Nutrition Chapter 3

The role of diet in health

1. Although diet plays a role, declines in physical activity have impacted health 2. Current recommendations for reducing the prevalence of chronic health conditions include dietary and physical activity changes

Asian influences

1. Based on large amounts of rice, vegetables, or noodles combined with small amounts of meat, fish, or shellfish 2. Characterized by use of flavorful sauces and seasonings 3. Health benefits arise from phytochemicals and other micronutrients 4. Stir frying and steaming help to retain nutrients in fresh vegetables 5. Asian Diet Pyramid a. Foundation of rice, noodles, fruits, vegetables, and beans b. Primary source of fat is vegetable oil c. Occasional use of fish, shellfish, eggs, and poultry d. Limited amount of calcium; may require supplementation or use of calcium-fortified foods 6. Americanized Asian restaurants incorporate larger portions of animal foods and fat compared to traditional Asian fare 7. Sushi consists of small pieces of raw fish or shellfish rolled with rice and vegetables and wrapped in seaweed 8. Traditional Okinawan (island south of Japan) diet, which consists of fresh vegetables, minimal amounts of salt and animal protein, and moderate fat, is associated with low rates of cardiovascular disease 9. Honshu diet is high in salt and is associated with increased risk of hypertension

Italian/Mediterranean

1. Based on pasta, other whole grains, fish, olive oil, nuts, fruits, and vegetables 2. Americanized Italian food includes much more meat and cheese than traditional Italian fare 3. Mediterranean Diet Pyramid a. Grains, fruits, and vegetables should form the foundation of a healthy diet b. Seafood, poultry, and wine may be included with meals c. Red meat and other sources of saturated fat are limited d. Olive oil, with its heart healthy benefits, is the primary source of fat

Sodium and potassium

1. Consume <1 tsp (2300 mg) sodium daily 2. Select low-sodium foods; limit canned and processed foods 3. Prepare foods with little salt 4. Consume more potassium-rich foods, including fruits and vegetables

Adequate nutrients within caloric needs

1. Consume a variety of nutrient-dense foods and beverages 2. Limit intake of added salt and sugars, alcohol, cholesterol, saturated fat, and trans fat 3. Adopt a nutritionally-balanced meal plan to meet nutrient needs

Food groups to encourage

1. Consume adequate fruits (2 cups) and vegetables (2 ½ cups) 2. Eat a variety of fruits and vegetables daily; incorporate legumes, orange, dark-green, and starchy vegetables into meals several times per week 3. Consume at least 3 ounces of whole-grain products daily 4. Consume 3 cups of fat-free or low-fat milk or equivalent milk products daily

Health claims

1. Describes the relationship between a food, food ingredient, or dietary supplement and the reduced risk of a nutrition-related condition 2. FDA allows claims that meet the following criteria: a. Indicate that the product only has health benefits when it is part of a daily diet b. Complete, easy to understand, honest, and not misleading c. Refers to a product that contains 10% or more of the DV for vitamins A and C, calcium, iron, fiber, or protein before fortification with nutrients d. Product intended for people 2 years of age and older e. Use "may" or "might" to describe the relationship between the product and the disease f. Not quantify any degree of risk reduction g. Indicate that many factors influence disease

Do Americans follow dietary recommendations

1. Do not meet recommendations on fruit, vegetables, whole grains, fat-free or low-fat milk 2. Exceeds recommendations on added sugar, solid fats, and sodium

Meat and meat substitutes

1. Examples: beef, pork, lamb, fish, shellfish, liver, poultry, beans, eggs, nuts, and seeds 2. Serving size = "1 ounce" a. 1 ounce of meat, poultry, or fish b. ¼ c cooked dry beans or peas c. 1 egg d. 1 tablespoon of peanut butter e. ½ ounce nuts or seeds f. ¼ cup of tofu 3. Nutrient profile: a. Macronutrients: protein b. Micronutrients: iron, zinc, B vitamins c. Foods in this group have a wide range of fat content i. Very lean (e.g., low-fat cottage cheese, white meat of turkey) ii. Lean (e.g., ground beef with <15% fat, tuna) iii. High-fat (e.g., pork sausage, bacon, regular cheeses, hot dogs) 4. Recommendations: limit saturated fat and cholesterol 5. Minerals are generally better absorbed from animal foods than from plant foods

Oils

1. Examples: canola, corn, and olive oils; products made from vegetable oils (some dietary guides also include nuts, olives, avocados, and some types of fatty fish)

Vegetables

1. Examples: fresh, cooked, canned, frozen, dried/dehydrated vegetables, 100% vegetable juice (some dietary guides also include dried beans and peas) 2. Serving size = "1 cup" a. 1 cup of raw or cooked vegetables b. 1 cup of vegetable juice c. 2 cups of uncooked leafy greens 3. Nutrient profile: a. Macronutrients: carbohydrate, some protein b. Micronutrients c. Fiber d. Phytochemicals e. Low in fat and calories

Ada's intention to prevent weight gain by finding a balance between her diet and activity. She needs

60 minutes of physical activity most days of the week To stay within her daily calorie needs

Fruits

1. Examples: fresh, dried, frozen, sauced, and canned fruit, 100% fruit juice 2. Serving size = "1 cup" a. 1 cup of fruit b. 1 cup of fruit juice c. ½ cup of dried fruit 3. Nutrient profile: a. Low in fat b. Phytochemicals c. Macronutrients: carbohydrate d. Micronutrients: potassium, vitamin C, folate e. Fiber 4. Recommendations: use whole fruit in place of fruit juice because whole fruits contain more fiber and fewer calories

Milk and milk products

1. Examples: milk and products made from milk that retain their calcium content 2. Nutrient profile: a. Good source of protein b. Good source of micronutrients: calcium, phosphorus, riboflavin c. Most milk products are fortified with vitamins A and D d. Foods in this group have a wide range of fat and sugar contents i. Ice cream, pudding, frozen yogurt, and ice milk are often grouped with milk and milk products, but they have high sugar and fat contents ii. Cream cheese, cream, and butter are dairy foods, but are not included in milk and milk products group because of their high fat and low calcium contents 3. Serving size = "1 cup" a. 1 cup of milk b. 1 cup of yogurt, frozen yogurt, or pudding c. 2 cups of cottage cheese d. 1.5 ounces of natural cheese e. 2 ounces of processed cheese

Grains

1. Examples: products made from wheat, rice, oats, and some corn products 2. Serving size = "1 ounce" a. 1 slice of bread b. 1 cup of ready-to-eat cereal c. ½ cup of cooked rice, pasta, or cereal d. 1/2 muffin 3. Nutrients often added to these products a. Enrichment is the addition of iron and B vitamins to cereal products b. Fortification is the addition of other nutrients, such as calcium or vitamin C, to foods 4. Dietary guides recommend choosing whole grains instead of refined grain products a. Refers to intact, ground, cracked, or flaked seeds of cereal grains, such as wheat, buckwheat, oats, corn, rice, wild rice, rye, and barley b. Whole grains supply more fiber and micronutrients than refined grain products

Weight management

1. Excess body fat increases risk for most major chronic nutrition-related diseases 2. As adults age, weight maintenance becomes increasingly difficult 3. Match caloric intake from foods and beverages with the calories your body uses for energy needs 4. Gradually reduce calorie intake, especially by eating fewer empty-calorie foods 5. Increase physical activity

Structure/function claims

1. FDA allows claims that describe the role a nutrient or dietary supplement plays in maintaining a structure (e.g., bone) or promoting normal function (e.g., digestion) 2. Labels may not list claims relating a nutrient, food, or supplement to prevention or treatment of disease

Food and Dietary Supplement Labels

1. FDA regulates information on food labels 2. Most food products have labels including product name, manufacturer name and address, amount of food in the package, ingredients, and nutrition facts B. Nutrition Facts 1. Required elements a. Serving size is consistent among similar food products b. Servings per container; do not assume the entire package is 1 serving c. Energy d. Energy from fat e. Total fat f. Saturated fat g. Trans fat h. Cholesterol i. Sodium j. Total carbohydrate k. Dietary fiber l. Sugars m. Protein n. Vitamin A o. Vitamin C p. Calcium q. Iron

Physical activity

1. For health maintenance and prevention of chronic diseases, perform at least 30 minutes of moderate physical activity (in addition to usual activities) on most days of the week 2. For weight management (preventing weight gain), engage in about 60 minutes of moderate- to vigorous-intensity physical activity on most days of the week and balance energy consumption with energy expenditure 3. To maintain weight loss, perform at least 60 - 90 minutes of moderate-intensity physical activity daily while controlling calorie intake

Dietary Guidelines Intro.

1. Many chronic diseases are associated with lifestyle practices including poor diet and lack of physical activity 2. Dietary Guidelines for Americans is a set of general nutrition-related lifestyle recommendations published by the U.S. Department of Health and Human Services and U.S. Department of Agriculture 3. Promote adequate nutritional status, good health, and reduce the risk of several chronic diseases

Religious Influences

1. Many religions have their own unique dietary practices 2. Jewish dietary laws require that milk products must be kept separate from meat and poultry 3. Kosher foods are prepared according to Jewish law

African

1. Migration of slaves from Africa introduced foods such as sweet potatoes, okra, and peanuts 2. Blending of African foods with Native American, Spanish, and French food traditions resulted in the creation of Creole and Cajun cuisines 3. "Soul food" includes sweet potato pie, fried chicken, black-eyed peas, and greens cooked with smoked pork 4. Health benefits of African diets stem from fruit, beans, and leafy vegetables, which provide fiber, vitamins, and minerals 5. Some health deficits of African diets stem from high levels of fat and sodium, which are associated with obesity and hypertension among African-Americans

Alcoholic beverages

1. Moderate alcohol consumption a. 1 drink/d for women b. 2 drinks/d for men 2. People who should not drink alcohol a. Pregnant/breastfeeding/likely to become pregnant b. Individuals under age 21 c. Individuals taking certain medications d. People who drive, operate machinery, or perform activities requiting attention, skill or physical coordination

Dietary supplement labels

1. Must contain the term "dietary supplement" or similar term 2. Label must also list several things 9 a. List of ingredients b. Manufacturer's address c. Suggested dose d. Supplemental facts panel 3. Dietary Supplement Health and Education Act of 1994 (DSHEA) allows manufacturers of dietary supplements to list claims on their labels a. Label must include the FDA disclaimer if the FDA has not reviewed the claim b. Manufacturers can be required to provide evidence to the FDA about a product's safety and label claims 4. In 2007, the FDA required supplement manufacturers to evaluate the purity, quality, strength and composition of products before marketing them

The MyPlate

1. MyPlate includes a variety of food, nutrition, and physical activity resources for consumers that are based on the recommendations of the Dietary Guidelines for Americans, 2010 2. Meal patterns can be personalized based on age, sex, height, weight, physical activity level, food preferences, and life stages; Table 3.5 presents recommendations for average adults 3. Interactive website at www.choosemyplate.gov provides personalized dietary patterns, estimation of daily energy needs, dietary and physical activity assessments 4. USDA has also developed MyPlate guidelines for pregnant and breastfeeding mothers and preschool and elementary school aged children

G. Organic foods

1. Sustainable agriculture focuses on producing food with our harming the environment 2. Strict standards govern use of the word "organic" on food labels; foods must be produced without the use of: a. Antibiotics b. Hormones c. Synthetic fertilizers and pesticides d. Genetic improvements e. Ionizing radiation 3. Many consumers are concerned about the environment and the effects of conventional farming methods on the safety and nutritional value of the food supply 4. More research is required to determine whether there are health advantages to eating organic foods

What is the Exchange System?

1. Tool for estimating the energy, protein, carbohydrate, and fat content of foods 2. Originally developed jointly by the Academy of Nutrition and Dietetics (formerly American Dietetic Association) and American Diabetes Association for people with diabetes, but is also useful for weight loss 3. Foods are broadly categorized as carbohydrates, meats or meat substitutes, or fats based on their macronutrient composition 4. Some foods are classified differently than MyPlate 5. Within each group, lists of exchanges (various foods and their serving sizes) are provided; each food in the exchange list provides approximately the same kcal and macronutrients 6. For any meal plan, countless combinations of exchanges may be used to achieve proper nutrition 7. More information can be found at www.eatright.org or www.mhhe.com/Schiff

Hispanic

1. Traditional Mexican diet includes rice, tortillas, corn, beans, chili peppers, avocados, papayas, pineapples, chayote, cherimoya, jicama, plantains, and cactus leaves and fruit, all of which provide lots of fiber, nutrients, and phytochemicals 2. To appeal to American palates, many Mexican restaurants feature large portions of meat and lots of fat-laden toppings rather than the nutritious plant-based meals of traditional Mexican diets 3. Many elements of Americanized Mexican diets contribute to risk for several chronic diseases

Native American influences

1. Traditional Native American diet was low in fat and sodium and high in fiber 2. As a result of adopting Westernized diets, Native Americans (particularly Pima Indian tribe) suffer high prevalence of obesity and type 2 diabetes 3. Traditional Native Alaskan diet included fatty fish and sea mammals, associated with decreased risk of cardiovascular disease

The Melting Pot

1. Traditional ethnic diets are often based on dishes containing small amounts of animal foods and large amounts of locally grown fruits, vegetables, and unrefined grains 2. Assimilation leads to adoption of many unhealthy food practices, which increases risk for many chronic diseases B. Northwestern European influences 1. Large portions of meat with small portion of potatoes (once boiled or mashed, now fried) 2. Mainstream American diet or "Western" diet 3. Provides abundance of protein and fat but lacks fruits, vegetables, and whole grains 4. Associated with increased risks for several chronic diseases

Other dietary guides

1. Various food pyramids are available for specific cultural/ethnic food patterns 2. Canada has produced "Eating Well with Canada's Food Guide"

Food safety

1. Wash hands, food preparation surfaces, fruits, and vegetables 2. Avoid cross-contamination from raw meat to cooked and ready-to-eat foods 3. Cook foods to safe temperatures to kill microbes 4. Refrigerate perishable foods promptly 5. Defrost foods properly 6. Avoid high risk foods a. Unpasteurized juices and milk products b. Raw or undercooked eggs, meat, and poultry c. Raw spouts

Organic Labeling Categories

100% organic (may use organic seal) organic, may use organic seal made with organic ingredients 100% organic ingredients including processing aids at least 95% organic ingredients, remaining 5% are on USDA list of allowable ingredients Contains 70 - 90% organic ingredients

The general requirements that must be met before a health claim can be made for a food product include which of the following? A. A single serving of the food product cannot contain more than 13 grams of fat, 4 grams of saturated fat, 60 mg cholesterol or 480 mg sodium B. A food must be a good source of saturated and trans fat but low in sodium and cholesterol C. The food must be a good source of fiber, protein, vitamin A, calcium and iron

A. A single serving of the food product cannot contain more than 13 grams of fat, 4 grams of saturated fat, 60 mg cholesterol or 480 mg sodium C. The food must be a good source of fiber, protein, vitamin A, calcium and iron

Using Dietary Analysis Software

A. Software nutrient databases contain average information; foods may vary depending on hereditary factors, age, growing conditions, and production methods B. Some nutrient data may be missing if accurate data for a particular food are missing C. Government-sponsored dietary analysis websites 1. MyPlate SuperTracker (https://www.choosemyplate.gov/SuperTracker) 2. What's in the Food You Eat Search Tool (http://www.ars.usda.gov/Services/docs.htm?docid=17032 ) 3. National Nutrient Database for Standard Reference, Release 24 (http://ndb.nal.usda.gov) D. What about fast foods? 1. Popular fast food items are available in dietary analysis programs 2. Restaurants often provide nutrition information in brochures or on websites, but consumers may need to ask for it

Adequate Intake (AI)

AI — assigned when no RDA can be determined. Assumes a population's average daily nutrient intakes are adequate. a. Dietary recommendations that assume a population's average daily nutrient intakes are adequate because no deficiency diseases are present b. Set when insufficient information is available to set EAR and RDA

Estimating Portion Sizes

Baseball = human fist = 1 cup or 1 large apple or 1 orange Small yoyo= 1 standard bagel or English muffin Deck of cards = 3 oz meat

Carb recommendations

Carbohydrates 1. Include fiber-rich fruits, vegetables, and whole-grain products daily 2. Choose and prepare foods and beverages with minimal added sugars 3. Practice good oral hygiene daily 4. Consume sugary and highly refined carbohydrates infrequently

Dietary Reference Intakes (DRI)

Dietary Reference Intakes (DRIs) are a set of energy and nutrient intake standards that are used to make dietary recommendations b. Include EARs, RDAs, AIs, ULs, and EERs c. Developed by the Food and Nutrition Board of the Institute of Medicine d. Adjusted as new information becomes available

Using Dietary Analysis Software

Dietary analysis software and web sites are quick and easy tools to determine nutrient and energy contents of commonly eaten foods. Government-Sponsored Dietary Analysis Web sites •MyPlate Tracker www.choosemyplate.gov •"What's in the Food You Eat Search Tool" www.nal.usda.gov/fnic/foodcomp/search/

things to watch for

eat less, no oversized portions make 1/2 plate fruit or vegetables whole grains watch sodium drink water

Estimated Average Requirement (EAR)

EAR — amount of a nutrient that should meet needs of 50% of healthy people. b. Established based on a measurable physiological marker that reflects proper functioning

Estimated Energy Requirement (EER)

EER - a. Average daily energy intake that meets the needs of a healthy person who is maintaining his or her weight b. Equation based on physical activity level, height, weight, age, sex, and life stage c. Does not include margin of safety

enrichment

Enrichment is the addition of iron and certain B vitamins to cereal grain products such as flour and rice. In general, enrichment replaces some of the nutrients that were lost during processing.

Fruits

Excellent sources of phytochemicals, folate, potassium, and vitamin C. •Whole or cut up fruits provide more fiber than juices. •Most are very low in fat. •Eat a variety of fruits, because they vary in vitamin and mineral contents.

According to the latest USDA food guide, fruits and vegetables are two separate food groups.

False

The Food and Drug Administration does not develop the Dietary Guidelines for Americans, this is done by the USDHHS and USDA.

False

Fat recommendations

Fats 1. Limit total fat intake to 20 - 35% of calories 2. Select rich sources of unsaturated fats (e.g., vegetable oils, fatty fish, nuts) 3. Limit saturated fat to 10% of kcals and cholesterol to 300 mg/d 4. Limit trans fat (no amount is recommended)

For nutrition labeling purposes, the Food and Drug Administration (FDA) uses RDAs to develop a set of standards called Daily Values (DVs).

For adults, DVs are based on a standard diet that supplies 2000 kcal/day and certain dietary recommendations. Consumers may find DVs useful for comparing the nutritional contents of similar foods.

Major Food Groups

Grouped according to natural origins & key nutrients: Six general groups: •Grains •Dairy products •Protein-rich foods •Fruits •Vegetables •Other foods

To establish an AI, scientists record eating patterns of a group of healthy people and estimate the group's average daily intake of the nutrient.

If the population under observation shows no evidence of the nutrient's deficiency disorder, the researchers conclude that the average level of intake must be adequate and use that value as the AI (Fig. 3.3). Vitamin K and the mineral potassium are among the nutrients that have AIs instead of RDAs.

catholic

fast before communion fasting during certain holidays

Most dietary guides recommend choosing dairy products that have most of the fat removed, such as fat-free or low-fat milk. (Fat-free milk may also be referred to as nonfat or skim milk.) Compared to whole milk, which is about 3.25% fat by weight, low-fat milk contains only 1% fat by weight and is often called "1% milk."

In general, 1 cup of milk is equivalent to 1 cup of plain yogurt, frozen yogurt, or pudding; 2 cups of cottage cheese; 1 ½ ounces of natural cheese such as Swiss or cheddar; or 2 ounces of processed cheese. To obtain about the same amount of calcium and protein as in 1 cup of fat-free milk, you would have to eat almost 1 cups of vanilla ice cream. This amount of ice cream provides 470 kcal and about 26 g of fat, whereas the same amount of fat-free milk supplies only 135 kcal and less than 1 g of fat.

Most dietary guides classify eggs and nuts with meat. Why?

In general, the body absorbs minerals, such as iron and zinc, more easily from animal foods than from plants.

scientists have been able to estimate the amount of many nutrients required by the body. A requirement can be defined as the smallest amount of a nutrient that maintains a defined level of nutritional health

In general, this amount saturates (fills) certain cells with the nutrient or prevents the nutrient's deficiency disease. The requirement for a particular nutrient varies to some degree from person to person. Your age, sex, general health status, physical activity level, and use of medications and drugs are among factors that influence your nutrient requirements.

Protein-rich foods

Include beef, pork, lamb, fish, shellfish, liver, and poultry. •Beans, eggs, nuts, and seeds are also included with this group because these protein-rich foods can substitute for meats. •Excellent sources of protein, iron, zinc, & B vitamins

The nutrition facts panel

Indicates the % DV of some food constituents Lists certain food constituents Indicates serving amounts

Examples of Permissible Health Claims for Food Labels

Lipids and heart disease diet and heart disease calcium, exercise and osteoporosis sodium and high blood pressure Folate (a B vitamin) and neural tube defects ( a condition which causes skull and spinal bones to not form properly before birth) fruits, vegetables and cancer risks

Acceptable Macronutrient Distribution Ranges

Macronutrient: Carbs - 45-65 AMDR (% of total energy intake) Macronutrient: Protein - 10-35 AMDR (% of total energy intake) Macronutrient: Fat* - 20 - 35 AMDR (% of total energy intake) *Fat - should include essential fatty acids a. Ranges of carbohydrate, fat, and protein intakes that provide adequate amounts of vitamins and minerals and may reduce the risk of diet-related chronic diseases

Grains

Made from certain plants such as wheat, rice, and oats •Primary macronutrients are carbohydrate and protein. •Enriched grains have iron and certain B vitamins added. •Whole grains provide more fiber, vitamins, and minerals than refined.

This is the evidence on which the DGA 2010 are based.

Major Themes •Reduce overweight and obesity •Shift intake to more nutrient dense foods •Reduce intake of added sugars and solid fats (empty calorie foods) •Meet 2008 PA Guidelines for Americans

Religious Influences

Many religions require members to follow strict handling and dietary practices that often include prohibition of certain foods.

Dairy Foods

Milk and beverages made from milk that retain calcium after processing •Excellent sources of calcium, protein, phosphorus, and riboflavin •High-fat milk products such as cream, cheese cream, and butter are NOT included.

The MyPlate Plan

MyPlate (www.choosemyplate.gov) •includes a variety of food, nutrition, and physical activity resources based on the recommendations of the Dietary Guidelines for Americans, 2010 •has useful interactive tools such as "MyFoodapedia," and "FoodTracker" for assessing the energy and nutrient content of your daily food choices

MyPlate

MyPlate (www.choosemyplate.gov) includes a variety of food, nutrition, and physical activity resources for consumers that are based on the recommendations of the Dietary Guidelines for Americans, 2010. MyPlate differs from the two previous USDA food guides in that it no longer has six food groups depicted by boxes or stripes within a pyramid (Fig. 3.7). MyPlate focuses on 5 different food groups: fruits, vegetables, protein foods, grains, and dairy.12 According to the USDA, "oils" is not a food group.9 The government agency, however, notes the need for some fat in the diet as well as limited amounts of "empty calories." In the previous guide (MyPyramid), oils formed a food group and empty calories were referred to as "discretionary calories."

Balancing Calories to Manage Weight

Recommendations: -Focus on the total number of calories consumed -Monitor food intake -When eating out, choose smaller portions or lower-calorie options. -Prepare, serve, and consume smaller portions of foods and beverages, especially those high in calories -Eat a nutrient-dense breakfast -Limit screen time

limits for empty calories

MyPlate dietary patterns allow some empty calories, based on a person's total energy needs. The empty calorie allowance is the amount of energy that remains after a person consumes recommended amounts of foods that contain little or no solid fats and added sugars from the major food groups. The 2000 kcal dietary pattern, for example, allows only 260 empty calories, which is less than the energy in a cup of ice cream or two 12-ounce sugar-sweetened soft drinks. You can use up your empty calorie allowance by choosing foods that contain a lot of solid fat and added sugars. For example, you could eat high-fat meats instead of lean meats, add cream cheese to your bagel instead of eating it plain, or eat a sugary breakfast cereal instead of unsweetened cooked oatmeal. On the other hand, you could spend your empty calorie allowance on more nutrient-dense foods, such as fresh fruits, vegetables, nuts, or minimally processed grain products.

Do Americans Follow Dietary Recommendations?

NO, we generally don't •Not enough fruits, vegetables, whole grains, and low-fat milk •Too much added sugar, solid fat, and sodium

Applying Nutrient Standards

Nutrient standards are used to: 1. DRIs are standards for planning nutritious diets for groups of people and evaluating nutritional adequacy of a population's diet 2. DRIs are often used to evaluate individual dietary practices a. Consistently falling short of the RDA/AI puts an individual at risk for deficiency b. Consistently exceeding the UL puts an individual at risk for toxicity (highest risk with excessive dietary supplementation) 3. DRIs are used to develop food products that replace food (e.g., infant formula or tube feeding formula) 4. RDAs are used by the Food and Drug Administration to develop Daily Values (DVs) shown on food labels

Food and Dietary Supplement Labels

Nutrition Facts panel: •Provides information about energy and nutrient contents of packaged foods •Not required on fresh fruits and vegetables

Adequate Intakes & Upper Limits

Nutrition scientists set an AI for a nutrient if there is not enough information to determine the RDA. The UL is the highest average amount of a nutrient unlikely to harm most people if consumed daily. Low intake - high risk of deficiency Moderate - low risk of deficiency High - high risk of toxicity

Dietary Guidelines

Nutrition-related lifestyle recommendations intended for healthy people over 2 yrs of age Designed to: -Promote adequate nutrition and good health -Reduce risk of nutrition-related chronic conditions such as CVD and obesity

Tofu, a food made from soybeans, is a good source of protein. One-fourth cup of regular tofu is equivalent to 1 ounce of meat.

One ounce of food from this group generally equals 1 ounce of meat, poultry, or fish; ¼ cup cooked dry beans or peas; 1 egg; 1 tablespoon of peanut butter; or ½ ounce of nuts or seeds.

Restaurant and Vending Machine Foods

Patient Protection and Affordable Care Act of 2010: •Retail food establishments with 20 or more locations must list calorie information for standard menu items on restaurant menus and menu boards •Companies that maintain 20 or more food vending machines must disclose calorie contents of certain items

Recommended Dietary Allowance (RDA)

RDA a. Standards for recommending daily intakes of nutrients b. Meet the needs of nearly all (~98%) of individuals in a life stage/gender group c. Established based EAR plus a margin of safety to allow for individual variations in nutrient requirements as well as maintenance of adequate tissue stores

The risk of a toxicity disorder increases when a person regularly consumes amounts of a nutrient that exceed its UL.

The UL for vitamin C, for example, is 2000 mg/day for adults.

Food and Nutrients to Increase

Recommendations: -Increase intake of fruits and vegetables -Eat a variety of vegetables, especially dark-green and red and orange vegetables and beans and peas -Consume at least half of all grains as whole grains (not refined) -Increase amount and variety of seafood -Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages -Choose foods that provide more potassium, dietary fiber, calcium, and vitamin D •These foods include vegetables, fruits, whole grains, and milk and milk products. -Use oils to replace solid fats where possible

Foods and Food Components to reduce also includes

Recommendations: -Limit consumption of foods that contain refined grains -Reduce the intake of calories from solid fats and added sugars -If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age

Foods and Food Components to reduce

Recommendations: -Reduce sodium intake- less than 2300 mg/day for healthy population and 1500mg/day of sodium for certain at risk groups -Limit sat fats to 10% of total cal. (Substitute mono and poly unsat fats) -Limit cholesterol to less than 300mg/day -Keep trans fat intake as low as possible

Requirement

Requirement •Smallest amount of a nutrient needed to maintain defined level of health a. Sufficient to prevent deficiency disease b. May vary based on age, sex, health status, physical activity, use of medications 2. Consuming more than the requirement allows for storage of nutrients (e.g., in liver, body fat, or bones), which can be drawn upon during physical stress or when intake does not cover needs

How RDAs Are Established

Scientists add a margin of safety amount to EAR that allows for individual variation. This makes a nutrient's RDA high enough to meet or exceed needs of ~98% of healthy people. (Distribution of usual intakes within a population about 50%) RDA high about 97 - 97%

The supplemental facts label must include

Serving size Manufacturer's contact information % of DV of each nutrient

Foods in the protein group are rich sources of micronutrients, especially iron, zinc, and B vitamins. In general, the body absorbs minerals, such as iron and zinc, more easily from animal foods than from plants. However, animal foods often contain a lot of saturated fat and cholesterol. Diets that supply high amounts of these lipids are associated with increased risk of heart and blood vessel diseases (cardiovascular disease or CVD).

Some dietary guides use fat content to categorize meats and other protein-rich foods. According to these guides, low-fat cottage cheese and the white meat of turkey are very lean meats; ground beef that is not more than 15% fat by weight and tuna are lean meats. Pork sausage, bacon, regular cheeses, and hot dogs are examples of high-fat meats.

Empty-calorie foods generally add a lot of sugar, alcohol, and/or solid fat to diets.

Sugary foods ("sweets") include candy, regular soft drinks, jelly, and other foods that contain high amounts of sugar added during processing or preparation. Sugary foods and alcoholic beverages typically supply energy but few or no micronutrients. Solid fats, such as beef fat, butter, lard (pork fat), and shortening, are fairly hard at room temperature. Solid fats are often grouped with sweets and alcoholic beverages, because diets that contain high amounts of these fats are associated with increased risk of CVD. Cream, cream cheese, and sour cream are liquid or soft at room temperature, but these foods are usually classified as solid fats.

Heart disease, cancer, hypertension (chronically elevated blood pressure), and diabetes mellitus (commonly referred to as diabetes) are among the leading causes of disability and death among Americans. According to a considerable amount of scientific evidence, risk of these diseases is strongly linked with certain lifestyles, particularly poor dietary choices and lack of regular physical activity. As required by law, the U.S. Department of Health and Human Services (USDHHS) and the U.S. Department of Agriculture (USDA) publish the Dietary Guidelines for Americans (Dietary Guidelines), a set of general nutrition-related lifestyle recommendations that are intended for healthy people over 2 years of age.

The Dietary Guidelines are designed to promote adequate nutritional status and good health, and to reduce the risk of major nutrition-related chronic health conditions, such as obesity and cardiovascular disease. These guidelines are updated every 5 years. The most recent version of the guidelines, Dietary Guidelines for Americans, 2010, was introduced in 2011. Table 3.2 indicates the overarching concepts of the guidelines, which focus on improving the nutritional quality of the population's food intake and reducing the prevalence of obesity. Table 3.3 lists the key components of the Dietary Guidelines.

Inspired the development of other food pyramids for people who don't follow the Western diet

The food guide pyramid

To establish an EAR for a nutrient, the Food and Nutrition Board identifies a physiological marker, a substance in the body that reflects proper functioning and can be measured.

This marker indicates whether the level of a nutrient in the body is adequate. A marker for vitamin C, for example, is the amount of the vitamin in certain blood cells. When these cells contain nearly all the vitamin C they can hold, the body has an optimal supply of the vitamin. Thus, a physician can diagnose whether a patient is vitamin C deficient by taking a blood sample from the person and measuring the vitamin C content of certain blood cells.

Native American Influences

Traditional native foods: wild game and vegetable crops (corn, tomatoes, and squash) Health benefits: Low in sodium and fat, high in fiber

According to the recommendations of the Dietary Guidelines for Americans 2010, it is acceptable for certain adults to consume moderate amounts of alcoholic beverages.

True

Last week, Colin didn't consume the recommended amount of vitamin C for a couple of days. Nevertheless, he is unlikely to develop scurvy, the vitamin C deficiency disease.

True

The Nutrition Facts panel on a food label provides information concerning amounts of energy, fiber, and cholesterol that are in a serving of food.

True

In the dairy group, the standard serving size is equivalent to a. 1 ounce natural cheese b. 2 ounces processed cheese c. 1 cup milk d. 1 cup yogurt

b. 2 ounces processed cheese c. 1 cup milk d. 1 cup yogurt

Tolerable Upper Intake Level (UL)

UL — a. Highest average amount of a nutrient that is unlikely to harm most people when the amount is consumed daily b. Daily intakes above the UL increase the risk of developing nutrient toxicity disorders

Applying the Dietary Guidelines to Your Usual Food Choices

White bread - Whole Wheat Sugary cereals - low sugar, high fiber Cheeseburger, fries, soda - chicken or turkey sandwich, low-fat milk potato salad/cole slaw - leafy greens, bean salad donuts, chips - bran muffin, peanut butter, whole grain bagel, fruit soda - water, milk, 100% juice boiled vegetables - steamed canned vegetables - frozen breaded or fried - broiled or roasted fatty meats - chicken, fish 2% milk - 1% ice cream - frozen yogurt or ice milk cream cheese - low fat cottage cheese or reduced fat cream cheese cookies - fruit bars salt - herbs, spices

Dietary Guides Introduction

a. 1943 - first guide, based on RDAs, 7 food categories, designed to help Americans plan nutritious menus despite food shortages during WWII b. 1950s - simplified to 4 food categories ("Basic Four" included meat, milk, fruits and vegetables, and breads and cereals), supplied 1200 - 1400 kcal as foundation of healthy diet c. 1979 - "Hassle-Free Guide to a Better Diet", added 5th category to Basic Four to address fats, sweets, and alcoholic beverages d. 1992 - Food Guide Pyramid incorporated knowledge about health risks and benefits associated with dietary patterns, ranked foods according to their emphasis in menu planning e. 2005 - MyPyramid is based on Dietary Guidelines for Americans 2005 f. 2011 - MyPyramid Plan was replaced with MyPlate, another interactive dietary and menu planning guide accessible at a website.

Foods are excluded from listing a health claim under the following circumstances

a. > 13 g fat/serving b. > 4 g saturated fat/serving c. > 60 mg cholesterol/serving d. > 480 mg sodium/serving

True facts about the percentages of Daily values when applied to the nutrition facts food label include

a. Based on 2000 kcalorie diet b. People requiring more or less than 2000 kcalories must make necessary adjustments c. The 2000 kcalorie diet allows easy comparison among similar foods

permissible claims, which require specific wording

a. Certain lipids and heart disease b. Diet and heart disease c. Calcium, exercise, and osteoporosis d. Sodium and high blood pressure e. Folate and neural tube defects f. Fruits and vegetables and risk of cancer

Daily Values (DVs)

a. Designed to allow simple comparison of nutrient contents of similar foods b. Compared to RDAs and AIs, which are specific to age, gender, and life stage, DVs are a more simplified and practical set of nutrient standards for food labeling c. Based on a standard diet providing 2000 kcal/d d. No DVs are available for protein, sugars, and trans fat e. Often based on the highest RDA or AI for the nutrient across age and gender groups f. DVs are listed in Appendix C g. Goals for menu planning based on DVs i. Strive to obtain 100% DV for fiber, vitamins, and minerals ii. Limit foods that have high %DVs for total fat, cholesterol, and sodium iii. 5% or less indicates a low source of the nutrient iv. 20% or more indicates a high source of the nutrient

Other descriptive labeling terms

a. Light or lite = at least 1/3 fewer kilocalories or ½ fat of reference food (may also describe texture or color) b. Natural = no food coloring agents, synthetic flavors, or other unnatural substances

On MyPlate

a. MyPlate illustrates the food groups that are the building blocks for a healthy diet using a familiar image—a place setting for a meal. b. The five major food groups: grains, vegetables, fruits, dairy, and protein c. Promotes dietary variety, nutritional adequacy, and moderation d. Allows evaluation of nutritional quality of individual diet e. Sweets or desserts can be included in a healthy diet as long as food group recommendations are met and overall calorie needs are not exceeded f. Includes resources for weight management and physical activity: interactive tools offer an option to "move toward a healthier weight"

Optional elements

a. Polyunsaturated fat b. Monounsaturated fat c. Other micronutrients (required if food is fortified or health claim is present)

FDA permits legally-defined claims about the levels of nutrients in foods

a. Sugar i. Sugar free: < 0.5 g sugar/serving ii. Reduced sugar: at least 25% less sugar/serving than reference food b. Calories i. Calorie free: < 5 kcal/serving ii. Low calorie: ≤ 40 kcal/serving iii. Reduced or fewer calories: at least 25% fewer kcal/serving than reference food c. Fat i. Fat free: < 0.5 g fat/serving ii. Low fat: ≤ 3 g fat/serving iii. Reduced or less fat: at least 25% less fat/serving than reference food d. Cholesterol i. Cholesterol free: < 2 mg cholesterol/serving (and < 2 g saturated fat/serving) e. Fiber i. High fiber: ≥ 5 g fiber/serving; must also meet definition of low fat ii. Good source of fiber: supplies 2.5 - 4.9 g fiber/serving f. Meats and poultry i. Extra lean: < 5 g fat, < 2 g saturated fat, and < 95 mg cholesterol/serving ii. Lean: < 10 g fat, < 4.5 g saturated fat, and < 95 mg cholesterol/serving

Identify the basic goals of the Dietary guidelines for Americans

a. To reduce the risk of chronic disease, such as diabetes and alcoholism b. To promote adequate nutritional status c. To set standards for energy and nutrient intake d. To provide individually tailored nutrition and physical activity guidance

mormon

alcohol and caffeine forbidden fasting practiced occassionally

seventh daySimply consuming required amounts of nutrients does not result in optimal nutritional status adventist

animal consumption limited to milk, milk products, eggs, alcohol and drinks with stimulants prohibited

Nutrition facts panel is not required on

fresh fruits and vegetables, fish and shellfish, meats, and poultry

hindu

beef forbidden pork restricted alcohol avoided fasting encouraged

A health claim could be included on a. A food with 15 g of fat per serving b. A food with 5% of DV for iron c. A food with 19% of DV for vitamin A d. A food with 2 g of fiber

c. A food with 19% of DV for vitamin A

The basic premise of the dietary guidelines for Americans includes which of the following statements? a. All nutrient needs should be met through dietary supplements to provide an array of nutrients and non-nutrients that may benefit health b. All nutrient needs should be met through intake of foods and supplements to ensure an array of nutrients and non-nutrients that may benefit health c. All nutrient needs should be met through consumption of foods to provide an array of nutrients and non-nutrients that may benefit health

c. All nutrient needs should be met through consumption of foods to provide an array of nutrients and non-nutrients that may benefit health

Empty calorie foods or beverages supply many calories relative to their micronutrient contents

candy, regular soft drinks, jelly, solid fats, cream, cream cheese, alcoholic beverages)

John consumed 5 servings of popcorn. Each serving contained 40% of the daily value for sodium. He consumed ________% daily value for sodium from the bag of popcorn a. 250 b. 20 c. 45 d. 200

d. 200

Recommendations are to choose a variety of foods from within

each food group

Limitations of MyPlate

i. Full use requires computer and Internet access ii. Difficulty categorizing combination foods iii. Many individuals have trouble accurately estimating portion sizes; Figure 3.7 provides visual guides for estimating portion sizes iv. Intended for healthy people v. The icon does not include all of the messages of the Dietary Guidelines

Simply consuming required amounts of nutrients does not result in optimal nutritional status

if your intake of a nutrient just meets the required amount, your body has no extra supply available to use in case your diet becomes limited. Many nutrients are stored in the body, and for optimal nutrition, you need to consume enough of those nutrients to maintain storage levels. Your body uses its nutrient stores much like you can use a savings account to help manage your money.

"Make your Calories Count"

is an interactive program designed to help individuals plan healthy diets while managing calorie intake; available online

fortification

is the addition of nutrients to food, such as adding calcium to orange juice, vitamins A and D to milk, and numerous vitamins and minerals to ready-to-eat breakfast cereals.

non-organic

limited restrictions on fertilizers sludge products can be used on some fields few manure restrictions government approved pesticides used per directions GMOs approved by government permitted irradiation may be used some by-products allowed some record keeping, no onsite checks regulated

Asian Food Diet Pyramid

meat = monthly sweets, eggs, poultry = weekly fish, shellfish, dairy = optional daily fruit, beans, legunes, vegetable oil, vegetables, rice, noodles, bread, millet, corn and other whole grains and physical activity - daily 6 glasses water or tea, sake, wine, beer in moderation

buddhist

meat avoided, vegetarian

eastern orthodox

meat/fish restrictions - fasting, specific food abstinence during certain holidays

jewish

only kosher food acceptable tref refers to forbidden food pork/shellfish prohibited no meat with dairy permitted no blood - raw meat soaked, salted for 1 hour, rinsed eggs, fruit, vegetables ok but inspected for blood fish with fins and scales ok only animals with split hooves and chew with cud ritual killing forbidden fasting on some holidays

Supplement Facts Label

per serving, nutrients, when contains a mix, descending order by content or weight, manufacturer's name/address, dietary supplement, % daily value (DV) must be listed when present, biochemicals and phytochemicals that do not have DV's must be listed, structure/function claim, FDA disclaimer

islam

pork, birds of prey, reptiles, insects except locusts, gelatins, alcohol forbidden ritual killing on animals for food coffee, tea avoided as stimulants ramadan holiday fasting of all food, also other religious holidays

Organic Foods

produced without use of antibiotics, hormones, synthetic fertilizers and pesticides, genetic improvements, or spoilage-killing radiation Technical or chemical definition - Substances containing the element carbon bonded to hydrogen

Traditional Asian foods usually consist of

rice, noodles, vegetables

Nutrient Content Claims

sugar free = less than .05 grams reduced sugar = less than 25% than reference food calorie free = fewer than 5kcal per serving low cal - 40kcal per serving reduced or fewer calories = at least 25% less than reference food fat free = less than .05 grams low fat = 3g or less per serving - 2% milk is not low fat, it has more than 3g kcal per serving, 2% milk is reduced fat reduced fat = less than 25% less than reference food cholesterol free = less than 2mg high fiber = 5g or more good source of fiber = 2.5 to 4.9g per serving extra lean = less than 5g of fat, 2g of saturated fat, 95 mg cholesterol per serving lean = less than 10g of fat, 4.5 g of saturated fat, 95 mg cholesterol per serving

organic

synthetic fertilizers not allowed sewage products not allowed raw manure restrictions synthetic pesticides not allowed genetically altered not allowed (GMA) feeding livestock mammal/poultry or manure by-products not allowed growth hormones, antibiotics not allowed irradiation is not allowed record keeping and site inspections required

In 1992, the USDA introduced the Food Guide Pyramid, a completely revamped version of the Hassle-Free Guide

the Food Guide Pyramid incorporated knowledge about the health benefits and risks associated with certain foods and ranked food groups according to their emphasis in menu planning. The Food Guide Pyramid displayed the groups in a layered format with grain products at the base to establish the foundation for a healthy diet. Fruit and vegetable groups occupied the next layer of the Food Guide Pyramid, followed by a layer shared by the milk and milk products and meat and meat substitutes groups. Fatty and sugary foods formed the small peak of the Pyramid, a visual reminder that people should limit their intake of these foods.

mypyramid plan

the USDA released the MyPyramid Plan in 2005 (Fig. 3.6). The MyPyramid Plan was a food guidance system, which was based on Dietary Guidelines for Americans, 2005. In addition to providing foods and nutrition information, the MyPyramid.gov website emphasized the importance of physical activity and enabled consumers to monitor their activity levels. In 2011, the USDA replaced the MyPyramid Plan with MyPlate, another interactive dietary and menu planning guide accessible at a website.

What Is the Exchange System?

• Categorizes foods into 3 food groups: • Carbohydrates • Meat & meat substitutes • Fats • Provides exchange lists of specific types of foods • Specified amounts of food listed have similar macronutrient and energy contents Exchange system purpose Provides a manageable framework for treatment of diabetes Organizes foods based on calorie, protein, carbs, and fat Provides a manageable framework for designing diets

Food guides have been issued by USDA for over 100 yrs:

•1943 — Food guide had 7 food groups •Mid-1950s — "Basic Four" food groups •1979 — "Hassle-Free Guide to Better Diet" •1995 —Food Guide Pyramid •2005 — MyPyramid •2011 — MyPlate

Daily Values (DVs)

•A set of nutrient intake standards developed for labeling purposes •A more simplified and practical set of nutrient standards than RDA •Most DVs based on highest RDA or AI •Goal is to obtain at least 100% of the DV per day -People may need to limit total fat, cholesterol, and sodium intakes

Requirements vary based on:

•Age •Sex •Health status •Physical activity level •Medication/drug use

The Role of Diet in Health

•As immigrants adopt the "American" lifestyle and become less physically active, they tend to develop obesity, type 2 diabetes, and hypertension. •Recommendations to reduce such diet-related health problems focus on: - Making certain dietary changes - Increasing physical activity

Dietary Guidelines for Americans 2010 include:

•Balancing Calories to Manage Weight -Control total calorie intake to manage body weight. -For people who are overweight or obese, this will mean consuming fewer calories from foods and beverages. Recommendations: -Increase intake of whole grains, vegetables, and fruits -Reduce intake of sugar-sweetened beverages -Monitor intake of 100% fruit juice for children and adolescents, especially those who are overweight or obese -Monitor calorie intake from alcoholic beverages for adults

Dietary Guidelines for Americans 2010; Key Recommendations

•Balancing Calories to Manage Weight •Prevent and/or reduce overweight and obesity through improved eating and physical activity behaviors. •Control total caloric intake to manage body weight. For people who are overweight or obese, this means consuming fewer calories from foods and beverages. Increase physical activity and reduce time spend in sedentary behaviors. •Maintain appropriate calorie balance during each stage of life childhood, adolescence, adulthood, pregnancy and breastfeeding, and older age.

Other Dietary Guides

•Developed for people that follow other cultural or ethnic traditions: -Mediterranean Diet Pyramid -Asian Diet Pyramid -Eating Well with Canada's Food Guide

Health Claims

•FDA allows certain health claims on food labels. •Claims describe relationships between a food, ingredient, or supplement and the reduced risk of nutrition-related conditions.

Structure/Function Claims

•FDA allows structure/ •function claims such as •"calcium builds bones" or •"fiber maintains bowel •regularity." • Manufacturers cannot claim a nutrient, food, or supplement prevents or treats a serious health condition.

Building Healthy Eating Patterns also includes

•Follow food safety recommendations when preparing and eating foods to reduce the risk of foodborne illnesses. -Clean hands, food contact surfaces, and vegetables and fruits. -Separate raw, cooked, and ready-to-eat foods while shopping, storing, and preparing foods. -Cook foods to a safe temperature. -Chill (refrigerate) perishable foods promptly.

Dietary Guidelines for Americans 2010

•Guidelines are revised and released every five years by law. •2010 Guidelines released January 31, 2011 • By USDA and HHS -United States Department of Agriculture (USDA) -US Department of Health and Human Services (HHS)

Other Descriptive Labeling Terms

•Light or lite — compared to reference food: -Has at least 1/3 fewer calories -Contains at least 1/2 the fat of the reference food •Light can also refer to texture or color •Natural — food contains no: •Food colorings •Synthetic flavors •Other unnatural substances

Tips for "Building a Better Plate":

•Make at least 1/2 of your grains foods whole grains. • Vary vegetable choices. • Make 1/2 of your plate fruits and vegetables. • Focus on fruit. • Consume sources of calcium. • Choose lean protein sources. • Find your balance between food and physical activity. •Keep food safe to eat.

Other Foods

•May include the oils group and the empty-calorie group. •Oils are often good sources of fat soluble vitamins and may be sources of "healthy" fats. •Empty- calorie foods generally add a lot of sugar, alcohol, and/or solid fat to diets.

The Melting Pot

•Northwestern European Influences -UK, Scandinavia, Germany Traditional diet: large portions of beef or pork with potatoes •Hispanic Influences - Spanish or Mexican ancestry Traditional Mexican diet: corn, beans, chili pepper, avocado, papaya, and pineapple •Italian or Other Mediterranean Influences •Traditional diet: pasta and other grains, olive oil, fish, and nuts •Major type of fat in olive oil reduces CVD risk. •Asian Influences •China, Japan, Vietnam, Thailand, and Korea •Traditional diet: large amounts of vegetables, rice, and noodles with small amounts of meat, fish, or shellfish

Building Healthy Eating Patterns

•Select an eating pattern that meets nutrient needs over time at an appropriate calorie level. -focus on nutrient-dense foods •Account for all foods and beverages consumed and assess how they fit within a total healthy eating pattern. -Self-monitor diet

What About Fast Foods?

•Some, but not all, restaurants display energy and nutrient information. •Ask the manager for the company's brochure that provides products' nutrition information. Can be found in the restaurant, online on the restaurant website or in dietary analysis software packages

African Influences

•Traditional African foods: sweet potatoes, okra, & peanuts •"Soul foods" include: sweet potato pie, fried chicken, black-eyed peas, and greens cooked with smoked pork. •Benefits: High in fiber and provide a variety of vitamins and minerals •Problems: High in fat and sodium

Vegetables

•Vegetables vary in their nutrient and energy contents. •Often grouped according to color and starch content •Dried peas & beans may be classified as vegetables as well as meat substitutes.

Labels must list product's:

•ingredient(s) •serving size •amount(s) per serving •suggested use •manufacturer's name and address •%DV (if established)