Assisting clients in selecting appropriate meals/fluids

To be able to assist clients in the selection of an appropriate diet it is important that health carer professionals understand the key components of a nutritious diet and are aware of factors affecting nutritional demands in the healthy individual. In addition, health promotion is a statutory requirement of the registered nurse so knowledge of what constitutes a healthy diet and fluid intake for the client is crucial. An in-depth discussion of what the constituents of a healthy balanced diet are is beyond the scope of this chapter and will require further reading, but an outline of the required nutrients and their role within the body is given in Table 5.4.
In addition to knowing about the various nutrients it is important to know what foods make up a balanced diet. This can be summarized by the percentages given below and is illustrated in Figure 5.3

• Starchy foods: 33%
• Fruit and vegetables: 33%
• Milk and dairy products: 14%
• Meat and alternatives (e.g. tofu, pulses): 12%
• Oils, fats, fatty foods, sugars, sugary foods (and alcohol, if taken): 8%

Nutrient	Function
Protein	• Used for building, growth or recovery of cells and tissues • Major constituent of hormones, enzymes and antibodies • Found in meat, fish, eggs, pulses (peas, beans and lentils), nuts, soya and textured vegetable protein (TVP)
Fats	• Source of energy • Component of cell membranes • Found in solid fats and liquid oils, in dairy produce and in hidden fat in food, for example between muscle fibres in meats, as oils, nuts, cereals, vegetables and fruit (especially avocados), or as fat used in the processing and cooking of foods
Carbohydrates	• Source of energy and fibre to aid digestion and bowel function and divided into starches and sugars • Starchy foods include bread, rice, cereals, pasta, potatoes, flour, crispbread, porridge and chapattis • Sugars are divided into intrinsic sugars (contained within plant cell walls) and extrinsic sugars (which are free in solution in the food, as in fruit juice, added sugar and honey in foods, and lactose in milk) • Processed foods, chocolates, sweets and snacks are dense sources of sugar
Vitamins	• Essential in small quantities for the normal growth and functioning of the body
Minerals	• Important building substances (e.g. calcium in bone tissues) and for the normal functioning of the body
Water	• Used for building, as a solvent for carrying nutrients and waste, and involved in temperature regulation
Fibre	• Dietary fibre is not strictly speaking a nutrient, but its presence in diet is necessary for the movement of food through the gastrointestinal tract. It is divided into two types – soluble and insoluble Soluble fibre is found in pulses, oats, barley, beans and lentils and also in fruit and vegetables Insoluble fibre is found in wheat-based breakfast cereals, bread, rice, maize, pasta, fruits and vegetables. Bran hurries the food through, reducing the absorption of vitamins and minerals, producing a sort of scouring pad effect, and should be used with caution