Nutrition
Ronald C. Gonzalez, DNP, MSN, MHA, RN
Principles of Nutrition
 Use of nutrients for tissue growth and energy
production
 Nutrients: substances that:
Supply body with energy
Build and maintain bones, muscles, and skin
Aid in the normal growth and function of each body
system
 Malnutrition: imbalance in the amount of nutrient
intake and the body’s needs
 Obesity: result of a person’s energy intake consistently
exceeding energy use
Six Classes of Nutrients
 Nutrients that supply energy
Carbohydrates
Protein
Lipids
 Nutrients that regulate body processes
Vitamins
Minerals
Water
Carbohydrates
 Supplies body with 4 kilocalories (kcal) per gram
 Major supplier of energy
45-65% of total calories
 Classified as simple or complex
Simple carbohydrates are broken down and
absorbed quickly
Complex carbohydrates take longer to break
down for body’s use
Proteins
 Supplies body with 4 kilocalories (kcal) per gram
 For development, maintenance, and repair of the
body’s tissues
Recommend 0.8 g/kg
 Consist of organic compounds called amino acids
Amino acids must be consumed in food every day
 Proteins are either complete or incomplete
Complete proteins contain all 9 essential amino
acids
Incomplete proteins lack one or more of the 9
essential amino acids
Lipids
 Fats yield 9 kilocalories (kcal) per gram
 Cholesterol is a fatlike substance found only in animal
products.
 Triglycerides are the most abundant lipids in food.
 Benefits of fat in the body:
Energy production
Insulation of major organs and nerve fibers
Lubrication for body tissues
Vitamin absorption (A, D, E, K)
Development of cell membranes
Fats
Contain mixtures of saturated and unsaturated
fatty acids
Most animal fats are saturated (limit to <7-10%
of total calories)
Most vegetable fats are unsaturated
Most concentrated source of energy in the diet
Should be no more than 20-35% total calorie
intake
Vitamins
 Organic compounds that contribute to important metabolic
and physiologic functions within the body.
 Do not produce energy, but are crucial in chemical reactions with
macronutrients.
 Fat-soluble vitamins = A, D, E, K
 Fat is needed to absorb them.
 Water-soluble vitamins = C, B complex
 Excreted in urine
 Easily destroyed by air, light, and cooking
 Must be ingested daily because not stored in body
Fat-Soluble Vitamins
 Vitamin A
 Helps resistance to infection and night vision; helps grow epithelial tissue and
development of bones and teeth
 Deficiency can cause night blindness, decreased immunity, and impaired
growth and development
 Vitamin D
 Vital for development of bone and tissue
 Vitamin E
 Antioxidant that protects cells from free radicals; promotes healthy immune
system
 Vitamin K
 Essential for synthesis of proteins that promote clotting of blood; deficiency
produces bruising and bleeding
Water-Soluble Vitamins
 Vitamin C: antioxidant
 Roles in synthesizing collagen and development of a strong immune
system
 Vitamin B complex: Facilitate energy production
 Help to form RBCs; act as coenzymes
 Thiamine (B1)
 Riboflavin (B2)
 Niacin (B3)
 Pantothenic acid
 Biotin
 Pyridoxine (B6)
 Cyanocobalamin (B12)
 Folic acid (B9)
Minerals
 Minerals are micronutrients that are classified as
macrominerals or microminerals depending on their daily
dietary requirements.
 Potassium, sodium, and chloride
 Critical role in the body’s fluid balance
 Important in nerve conduction and muscle contraction
 Calcium, phosphorus, and magnesium
 Important in production and maintenance of bone
 Calcium required for nerve conduction, muscle contraction, blood vessel
expansion/contraction, secretion of hormones
 Phosphorus aids in bone development, muscle contraction, kidney
function, nerve conduction, heartbeat regularity
 Magnesium works with calcium in structural support, blood pressure and
heartbeat regulation, nerve/muscle function
Water
 Necessary for:
 Controlling body temperature
 Maintaining acid-base balance
 Regulating fluid and electrolytes
 Transporting nutrient and waste products
 When water lost without replacement:
 Blood volume diminished; oxygen, nutrients, and wastes cannot be
moved
 Thirst is an indication that the body needs water or fluids
Metabolism
The process of chemically changing nutrients into
end products that are used to meet the energy
needs of the body
Anabolism = use of energy to change simple
materials into complex body substances
Catabolism = the breaking down of substances
from complex to simple, resulting in a release of
energy
Basal Metabolic Rate (BMR) is the minimum
amount of energy required to maintain bodily
functions at rest while awake
Determining Ideal Body Weight
 For adult females:
 100 lb (for height of 5 ft.) ± 5 lb. for each additional inch over 5 ft
 For adult males:
 106 lb (for height of 5 ft.) ± 6 lb. for each additional inch over 5 ft.
 Males have a higher BMR due to larger muscle mass
 BMR is about 1 cal/kg of body weight per hour for men
 BMR is about 0.9 cal/kg of body weight per hour for women
 Factors that increase BMR
 Growth, infections, fever, emotional tension, extreme
environmental temperatures, elevated levels of certain hormones
 Factors that decrease BMR
 Aging, prolonged fasting, and sleep
Digestion
 Breaking down of food into smaller particles of nutrients.
Absorption: movement of smaller elements through the
digestive tract walls and into the blood
Glucose is then carried through the bloodstream to the
liver, where it is stored or used to provide energy for the
body
 As food is digested, it becomes a semiliquid mass called
chyme as it travels through the intestines
 Peristalsis, a wavelike muscular movement moves waste
through the intestines for elimination
Factors Affecting Food Habits
Physiologic Factors
Stage of development
State of health
Medications
Psychosocial and Sociocultural Factors
Economics
Culture
Religion
Developmental Considerations
Growth increases nutritional needs
Nutritional needs level off in
adulthood
Fewer calories required in adulthood
because of decrease in BMR
Dietary Guidelines
Assessment
Health History
Dysphagia
Nutritional history
Social history
Labs
IBW, Height/Weight, BMI
Implementation
 Early identification of potential or actual problems
Education
Special diets
Health promotion
Meal planning
Weight loss plans