Nutritional SupplementsFluids, ElectrolytesVitamins, MineralsTotal Parenteral NutritionNatural Supplements, Herbs

Basic Nutrition Categories Macronutrients

Carbohydrates Proteins Fats

Micronutrients Vitamins Minerals Water

Carbohydrates (fruit/veg/grains) Simple

Sugars containing no energy yielding calories Empty calories (candy)

Complex Carbohydrates Starches take longer to break down in digestive

tract and have more nutritional value than sugars Food energy (whole grain bread)

All carbs are broken down in to glucose

Glucose Stored in the liver and muscle tissue as

glycogen Carbohydrate rich diet needed to

maintain muscle glycogen, preferred fuel 55% of daily calories complex carb 10% or less of daily calories from simple

carbs

FATS Only source for fatty acid linoleic acid that is

essential for growth and skin maintaince Provides lubrication & shock absorber, insulates and

protects the body’s organs against trauma & cold Energy reserve

Helps metabolize carbohydrates & proteins Manufacture needed cortisol, sex hormones and cholesterol Carrier for fat soluble vitamins D,E,A,K

No more than 30% diet from fat and preferably monosaturated fat

Saturated Solid at room temp/Raise blood cholesterol & LDL Animal source and dairy products Palm & coconut oils increase cholesterol Trans-fatty acids (margarine & packaged foods)

Unsaturated (monounsaturated & polyunsaturated) Liquid at room temp/Lower blood cholesterol Mono-unsaturated

Olive oil, canola oil Poly-unsaturated

Veg oils, nuts, deep water cold fish

PROTEIN Breaks down into amino acids

Meat, dairy, fish, beef, chicken and pork Incomplete proteins

Plant based (soy, tofu, beans, peanuts) Building Blocks

For hormones, enzymes, blood-plasma transport system, repair body cells, tissue and muscle

Hi protein diets excrete extra Nitrogen, increase fluid requirements.

Vitamins and Minerals Solubility

Water-Carried in blood stream & excreted CB

Fat-Stored liver & adipose DEAK

Diseases Scurvy (C) Ricketts (D) Beriberi (B)

MineralsCalcium Iron Acetate, carbonate, * keeps O2 in bloodchloride, gluconate * females 18mg * males 8mg

Others: Na, Zn, K, Mg, Phosphorus, Selenium

Fluids Average water

percentage Can we drink too much

water? Body weight X 0.6

divided by 12 equals number of 8 oz. glasses of H20 per day

Electrolytes (mEq) Sodium (Na+)

Retains body fluid & enzyme activities

Generate/transmit nerve impulses & acid/base balance

Potassium (K+) Cardiac rhythm &

glycogen, enzymes, conduct nerve impulses

Chloride (Cl-) Transport CO2, form

HCl, retain K, Hydrogen (H+)

Malnutrition Consequences 20% reduction in body mass –

moderate 40% reduction in body mass –

severe Marasmus

Growth retardation due to imbalance of protein-calorie, patients thin develops over months to years

Kwashiorkor Lack of dietary protein

Poor wound healing Immune system suffers

and infection rate rises Organ failure

CV, Renal, GIT, respiratory,

Total Parenteral Nutrition (TPN) Food and calories

given intravenously Indications- Patients

who Cannot eat or eat

enough Have severe burns,

pancreatitis, gallbladder & inflammatory bowel disease, diarrhea

Central Line attached via superior vena cava to the heart

Peripheral Line attached to an extremity usually the arm at the wrist or back of the knee.

Special TPN Issues Renal Failure Catabolic patient Compatibility Stability Thrombosis Non-tunneled catheters Tunneled catheters Implanted ports

Complications of TPN Dehydration Liver toxicity Elevated

TG, glucose, lipids, albumin

Reduced Glucose, albumin

Imbalance Acid-Base Electrolytes

Nutrition

The TRAPEZOID !

The REAL Thing – Coca-Cola Active ingredient is

phosphoric acid. pH of 2.8 Dissolves a nail in 4

days. Dissolves a tooth in 24-

48 hours.

Trucks carrying Coca Cola syrup (the concentrate) must use Hazardous Material placards.

The distributor of Coke use it to clean the engines of their trucks.

Diets? Atkins

SouthBeach

Somersizing

Zone Mediterranean

Blood Type

Weightwatchers

Labels ! Read them.

Natural Supplements

Selected Natural Supplements Camomile

Anti-inflammatory, spasmotic, infective

Chondroitin Interferes with enzymes

that break down cartilage

Chromium picolate Weight loss Glucose CV toxicity

Common Herbal Supplements Feverfew

Migraine headaches Ginger

Antiemetic Ginkgo, ginseng

Oxygen and energy

Glucosamine Cartilage

Melatonin Hormone

St. Johns’s wort Natures Prozac

Let the Sunshine In ! Summer surgeries with improved recovery

times High levels Vit D Mood

Summary Slide Fluids Electrolytes (mEq) Vitamins and Minerals Calcium Malnutrition Total Parenteral Nutrition (TPN) Common Herbal Supplements