NUDIET LECTURE

PROF. MENCHIE PAGDILAO

21 August 2020 / Prof. Pagdilao
DIETETICS VS. DIET THERAPY
OUTLINE DIETETICS
I.INTRODUCTION  Combined science and art of regulating and planning,
preparing and serving of meals to individuals or groups
I. Introduction
II. Principles in promoting according to principles of nutrition and management with due
good nutrition consideration to economic social and psychological factors

NUTRITION DIET THERAPY

 Study of food in relation to health of an individual, community  Branch of dietetics specialized in the use of food for the
or society and the process through which food is used to treatment of disorder disease
sustain life and growth  Planned diet must be eaten to maximize effectiveness
 Study of essential nutrients and the process by which nutrients
are used by the body FOOD
 Study of the process by which an organism ingests, digests,  Any substance, organic or inorganic when digested or eaten
absorbs, transports, utilizes and excretes food substances nourishes the body by:
Cornerstone (foundation or basis to have holistic health)  Building and repairing tissue
 Supplying heat and energy
Food of Good Health  Regulating/metabolic process
“Right kind and amount of food eaten at the right time” “Food also sustains life”

Nutrition is the cornerstone of each health dimension: FOOD SELECTION

 Physical health: If we don’t eat food at the right time then we  Food preferences
do not have enough energy o Foods chosen to be eaten when all foods are available at the
 Intellectual health: ability to learn and adapt same time
 Emotional health: eating chocolate when sad  Food Choice
 Social health: interact with people o Specific foods that are convenient to choose when we are
 Spiritual health actually ready to eat
 Food liking
ROLES OF NUTRITION o Food we really like to eat
Wellness
 A lifestyle that enhances each of the five dimensions of health Food choices are affected by
Wellness nutrition  Money: what you can afford
 An approach to food consumption as a positive way to nourish  Time:30 minutes break so you go to canteen mahal or carkpark
our body na farther away
 Organize our lives so we can easily follow a healthy eating  Work patterns
pattern  Cooking skills
 Emotions
NUTRITION EDUCATION  Family traditions
1. Utilized to promote positive behavior changes:
 Assortment FOOD LIKES
o eating variety of food from every food group  Security foods, reward foods
 Balance  Fetish foods, show off foods
o Provide food from all food groups in quantities so essential  Grown up foods, advertised foods
nutrients are consumed in proportion to each other
2. May be given through FOOD DISLIKES
 formal  Cultural taboo foods, religious taboo
 non formal: outside classroom  Familial and individual taboo foods
 informal:
PLEASURABLE /UNPLEASURABLE ASSOCIATION FOODS
REASONS WHY NUTRITIONAL SCIENCE IS APPLIED IN  Familiarity on food preparation
NURSING CARE  Easy/heard to prepare
-health teachings  Sanitary/filthy source
-we should know the food patterns (of the patient  Allergies
1. prevention of diseases or illnesses
2. to adapt food patterns within the framework of individuals’ AGREEABLE/DISAGREEABLE SENSORY PROPERTIES
cultural, economic and psychological situation and style  Spoiled/unspoiled
3. to modify the nutritional factors for therapeutic purposes  Color odor, taste texture and temperature
FUNCTIONS OF NUTRITION IN RELATION TO NURSING QUALITIES OF GOOD FOOD
FUNCTION  It is nourishing or nutritious
NUTRITION NURSE  It has satiety value
To sustain life To sustain and support persons through
 Prepared under sanitary conditions, aesthetically and scientifically
times of dependence and need
 It is free from toxic agents
To promote growth To promoted personal growth and restore
 Its palatability factors satisfy with customers
health
 Offers variety and planned within the socioeconomic context
To replace loss To replace the loss of selfcare and help
maintain a sense of personal wholeness
Calorie (Kcal)
To provide energy To help provide emotional strength to
 Unit of energy measurement
cope with the total experience of illness
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 Amount of heat required to raise the temperature of  0.005% of body weight

 1kg of water by 1degree Celsius  CHON,CHO,Fats Ca, P, K, Na
Fuel factors  Micronutrients
 1g of carbo =4cal  0.005% of body weight
 1g of protein =4cal  Vitamins, Fe, Iodine, Fluorine
 1g of fat=9cal
» Energy needed for an activity ENZYMES VS. HORMONES
» When energy requirements are completely met by caloric intake ENZYMES
people maintain their activity level without wright change  Organic catalysts that are protein in nature and produced by
» An adequate diet is the foundation of good nutrition living cells.
• Hastens chemical reactions without itself undergoing changes.
NUTRIENTS • Usually ends in “-ase”. E.g. Maltase, amylase, etc.
 Chemicals or substances in food required by the body for heat and
energy to build and repair tissues and to regulate body processes HORMONES
 Some are manufactured in the body thru biosynthesis, others are  Organic substances produced by special cells in the body
man made discharged into the bloodstream to be transported to specific
 Essential nutrients are organs and tissues remote from the point of manufacture.
o Water  Regulate vital processes which are highly specific
o CHO  Some are protein in nature other lipid related
o CHON
o Fats Ex. Of hormones with direct involvement to nutrition
 Posterior pituitary: Vasopressin
o Vitamins
 Anterior pituitary: Lipotropin
o Minerals
 Parathyroid: Parathyroid hormone, calcitonin
ESSENTIAL NUTRIENTS  Thyroid: Thyroxine
C.P.F.V.M.W.  Pancreas: Insulin, glucagon
Carbohydrates (CHO)  GI: Gastrin, secretin, cholecystokinin
 Major source of fuel
 Simple- white sugar fruits and milk Happy hormone: FROM BANANA
 Complex -c cereals, grains, pastas and vegetable
Protein NUTRITIONAL STATUS (NUTRITURE)
 performs extensive range of function aside from being a source Optimum Good Nutrition
of energy  Body has adequate amount of essential nutrients that are
 Contains essential and non-essential amino acids efficiently utilized such that growth and good health are
Fats/lipids maintained at the highest possible level
 Densest form of energy Malnutrition
 Roles in hormone production and padding of body organs  Lack of one or more essential nutrients (nutritional deficiency)
 Triglycerides, phospholipids and sterols  Or excessive nutrient supply to the point of creating harmful
Vitamins effects (over nutrition)
 Indirectly assists other nutrients in various body processes
 Fat soluble and water-soluble vitamins CAUSES OF MALNUTRITION
Minerals Primary Factor
 Structural purposes a  Refers to faulty diet
 Body functions  Inadequate intake
 Major and trace minerals o Poverty
Water o Ignorance
 Major part of every tissue in the body o Poor food habits (due to poverty)
 Comprises 60-70% of total body weight o Limited food supply
o Poor distribution of food
NURSING CLASSIFICATION
o Cultural taboos
F.C.C.C
Secondary factors
A. According to Function:  Refers to all condition within the body that reduce the nutrient
1. Body building supply of the cells
 Form tissues  Inefficient use of the nutrient
2. Energy giving o Digestion
3. Regulate processes o Absorption
o Metabolism and utilization
B. According to Chemical Nature o Increased excretion
 Organic- CHON, CHO, Fat & Vitamins
 Inorganic PATHOGENESIS OF NUTITIONAL DEFIECIENCY DISEASE

C. According to Concentration Dietary deficiency Tissue Depletion Biochemical

(Primary factor) lesions or changes
 Dietary Essential
 Cannot be made by body must be provided by food Nutritional deficiency Depletion of Functional changes
 Non-essential nutrient
reserves
 Body can make on its own Conditioning factors Anatomic changes
(Secondary factors)

D. According to Concentration PART 2

 Macronutrients PRINCIPLES IN PROMOTING GOOD NUTRITION

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1. The body requires food to 2. Weight for height

 Provide energy for organ function, movement and work  Used for adults, useful in assessing acute malnutrition
 Maintain body temperature (obesity and wasting)
 Provide raw mineral for enzyme function growth,  Body Mass Index (BMI) = Weight (kg)/height in m)^2
replacements of cells and repair o 20-25 Normal
2. The process of digestion absorption and metabolism work together o 27.5-30 Mild Obesity
to provide all body cells with energy and nutrients o 30-40 Moderate Obesity
3. Man’s energy/requirements vary is influence by many factors such o Above 40 Severe Obesity
as
o Age 3. Hahmwi Method
o Body size a. Ideal weight based on height
o Gender  Men 160lbs (first 5 feet of height) +6 lbs for each
o Climate additional inch
o Sleep  Women: 100lbs (first 5 feet of height) +5 lbs for each
o Physiologic stress (pregnancy lactation) additional inch
o Pathological disorders (diabetes)  Add or subtract 10% depending on body frame
o Activity/Occupation
o Life style b. Height for age
4. Foods are described according to the density of their nutrients  Reflects skeletal growth for age, also used in young
o Nutrient density-the proportion of essential nutrients to children, helpful in diagnosing chronic undernutrition
the number of calories
5. Nutrient content is variable c. Mid upper arm circumference (MUAC)
o Enrichment- the addition of vitamin/or minerals to the  Estimate muscle mass hence the protein & energy
food at a concentration level in excess of the amounts reserves at the mid-arm area; used only on 1-4 yrs. old
naturally present in food. Ex. Rice enriched with age group
thiamine  For rapid screening
o Fortification- the food is used as a vehicle to carry the  13cm or more=normal
added nutrients which are absent originally in that food  Less than 13 cm=wasting
ex. Rice is fortified with vitamins
6. When energy requirements are completely met by caloric intake, d. Triceps skin fold
people maintain their activity level without weight change  Measures the amount of subcutaneous fat
7. An adequate diet is the foundation of good nutrition and it should  Used for adults only
consist of a wide variety of foods  Normal value is 1in
8. Measures for improvement of nutritional status are:
o Nutrition education
o Abundant food supply
o Use of various resources
9. Malnutrition is brought about faulty diet and conditioning factors
10. Study of nutrition is interrelated with arts and sciences

NUTRITIONAL ASSESSMENT OTHER WAYS TO ASSESS NUTRITIONAL STATUS

 Process of determining nutritional status
 With 4 Components (A,B,C,D) Biochemical tests
o Anthropometry  Blood Hgb & Hct,serum albumin, transferrin
o Biochemical tests  Urine-creatine excretion
o Clinical Examinations
Chemical examination
o Dietary Surveys
 Detects physical symptoms associated with malnutrition
 Hair, skin, eyes, tongue, etc.

Medical history
 Reveal secondary factors to malnutrition
ASSESSING NUTRITIONAL STATUS
Physical/Instrumental Method (Anthropometry) Dietary survey
Weight -reflects BODY MASS  Evaluate primary factor of nutritional inadequacy
1. Weight for age o Food recall
 used in under 5yrs old children as in Operation Timbang o Food record
 Helpful in diagnosing acute undernutrition (wasting) & o Food inventory/diary
chronic undernutrition (stunting) o Dietary history
 Gomes classification of nutritional stay based on
percentage of expected body weight 1. 24hr food recall
 Formula % of EBW =ABW/EBW  Recall all food and beverages the client consumes during a
Classification typical 24-hour period
 110% of EBW overweight  Usually gathered in a personal interview or by telephone
 91-110 = normal  Evaluated according to the food guide pyramid
 76-90=1dt degree undernutrition
 61-75= 2nd degree of undernutrition 2. Food Frequency record
 60 or less = 3rd degree of undernutrition
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 TIGULO NUDIET LEC
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 Checklist that indicates how often general food groups or

specific foods are eaten Food group/ Food guide pyramid (FCT)
 May be categorized as times/day, times/week, times/month or  Food containing high levels of certain nutrients or group
frequently, seldom, never together and the serving portions are stated in household
 Helps to focus on groups of foods that are either deficient or measures for the layman to understand
excessive
Nutrient density
3. Food Diary/Periodic Food Records  Relative measure of nutrients and food and proportion to its
 Detailed record of measure amount (proportion (sizes) of all calorie content
food and fluids a client consumes during a specific period,  A nutrient that can carry out one function is equally essential
usually 3-7 day as nutrient with three functions
 Helpful for assessing food patterns  Index of nutrient quality (INQ) =
%RDA of the nutrient /%energy requirement
4. Diet history  If INQ is one or more for at least 4 nutrients and INQ of two
 Comprehensive time-consuming assessment of a client's food or more for these two nutrients = food is considered nutritious
and take that involves an extensive interview by a nutritionist  Example in liver 7 lean chicken meat= liver is more iron dense
or dietician than chicken
 Includes characteristics of foods usually eaten as well as the
frequency and amount of food consumed may include a 24- Use of computers
hour recall a food frequency record a food diary  Nutrition education
 Data are gathered through interviews or questionnaires  Recordkeeping jobs
 Dietary analysis
 Diagnosis
 Information storage and retrieval
 Prediction and forecast
 Robotics
 Etc.

Nutritional labeling
 label should have the following format
BASIC TOOLS IN NUTRITION
o Calories
o CHON
Dietary reference intakes
Standards used to: o CHO
 Review scientific data on a specific nutrient o Fat
 Assess functions of nutrients to reduce chronic diet related o vitamin C and A
conditions
 evaluate current data on nutrient consumption ¦ WHEN PRESENTING IN LAB DAPAT SUPPER
ORGANIZED
Dietary standards ¦ REFERENCE IS IN THE COURSE SITE WHICH IS IN THE
 Provide a guide to adequate nutrient intake levels against BOOK
which to compare neutral use of food consumed ¦ ideal time of eating
¦ 7am breakfast
Dietary requirement ¦ 10am snack
¦ 12pm lunch
 Is the minimum amount of nutrients needed to provide for
¦ 4pm snack
basic physiological functioning of our bodies
¦ 6pm dinner
Recommended dietary allowance (RDA)
Transcription of Butot balat
 Is the minimum requirement plaza safety factor or margin of
In a country that boasts of rich natural resources, there's a shocking
safety to account for variations in individual needs
reality that still needs government and citizens’ attention. Kara David
 Level of nutrient intake sufficient to meet the needs of almost
finds extreme cases of malnutrition and reveals its shocking extent in the
all healthy individuals
country. The Philippines ranks second to the African average in terms of
malnutrition, and first in the Asia-Pacific region. United Nations
Adequate intake (AI)
Children's Fund (Unicef) studies show 29% of African children are
 Approximate level of an average nutrient intake with a sample malnourished, while Filipino kids follow closely at 27%. I-Witness finds
population one of the worst manifestations of this problem in a town in the Bicol
region. Mercedes is Bicol’s seafood capital. Each day, bountiful catch of
Tolerable upper intake level (UL) fish arrives on its shores. Ironically, although blessed with rich marine
 Level of nutrients intake that should not be exceeded to resources, there are extreme cases of starvation among some locals.
prevent adverse health risk Angela’s family relies on fishing for a living. If her father gets no catch,
they would not have anything to eat. At 19 years old, Angela was reduced
Food exchange list to skin and bones and was bed-ridden for more than three months. Soon
 Is a system of grouping of common foods that have practically after this documentary was made, the girl succumbed to death because of
the same amount of CHON, CHO and fat severe malnutrition. According to surveys, with four in 10 children
considered malnourished. Bicol has the worst case of malnutrition among
Food consumption table the country’s regions. Not far from Angela’s house, one may indeed find
 Lift the chemical composition of a food whether of plant or some other kids who have suffered the same fate. It pains Mang Ciriaco,
animal origin a market stevedore, that abundant catch of expensive fish pass through his
 With variations according to kind breed part soil fertility and hands but he never gets the chance to actually serve them to his own
uncontrollable factors children. Forhis work, he earns an average of 30 pesos a day — money
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 TIGULO
that can hardly afford him to buy the sub-standard fish sold in the market
at very cheap prices. Mang Ciriaco carries the heavy burden of feeding
nine children. The constant lack of decent meals has greatly manifested
on his children. His six-year old son Joey weighs only that of a three-
month old baby, while his 14-year old son Jeremy weighs only that of a
two-year old boy. When examined by the local health workers, it was
found out that Jeremy's lungs, due to severe malnutrition, struggles to use
his lungs to breathe. Kara David also encounters babies whose stomachs
have never known milk, with their parents resorting to instead giving
them coffee. Malnutrition also exists among children in the National
Capital Region. Instant noodles have become today’s poor man’s diet.
Not only are these affordable to families, who only get by with 30 pesos a
day, but it can also make them feel full easily. The estimate of five
million Filipino children suffering from severe malnutrition proves to be
largely alarming. Finding a long-term solution to the problem can never
be realized if we refuse to acknowledge that this issue exists. Dr. Cecilia
Florencio of the University of the Philippines sums up what may become
its repercussions: "Malnutrition can be passed on to generations. Right
now, these kids are the only ones affected. But if you’re really think
about it, these kids will be our future generation…and they are
malnourished."
Important points
 Despite being a country with many resources there have findings
of cases of extreme malnutrition
 Philippines ranks second to the African average in terms of
malnutrition, and first in the Asia-Pacific region.
 (Unicef) studies show 29% of African children and 27% of
Filipino are malnourished
 Worst manifestation found in Bicol (blessed with marine source
and that Mercedes is Bicol’s seafood capital), extreme case of
starvation in locals
 Angela’s family relies on father’s livelihood fishing to eat
 At 19 years old, Angela was reduced to skin and bones and was
bed-ridden for more than three months
 four in 10 children considered malnourished (according to
survey)
 Bicol has the worst case of malnutrition among the country’s
regions
 Mang Ciriaco, a market stevedore, that abundant catch of
expensive fish pass through his hands but he never gets the
chance to actually serve them to his own children.
 Forhis work, he earns an average of 30 pesos a day — money that
can hardly afford him to buy the sub-standard fish sold in the
market at very cheap prices.
 Mang Ciriaco carries the heavy burden of feeding nine children
 six-year old son Joey weighs only that of a three-month old baby,
while his 14-year old son Jeremy weighs only that of a two-year
old boy
 Jeremy's lungs, due to severe malnutrition, struggles to use his
lungs to breathe.
 Discovers a baby that never had milk and parents gave coffee
 The estimate of five million Filipino children suffering from
severe malnutrition
 Usually eats instant noodles because it is feeling and cheap for an
income of 30 pesos a day
Transcript of supersize me
Cannot get whole transcript nor summarize points because the movie can
be depicted in many ways
So far these are the best links I can find that can explain the details of the
video
https://www.youtube.com/watch?v=8Ym2E3gEN48
https://www.rogerebert.com/reviews/super-size-me-2004
https://www.gradesaver.com/super-size-me/study-guide/summary
https://www.imdb.com/title/tt0390521/plotsummary
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NUDIET LEC
BLOCK 9
SUPERSIZE ME
1. Why do people eat at fast food restaurants?
2. What are the disadvantages of eating at fast food restaurants?
3. Is it fair to point the blame at Mcdonald’s?
4. How much influence do you think the media has on the way
we select the food that we eat?
5. How will this documentary influence your future food choices
and perception of health?
6. Are they any changes in food and beverage choices that you
would like to recommend to fast food restaurants?
SALAT
1. Explain the different determinants of health and nutrition in
terms of environmental, personal, psychological, lifestyle factors that are
reflected on the film?
2. Explain how poor eating habits impact on the overall health
status.
3. As a student nurse studying Nutrition, how can you help
contribute to the resolution of these health-related issues and concerns?
deadline before Thursday
next topic is malnutrition
Supersize Me depicts a man, Morgan Spurlock, showing the effects of a
30-day McDonalds diet he was inspired by the obesity trend, a growing
problem in America. He starts the experiment with a healthy weight,
good blood levels and 11% body fat. We can see in the first few minutes
he enjoys his food but later on shows signs of discomfort. Along the
period of his 30-day diet it was shown that he fully committed to the
lifestyle through eliminating exercise and eating supersize meals. In the
end he gained a lot of weight, developed high cholesterol and higher body
fat percentage, all of which contributed to his high risk of contracting
diseases. This diet not only affect him physically but also mentally by
giving him symptoms of withdrawals, he was depressed and frequently
having headaches if he did not eat McDonald’s. This documentary really
leaves people with unpleasant feelings towards fast food and it cleverly
shows that one of the reasons behind obesity is fast foods. This film also
makes it a great way to see the effects of our eating habits that we don’t
even realize until we see it on another person. Although, watching this
film, I would say that fast food is not the sole reason of obesity because
there are other factors affecting a person towards the path of extreme
weight gain such as the decision of frequency, amount and especially
what kind of food we eat. Overall, watching this film we learn and
become aware of the advantages and disadvantages of our eating habits
which will affect out nutrition.
Butot Balat shows the sad reality of country that despite having abundant
resources we have on one of the most extreme cases of malnutrition. One
of which is found in Bicol, the capital of seafood, however, it was
discovered that frequently locals suffer from extreme malnutrition. The
common livelihood is fishing, and the family usually relies on the father’s
income to survive but it was said that the daily income is 30 pesos and so
they resort to instant noodles because it is cheap and filling. The locals
carry not only income burdens but as well as psychological burdens.
Mang Ciriaco carries the heavy burden of feeding nine children and has
six-year old son Joey that weighs a three-month old baby, while his 14-
year old son Jeremy weighs only that of a two-year old boy. Jeremy
struggles to use his lungs to breathe due to severe malnutrition. It was
also discovered a baby is fed with coffee because the mother is too
malnourished to produce any breast milk. Overall, depriving the body of
the daily nourishments it needs it would lead to poor nutrition and health.
Our health is influenced by many factors such as stress, tiredness and our
capacity to work, and over time, it can contribute to the risk of
developing some illnesses and other health problems. As future
Thomasian nurses we must start with having good nutrition ourselves in
order to help others. We can start within ourselves by reflecting if the
things we do right now is healthy, if not, then change. Starting with
ourselves then sharing it and promoting it to our families, friends and the
community, especially with our future patients.
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