Lecture 2: Nutrition and Health Care

Introduction

• Importance of identifying sources for nutrition information.
• Consider whether sources are credible and valid.

Reliable Nutrition Information

• Credible sources often end with:
  • .gov (government agencies)
  • .edu (educational institutions)
  • .org (professional organizations)

Key Considerations

• Credentials: Verify the qualifications of the information provider (e.g., registered dietitian vs. unqualified individual).
• Evidence: Look for information backed by scientific research (double-blind studies, peer-reviewed studies).
• Updates: Ensure the website is regularly updated (avoid outdated information).
• Purpose: Determine if the site aims to educate or sell products (free information is often more trustworthy).

Warning Signs of Nutrition Quackery

• Quick fixes
• Personal testimonies promoting unrealistic outcomes

Nutrition and Health Care

• Illness impacts nutritional status; nutrition therapy can enhance medical care.
• Optimal nutrition can improve patient outcomes and prevent complications.

Malnutrition in Hospitalized Patients

• Prevalence: 15-60% of hospitalized patients may experience malnutrition.
• Negative Implications:
  • Weakens immune function
  • Delays healing
  • Increases hospital stay duration

Definition of Malnutrition

• Any condition caused by insufficient or excessive nutrient intake or imbalances.
• Not just undernutrition; overnutrition can also lead to deficiencies (e.g., limited variety in diet).

Causes of Malnutrition

• Reduced Food Intake: e.g., anorexia due to illness or treatment (e.g., chemotherapy).
• Impaired Digestion: conditions leading to absorption issues (e.g., GI surgeries).
• Altered Metabolism: illnesses affecting nutrient processing.

Interdisciplinary Healthcare Team

• Key Members:
  • Registered Dietitians (RDs): Nutrition experts; perform assessments, diagnoses, and interventions.
  • Nurses: Screen for nutrition issues, assist with feeding, and monitor intake.
  • Other Professionals: Speech therapists, occupational therapists, etc.

Responsibilities of Healthcare Team

• RDs design nutrition plans; nurses provide daily care and monitoring.

Identifying Malnutrition

• Conduct nutrition screening within 24 hours of admission.
• Use data to identify risk factors (e.g., unintentional weight loss, dietary changes).

Examples of Screening Data

• Admission Data: Height, weight, BMI, medical history, lab tests, symptoms.
• Nursing Diagnoses: Assess functional impairments affecting nutrition.

Screening Tools

• Subjective Global Assessment: Used to classify malnutrition risk based on history and physical examination.
• Categories: A (well-nourished), B (moderate malnutrition), C (severe malnutrition).

Nutrition Care Process

• Steps:
  1. Nutrition Assessment: Collect and analyze health data.
  2. Nutrition Diagnosis: Identify problems based on assessment.
  3. Nutrition Intervention: Implement measurable dietary strategies.
  4. Nutrition Monitoring & Evaluation: Track progress and adjust care as needed.

ABCD of Nutrition Assessment

• A: Anthropometric measurements (height, weight, BMI).
• B: Biochemical data (serum protein levels, lab tests).
• C: Clinical evaluation (physical signs).
• D: Dietary history (food intake assessments).

Assessment Methods

• Dietary Assessments:
  • 24-Hour Recall: Guided interview recalling food intake.
  • Food Frequency Questionnaire: Assessing dietary patterns.
  • Food Records: Detailed records of food intake.
  • Direct Observation: Monitoring meal intakes directly.

Nutritional Genomics

• Study of how diet affects gene expression (nutrigenomics).
• Nutrients can influence gene expression, potentially leading to personalized nutrition plans.

Genetic Variations

• Polymorphisms: Variations in DNA sequences can affect health (e.g., single nucleotide polymorphisms).
• Single-gene disorders: Rare, affect specific genes (e.g., sickle cell anemia).
• Multi-gene disorders: Common diseases influenced by multiple genes (e.g., heart disease).

Challenges in Gene Testing

• Motivation to change health behaviors.
• Confidentiality of genetic data.

Conclusion

• Importance of understanding and applying nutritional knowledge in healthcare settings.
• Familiarize with key concepts (e.g., nutrigenomics, personalized nutrition) for future application.