Dent 214 Nutrition CH 16 MDA Seema Jain. Introduction You probably have heard the expression, “You are what you eat.” This is true because food is used.

Dent 214 Nutrition

CH 16 MDA

Seema JainSeema Jain

Introduction

You probably have heard the expression, “You are what you eat.” This is true because food is

used to build and repair the body. Food choices must therefore be based on sound information

and knowledge.

Malnutrition during crucial periods may result in physical or mental disabilities. Well-nourished

persons are usually better able to heal and ward off infections than poorly nourished individuals.

Introduction-cont’d

The study of nutrition includes all the processes involved in the selection, intake, and utilization of nutrients.

Nutrients are the components in food that supply the elements necessary to meet the

bodies requirements for energy, growth, maintenance, and well-being.

Understanding Nutrition

• Your body is a giant chemistry lab

• Nutrients are the reagents in the lab

– Question: Why does a dental assistant need to know anything about nutrition?

The Role of the Dental Assistant• As a dental assistant, you will be discussing

nutrition and food choices with patients in a variety of circumstances including:

– Counseling patients about the prevention of tooth decay

– Counseling patients regarding their diet following oral surgery or other dental procedures

– Performing dietary analysis with patients

– Counseling patients who have orthodontic appliances on their teeth regarding food choices

Fig. 16-1 The dental assistant discusses nutrition with the patient.

Recommended Dietary Allowances (RDA)

• The RDAs are the levels of essential nutrients that are needed by individuals on a daily basis.

• The RDAs are based on scientific knowledge about each nutrient.

• The RDAs are determined by the Food and Nutrition Board of the National Academy of Sciences.

• The RDAs are reevaluated and reissued approximately every 4 years to keep up with emerging research.

Food Guide Pyramid

• The Food Guide Pyramid is designed to reflect the new dietary guidelines that call for more consumption of grains and less consumption of meat, sweets, and fats.

• The pyramid is divided into six sections.

– Two symbols, a circle and a triangle, are used on the pyramid. The circle indicates fat that occurs naturally or is added, and the triangle indicates sugar that is added.

Fig. 16-2 The Food Guide Pyramid (From U.S. Dept. of Agriculture and U.S. Dept. of Health and Human Services, 1996.)

Latest Food Pyramid

• One size doesn't fit all. MyPyramid Plan can help you choose the foods and amounts that are right for you. For a quick estimate of what and how much you need to eat, enter your age, sex, and activity level in the MyPyramid Plan box.

• Make smart choices from every food group.

• Find your balance between food and physical activity, and

• Get the most nutrition out of your calories.

Key Nutrients

• Carbohydrates

• Proteins

• Lipids (fats)

• Water

• Vitamins

• Minerals

Nutrients

• A.A. 6 Essential Nutrients –must be supplied by

food.

• B.B. Energy yielding nutrients~Energy measured as kcalories (kcal)

– 1.1. FatFat = 9 kcal/gram

– 2.2. ProteinProtein = 4 kcal/gram

– 3.3. CarbohydrateCarbohydrate = 4 kcal/gram

Energy in almost all foods is provided by a mixture

of energy yielding nutrients

Nutrients

– 4.4. VitaminsVitamins

Organic Compounds

Consumed in smaller quantities

Assist in body processes

Vulnerable to destruction

Nutrients

– 5. Minerals5. Minerals

Inorganic elements

Consumed in varying quantities

Indestructible yet can by bound by substances

Nutrients

• 6. Water6. Water

Indispensable and abundant

Often taken for granted (forgotten nutrient)

Enormous consumption compared to other nutrients

Participates in many chemical reactions

Provides environment for many body activities

Recommended Nutrient Intakes

• A. Recommended Dietary Allowances (RDA)A. Recommended Dietary Allowances (RDA)

– 1. Energy intake is set at the population average

– 2. Protein is based on body weight

– 3. Thirteen vitamins and seven major minerals

• a. Specific recommendations

• b. Based on valid scientific studies

• c. Vary among individuals

Recommended Nutrient Intakes

• B. Using the RDAB. Using the RDA

– 1. Healthy people only

– 2. Safe and adequate recommendations not requirements

– 3. Intended to be met by consuming a variety of foods

– 4. Average daily intakes

– 5. Used to plan and evaluate diets for populations

– 6. Guidelines for nutritional labeling of foods

– 7. Safety margins

Vegetarian/Vegan

• 1. whole grainswhole grains: (unprocessed) bread, pasta, cereal, rice, corn (fiber, complex CHO, vits, protein)

• 2. vegetablesvegetables: rich in vits and mins

• 3. fruitsfruits: high complex CHO, vits, fiber

• 4. legumeslegumes: high fiber, complex CHO, protein, mins

Dental Nutrition

Carbohydrates

• Carbohydrates

– Simple sugars

– Complex carbohydrates

– Dietary fiber

• Cariogenic=producing or promoting decay

• Sugars +bacteria = acid

• Acid dissolves minerals in tooth structure - weak

Cariogenic Foods (Causing Decay)

• Any food that contains sugars or other carbohydrates that can be metabolized by bacteria into plaque is said to be cariogenic.

• Refined carbohydrates, such as candy and other sweets, are cariogenic because their sugars are readily available.

• A major factor in determining the cariogenicity of carbohydrate depends on how long the food stays in the mouth.

Cariogenic Foods-cont’d• Sugary liquids, such as soft drinks, leave the

mouth quickly and are not as cariogenic as sticky foods, such as raisins or caramels.

• Foods such as crackers, although not sweet, are cariogenic because they stick to the teeth and remain in the mouth long enough to be broken down into sugars.

• Another important factor in determining the cariogenicity is whether the food stimulates the flow of saliva.

Tooth Development• Nutrients essential for tooth development and

maintenance include vitamins A, C, and D, as well as calcium, phosphorus, and fluoride.

• The protein in dentin is collagen, which is dependent on vitamin C for normal synthesis.

• A tooth’s enamel contains keratin, a type of protein, and requires vitamin A for its formation.

Tooth Development contd.• Vitamin D is essential to the process by which

calcium and phosphorus are deposited into crystals of hydroxyapatite, the structural matrix of bones and teeth.

• During tooth development, fluoride is incorporated into the pre-eruptive tooth’s mineralized structure, along with calcium and phosphorus to form fluorapatite, a compound more resistant to erosion than hydroxyapatite.

Caries

• A. Causative agents:

– 1. Tooth chemistry

– 2. Salivary flow

– 3. Types of plaque

– 4. Type of fermentable CHO

– 5. Frequency and consistency of intake

(Nursing bottle syndrome)

Periodontal Disease

• A. Food and nutrition can affect periodontal disease at three levels by:

– 1. Contributing to microbial growth in the gingival crevice

– 2. Affecting the immunological response to bacterial antigens

– 3. Assisting in the repair of connective tissue at the local site after injury from plaque, calculus, and so forth.

Periodontal Disease

• B. Nutritional deficiencies can contribute to periodontal disease by interfering with:

– 1. Integrity of the epithelial barrier

• a. Vit A is needed

– 2. Tissue repair process

• a. protein, Vit C, zinc, calcium, phosphorus

– 3. Resistance mechanisms

• a. protein

Periodontal Disease

• C. Summary:

– 1. “To maximize periodontal health, one must eat a diet that is varied, adequate, and balanced”

Copyright © 2005 by Elsevier Inc. All rights reserved.

Key Nutrients

• Carbohydrates

• Proteins

• Lipids (fats)

• Water

• Vitamins

• Minerals


Carbohydrates

• Carbohydrates

– Simple sugars

– Complex carbohydrates

– Dietary fiber


Cariogenic Foods (Causing Decay)

• Any food that contains sugars or other carbohydrates that can be metabolized by bacteria into plaque is said to be cariogenic.

• Refined carbohydrates, such as candy and other sweets, are cariogenic because their sugars are readily available.

• A major factor in determining the cariogenicity of a carbohydrate depends on how long the food stays in the mouth.


Cariogenic Foods-cont’d

• Sugary liquids, such as soft drinks, leave the mouth quickly and are not as cariogenic as sticky foods, such as raisins or caramels.

• Foods such as crackers, although not sweet, are cariogenic because they stick to the teeth and remain in the mouth long enough to be broken down into sugars.

• Another important factor in determining the cariogenicity is whether the food stimulates the flow of saliva.


Sources of Carbohydrates

• Cereal grains

– Wheat, corn, oat, rice, barley, and buckwheat

• Sweets

– Table sugar, honey, maple and corn syrups

• Vegetables

– Green leafy vegetables, dried beans, and peas


Proteins

• Proteins are composed of amino acids, which are materials our bodies use in the building and repair process.

• There are 20 amino acids, of which 8 are essential in the adult for normal growth and maintenance of tissues.

– These 8 essential amino acids must come from food.

• A complete protein is one that contains a well-balanced mixture of all 8 essential amino acids.


Sources of Proteins

• Complete proteins

– Meat, fish, poultry, eggs, and dairy products

• Partially complete proteins

– Grains and vegetables

• Incomplete proteins

– Corn and gelatin


Fats

• Fats are important sources of energy.

• Fats provide essential fatty acids.

• Fats transport vitamins.

• Fats provide heat insulation.

• Fats are components of cell membranes and myelin, which is the covering around nerve fibers.

• Fat forms protective cushions around the body organs.


Cholesterol

• Cholesterol is a fat commonly found in saturated fats (from animal sources).

• The fat in the body is divided into two categories:

– Good fat is high-density lipoprotein (HDL).

– Bad fat is low-density lipoprotein (LDL).

• The recommendation is that cholesterol be limited to less than 250 mg per day, which is the amount in one egg yolk.


Antioxidants

• The antioxidant vitamins, E and C, and betacarotene can prevent cholesterol from oxidizing and damaging arteries.

• Many fruits, vegetables, and certain seasonings contain naturally occurring antioxidants.


Vitamins• Vitamins are organic substances that occur in

plant and animal tissues.

• They are essential in minute amounts for the human body to maintain growth and good health.

• Vitamins do not supply energy, but they are needed to release energy from the carbohydrates, fats, and proteins.

• To date, 13 vitamins have been discovered.

– Four are fat soluble.

– Nine are water soluble.


Minerals

• Minerals are inorganic substances that make up about 4% of the body weight.

• There are 14 essential minerals.

• The minerals present in the largest quantities include sodium, potassium, calcium, chlorine, phosphorus, and magnesium.

• The trace elements include iron, zinc, copper, selenium, chromium, manganese, iodine, and fluorine.


Water

• Approximately two thirds of the body weight is water.

• Often called the forgotten nutrient, water helps to:

– Build tissue

– Aids in regulating body temperature

– Acts as a lubricant for joints and mucous membranes


Diet Modification

• A dental assistant may be called upon to assist a patient with modifying his or her diet.

• The normal diet can be modified according to:

– Consistency: Sticky or chewy foods should be avoided when temporary restorations have been placed. Soft foods are recommended for patients with orthodontic appliances on their teeth.


Diet Modification-cont’d

• Caloric level: An adequate number of calories is necessary for proper healing following oral surgery.

• Spiciness: Foods that are too spicy can irritate the oral tissues following dental procedures.

• Levels of one or more nutrients: A properly balanced diet promotes all forms of healing.

• It is helpful to have special instructions written out for the patient to take home.


Dietary Analysis

• A dietary analysis can be used to help a patient understand the role of nutrition in his or her dental and general health.

• The patient must keep a diet diary for about 3 days.

• The patient must record every food eaten, including the amount, how it was prepared, and when it was eaten.

• The dental team then reviews the completed diary with the patient using a dietary analysis form.


Fig. 16-3 Sample dietary analysis form


Reading Food Labels

• Every food label must contain the following information:

– Individual serving size

– Number of servings per container

– Total calories

– Calories derived from fat content

– Percentage of daily value (% of RDA)


Fig. 16-4 Nutritional facts label


Nutrient Claims

• Examples of nutrient claims include:

– “Low fat”

– “High fiber”

– “Reduced calories”

– “Cholesterol free”


Fig. 16-5 Comparative versus absolute nutrient claims (From Kinn ME, Woods M: The medical assistant: administrative and clinical, ed 8, Philadelphia, 1999, Saunders.)


Organic Foods

• Foods with the organic label must have been grown without the use of any chemical pesticides, herbicides, or fertilizers.

• The use of hormones in seed preparation is prohibited.

• Organic milk must have no added vitamins or chemicals and preparation is closely monitored.

BULIMIA AND ANOREXIA AND THEIR IMPACT ON THE ORAL HEALTH

BULIMIA

Anorexia's Living Face (CBS News)

BULIMIA AND ANOREXIA



Eating Disorders

• Influences of the media, food industry, and society have led to a preoccupation with being thin. Such influences have contributed to a society of weight-conscious adolescents and adults and an increase in eating disorders.

• Eating disorders have serious medical, oral, and psychological implications and can be life threatening.


Eating Disorders-cont’d.

• Eating disorders commonly occur during adolescence and adulthood and include anorexia nervosa, bulimia (the two most common), and other disorders such as binge eating, compulsive overeating, female athlete triad, and chronic dieting syndrome.

• Most of those who suffer from eating disorders are 14 to 25 years old, white, and affluent. The occurrence of eating disorders is more common in females; the ration of females to males is 10:1.


Eating Disorders

• The two most serious eating disorders seen today are anorexia nervosa and bulimia.

– Bulimia is often referred to as a bingeing and purging disorder.

– Anorexia nervosa is characterized by self-starvation.


Female Athlete Triad

• This term refers to young female athletes with an eating disorder that includes restrictive dieting, overexercising, weight loss, and a lack of body fat.

• It results in osteoporosis (bone thinning) and amenorrhea.

• Dental risks include enamel decalcification, increased caries, and increased periodontal and soft tissue inflammation.


Managing Eating Disorders

• Anorexia nervosa and bulimia are considered psychiatric diseases with serious medical, dental, and nutritional complications.

• Dental professionals are often the first health care providers to diagnose an eating disorder.

• In addition to providing dental care and education, the dentist is obligated to assist the patient in obtaining psychotherapy and medical care.


Managing Eating Disorders-cont’d.

• Successful management of these disorders requires a team approach including psychiatrists, psychologists, physicians, nurses, dietitians, social workers, and dentists.

• The road to recovery is often long and expensive.


Healthy Habits

• Eat right. Consume five servings of fruits and vegetables daily, plus generous portions of grain, beans, and dairy products.

• Keep bones strong. Include sufficient calcium in your diet. Take a daily supplement for vitamin D, which helps your body absorb more calcium effectively.

• Protect immune system. Be sure to eat whole grains, green leafy vegetables, seafood, lean meats, and moderate amounts of vegetable oils to receive vitamins E and B6 and the trace mineral zinc. They help your body to fight infection and chronic disease.


Healthy Habits-cont’d.

• Maintain body weight. Excess fat can hasten the onset of diabetes, heart disease, arthritis, and other problems.

• Exercise. Combine aerobic exercises such as walking and running with simple stretch training to strengthen your muscles.

Dent 214 Nutrition CH 16 MDA Seema Jain. Introduction You probably have heard the expression, “You are what you eat.” This is true because food is used.

Documents

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utilization of nutrients

levels of essential