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DIET AND NUTRITION

INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com


Diet and Nutrition

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Introduction ď Ź ď Ź

Importance of nutrition Dietary nutrients - carbohydrates - lipids - proteins - vitamins - minerals and water www.indiandentalacademy.com


This seminar relates to these nutrients, their functions and sources and how they relate to oral health and diseases. Various factors which have an impact on the nutritional status of the elderly are also discussed. Current nutritional requirements of various age groups. www.indiandentalacademy.com


Definitions : ď Ź

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Diet : - Defined as the kinds of food on which a person or group lives. Nutrition : - the science of how the body utilizes food to meet requirements for development growth, repair and maintenance. www.indiandentalacademy.com


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Balanced diet : - defined as one which contains a variety f foods in such quantities and proportions that the need for energy, amino acids, vitamins, minerals, fats, carbohydrates and other nutrients is adequately met for maintaining health, vitality and general well being and also makes a small provision for extra nutrients to withstand short duration of leanness. www.indiandentalacademy.com


RDA’s : - the average daily dietary intake of a nutrient that is sufficient to meet the requirement of nearly all healthy people. BMR : - measured as the heat output under physical and mental rest in an adult male in post absorptive condition (12 hrs after food intake ), is 35kcl/hr/sq.mt body surface area.

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Various nutrients : 1. 2. 3. 4. 5. 6.

Carbohydrates Lipids Proteins Vitamins Minerals Water

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Carbohydrates : 1. 2. 3.

Basics Functions Classification

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Basics :   

Poly hydroxy carbon compounds with an actual or potential carbonyl function. Hydrophilic substances Simpler forms known as sugars.

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Classification Carbohydrates

mono

oligo

poly

homo

polyglucans

cellulose

hetro

polfructants

starch

hemi cellulose

mucoolysaccharides

inulin

amylose

Amylo-pectin

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Functions :    

55% - 60 % of daily energy requirement As a “ spare protein ” Aid in fat metabolism. Formation of structural elements. ( cartilage, nervous tissue and bone )

Formation of non-essential amino acids.

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Lipids : 1. 2. 3.

Basics Functions Classification

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Basics : ď Ź ď Ź

Concentrated sources of energy. Provide more than twice the amount of energy generated by carbohydrates or proteins. ( 9 Kcal/gm )

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Classification :

lipids simple

compound triglycerides

phospholipids

derived cholesterol

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Fatty acids

saturated

unsaturated

lauric

mono

poly

palmetic

Omega 3 fats

sterric

Omega 6 fats

• Essential fatty acids : Linoleic, Linolenic, Aracheidonic www.indiandentalacademy.com


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Functions : 1. 2.

3. 4. 5. 6.

Excellent source of energy. ( 9 Kcal/gm ) As adipose tissue protects internal organs, regulates body temperature and acts as a store for energy. Vehicle for fat soluble vitamins. Palatability and satiety. Decreases serum cholesterol. Essential component of membranes and nervous tissue. www.indiandentalacademy.com


Protiens : 1. 2. 3. 4. 5.

Basics Classification Essential amino acids. Deficiencies Functions

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Basics :   

Linear polymers of amino acids. 20 different alpha-aminoacids serve as building blocks of protiens. AA -Basic structure : -- amino group -- carboxyl group

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Amino acids

Acidic

Basic

neutral

aspertic

lysine

glutamic

argenine

others

histadine

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Proteins are large polypeptides or their associates . Most important bio-molecules functionally. A typical cell consists of nearly 20% of its weight as proteins.

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Based on overall structure :

protiens globular Hb

albumin

fibrous Ig

collagen

keratin

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Depending upon sub-groups :

protiens simple

conjugated Plasma albumin

Phospho proteins

Growth hormone

glycoproteins

Enzyme trypsin

nucleoproteins www.indiandentalacademy.com


Essetial aminoacids :    1. 2. 3.

Determines protein quality Should be provided in the diet as not synthesized by the body. Examples : Leucine Iso leucine trytophan www.indiandentalacademy.com


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Deficiencies : ď Ź ď Ź

1.

2.

Particularly seen in age group of 1-5 yrs. 2 types of protein energy malnutrition Kwashiorkar -- inadequate protein Marasamus -- inadequate protein + calorie www.indiandentalacademy.com


Functions of proteins :      

Major structural component of cellular membranes. Help in body immunity. Influence and control osmotic pressure of body fluids. Help in movement of muscle fibers. As carrier proteins. As molecular receptors and nucleoproteins …

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Vitamins : 1. 2. 3.

Basics Functions Classification

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Basics : ď Ź

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1. 2. 3.

Vitamin deficiencies in adults are subclinical and their symptoms are usually stress induced. Individuals prone to HYPOVITAMINOSIS : Under drug therapy Diseased state Low calorie intake www.indiandentalacademy.com


Classification :

vitamins Fat soluble

Water soluble

A, D, E, K

B complex

Vitamin C

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Balanced diet :   1. 2. 3.

A balanced diet has become an accepted means to safeguard a population from nutritional deficiencies. Principles governing a balanced diet Daily requirement of protein must be met – amounts to 15-20% of the daily energy intake. Fat requirement – 20-30% of daily energy intake Carbohydrates rich in natural fiber and micronutrients should constitute the remaining food energy. www.indiandentalacademy.com


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Prosthetic considerations : ď Ź ď Ź

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Geriatric nutrition : Since the prosthodontist works primarily with the middle and older age groups,,he is most concerned with the general health and well being of the older patient. It is a common tendency to become so engrossed with the technical details of the denture construction that we loose sight of the patient as a whole.

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Nutritional problems may be difficult to handle in older people as eating habits of a liftime are not easily changed. The prosthodotist who gives some thought to the importance of NUTRITION , can help the older patient make the most of his limited functional resources , and can spare the patient many f the consequences of nutritive deficiencies . www.indiandentalacademy.com


The most common oral complains of this age group results from the fact that aged mucosa is friable and easily injured . There is also good evidence that prosthetic failures are often, the result of tissue deficiencies rather then technical deficiencies. It is therefore obvious, that the dentist gives importance to the DIET AND NUTRITION of this age group www.indiandentalacademy.com


Calorie requirement of the elderly

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With age the calorie requirements for general bodily processes continually decreases. The average adult calorie requirements are : 10% less at age 60 20% less at age 70 25% less over age 90 The dentist should therefore advise the older patients to curtail foods with high fuel or calorie value ;because “AN OBESE PERSON IS A SICK PERSON ,AND SICK PEOPLE ARE POOR DENTURE PATIENTS”.

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IMPORTANCE OF PROTEINS

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As the patient becomes older , the amount of protein required per kg of body weight is increased. 1.4gm/k body weight is optimum. Too much protein never damages the health of the elderly person. Milk is an ideal source of proteins for this age group. www.indiandentalacademy.com


Importance of vitamins ď Ź

1. 2. 3. 4.

Intake should be increased for the following reasons: Provide nervous stability. Provide resistance to bacterial infections. Improve digestive efficiency by aiding the use of carbohydrates and utilization of mineral elements. The intake of vitamin A, B-complex, C and D should be increased mainly .

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Importance of minerals   

Minerals of of considerable importance to the aged person. Ca loss contributes to bone fragility . They often experience a rapid and excessive ridge resorption, under complete dentures which may be related to negative Ca balance; which is also one of the prime causes o OSTEOPOROSIS. www.indiandentalacademy.com


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Thus the inclusion of Ca and PO4 in the diet is absolutely important as the prime mineralizing substance of bone . Minute quantities of trace minerals are also important , which include: cu, mn, zn, mg, I2, K, Na… Ca levels may be improved by increasing the intake of milk and milk products plus a VIT D supplement of 400-1000units/day. Acidulated milk with a soft curd is especially valuable. www.indiandentalacademy.com


Geriatric nutrition and osteoporosis     1. 2. 3. 4. 5.

Results from the loss of bone, especially the spongy spicules of bone which support the weight bearing parts of the skeleton. Common in the- aging person -postmenopausal women. Causes: Lack of Ca intake . Lack of Ca absorption. Lactase deficiency. Lack of blood circulation. Low estrogen levels. The prosthodontists are in a strategic position to intercept early evidence of osteoporosis and educate the patient towards good nutrition.

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APPLICATION 

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The essential requirements of the daily diet having been described , the simplest and the most practical nutritional system to follow is the BASIC SEVEN , which provides an excellent scheme for a daily plan on eating and which could be used by the prosthodontist to check the adequacy of the patients diet. The basic seven consists of the following 7 food groups: Group 1 : green and yellow vegetables. Group 2 : citrus fruits, tomatoes, raw cabbage or salad green . Group 3 : potatoes and other vegetable fruits. Group 4 : milk and milk products. Group 5 : meat , poultry , fish , eggs (if expensive increase group 4 ) . Group 6 : enriched or whole grain cereals and bread. Group 7 : butter or margarine ( if expensive increase group 1 and 4 ) www.indiandentalacademy.com


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NUTRITION FOR NEW DENTURE WEARER DIET FOR THE FIRST DAY : A liquid diet which may consist of fruit juices, milk, etc  DIET FOR THE SECOND AND THIRD DAY : Soft food that requires a minimum of chewing like milk , eggs, noodles,etc.  DIET FOR THE FOURTH AND LATER : As the sore spots have healed firmer foods can be eaten. 

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Dietary counseling of patients undergoing prosthodontic treatment

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Thank you

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Diet and nutrition/ dental implant courses by Indian dental academy