Introduction to Nutrition - BSc Nursing Notes

Note: The textbook "Bandana" (likely Nutrition and Dietetics for Nurses by Bandana Baruah or a similar author) is not available in our medical library database. The following notes are compiled from standard BSc Nursing nutrition curriculum content, covering all the key topics typically found in that chapter.

1. Definition of Key Terms

2. Scope and Importance of Nutrition in Nursing

• Nurses play a key role in assessing nutritional status of patients
• Proper nutrition supports wound healing, immunity, drug metabolism, and recovery
• Malnutrition is common in hospitalized patients (30-50%) and worsens outcomes
• Nutrition education is part of patient and community health promotion

3. Classification of Nutrients

A. Macronutrients (needed in large amounts)

• Primary source of energy: 4 kcal/g
• Types: Monosaccharides (glucose, fructose, galactose), Disaccharides (sucrose, lactose, maltose), Polysaccharides (starch, glycogen, dietary fiber)
• Functions: Energy supply, protein-sparing, fat metabolism, gut health (fiber)
• Sources: Cereals, rice, wheat, potato, sugars

• Energy value: 4 kcal/g
• Building blocks: Amino acids (20 total; 9 are essential: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine)
• Functions: Growth and repair, enzyme/hormone synthesis, immune function (antibodies), transport (hemoglobin), fluid balance
• Sources: Eggs, meat, fish, pulses, milk, soybean
• Complete proteins (all essential AAs): animal sources
• Incomplete proteins: most plant sources

• Highest energy value: 9 kcal/g
• Types: Saturated (solid at room temperature, animal fats), Unsaturated (plant oils - mono and polyunsaturated), Trans fats
• Essential fatty acids: Linoleic acid (omega-6), Alpha-linolenic acid (omega-3)
• Functions: Energy storage, fat-soluble vitamin absorption (A, D, E, K), cell membrane structure, thermal insulation, hormone synthesis
• Sources: Oils, butter, ghee, nuts, meat

B. Micronutrients (needed in small amounts)

C. Water

• Makes up 60-70% of body weight
• Functions: Solvent for reactions, temperature regulation, transport medium, lubricant
• Daily requirement: 2-3 liters/day (8-10 glasses)

D. Dietary Fiber

• Non-digestible carbohydrates
• Functions: Prevents constipation, reduces cholesterol, controls blood glucose
• Sources: Whole grains, fruits, vegetables, legumes

4. Energy Metabolism

• Calorie (kcal): Unit of energy in food
• Basal Metabolic Rate (BMR): Energy needed at complete rest to maintain basic life functions
  • Average adult BMR: ~1200-1800 kcal/day
  • Factors affecting BMR: Age, sex, body composition, thyroid function, fever
• Total Daily Energy Expenditure (TDEE) = BMR + Physical Activity + Thermic Effect of Food
• Recommended daily caloric intake:
  • Adult males: ~2000-2500 kcal/day
  • Adult females: ~1800-2000 kcal/day

5. Balanced Diet

• A diet that provides all nutrients in adequate amounts to meet body requirements
• Based on ICMR (Indian Council of Medical Research) guidelines for Indian population

1. Adequate calorie intake
2. Variety of foods (use food groups)
3. Moderate fat, especially saturated fat
4. Adequate protein from mixed sources
5. High fiber from whole grains and vegetables
6. Adequate vitamins and minerals
7. Adequate water intake
8. Minimal processed/refined foods

1. Cereals and millets
2. Pulses and legumes
3. Milk and milk products
4. Fruits and vegetables (green leafy + others)
5. Fats and oils
6. Sugar (in moderation)

6. Nutritional Assessment

• A - Anthropometric: Weight, height, BMI, mid-arm circumference, skinfold thickness
  • BMI = Weight (kg) / Height (m)²
  • Normal BMI: 18.5-24.9 kg/m²
• B - Biochemical: Serum albumin, hemoglobin, blood glucose, electrolytes
• C - Clinical: Signs and symptoms of nutritional deficiencies (hair, skin, nails, eyes, mucosa)
• D - Dietary: 24-hour dietary recall, food frequency questionnaire, diet history

7. Factors Affecting Nutrition

1. Age: Infants need high protein/fat; elderly need calcium and vitamin D
2. Sex: Men need more calories; women need more iron and folate
3. Physiological state: Pregnancy and lactation increase nutrient needs
4. Physical activity: Higher activity = more energy needed
5. Disease conditions: Fever increases BMR; malabsorption reduces nutrient uptake
6. Socioeconomic factors: Poverty limits food access and variety
7. Cultural and religious factors: Food taboos, fasting practices
8. Geographic/seasonal factors: Availability of local food
9. Psychological factors: Stress, depression affect appetite

8. Types of Malnutrition

9. Role of the Nurse in Nutrition

1. Assessment: Identify patients at nutritional risk using screening tools (e.g., MNA, NRS-2002)
2. Planning: Develop individualized dietary plans with the dietitian
3. Implementation: Ensure meals are served correctly, assist with feeding if needed
4. Monitoring: Track weight, intake/output, lab values
5. Education: Teach patients and families about healthy eating
6. Referral: Refer to registered dietitian for complex nutritional needs
7. Documentation: Record nutritional assessment and interventions

10. Routes of Nutritional Support

Quick Revision Points for Exams

• Caloric values: Carbohydrate = 4, Protein = 4, Fat = 9, Alcohol = 7 kcal/g
• Essential amino acids: 9 (mnemonics: PVT TIM HALL - Phenylalanine, Valine, Threonine, Tryptophan, Isoleucine, Methionine, Histidine, Arginine*, Leucine, Lysine)
• Fat-soluble vitamins: A, D, E, K (stored in liver/fat, risk of toxicity)
• Water-soluble vitamins: B-complex, C (excreted in urine, need daily replenishment)
• Scurvy: Vitamin C deficiency - bleeding gums, poor wound healing
• Rickets: Vitamin D deficiency in children
• Pellagra: Niacin deficiency - "3 Ds"
• Beriberi: Thiamine deficiency - wet (cardiac) and dry (neurological) forms
• Normal serum albumin: 3.5-5.0 g/dL (indicator of nutritional status)
• Normal BMI range: 18.5-24.9