CHAPTER 7 Nutrition
Nutrients are substances obtained from food and promote growth, maintenance, or repair. Six classes of nutrients include macronutrients (biomolecules) of proteins, carbohydrates, and lipids, as well as vitamins, minerals, and water. For Acceptable Macronutrient Distribution Ranges (AMDRs), adults should obtain 10% to 35% of calories from protein, 45% to 65% from carbohydrates, and 20% to 35% from lipids (fat). Acceptable ranges for children are SIMILAR, except that infants and younger children need higher proportion of fat (25% to 40%).
For vitamins and minerals, Dietary Reference Intakes (DRIs), issued by the Institute of Medicine of the National Academy, are the average daily dietary intake level sufficient to meet nutrient requirements of nearly ALL (~98%) healthy individuals (includes Recommended Dietary [Daily] Allowance [RDA]) (Table 7-1). RDIs (Reference Daily Intakes) and DVRs (Daily Recommended Values) are comparable standards and can be combined to create DVs (Daily Values), as published by the FDA.
|Protein||46 g||56 g|
|Vitamin A (retinol)||700 μg||900 μg|
|Vitamin D||5 μg (AI)†||Same|
|Vitamin E||15 mg‡||Same|
|Vitamin K||90 μg (AI)||120 μg|
|Thiamine (vitamin B1)||1.1 mg||1.2 mg|
|Riboflavin (vitamin B2)||1.1 mg||1.3 mg|
|Niacin (vitamin B3)||14 mg||16 mg|
|Pantothenic acid (vitamin B5)||5 mg (AI)||Same|
|Pyridoxine (vitamin B6)||1.3 mg||Same|
|Cobalamin (vitamin B12)||2.4 μg||Same|
|Vitamin C (ascorbic acid)||75 mg§||90 mg§|
|Biotin||30 μg (AI)||Same|
|Folate (folacin, folic acid)||400 μg||Same|
|Calcium||1000 mg (AI)||Same|
|Magnesium||310 mg||400 mg|
AI, Adequate intake.
Malnutrition is an imbalance between nutrients the body needs and nutrients it receives. Includes overnutrition (consumption of too many calories or too much of specific nutrient) and undernutrition (deficiency MAINLY of calories or protein). Deficiencies of vitamins and minerals are usually considered separate disorders. When calories are deficient, however, vitamins and minerals are also likely to be. Calorie or kilocalorie (kcal) is a unit of measurement for energy, in this case food energy. Energy is measured by heat expenditure; 1 kilocalorie is the amount of heat produced to raise temperature of 1 kilogram of water 1° C.
Proteins are organic compounds that are composed of amino acids, building blocks of proteins. Contain carbon, hydrogen, oxygen, nitrogen. MAIN function is to build tissue and replace cells. Presence of proteins affects ALL body activities.
Scenario: The 8-year-old patient is in the dental office for a 6-month oral prophylaxis maintenance appointment. When asked more about the child’s health, the mother said the girl even wet her bed a couple of nights ago. The mother also notes that she has recently had an increased appetite yet has lost weight. “My daughter had a severe chest cold about 2 months ago and now she is waking up frequently during the night to urinate.”
Vitamins are organic nutrients needed by the body in small quantities. They do NOT contribute energy to the body but are facilitators of body processes. Fat-soluble vitamins include A, D, E, and K; water-soluble vitamins include the Bs and C. Note that DRI is for adults.