1. HEALTH EDUCATION NUTRITION AND DIETETICS
GENERAL BOJECTIVES:
The course is designed to assist the students to acquire basic knowledge and understanding of the
principles of Nutrition and Dietetics and apply this knowledge in the practice of Nursing.
SPECIFIC OBJECTIVES:
On completion of the course, the students will be able to
1. Identify the importance of nutrition in health and wellness.
2. Apply nutrient and dietary modifications in caring patients.
3. Explain the principles and practices of Nutrition and Dietetics.
4. Identify nutritional needs of different age groups and plan a balanced diet for them.
5. Identify the dietary principles for different diseases.
6. Plan therapeutic diet for patients suffering from various disease conditions.
7. Prepare meals using different methods and cookery rules.
2. TIME SPECIFIC
OBJECTIVES
CONTENT TEACHING
LEARNING
METHOD
A.V.AIDS EVALUATION
4mint Define
nutrition
and its
relationship
to Health
Introduction to Nutrition:
Nutrition is the biochemical and physiological
process by which an organism uses food to support
its life. It provides organisms with nutrients, which
can be metabolized to create energy and chemical
structures.
-Definition
of Nutrition, Health and nutrition:
nourishment that sustain life, it begins from the
moment of conception until death .The food
people eat, and how it nourishes their bodies.
Health:
Health is a state of complete physical, mental, and
social well-being and not merely the absence of
disease or infirmity. It is a multidimensional concept
that encompasses various aspects of our lives,
including physical, mental, emotional, social, and
Lecture
cum
Discussion
charts What is the
nutrition
3. spiritual well-being.
Dietetics is the health profession ,having primary
responsibility of application of nutritional care, in
various state of health , and disease, with
assistance of nurse and physician.
-Malnutrition & OverNutrition
Malnutrition :Nutrients energy are not enough to
meet day to day needsAssociated with
poverty .Affect infants, children, pregnant women,
and elderly.Increase infant mortality rate, because
of poverty, low income and, un-educated mother.-
Children and pregnancy ,develop anemia result
in , Low resistance to infectious disease.
Over nutrition .- -Over weight and obesity . -
Excess energy intake .
Lead to chronic disease, as hyper tension, and DM
.Note: *-Specific dietary factors lead to:-Coronary
heart disease( CHD).High blood
pressure( HTN ).Stroke( CVA).cerebro-vascular
accidentSome type of cancer .DM. diabetes
mellitusObesity .
-Role of Nutrition in maintaining health
Nutrition is a critical part of health and development.
4. Better nutrition is related to improved infant, child and
maternal health, stronger immune systems, safer
pregnancy and childbirth, lower risk of non-
communicable diseases (such as diabetes and
cardiovascular disease), and longevity.
2mint Classification
of food
Food Classification –
Nutrients are substances that our bodies require for
proper functioning, growth, and development. There
are six main classes of nutrients: carbohydrates,
proteins, fats, vitamins, minerals, and water. Each
nutrient plays a unique role in our body, and a
deficiency in any of these can lead to various health
problems.
Classification of nutrients based on chemical
nature
Though there are more than 40 different kinds of
nutrients in food and they can generally be classified
into the following, based on chemical nature –
1. Carbohydrates
2. Proteins
3. Fats
4. Vitamins
5. Minerals
discussion chart What are
the types of
food
5. 6. Water
Carbohydrates
Carbohydrates are the body’s primary source of
energy, and they are classified into three groups:
monosaccharides, disaccharides, and
polysaccharides. Monosaccharides are single sugar
molecules, while disaccharides are composed of two
sugar molecules. Polysaccharides are complex
carbohydrates made up of many sugar molecules.
Sources of carbohydrates include fruits, vegetables,
grains, and dairy products.
Proteins
Proteins are crucial for building and repairing tissues,
producing hormones, and supporting the immune
system. Proteins are classified based on the number
and types of amino acids they contain. Complete
proteins, found in animal products and some plant-
based sources, contain all nine essential amino
acids. Incomplete proteins, found in plant-based
sources, lack one or more of the essential amino
acids. Good sources of protein include meat, fish,
beans, and tofu.
Fats
Fats are essential for proper brain function, energy
6. production, and the absorption of fat-soluble
vitamins. Fats are classified as either saturated or
unsaturated. Saturated fats are typically solid at room
temperature and are found in animal products, while
unsaturated fats are typically liquid at room
temperature and are found in nuts, seeds, and
vegetable oils.
Vitamins
Vitamins are essential for various bodily functions,
including immune system support, growth, and
development. They are classified as either water-
soluble or fat-soluble. Water-soluble vitamins,
including vitamin C and B vitamins, are not stored in
the body and must be obtained from food or
supplements. Fat-soluble vitamins, including vitamins
A, D, E, and K, are stored in the body and can
accumulate to toxic levels if consumed in excess.
Minerals
Minerals are important for maintaining healthy bones,
producing hormones, and regulating heart rate and
blood pressure. They are classified as either major or
trace minerals. Major minerals, including calcium and
sodium, are needed in larger amounts, while trace
minerals, including iron and zinc, are needed in
7. smaller amounts.
Water
Water is essential for many bodily functions,
including regulating body temperature, transporting
nutrients, and removing waste. It is classified as
either visible or invisible water. Visible water is
obtained through beverages and foods with a high
water content, such as fruits and vegetables.
Invisible water is obtained through metabolic water,
which is produced as a byproduct of cellular
respiration.
Classification of Nutrients (Based on
requirements by the body)
Macronutrients
Micronutrient
Both are equally important for good health. The
amount needed to ensure good health varies from
individual to individual depending on their age,
gender, body size, activity and state of health. ICMR
gives the RDA for Indians.
Macronutrients
Macronutrients are consumed in relatively large
amounts, macronutrients are used primarily to
generate energy or to incorporate into tissues for
8. growth and repair.
Micronutrients
Micronutrients are needed in smaller amounts they
have subtle biochemical and physiological roles in
cellular processes, like vascular functions or nerve
conduction.
2mint Balance diet Balanced diet
Eat variety of food ,
Well balanced diet.
Maintain ideal weight.
-Avoid too much fat ,saturated fat, and
cholesterol.Eat food with adequate starch, and
fiber .
-Avoid too much sugar.
-Avoid too much sodium.Avoid alcohol intake.
Explanation Chart What is
balance diet
1mint Nutrients
deficiency
disorders
Nutritional deficiency disorders
Malnutrition
Causes of malnutrition include:
unsuitable dietary choices
having a low income
difficulty obtaining food
Lecture
cum
discussion
Ppt What are
the nutrients
deficiency
disorders
9. various physical and mental health conditions
Undernutrition is one type of malnutritionTrusted
Source. It occurs when the body does not get
enough food and enough necessary nutrients. It can
lead to:
delayed growth
low weight
wasting
short- and long-term health problems
slow recovery from wounds and illnesses
a higher risk of infection
Some signs and symptoms of malnutrition include:
weight loss
a lack of appetite or interest in food or drink
tiredness and irritability
an inability to concentrate
10. always feeling cold
depression
loss of fat, muscle mass, and body tissue
a higher risk of getting sick and taking longer to
heal
longer healing time for wound.
1mint Therapeutic
diets
Therapeutic diets
A therapeutic diet is a meal plan that controls the intake
of certain foods or nutrients. It is part of the treatment of
a medical condition and are normally prescribed by a
physician and planned by a dietician. A therapeutic diet is
usually a modification of a regular diet. It is modified or
tailored to fit the nutrition needs of a particular person.
Therapeutic diets are modified for
(1) nutrients,
(2) texture, and/or
(3) food allergies or food intolerances.
Common therapeutic diets include:
1.Nutrient modifications
• No concentrated sweets diet
• Diabetic diets
• No added salt diet
Explanation Ppt What is
therapeutic
diet
11. • Low sodium diet
• Low fat diet and/or low cholesterol diet
• High fiber diet
• Renal diet
2. Texture modification
• Mechanical soft diet
• Puree diet
3. Food allergy or food intolerance modification
• Food allergy
• Food intolerance
4. Tube feedings
• Liquid tube feedings in place of meals
• Liquid tube feedings in addition to meals
5. Additional feedings – In addition to meal, extra
nutrition may be ordered as:
• Supplements – usually ordered as liquid nutritional
shakes once, twice or three times per day; given either
with meals or between meals
• Nourishments – ordered as a snack food or beverage
items to be given between meals mid-morning and/or
mid-afternoon
• HS snack – ordered as a snack food or beverage items
to be given at the hour of sleep
1mint Cookery
rules and
prevention
Cookery rules and preservation ofnutrients
In carbohydrates, cooking has a beneficial
Explanation Ppt What are
Cookery
rules and
12. of nutrients effect as it leads to gelatinization of starch and
caramelization of sugar which gives color and
flavor to food.
Proteins get denatured thus access to enzymes
and digestibility increases.
Moist heating of pulses improves protein
quality.
Chemical reactions take place when oil is
continuously heated. Reactions like hydrolysis,
oxidation, and polymerization of the oil. Oil
becomes dark and foamy, such an oil should
not be used for consumption
Blanching inactivates certain enzymes that lead
to undesirable browning.
Heat labile vitamins are lost.
Fat-soluble vitamins are lost during fat frying if
a product is not coated properly.
Guidelines For Preserving Nutrients
Wash vegetables, fruits and rice in just a
sufficient amount of water. It is advisable either
prevention
of nutrients
13. to cook in a minimum amount of water or to use
the cooking water in soups and gravies.
Cutting vegetables to small pieces and
exposing them to air before cooking leads to
loss of vitamins particularly vitamin C. Thus it is
advisable to cut large pieces and cook for a
shorter period.
The 3 R’s of cooking to conserve nutrients are:
1. Reduce the amount of water
2. Reduce the length of the cooking period
3. Reduce the amount of surface area exposed
Oil heated repeatedly should not be consumed
as repeated heating during frying leads to the
production of toxic substances due to pre-
oxidation and rancidity.
2mint Nutrition
assessment
and
education
Nutrition assessment and nutrition education
Nutritional assessment:
Nutritional assessment is the process of
determining nutritional status. It may reveal
Discussion Chart What are
Nutrition
assessment
and
education
14. nutrient deficiencies or excesses. The deficiency
may be primary due to inadequate intake or
secondary as a result of body inefficient use of
nutrients. We can use two levels: evaluating the
dietary intake, and evaluating the intake besides
considering how the body uses the nutrients.Diet
Evaluation: 24-hour recall, usual food intake, a
food record, a food frequency checklist, or a diet
history. One the data collected, they can be
analyzed.Assessment of nutritional status:1.
Clinical examination, observing eyes, mucous
membranes, skin, hair, mouth, teeth, and
tongue.2. Biochemical analysis of body tissue,
blood and urine tests, iron.3. Anthropometric
measurements, Ht, wt, limp circumference.
Nutrition education:
is the process of teaching the science of nutrition to
an individual or group. Health professionals have a
different role in educating an individual in the clinic,
community, or long-term health-care facility. In these
settings, the dietician, nutritionist, or nurse serves to
assist or enable individuals to incorporate changes in
eating patterns and behavior into their lives. The
major focus of this type of nutrition is not knowledge
and facts, but rather the development of permanent
15. behavioral changes. This is the art of nutrition
education – breaking down a large body of
knowledge into small, individual components that are
represented to a patient or client at a rate and level,
at which they are able to absorb and use the
information. Effective education is making nutrition
information digestible and usable in an everyday
setting.
1mint Food safety Food safety
Freezing food safely
When shopping, buy chilled and frozen foods at the
end of your trip and take them home to store as
quickly as possible. On hot days or for trips longer
than 30 minutes, try to take an insulated cooler bag
or ice pack to keep frozen foods cold. Keep hot and
cold foods separate while you take them home.
When you arrive home, put chilled and frozen foods
into the fridge or freezer immediately. Make sure
foods stored in the freezer are frozen hard.
Storing cooked food safely
When you have cooked food and want to cool it:
Put hot food into shallow dishes or separate
into smaller portions to help cool the food as
Lecture
cum
discussion
Ppt what is Food
safty
16. quickly as possible.
Don't put very hot food into the refrigerator.
Wait until steam has stopped rising from the
food before putting it in the fridge.
Avoid refreezing thawed food
Food poisoning bacteria can grow in frozen food
while it is thawing, so avoid thawing frozen food in
the temperature danger zone. Keep defrosted food in
the fridge until it is ready to be cooked. If using a
microwave oven to defrost food, cook it immediately
after defrosting.
As a general rule, avoid refreezing thawed food.
Food that is frozen a second time is likely to have
higher levels of food poisoning bacteria. The risk
depends on the condition of the food when frozen,
and how the food is handled between thawing and
refreezing. Raw food should never be refrozen once
thawed.
1mint National
nutritional
programs
and role of
National Nutritional Programs and roleof nurse
Currently major nutrition supplementation
programs in India are:
discussion ppt What are
the National
nutritional
programs
17. nurse 1) Integrated Child Development Services Scheme
(ICDS);
2) Mid-day meal Programs (MDM);
3) Special Nutrition Programs (SNP);
4) Wheat Based Nutrition Programs (WNP);
5) Applied Nutrition Programs (ANP);
6) Balwadi Nutrition Programs (BNP);
7) National Nutritional Anaemia Prophylaxis Program
(NNAPP);
8) National Program for Prevention of Blindness due
to Vitamin A Deficiency; and
9) National Goiter Control Program (NGCP).
The ICDS beneficiaries are children below 6 years,
pregnant and lactating mothers, and women aged
15-44 years, who are provided the following:
supplementary nutrition; immunization; health check-
ups; referral services; treatment of minor illnesses;
pre-school education to children aged 3-6 years. The
MDM program's intended beneficiaries are children
attending the primary school. Children belonging to
backward classes, scheduled caste, and scheduled
tribe families are given priority. The SNP is to provide
supplementary nutrition and health care services
including supply of vitamin A solution and iron and
and role of
nurse
18. folic acid tablets to pre-school children, and pregnant
and lactating mothers of poor groups in urban slums
and tribal areas. The ANP strives to make people
conscious of their nutritional needs and to provide
supplementary nutrition to children aged between 3-
6 years and to pregnant and lactating mothers. The
beneficiaries of the WNP scheme are children of pre-
school age and nursing and expectant mothers in
areas with high infant mortality such as urban slums
and backward rural areas. The program of BNP aims
to supply about one-third of the calorie and half of
the protein requirements of pre-school children
between the age of 3-5 years to improve the
nutritional status. The NNAPP scheme beneficiaries
are children in the 1-5 age group and pregnant and
nursing mothers, female acceptors of terminal
methods of family planning and IUDs. The NGCP
aims to supply iodized salt to the entire country by
1992.
Health Education
Health education being an extremely powerful
component in achieving the adequate healthy life,
nurse uses health education component as a tool
19. in every setting and where ever needed like
hospitals, clinics, community, schools, etc.
1. Nurse educates about healthy and balanced diet
to the peoples.
2. Gives knowledge about recommendations
required by different age and gender groups.
3. Educated about best and easy ways to achieve
good nutritious diet.
4. Managing easy nutrients from locally available
foods
5. Education about the Menu planning.
Hospitals
Nurse working in different wards of hospital are
very vigilant in maintaining adequate nutrition
levels for the client admitted.
1. In hospital nurse has to take care of nutritional
aspects of the admitted client in ward.
2. Educates the client as well as family members
20. regarding the importance of the healthy and
nutritious diet.
3. Nurse maintains the adequate diet plans for the
client.
4. Helps in monitoring the conditions of the client
like vomiting, input-output, electrolyte
monitoring, in order to add different components
in the diet.
5. Maintaining parental nutrition for the client.
6. Maintenance of adequate hydration.
Community
In community nurse focuses on the prevention
aspect i.e. helps in giving the basic education
regarding prevention of certain nutritional
deficiency disease. At the community level the
nurse can act as:
1. Community health nurse.
2. School health nurse.
21. And work in different sectors where she mainly
works at grass root levels to correct the nutritional
deficiencies in the client.
1. Nurse rectifies the different patterns of the
nutrition opted by the people.
2. Nurse collaborates with government and non-
govt. agencies working for nutritional betterment
of public sectors.
3. Nurse plays a role in school health programs as
school health nurse, helps in identification of
malnourished children and maintains growth
charts.
4. Involvement of family.
Bibliography :
1) Shubhangi Joshi, Nutrition and Dietetics 2 nd edition, Tata McGraw – Hill publishing company Limited,
New Delhi, 2002.
22. 2) Dr. M. Swaminathan, Handbook of Food and Nutrition, The Banglore printing and publishing Co. Ltd.
(Banglore press) 2004.
3) C. Gopalan, B. V. Ramasastri and S.C. Balasubramanian Nutritive value of Indian Foods, National
Institute of Nutrition, Indian Council of Medical Research, Hyderabad 1999.
4) Joshi V.D. Handbook of Nutrition and Dietetics vora medical publications, 1999.
5) Kusum Gupta (L. C.Guple, Abhishek Gupta) Food and Nutrition Facts and Figures, 5th edition Jaypee
brothers Medical publications (P) Ltd., New Delhi, India 2003.
6) T. K. Indrani, Nursing Manual of Nutrition and Therapeutic Diet, 1st edition Jaypee Brothers medical
publishers (P) Ltd., 2003. 7) Antia – Clinical Dietetics and Nutrition, ed., 4th .
