NURS 2090 Lecture Notes - Kwashiorkor, Water–Electrolyte Imbalance, Lipoprotein

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16 Apr 2013
Altered Nutrition
Nutrition: Ingestion and utilization of nutrients for energy
*nutrition is as (if not more) important as pharmaceuticals for our health and healing.
Essential Nutrients: must be consumed regularly in diet as body is unable to synthesis
quantities needed
Metabolism allows chemical reactions that:
1. Produce heat and maintain body temp
2. Conduct neuronal impulses
3. Contract muscle
Hippocrates said let food be thy medicine; however, we have changed the way we look
at health. We no longer look at optimal nutrition, but rather medications. Dr’s nowadays
get very little education on nutrition.
There is a lot of money to be made, by having ppl sick.
You are what you eat! Food does matter.
How old is your food? By the time it gets to you, it has travelled 2000 km. It is at least 5
days old. How much nutritional value does it have? If you are lucky, you are getting at
least 40% of what you need.
Foods are being genetically modified (which we know nothing about), the fertilizer
nowadays has (P, K, N); however it actually needs 52 other types … which are missing.
Plants become diseased, less resistant to pest.
There is business in selling pesticides to ‘fix the problem’
On top of having the food grow deficient in nutrients, we then cook it. Which then
looses more of the nutritional value (because of decreased enzymes, remember heat
denatures proteins/enzymes)
In response to COOKED food, our body launches an inflammatory process, digestive
leukocytosis (generating WBC activity). It recognizes the food as a toxin.
Study done that showed if you eat 51% of your diet in COOKED food, your body will
react in the same way, as if your body was being invaded by a foreign organism.
If 51% of your food is RAW, you will have no leukocytosis (no WBC’s activated),
which means you will not overburden your immune system.
Nutrient deficiency is the #1 cause of illness and disease
Water: *adults can survive only 10 days w/out water (children only 5 days), metabolically
active cells have the most devastation (i.e mucles b/c they have the most water)
1. Solvent promoting availability of
solutes to cell
2. Promotes/maintains fluid balance
3. Transport medium for
4. Serves as a lubricant
5. Regulates body temp
6. Foundation for metabolic reactions
7. Contributes to structure of cells
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1. Protein (proteins → amino acids, which are absorbed. Amino acids synthesize proteins)
20 different kinds in the body (9 are essential)
Required to build/maintain body tissue (muscle, bone matrix and connective tissue)
Composes blood, cell membranes, immune factors, enzymes and hormones
Transports substances across membrane
Combines with other substances to form new substances (protein + nucleic acid =
DNA/RNA, protein + carbs = glycoproteins, protein + lipids = lipoproteins, proteins
+ metals = hemoglobin)
Public has a fear in protein deficiency. But it’s easy to eat too much of it, will burn it
as a fuel (but it is much less efficient than carbohydrates/fats, and does not burn
clean. It will leave ashes, amino acid residue that must be filtered by the
Too much protein will cause the liver and kidneys to become overrun with residue
(this is why in kidney and liver failure patients are often on a protein-restricted diet,
but not just end stages!!! May help prevent/delay end stage kidney failure.
Reduce animal proteins. Try to substitute veggie proteins/soy. Evidence for soy is
strong (but not soy substitutes/supplements). Offers protection against cancer,
especially for prostate and breast cancers.
2. Carbohydrates
Glucose is absorbed across the intestinal wall and transported to the liver
50% is used for oxidation of stored as glycogen and the other 50% exits the liver and
is circulated throughout the body to be used by cells for energy
Main role of carbs is to provide energy (but they are not considered essential
nutrients, because the body can make them from other sources; however, the other
ways are less efficient)
The brain is the largest consumer of glucose but this can be provided by fats and
proteins (AAs from protein and glycerol from triglycerides can be converted into
glucose)*this is not an efficient but adaptive process
Carbs (complex rather than sugar) should compose the largest part of the diet,
because complex have vitamins and minerals and is broken down slower.
1. Monosaccharides: glucose & fructose
2. disaccharides & oligosaccharides: glucose & fructose
3. polysaccharides: starch & fiber
Fiber (indigestible carbs)
Reduces serum cholesterol levels
Binds to bile acids (cholesterols) to prevent absorption
Influences gastric motility
It binds to bile salts to prevent obstructions in the bowel
It decreases colon cancer and cholesterol, We should be consuming 35mg/day
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Video on Carbs:
Plants make carbohydrates by binding energy of sunlight, with CO2 + water, to create
glucose (energy currency of all life).
Misinformation of carbs in our culture. Simple/complex, told to eat less simple and more
complex. Glycemic index/load is actually more important to look at it. Culture is slow to
accept this new outlook. More difficult to understand. Less familiar.
Glycemic index: 1. Puffed rice cake is at the top of the scale b/c infinite surface area to
digest, 2. Table sugar is low because body has little ability to metabolize fructose. 3.
Oatmeal cookie has less glycemic value than oatmeal b/c it has fat, which slows gastric
emptying, 4. Acid added to food lowered the glycemic load because it slows gastric
Forms of glycemic index determined by chemical, mechanical nature.
Glycemic index vs load depending on the type of carb we eat, this will cause a spike in
blood sugar at different rates (fat and acid will slow this down)
Grains have sustained human life. But it’s what we have done with grains that is the
problem. Almost everything is made with grain. Also high sugar. Its everywhere.
Combination of high sugar, and carbohydrates (flours), is a huge glycemic load, which
creates obesity, insulin resistance, metabolic syndromes.
Glycemic load: more useful, is a number that estimates how much the food will raise a person's
blood glucose level after eating.
Glycemic index: If you take this into account, you will tell ppl not to eat carrots/beats because of
the high index, but that is not sound nutritional advice. Content is important. May have to eat a
large quantity to have a negative effect. It is a scale that ranks carbohydrate-rich foods by how
much they raise blood glucose levels compared to a standard food. The standard food is glucose or
white bread.
3. Lipids (insoluble in water) **it’s the overabundance of sugars- NOT FATS in obesity prob
Provide a rich source of energy, stored in adipose (a small amount can be stored in
other parts, like the liver, but too much will impair its function)
Structural fat is not accessed for energy. It is used structure/ protection to body
organs/nerves. Found in brain, liver, kidney, heart, etc (essential for survival)
1. Supports digestion (decreases gastric motility & secretions)
2. Stimulates pancreatic and bile secretion
3. Facilitates digestion, absorption and transport of fat soluble vitamins
4. Supports brain, CNS and cell membrane function (Omega 3, and phospholipids)
5. Hormones
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