary Assessment
Internet Dietary Assessment Resources
High-quality interactive program that provides
an analysis of nutrient & food intake
Food Tracker (MyPlate.gov site)
USDA’s Automated Multiple-Pass Dietary Recall
(24˚ Dietary Recall)
The Healthy Eating Index (HEI) – population
monitoring of dietary quality, evaluation of
interventions & research
ASSESSMENT OF NUTRITIONAL STATUS
3. Anthropometric
Assessment
Individual measures of body size:
Height & weight
Percent body fat
Bone density
Head & waist circumference
.
Age 20–29 30–39 40–49 50–59 60+
12– 14– 16– 17–
Male 7–17%
21% 23% 24% 25%
Femal 16– 17– 19– 22– 22–
e 24% 25% 28% 31% 33%
e American College of Sports
Medicine has shared guidelines for
body fat percentage by sex and age.
Falling within these ranges is
considered “ideal.”
If you have too little body fat, your
body may not have enough energy to
carry on with the day’s tasks. If you
have too much body fat, you may
increase your risk of developing
hypertension, high cholesterol,
diabetes, and heart disease
ASSESSMENT OF NUTRITIONAL STATUS
4. Biochemical Assessment – laboratory assessment
Nutrient & enzyme level
Gene characteristics – “NUTRIGENOMICS PROFILE”
Other biochemical markers dependent on what
problems are suspected based on other evidences
END OF
INTRODUCTION TO
NUTRITION
