The adequacy of the individual nutrition study according to the daily energy intake icon

The adequacy of the individual nutrition study according to the daily energy intake




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Лекция на тему: Здоровье детей и подростков как гигиеническая проблема. Физиолого-гигиенические
Лекция на тему: «Окружающая среда и здоровье»
Health (who) it is a state of complete physical, mental and social well-being, and not merely the absence of diseases or infirmity
Lecture “ Nutrition as a health factor”
Лекция на тему «Труд и здоровье»
Вода и здоровье” ( лекция для англоязычных студентов 3- го курса ммф ) Лекцию подготовил доцент кафедры гигиены и экологии Клименко А. И
Theme Hygienic assessment of the complex microclimate influence to the human organism
Тopic 8 methods of hygienic assessment of complex effects of the microclimate on the human heat exchange
Theme: methods of hygienic assessment of the dust and chemical admixtures level in atmospheric air
The methods of air sampling
Methods of determination and hygienic assessment of the dust content in the air
Theme: Food poisoning prevention
Theme: the complex assesment of individual health of children and adolescents
Hygienic assessment of conditions and organization of education in comprehensive school
Hygienic estimate of insolation regimen, daylight and candlelight of hospital apartments
Theme: Methods of hygienic investigations and assessment natural illumination and insolating regime in premises Purpose
Solar radiation and its hygienic importance
Topic №4 methods of determination and hygienic assessment of natural lighting in different premises
Topic №5 methods of determination and hygienic assessment of artificial illumination in different premises
Theme: Methods of the hygienic investigation and assessment of the artificial illumination in premises Purpose
The adequacy of the individual nutrition study according to the daily energy intake
Hygienic importance of the air movement in premises
Determination of atmospheric pressure
Research of the factor of infra-red radiation
Тopic №6 Method of determination of temperature and humidity conditions indoors and their hygienic assessment
Method of determination and hygienic assessment of the air movement direction and speed
Methods of determination of со
Microclimate of premises
Theme: Hygienic assessment of the noise and vibration as occupational hazards
Topic №18 method of hygienic assessment of soil according to sanitary examination of the land parcel and results of laboratory analysis of samples
The hygienic estimation of quality of potable water according to inspection and to results of the laboratory analysis
Umanskiy, А. N. Bessmertniy hygienic regulation of water quality. Basic methods of water treatment
Theme: Hygienic assessment of occupational hardness and intensity
Theme: Methods of determination of the ultraviolet radiation intensity as such as preventive dose of it’s irradiation and use it for diseases prevention and air disinfection in premises




THE ADEQUACY of the INDIVIDUAL NUTRITION STUDY ACCORDING TO the DAILY ENERGY INTAKE.

Topicality of the theme:

The adequate nutrition corresponding to the organism physiological needs of energy and chemical substances provides the organism resistibility to adverse environmental factors and is the basis of the person’s health. It can be assessed by the menu- apportion. A general physician should be able to control of the menu – apportion proceeding correctness and assess the individual nutrition according to physiological requirements as such as work out recommendations to the ration nutrition optimization. Main feature this theme is the possibilities for each student to assess his/her individual nutrition, correct it and this measure provides a strengthening health condition.

The purpose (general)- to be able to assess the adequacy of the individual nutrition by on the menu – apportion and work - out recommendations to it’s optimization.

Specific goals:

To know how:

  1. To make a menu- allocation and to carry out on it’s calculations with determining of caloric value and nutrients contents.

  2. To determine the proteins, fats, carbohydrates, minerals and vitamins amount.

  3. To assess balance nutrients and vitamins.

  4. To assess nutrition regime.

  5. To work-out recommendations to nutrition optimization.

ACADEMIC CONTENT.

Theoretical questions underlining the implementation of purpose full activities.

  1. The notion, about the adequacy nutrition, balanced diet, general requirements to the nutrition.

  2. Nutrients and biological active substances in the ration hygienic importance, indices which nutrition value of the ration characterizing.

  3. The nutrition regime notion, indices which it characterizing, hygienic requirements.

  4. Physiological principles of the nutrition standardizing in Ukraine.

  5. Methods of population nutrition adequacy studying and assessment.

  6. The students’ nutrition by menu – apportion assessment proceeding.

7. Principles of ration nutrition optimization.

On mastering required knowledge start to study the following literature:

Basically.

  1. Даценко І.І., Габович Р.Д.Профілактична медицина. Загальна гігієна з основами екології: Навчальний посібник. K.: Здоров’я, 1999.-С. 310-354.

  2. Даценко І.І., Денисюк О.Б., Долошицький С.Л. Загальна гігієна, посібник для практичних занять.-Львів: Світ, 2001.- С. 147-157.

  3. Лекція по теме.

  4. Граф логической структуры темы (Приложение 1).

Supplementary:

  1. Габович Р.Д., Познанский С.С., Шахбазян Г.Х. Гигиена. - К.: Вища школа, 1983.- С. 134-155.

  2. Румянцев Г.И., Вишневская Е.П., Козлова Т.А. Общая гигиена.- М.: Медицина 1985.-С.24-53.

  3. Пивоваров Ю.П., Гоева О.Э., Величко А.А. Руководство к лабораторным занятиям по гигиене. – М.: Медицина, 1983.- С. 4-12.

Oriented bases for activities.

After mastering the above problems acquaint yourself with supplements to this theme , which will allow you to muster professional skills in a more successful.

To check knowledge of the given material do the following tasks.

Teaching type tasks:

The task 1.

A list of the products, their caloric, nutrients, vitamins contents were presented in the menu – apportion What index was absent in this list?

  1. Proteins.

  2. Fats.

  3. Carbohydrates.

  4. Minerals.

  5. Hormones.


The task 2.

The doctor’s diet includes breakfast, dinner and supper with interval between breakfast and dinner of 8 hours, dinner and supper- 6 hours. Look for regimen infringement in this situation as:

  1. It should be adequacy nutrition

  2. The diet is rational.

  3. Long interval between breakfast and dinner.

  4. Shot interval between dinner and supper.

  5. The diet is irrational.


The task 3.

In the diet the protein calorie quota makes 11 %, fats of 25 %, carbohydrates of 64 % Assess the diet balanced as:

  1. The diet is not balanced.

  2. The protein quota is reduced.

  3. The carbohydrates quota is increased.

  4. The fats quota is reduced.

  5. The diet is balanced.

The task 4.

It is necessary to assess population nutrition state in Ukraine. Select adequacy investigation method as :

  1. Balancing.

  2. Budgetary.

  3. Questionnaire.

  4. Menu apportion.

  5. Laboratory.



The task 5.

The daily student’s diet contains 30 mg of vitamin C. Student complains of the general weakness, gingival hemorrhage, the contents of vitamin C in urine is

reduced. Offer measures of preventive prophylaxis of hypovitaminosis.

  1. Hardening the organism.

  2. Inclusion in the diet of the fresh vegetables, fruit.

  3. Decrease of the teaching loading.

  4. Inclusion in a diet of the meat.

  5. Inclusion in a diet of the butter.

The task 6.

The daily diet contains 92 g proteins. How many it should be animal protein origin?

  1. 20 gr.

  2. 34gr.

  3. 46 gr.

  4. 51 gr.

  5. 75 gr.

The task 7.

The student’s daily animal fat intake makes under the norm. Select product which animal fat source as:

  1. Bread.

  2. Apple.

  3. Corn.

  4. Fish.

  5. Salt.

Keys: 1-D; 2 - C; 3 – E.

Concise methodical recommendations for a study .

The students’ independent work includes the menu - apportion drawing up and analysis of indices which individual nutrition characterizing. Then each student makes a conclusion about his/her ration nutrition assessment and works out recommendations by it’s optimization. For this purpose should be used instructions and samples in sup. 2.The final test control over the theme is carried out.


Technological chart of the practical study.





Stages

Time,

Min.

Teaching aids used at classes , location and characteristic of study

A site and character of occupation

1.


2.


3.


4.


Checking and correction base line level.


Independent work.

2.1 The menu apportion drawing up and analysis of indices which individual nutrition characterizing.

2.2 Each student makes a conclusion about his/her ration nutrition assessment and works out recommendations by it’s optimization..

Analysis and correction of conclusions

The final test control and determining the assessment of study outcome

15


220


20


15

Test tasks, educational tables, graph of logical structure, instructions, normatives.

Laboratory of the department, seminar-pract.



Sup. 1

Graph of logical structure of the theme


THE ADEQUACY of the INDIVIDUAL NUTRITION STUDY ACCORDING TO THE DAILY ENERGY INTAKE.


The adequacy nutrition


General requirements to nutrition


Calorie content

Nutrition regimen

Ration balance

Nutrients amount


Methods of the assessment population nutrition value


Calculating

Quest–weight

Questionnair

Budgetary

Balancing


Nutrition status

Morbid. rate

Laboratory


Nutrition value assessment


Inadequacy

Adequacy


Optimization measures to regimen


Optimization measures to ration


Sup. 2

Instructions


of the drawing up, calculation and assessment of the menu-apportion

1. Draw up the special table as a sample below:

N

Menu

Dishes apportionby products amount

Weight,g

Calorie

Kcal

Proteins,g

Fat,g

Carbohyd,g

Ca,mg

P,

mg

Vitamins

A, B1 C,

mg mg mg

1

2

3

4

5

6

7

8

9

10

11

12

13

I. B r e a k f a s t:

1. Fried eggs 2 eggs 100

with a boi butter 5

led sausage sausage 50

  1. Bread bread 100

  2. Coffee Sugar 10

with milk Milk 20

ETC.


2. Fill in columns 1 and 2 by each meal

according to time – keeping data which had done on the previous study

3.Fill in columns 3-4 . Every dish you should lay out to component products. It’s very simple for dishes as such as sandwiches etc. Dish bread is bread product, but fried eggs could contain-eggs, butter, sausage etc. (see sample). For complex dishes you should use

department manual “Nutrition hygiene (tables), p3-7

Remember about some weight of :

-middle size egg - 50 gr.

-small bread piece - 20 gr.

-small butter piece - 10 gr.

-small a soup plate - 250 gr.

-1 glass of a milk - 200 gr

If you have problem ask instructor about the products weight.

  1. Fill in columns 5-13, using special tables from.

  2. When fill in all columns calculate sum by columns 5-13 and this action you will finish draw up the menu apportion.

  3. By the next step you have convenient and obvious form for the menu - apportion date assessment. For this purpose draw up the next special table.



Analytical table

characterizing student’s nutrition ration





N

Characterizing index

Value

Norm

Difference from the norm (+, -)

1

2

3

4

5

I. Energetic ration value

1.Calorie ration content, kcal

II. Nourishing ration value

2. Total proteins amount, gr

3. Animal origin protein, % 50

4. Total fat amount, gr

5. Animal origin fat, % 70

6. Total carbohydrates amount, gr.

7. Mono-disaccharides amount, % 20

8. Ca amount, mg

9.P amount, mg

10. Vit. C amount,mg

11. Vit. A amount, mg

12. Vit. B1 amount, mg

III. Ration balance indices

13. Proteins : Fat : Carbohydrates ratio 1:1:5,8

(proteins amount are taken for 1)

14. Caloric quota, %

14. 1 Proteins 11

14. 2 Fat 25

14. 3. Carbohydrates 64

15. Ca : P ratio ( Ca amount is taken for 1) 1:1

IY. Student’s ration regimen


16. Meals number 4

17. Intervals between meals

17. 1. Breakfast –Snack 4

17. 2. Snack – Dinner 3

17 3. Dinner-Supper 4

18. Daily calorie content to meals distributed ( percentage ):

18. 1. Breakfast 20

18. 2. Snack 10

18. 3. Dinner 50

18. 4. Supper 20

19. Meals duration, min

19. 1. Breakfast 20

19. 2. Snack 10

19. 3. Dinner 40

19. 4. Supper 20


  1. Rewrite columns N1-2 and fill in column 3, calculating proper values. Some of them you should carry from previous table (total calorie, proteins etc) others by calculating

    1. Animal origin protein amount:

Animal origin protein amount x100%

Total protein amount

7.2. Proteins : Fat : Carbohydrates ratio

(proteins amount are taken for 1):

Fats Carbohydrates

1: Proteins : Proteins

7. 3. Calorie quota as you did

  1. Fill in column 4. Part of norms rewrite as you see, for others:

8. 1. Line 1 – daily energy expenditure.

8. 2. Lines 2, 4, 6 – from previous study.

8. 3. Lines 8-12 from department manual “Nutrition hygiene (tables), p10.

corresponding to your sex.

  1. Calculate or determine difference from the norm by each line and fill in column 5 keeping a difference sign.

  2. Analyse column 5 data and notice index which the difference is more then 10% out of norm. It means that you have determined index which difference is departure from the norm.

  3. Make a conclusion about your nutrition assessment by following variants:

11. 1. The nutrition is adequacy – this variant you should use in case all indices are in normative limits.

11. 2. The nutrition is inadequacy – this variant has subvariants as :

11 .2. 1. The nutrition is inadequacy insufficient . This variant you use in case even only one index is under the norm

11. 2. 2. The nutrition is inadequacy superfluous. This variant you use in case even only one index is over the norm

11. 2. 3. The nutrition is inadequacy with regimen infringement. This variant you use in case even only one index of the nutrition regimen exceeded of the norm.

11. 2. 4. The nutrition is inadequacy insufficient by some indices (listed) and superfluous by others indices and regimen infringement characterizing.

  1. Select and substantiate variant of conclusion.

  2. Work out recommendation for your nutrition optimization toward changing ration structure or (and) nutrition regimen.

Sup. 3

The brief contents of theoretical questions


1. Rational nutrition should be considered as a most important life style component as well as the factor of the expectancy active life. prolongation. The evidence of this fact is the consumption more then 70 irreplaceable substances each of which makes strict determination role in metabolism. Metabolism disturbances are the basis of each pathological process . Metabolism disturbances originated from inadequacy nutrition, that is nutrition does not correspond to physiological needs.

Rational nutrition is the organised correctly well cooked food in time provision , which supplies the organism daily energy expenditure and all optimal amount nutrients and biologic active substances contains balancing form results that in good development, high capacity for work, resistance to adverse factors etc other vital functions.

Rational nutrition provides not only life duration but life quality as well.

Homeostasis preservation is the most important condition for normal metabolism depending on nutrition. Nutrition structure infringements leads to many grave diseases widespread including as well.

Requirements to the nutrition ration:

- nutrition ration should cover daily energy expenditure;

- should contain all necessary in optimal amount nutrients. The notion optimal in this case is determined by age, sex, work intensity, environment quality etc. ;

- all nutrients and biologic active substances should be balanced ;

-nutrition should be various;

-nutrition ration should make satiation sensation , but not to overfill the gastrointeric tract ;

  • Ration organoleptic characteristics should contribute to good appetite;

  • Ration should be digestible and assimilated.

  • Ration should be harmless.

With the purpose a ration assimilation and good digestion one should nutrition regimen keep.

2. Physiologic valuable nutrition is provided balance by nutrients and active biologic substances . The ration balance makes for nutrients assimilation, normal metabolism and minimise their loss in human organism. . Most important balanced indices in ration are proteins : fat : carbohydrates ratio. It should be 1:1:5,8 , Ca : P (1:1) and Ca :Mg ( 1 : 0,3 ). Normative caloric quote for proteins is - 11%; fat - 25%; carbohydrates – 54%.

3. Physiologic importance nutrients for human organism.

3.1. Proteins:

- plastic function. They includes to all tissue of the organism;

- regulating function. They includes to all enzymes, and majority of hormons;

- transport function. They transports a blood oxygen, lipids, carbohydrates, hormons and some vitamins as well as minerals through the cellular membrana ;

- immunobiological function. They take a part in antibodies formation , increase the human body resistance to adverse factors ;

- metabolic function. They provide proteins, fats, carbohydrates, vitamins, minerals normal metabolism;

-energetic function. They are degraded and 1 gr out puts 4 kcal energy ;

-specific functions. They take parts in hemopoiesis, reproductive and endocrine functions.

For vital processes providing the daily nutrition ration should contain 55% animal origin proteins and 45% vegetable one, for infants – 80 - 100%.

3.2. Fats:

  • energetic function. They are degraded and 1 gr out puts 9 kcal energy ;

  • plastic function. They includes to all tissue of the organism, take part in lipid structures building, cellular membranes forming;

- -metabolic function. They are related to proteins, fats, carbohydrates, vitamins, minerals normal metabolism;

  • protective function. They protect human bogy out of the supercooling;

  • they are vitamin F providers ( polyunsaturated fatty acids, PUFA);

  • they are fatty- soluble vitamins providers ;

  • They improve the foods taste characteristics.

For vital processes providing the daily nutrition ration should contain 20-30 vegetable origin fat.

3.3. Carbohydrates:

  • energetic function. They are degraded and 1 gr out puts 4 kcal energy ;

  • plastic function. They includes to all tissue of the organism;

  • detoxicating function. They promote to not only metabolism product , but toxic and drug substances excretion as well;

  • they are CNS provider;

  • they provide gastrointestinal tract secretory and motor functiones;

  • they intestinal microflora normalize ;

  • specific functions. Heteropolisaccarides determine blood groups formation, anticoagulant system is determined by carbohydrates. C vitamin is carbohydrate by it’s nature.

The optimal ration carbohydrates amount should be 80%- polysaccharides ( 75% - starch), 3% - pectins, 2%- nutrient enema) and 20%-mono-disaccharides . Pectins and nutrient enema are nonassimilating carbohydrates but they have big importance for organism because gastrointestinal motor and secretory functions, cholesterin metabolism and intestine microflora normalize, help to organism decantomination.

Depending on enema amount foods are classified as “protected” ( enema amount more then 0,4% ) and “unprotected “ ( enema amount under 0,4% ) carbohydrates. “Protected” carbohydrates are not transformed to adipose.

4. Nutrition regimen it is an organization of the food consumption. It is characterized by following indices:

  • a meals number;

  • an intervals between meals;

  • a total caloric percentage to the each meal;

  • a meal time constancy ;

  • a time meal duration;

  • a dish intake succession.

Requirements to regimen indices are based on digestion, central and vegetative systems physiology . A meals number is physiology based in case it is 4 number, and the time between meals at least 4 and no more 5 ours. A total caloric percentage to the each meal would be two variants. The first variant includes 2 breakfast, dinner, supper. The breakfast caloric value is – 20%, second one-15%, dinner-45%, supper –20%. Second variant includes breakfast, dinner, snack, supper. In this case the breakfast caloric value is 25%, dinner – 45%, snack – 10%, supper – 20%. A time meals constancy has importance meaning because a trace reflex making helps to food intake,

gastric juice producing when one in time provides. The meal time depends on food value. This time is spent for the food intake, grinding and in gastric juice soaking. It should begin a meal by appetizers , salads using which digestive glands stimulate and to finish with dessert because sweet dishes inhibit activity one.

The correct nutrition regimen helps to digestion efficacy, assimilation of ration , metabolism is regulated, necessary nutrients and energy intake in time provided. Diseases of the digestive system are prevented

Regimen forming depends on age, work, health, as well as weight superfluous or tendency to corpulence. A meals number are made more frequent for child, elderly age, corpulent people, patients etc. Maximal caloric value in hot climate has morning and evening time meals and minimal one in hot day .part. In night shift dinner and supper caloric value are changed.

5. The making physiological norms base is the physiological needs of human organism covering of energy and nutrients. Physiological needs depends on work intensity, age, sex, some specific functional states, climate conditions etc. All these factors influence on human metabolism, organs and systems functioning. According to these principles all Ukrainian population are distributed to 2 sex, children and adult, 3 adult age , 4 work intensity groups. For each groups are suggested nutrients, vitamins and minerals norms. It were suggested also norms for elderly people in 60 - 75 years and older, for pregnant and nursing women as well.

6. For the adequacy nutrition assessment are classified following methods:

6.1. Balancing method is a consumption foods balance for city, region, country population are studied. Not only qualitative but quantitative nutrition side are studied also.

6. 2. Budgetary method – average family budget is estimated for nutrition using.

6. 3. Questionnaire method - questioning of population is made by special questioner for assessment quantitative nutrition side.

6. 4. Questioning – weighting method – the closed groups nutrition are assessed depending on subjective attitude to their nutrition and by foods weight and body mass control.

6. 5. Calculating by menu - apportion. Menu - apportion are made in medical and child establishments, military sub-units etc for 7 - 10 days for the nutrition adequacy assessment by the caloric, nutrients, foods list and their variety value.

6. 6. Laboratory method . This is the objective by energy and nutrients value method assessment. It is accurate but difficult, labour - intensive and expensive method for the percentage menu – apportion realization assessment.

6. 7. Population morbidity assessment. Morbidity rate nonspecific diseases are increased in adequacy nutrition case.

  1. 8. Nutrition status assessment. It is classified following human health status depending nutrition level as:

- Normal (ordinary) status. Organism structure and functions are not impaired. Adaptation reserves are equal for adaptation to the ordinary conditions of activity.

- Optimal status is formed by special rations using for high level tolerance to adverse and stressful factors providing.

- Overnutrition status. Organism structure and functions are impaired leading to capacity for work and health level decreasing

- Insufficient status is formed by caloric and nutrients level are insufficient, leading to health level decreasing also.

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