7: Nutrition

CHAPTER 7 Nutrition

NUTRIENTS AND DEFICIENCIES

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.

Table 7-1 Acceptable macronutrient distribution ranges (AMDRs) and dietary reference lntakes (DRIs) for adults per day

Macronutrient Females Males
Protein 46 g 56 g
Carbohydrates 130 g Same
Lipids None Same
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
Phosphorus 700 mg Same
Magnesium 310 mg 400 mg
Sodium 500 mg Same
Chloride 750 mg Same
Potassium 2000 mg Same
Sulfur None Same

AI, Adequate intake.

Includes adequate intake or Estimated Average Requirement (EAR), where NO DRI has been established, expected to satisfy needs of 50%.

5 μg = 200 IU (International Units).

Tolerable upper intake limit (UL) is 1000 mg/day.

§ Smokers should add 35 mg to these values.

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.

See Chapters 3, Anatomy, Biochemistry, and Physiology: biomolecules; 6, General Pathology, and 16, Special Needs Patient Care: nutrition-related conditions and diseases.

Proteins

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.

B. Physiology and metabolism of proteins: see Chapter 3, Anatomy, Biochemistry, and Physiology
H. Nutritional deficiency and diseases related to proteins:

Carbohydrates

Carbohydrates are organic compounds (contain carbon) that also contain the elements hydrogen and oxygen. Provide energy during metabolism (you burn 20 calories per hour chewing gum).

A. Types of carbohydrates:

B. Physiology and metabolism of carbohydrates: see Chapter 3, Anatomy, Biochemistry, and Physiology.
E. Nutrient sources of carbohydrates:

F. Nutritional management of disease and deficiency related to carbohydrates. See Chapter 6, General and Oral Pathology.

4. Dental caries:

CLINICAL STUDY

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.”

Lipids

Lipids (fats) are organic compounds composed of carbon, hydrogen, oxygen. Types include triglycerides (fats and oils), phospholipids, sterols (cholesterol). MAIN function is to provide energy.

A. Types of lipids:

2. Compound lipids are compounds added to glycerol and fatty acids.

b. Lipoproteins are produced in the liver and allow cholesterol, triglycerides, phospholipids to be transported in the bloodstream.

B. Physiology and metabolism of lipids: see Chapter 3, Anatomy, Biochemistry, and Physiology, and Chapter 9, Pharmacology, for control of LDLs.
F. Nutritional management of deficiency and disease related to lipids:

1. Atherosclerosis: degenerative disease that produces hardening of large and medium arteries.

Vitamins

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.

A. Fat-soluble vitamins: soluble in fats and fat solvents; mineral oils interfere with absorption; NOT readily excreted and so can build up to toxic levels; stored in liver and fatty tissues:

1. Vitamin A (retinol):

Jan 1, 2015 | Posted by in Dental Hygiene | Comments Off on 7: Nutrition
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