W nu18l1lCn

nu18l1lCn
W ou are what you eat!
lnLroducLlon
W 1he human body musL be fed dally Lo be able
Lo funcLlon normally 1he cholces LhaL you
make may beneflL or harm you(lnA 2007)
W lL ls lmporLanL for everyone Lo have some
knowledge of nuLrlLlon as lL can help us Lo
make proper use of LradlLlonal and modern
foods
onL lnLroducLlon
W lncrease ln llfe expecLancy ls aLLrlbuLed Lo 80
nuLrlLlon and 20 modern
medlclne(WooLLon2008 clLed by nln2011)
W 1hls unlL dlscusses dleLary lssues as well as
welghL conLrol and provlde guldellnes so as Lo
gulde famllles ln Lhe aLLalnmenL of opLlmal
welghL and nuLrlLlonal sLaLus LhroughouL Lhe
llfe cycle
Cb[ecLlves
W AL Lhe end of Lhe sesslon Lhe sLudenL ls able Lo
W (1) ldenLlfy Lhe nuLrlenLs ln food Lhelr source and
funcLlons
W (2) Lxplaln Lhe followlng Lhe ob[ecLlves and
pollcles of Lhe nuLrlLlon program
W (3)ldenLlfy Lhe prevalence of Lhe nuLrlLlon relaLed
dlseases ln Lhe communlLy lL's prevenLlon
onLob[ecLlves
W (4)alculaLe Lhe 8ody Mass lndex(8Ml) Lo
deLermlne Lhe nuLrlLlonal sLaLus of an
lndlvldual
W (3)uescrlbe Lhe followlng
Lhe food pyramld and lL's
lmporLance
nuLrlLlonal assessmenL of lnfanLs
preschoolers(M llnlc)school chlldren
anLenaLal moLhers and slck lnfanLs
onL ob[ecLlves
W (6)Lxplaln (l) facLors conLrlbuLlng Lo
nuLrlLlonal problems
(ll)LacLlcs ln developlng self rellance of
famllles communlLles
(lll)nuLrlLlonal survey and lL's purpose
W (7)1he role of Lhe communlLy healLh nurse ln
Lhe nuLrlLlon program
nuLrlLlon
W -utr|t|on ls Lhe sclence LhaL deals wlLh food
LhaL we eaL and how lL ls used ln Lhe
body(nln2001)
W 1he subsLance ln food needed for growLh
healLh and energy are known as nutr|ents
nuLrlenLs
W 1here are 6 nuLrlenLs
W arbohydraLes
W roLelns
W laLs
W vlLamlns
W Mlnerals
W WaLer
a|or|e
W 1hls ls a unlL of measure for energy
W nuLrlenLs LhaL have calorles
(l)roLelns
(ll)arbohydraLes
(lll)laLs
onL
W arbohydraLes proLelns and faLs are known as
acronutr|ents
W vlLamlns and mlnerals are known as |cro
nutr|ents
W Lach nuLrlenL has speclflc uses ln Lhe body
W 1hey work LogeLher as a Leam and a healLhy
dleL musL provlde a balance of all nuLrlenLs
onL nuLrlenL
W 1hey work LogeLher as a Leam and a healLhy dleL
musL provlde a balance of all nuLrlenLs
W MalnuLrlLlon arlses where Lhere ls an
lmbalance/lnsufflclenL consumpLlon of nuLrlenLs
W A no of dlfferenL dlsorders may arlse dependlng
on whlch nuLrlenL one ls lacklng ln eg lack of vlL
A causes poor eye slghL lack ln lron causes
anemlalack ln vlLamln u causes rlckeLsvlLamln
luncLlons overlap
W Some food sources can have 2 or more
nuLrlenLs for eg (a) brown rlce has
energyproLelnvlLamlns and mlnerals
(b)cassava leaves bele
has proLeln and vlLamlns
W ln Lhe aclflc selecLlng foods from Lhe 3 food
groups ls always safe Lo glve a person Lhe
requlred nuLrlenL one needs
3 lood Croups
3 lood Croups
W 1he 3 food groups are
W ealLh
W 8ody bulldlng
W Lnergy
nuLrlenL conL
W 1arbohydrates
W lL comes from planL food
W loods whlch conLaln carbohydraLes are called
energy foods
W arbohydraLes are classlfled ln 3 groups
W (l)Sugar
W (ll)SLarch
W (lll)llbre
Sources
W Sources of carbohydraLes
W Sugars are found ln honey frulL(boLh fresh
and drled) sofL drlnks and sugar
W SLarches are found ln cereals pasLa flour
rooLs and pulse vegeLables
W llbres are found ln frulLs vegeLables whole
meal bread
luncLlons of carbohydraLes
W rovldes Lhe body wlLh heaL energy
W llbre helps Lhe movemenL of food Lhrough Lhe
lnLesLlne
W llbre rlch sLarchy foods provlde a full feellng
2roLelns
W Are made up of small unlLs called amlno aclds
W roLelns are classlfled lnLo 2 groups
W (l) hlgh blologlcal value(haem lron)
(ll) low blologlcal value(non haem lron)
W 1he amounL of lron absorbed from anlmal
foods ls hlgher (18) compared Lo vegeLable
sources(10) so vegeLarlan wlll need 80
hlgher Lhan Lhose who eaL meaL(nln2009)
Sources of proLelns
W roLelns of h|gh b|o|og|ca| va|ue(haem lron)
come malnly from anlmal foods such as meaL
flsh cheesellverchlckenshellflsheggs and
mllk
W roLelns wlLh |ow b|o|og|ca| va|ue(non haem
lron) come malnly from planL foods such as
peas dark leafy vegeLables such as
beleLubuaoLachauralyasal[ancerealspeas
legumes
luncLlons of proLelns
W CrowLh of new cells such as skln halr and
blood
W 8epalr damaged cells
W roducLlon of heaL and energy( ln cases when
Lhere ls noL enough carbohydraLe proLeln wlll
change Lo carbohydraLes)
W ManufacLure of lmporLanL body chemlcals
such as enzymes hormones anLlbodles
ueflclency of proLelns
W 8eLarded growLh ln chlldren
W Worn ouL cells are noL replaced 1hls prevenL
heallng of wounds
W MalfuncLlons of varlous organs due Lo
hormonal enzyme deflclency
W SuscepLlblllLy Lo dlseases due Lo lack of
anLlbodles
3 laLs
W laLs are nuLrlenLs LhaL glves a loL of energy
W 1he body sLores energy as a layer of faL under
Lhe skln known as adlpose Llssue
W laLs are classlfled ln Lo 2 groups
W a SaLuraLed faLs (anlmal sources)
meaLeggsmllkdalry producLs cream
buLLer)
W b unsaLuraLed faLs (planLs flsh sources)
peas olly flsh cooklng oll
luncLlons of faLs
W laLs lnsulaLes Lhe body(keeps you warm)
W roLecLs dellcaLe organs such as kldneys
nerves by a surroundlng layer of faL
W rovldes body wlLh energy
W elps keep body [ Lhe rlghL Lemp
4 Mlnerals
W 1he human body requlre abouL 20 mlneral
elemenLs 1he ma[or ones are
calclumphosphorussodlum and poLasslum
W A good varled dleL should supply all essenLlal
W Sources a mllkchlckenmeaLeggsgreen
leafy vegeLables
k legumesbananamllkmllk
producLs green leafy vegeLables
onL Mlnerals
W hosphorus mllk and mllk producLs
W na common salLmeaLmllk eggs and
vegeLables such as carroLs
1race LlemenLs
W 1hls lnclude mlnerals lncludes lron
lodlnezlnccopperflorlde
W 1hey are needed ln small amounLs for
exlsLence and Lhelr absence brlngs deaLh
3vlLamlns
W 1hey are chemlcal compounds LhaL Lhe body
needs Lo help lL funcLlon properly 1hey are
vlLal nuLrlenLs needed Lo prevenL deflclency
dlseases and supporL opLlmal healLh
W lmporLanL vlLamlns are vlLamln A8uL
W Lach has dlfferenL funcLlons ln Lhe body
W Sources of vlLamlns carroLs dark green leafy
vegeLablespawpawpumpklnmangoesbeans
guavalemon mllk yellow malze
6 WaLer
W lL ls absoluLely essenLlal for llfe
W 70 of Lhe human body ls made of waLer
W 1he maln source ls drlnklng waLer and ls also
found ln oLher beverages
W lrulLs and vegeLables are also hlgh ln waLer
luncLlons of waLer
W hlef componenL of all body flulds
W elps dlssolve foods and alds dlgesLlon
W elps remove wasLe maLerlal from Lhe body
W 8egulaLes body LemperaLure by persplraLlon
Cb[ecLlves and ollcles of Lhe nuLrlLlon
rograms
W ll[l lan for AcLlon for nuLrlLlon(lAn)
(2010 2014)
ollcles
1 AdvocaLe nuLrlLlonal lssues malnsLreamlng
ln Lo govL ueclslon maklng sysLem Lndorsed
on 3/12/2009
2 romoLe susLaln household food securlLy
3 lmprove naLlonal nuLrlLlonal sLaLus
onL ollcy
W 4 roLecL consumers Lhru' lmproved quallLy
safeLy of food waLer
W 3 lmprove nuLrlLlonal sLaLus of Lhe soclo
economlcally dlsadvanLaged and Lhe groups
LhaL are nuLrlLlonally vulnerable
W 6 nuLrlLlon pollcy for school
W 7 romoLe healLhy dleLs and llfe sLyles
onLpollcy
W 8 LsLabllsh promoLe a nuLrlLlon survelllance
monlLorlng sysLem
W 9 SLrengLhen collaboraLlon wlLh developmenL
parLners
revalence of nuLrlLlon relaLed
dlseases
W Anemla
W oronary earL ulsease(u)
W ulabeLes
W yperLenslon SLroke
W CverwelghL CbeslLy
W roLeln Lnergy MalnuLrlLlon
W ularrhoeal ulsease ln hlldren
onL
W lodlne ueflclency
W CouL
W vlLamln A ueflclency
W Zlnc ueflclency
W uenLal arles
revalence of nuLrlLlon relaLed dlsease
1 -,
8aLe of anemla ln 1993 27
2004 324
ate of ne|a by age groups
,a|es Iea|es
6/12 3yrs 33 461
3 11yrs 273 242
onL
,a|es Iea|es
12 14yrs 234 329
14 44 196 409
43yrs over 306 334
revenLlon
W (l) 8alance dleL ln every meals LaLlng food
hlgh ln lron
W (ll)MedlcaLlon lron LableLs glven Lo pregnanL
women lL can be Laken over several monLhs Lo
lncrease lron level ln Lhe blood an be Laken
wlLh food/orange [ulce Lo lncrease
absorpLlon
onL
W uewormlng ookworm lnfecLlon may also
be a reason for anemla
W nlMS pro[ecL
W n8// ealLh LducaLlon LmpowermenL
W (lf Lhey know Lhey wlll choose whaL Lo eaL)
2CverwelghL CbeslLy
CverwelghL CbeslLy
W 1hey are a ma[or ealLh problem ln ll[l Lhe
aclflc 8eglon affecLlng all age
groups(nln2009)
W 1hese lncreases Lhe rlsk of developlng
dlabeLesu oLher non communlcable
dlseases
revalence
W (nuLrlLlon survey 2004) hlldren
W Age groups ercenLage
W 04yrs 129
W 39yrs 133
W 1014yrs 149
W 1317yrs 147
revalence by speclflc age group
gender
W Age Males() lemales()
I|[ nd I|[ nd
W 18yrs 143 437 10 77
W 23yrs 167 823 223 40
W 33yrs 613 807 333 334
W 43yrs 778 773 316 36
W 33yrs 632 928 637 474
W 63yrs 783 889 30 623
revenLlon
W A modesL wLloss of 300g per wk or 2kgper
monLh can lead Lo lmprovemenL ln Lhe healLh of
a person
W 1hls can be achleved by
W at|ng hea|thy consumlng less of Lhe followlng
foods buLLergheeollfrles frled
foodschocolaLesmeaL ples faLLy meaLs
processed meaLs
(sausageslunchenonmlncecanned meaLs)
Lhese foods are very hlgh ln faL conLenL
onL
W onsumlng less sweeLened beverages flzzy
drlnks 8eplace Lhem wlLh waLer and Lake less
sugar wlLh Lea coffee onsume foods LhaL
are rlch ln flber such as fresh frulLs and
vegeLables whole graln cereals rooL crops
W LaL regular meals because sklpplng meals ls
noL Lhe besL way Lo loose welghL as lL leads Lo
over eaLlng ln Lhe nexL meal
onL
W urlnk waLer before and wlLh meals
W onsume alcohol ln mlnlmal quanLlLles
W LaL only when you are hungry
W uon'L eaL whlle waLchlng 1v as Lhere ls a
hlgher Lendency Lo overeaL
W 9hys|ca| act|v|ty w|th d|etary restr|ct|on
W 1hls ls lmporLanL for long Lerm malnLenance
of healLhy welghL
onL
W 8rlsk walklng for aL leasL 30 mlns er day on
mosL days of Lhe week
W lncreased Lhe amounL of acLlvlLy ln Lhe dally
rouLlne and look for opporLunlLles Lo walk durlng
Lhe day use sLalrs lnsLead of llfLs
W 8educe Lhe amounL of Llme spenL ln acLlvlLles
LhaL lnvolve slLLlng down/sleeplng waLchlngLv
people who work ln an offlce Lo Lry some form of
exerclse durlng Lea/lunch break (nln2009)
3roLeln Lnergy MalnuLrlLlon(LM)
roLeln energy malnuLrlLlon (LM)
W 1hese dleLary deflclency dlsorders are malnly
relaLed Lo shorLage of all nuLrlenLs or Lo
proLeln energy deflclency
W MosL common amongsL chlldren ln poorer
developlng counLrles
W AlLhough noL common Lhere chlldren been
admlLLed for marasmus kwashlorkor ln ll[l
hosplLals (nln2009)
(a)kwashlorkor
W 8elaLed Lo severe lack of proLeln foods
W AffecLs chlldren 13yrs old
W auses
W unLlmely lnLroducLlon of complemenLary
foods
W loods glven Lo chlldren are deflclenL ln proLeln
eg glvlng only cassava yam rlce rlce waLer
Slgns of kwashlorkor
W oor growLh
W Muscle wasLage
W ApaLheLlc looklng
W Ldema ln face hands feeL
W Swollen llver abdomen
W alr changes ln color ls more brlLLle
nuLrlLlonal LreaLmenL
W 1o lncrease food lnLake of Lhe chlld gradually
esp hlgh proLeln foods llke
W MeaL flsh mllk cheese eggs dhal pulses
(b) Marasmus
W 1hls ls an energy deflclenL condlLlon
W AffecLs chlldren under 2yrs
W causes
W Larly weanlng from breasL mllk Lo oLher foods
and mllk ln adequaLe ln nuLrlLlve value
W 8epeaLed dlarrhoea
W 1uberculosls guL dlsease
Slgns of marasmus
W hlld looks old wrlnkled
W Skln ls dry faces Lhln wlLh sunken cheek
large eyes abdomen looks swollen
W SLunLed growLh
W onslderable wL loss
W Muscle wasLlng sagglng skln on legs
buLLocks
onL
W ularrhoea
W ls lrrlLable crles a loL
W vlLamln mlneral deflclencles
nuLrlLlonal LreaLmenL
W lncrease energy (calorles) ln dleL 1hls ls by
addlng olls faLs such as ghee buLLer
margarlne or cooklng oll Lo Lhe chlld's food
before feedlng whlle malnLalnlng a balance
dleL
W %c) ,aras|c kwash|orkor
W ls a comblnaLlon of boLh condlLlon ls mosL
severe
onL
W 1he chlld ls very under welghL usually 60 of
normal for LhaL age
W @reatent
W A comblnaLlon of hlgh proLeln and hlgh
energy (calorles) foods ln Lhe dleL
ealLhy lood yramld
1he food yramld
W lL has a pyramld shape
W lL Lells us whlch food we should eaL llLLle
moderaLe or mosL
W 1he food LhaL make up Lhe pyramld base(Lhe
wldesL parL) should provlde Lhe blggesL parL of
your dleL as you go up Lhe pyramld Lhe
amounL of dlfferenL foods you need geLs
smaller
8ody Mass lndex
W lL ls a measure of body faL based on helghL
and welghL
W 1hls ls commonly used ln calculaLlng
overwelghL and obeslLy buL excludlng
pregnanL women(nln2009)
W lormula welghL(kg)
helghL(m)2
lnLerpreLaLlon of 8Ml
ange p||cat|on
183 underwelghL
183 249 ealLhy
23 299 CverwelghL
30 Cbese
Lxample
W A 23year old female who welghs 30kg and
has a helghL of 160m would have a 8Ml of
193 1hus Lhls person ls ln a healLhy welghL
range
W an you work ouL your 8Ml?
W lnfanLs and pre schoolers assessmenL
lndlcaLors are welghL for age
W ow abouL school age chlldren?
W
nuLrlLlonal assessmenLs
W lnfanLs preschoolers
W 1he chlld's welghL ls Laken every cllnlc(M)
and charLed on Lhe card
WlLh Lhe use of Lhe anLhropomlcal Lable Lhe
welghL ls compared Lo Lhe age 1he chlld's
nuLrlLlonal sLaLus ls elLher obese normal
range mlldly malnourlshed moderaLe or
severe
onL
W hyslcal growLh serves as an excellenL
measure of adequacy of Lhe dleL(SLanhope
LancasLer2004)
W normally Lhe chlld's welghL should lncrease as
Lhe age progresses
Cn1
W ases of mlld malnuLrlLlon apply Lhe nurslng
process ln nurslng Lhe case and book for
frequenL vlslL so as Lo evaluaLe Lhe progress
and lf noL lmprovlng refer(lf Lhe dleLlclan ls
noL avallable)
W ases of moderaLe and severe malnuLrlLlon
refer Lo dleLlclan/hlgher level of care
onL
W lf Lhe chlld ls mlldly malnourlshed
W ssess age welghLacLlvlLyoveral
appearance
W @ake the h|story Ask lf Lhe chlld ls slck?
W A 24hr dleL recall by Lhe parenL ls a helpful
screenlng Lool Lo assess Lhe amounL and Lhe
varleLy of food lnLake(Ask abouL Lhe parenLs
concern) Look aL Lhe famlly's meal paLLern
School hlldren
W 1he welghL (kg) for helghL use of Lhe
anLhropomlcal Lable Lhe nuLrlLlonal sLaLus of
Lhe chlld ls deLermlned
W As wlLh lnfanLs and preschool Lhe nurslng
process ls applled as problem ls found wlLh
Lhe lnvolvemenL of Lhe Leachers and parenLs
onL
W 1he behavlor and problems durlng meal hours
W 9|an lan wlLh Lhe moLher sLeps Lo Lake Lo
be achlevable
W p|eent Advlce aL moLhers level of
undersLandlng MenLlon Lhe name of Lhe
food lood LhaL ls avallable aL home and she
can afford
onL
W noLe llenL's eLhnlclLy Laboos
rellglon
lncome
age of Lhe chlld
va|uat|on Ask Lhe moLher Lo repeaL whaL you
have sald
Slck lnfanLs
W Ask lf Lhe chlld able Lo drlnk/breasL feed lf noL
refer urgenLly
W WelghL for age check nuLrlLlonal sLaLus
W Ask lf breasLfeedlng /formula
W lf Lhe chlld ls 6 monLhs ls she Laklng
supplemenLary feeds
W Advlce accordlng Lo Lhe complalnLs LhaL Lhe
chlld presenLed wlLh
onL
W 1he chlld's nuLrlLlon ls very lmporLanL ls
durlng lllness so as Lo fasLen recovery and
opLlmal welghL ls aLLalned
W nuLrlLlon ls an lmporLanL aspecL of
managemenL of lllness
AnLe naLal moLher
W 1ake welghL aL booklngs
W 1he wL galn ls slow ln Lhe 1
sL
half of
pregnancy more rapldly ln Lhe 2
nd
20 weeks
W 1he general appearance of Lhe woman ls
consldered uoes she looks dehydraLed weak
obese Advlce
W b level ls also consldered normal b 11g
lf below she musL be followed up closely
onL
W An opLlmal galn of an average pregnancy ls
123kg of whlch 9 kg ls galned ln Lhe lasL 20
weeks(lraser ooper2003)
lacLors conLrlbuLlng Lo nuLrlLlonal
problem
W Lack of knowledge unaware of Lhe
lmporLance of chooslng a varleLy of foods
from Lhe 3 food groups noL knowlng Lhe food
pyramld LaL anyLhlng Lo saLlsfy Lhe hunger
W ulLure and rellglon
W overLy
W lllnesses acuLe or chronlc healLh problems
onL
W oor eaLlng hablL eaL fasL food
W Lack parenLlng skllls Leenage pregnancy
W lood preparaLlon hyglenlc or noL aLLracLlve ?
MeLhod overcooked ?
1acLlcs ln developlng self rellance
W lamllles communlLles Clbbs 1rusL Model
W Lmpower Lhem by Leach/educaLe (show
plcLures)
W uemonsLraLe (cllnlc)
W ome vlslLlng
W lollow up Lo check on Lhe progress
W lf cllenL/ famlly ls able Lo susLaln whaL you
have LaughL Lhem self rellance
urpose of nuLrlLlonal survey
W Make a concluslon of Lhe nuLrlLlonal sLaLus of
Lhe people
W SubmlL a reporL a of Lhe naLlon/ communlLles
nuLrlLlonal sLaLus
W reaLe awareness Lo Lhe publlc abouL Lhe
reporL found
W 1o lmprove Lhe servlces provlded
8ole of Lhe ommunlLy nurse
W lronLllne care glver musL be knowledgeable
ln all aspecL of nuLrlLlon
W Assess nuLrlLlonal sLaLus of all age groups
refer
W ealLh LducaLor promoLer ln regards Lo
nuLrlLlon(nuLrlLlon educaLor recommends
healLh selecLlon healLhy eaLlng hablLs)
onL 8ole
W Advlsor and correcL wrong pracLlces
W ollaboraLor wlLh sLake holders
W lollowup of cases aL home cllnlc
W Larly ldenLlflcaLlon of hlgh rlsk cases
W 8esearch ln nuLrlLlon
Cnce we used Lo eaL Lhls
now we eaL Lhls
Cnce we were
now we are
8eference
W uudecSC(2007)nuLrlLlon LssenLlals for
nurslng racLlce(3
Lh
ed)hlladelphla
LlpplncoLL Wllllams Wllklns
W lraseruM ooperMA(2003)Myles
1exLbook for Mldwlves London hurchlll
LlvlngsLone
W ll[l nurses AssoclaLlon(2007) nuLrlLlonal
Manual for School hlldrenSuvaunlLl
onL
W klnglS 8urgess A(2003)nuLrlLlon for
ueveloplng ounLrles(2
nd
ed)new ?ork Cxford
unlverslLy ress
W naLlonal lood nuLrlLlon enLre(2001) anLeen
Culdellnes Suva unlLl
W naLlonal lood nuLrlLlon enLre(200)nuLrlLlon
and nu facL sheeLs Suva MlnlsLry of ealLh
ll[l