nutrition chpt 2

Expect the Following from Nutritional Professional

Ask questions about medical history, lifestyle, current eating habits Formulates a diet plan tailored to your needs Schedules follow-up visits to track progress, answer questions, help with motivation Involve family members in the diet plan, when appropriate Consults directly with your physician, readily refers you back to physician

KEY RECOMMENDATIONS

Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level Imbalances between calories consumed and calories expended could lead to changes in body weight and chronic disease risk Aim to meet nutrient needs primarily with nutrient dense foods Fortified foods and dietary supplements may be useful Healthy eating patterns are adaptable to socio-cultural and individual preferences A healthy eating pattern includes: A variety of vegetables from all subgroups Fruits, especially whole fruits Grains, at least half of which are whole grains Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products Oils A healthy eating pattern limits Saturated fats (<10% of kcal) Trans fats Added sugars (<10% of kcal) Sodium (<2300 mg) If alcohol is consumed, it should be consumed in moderation, and only by adults of legal drinking age Up to one drink per day for women Up to two drinks per day for men

A Food Philosophy That Works

Consume a variety of foods Control how much you eat Pay attention to what you eat Choose whole grains, fruits, and vegetables There are no exclusively "good" or "bad" foods Stay physically active

Exceptions to Food Labeling

Nutrition Facts panel is not mandatory on all foods Fresh fruit Fresh vegetables Fish %DV for protein

Nutritional state

Nutritional health of a person determined by anthropometric measurements, biochemical measurements of nutrients, their by-products in blood and urine, clinical examination, dietary analysis, and economic evaluation; also called nutritional status

1. What are the main differences between the undernutrition, desirable nutrition, and overnutrition states of nutritional health?

A desirable nutritional state results when the body has enough nutrients to function fully and contains stores to use in times of increased needs. When nutrient intake fails to meet body needs, undernutrition develops. Symptoms of such an inadequate nutrient intake can take months or years to develop. Overloading the body with nutrients, leading to overnutrition, is another potential problem to avoid.

overnutrition

A state in which nutritional intake greatly exceeds the body's needs

malnutrition

Failing health from long-standing dietary practices that do not coincide with nutritional needs

undernutrition

Failing health that results from a long-standing dietary intake that is not enough to meet nutritional needs

2. What are the five major food groups represented on MyPlate?

Grains, fruits, vegetables, protein, and dairy are the five major food groups represented on MyPlate.

1. What is the website where you can find all of the tools associated with MyPlate?

MyPlate and associated tools found at www.ChooseMyPlate.gov embody the Dietary Guidelines with a plate icon that serves as a reminder for healthy eating.

Specific Nutrient Standards and Recommendations

Dietary Reference Intakes (DRI) Recommended Dietary Allowances (RDA) Adequate Intakes (AI) Estimated Energy Requirements (EER) Tolerable Upper Intake Levels (UL)

Claims on Food Labels

Health claims: closely regulated by FDA Preliminary health claims: regulated by FDA but evidence may be scant for the claim Nutrient claims: closely regulated by FDA Structure/function claims: these are not FDA-approved or necessarily valid

Shifting to Healthy Eating Patterns

Healthy U.S.-Style Eating Pattern Healthy Mediterranean-Style Eating Pattern Healthy Vegetarian Eating Pattern

Daily Food Checklists---ChooseMyPlate.gov

Interactive tool that estimates your calorie needs and suggests a food pattern based on your age, gender, height, and weight Modified plans for preschoolers, pregnant or breastfeeding mothers, those interested in losing weight

Tolerable Upper Intake Level (UL)

Maximum chronic daily intake level of a nutrient that is unlikely to cause adverse health effects in almost all people in a specific life stage Problems arise for those who use many fortified foods, excess doses of vitamins and minerals

Dietary Reference Intakes (DRI)

Term used to encompass nutrient recommendations by the Food and Nutrition Board of the Institute of Medicine These include RDAs, AIs, EERs, and ULs

1. How many minutes of moderate-intensity physical activity are advised per week in the 2008 Physical Activity Guidelines for Americans?

The 2008 Physical Activity Guidelines for Americans advise a minimum of 150 minutes per week of moderate-intensity physical activity for adults or at least 60 minutes daily for children and adolescents.

Additional MyPlate Resources

USDA's Ten Tips Nutrition Education series Topics include: Kid-friendly veggies and fruits Healthy eating for vegetarians Got your dairy today Online sample menus and recipes Food-A-Pedia The SuperTracker

Tips for Boosting Phytochemical Content in the Diet

Use vegetables in main and side dishes Look for quick-to-fix grain side dishes in the supermarket Use fruit to sweeten desserts Get creative at the salad bar Fresh or dried fruit for snacks away from home Add vegetables to sandwich Vegetarian meals once or twice a week Container of vegetables in your fridge for snacks

functional foods

provide health benefits beyond those supplied by the traditional nutrients they contain

Proportionality (Balance) Means Eating More Nutrient-Dense Foods

↑ nutrient-dense foods and beverages (e.g., fruit, vegetables, whole grains, fat-free or low-fat milk products) ↓ foods high in certain types of fat, sugars, cholesterol, salt, and alcohol Match energy intake with energy expenditure Nutrient density =nutrient content/kcal content

Variety Means Eating Many Different Foods

Choose foods from ALL the food groups No one food meets all nutrient needs Eat from the five food groups every day: Grains Fruits Protein Vegetables Dairy

Consumer Health Messages

ChooseMyPlate.gov provides simple, actionable recommendations to help consumers make healthier food choices Balancing Calories Enjoy your food, but eat less Avoid oversized portions Foods to Increase Make half your plate fruits and vegetables Make at least half your grains whole Switch to skim or 1% milk Foods to Reduce Compare sodium in foods such as soup, bread, and frozen meals, and choose the foods with lower numbers Drink water instead of sugary drinks

daily value (dv)

Daily Value is the nutrient standard used on the Nutrition Facts portion of the food label The percent Daily Value for each nutrient is based on consuming a 2000-kcal diet Set at or close to the highest RDA value or related nutrient standard DVs have been set for vitamins, minerals, protein, other dietary components Allow intake comparison from a specific food to desirable (or maximum) intakes

Estimated Energy Requirement (EER)

Estimates energy (kcal) intake needed to match the energy use of an average person in a specific life stage EER needs to be specific, taking into account age, gender, height, weight, and physical activity Serves as a starting point for estimating calorie need

Dietary Guidelines— the Basis For Menu Planning

General goals for nutrient intakes and diet composition Set by USDA and DHHS Translate nutrition science into food-based guidelines that will help Americans meet nutrient needs and reduce risk for many chronic diseases Based on the latest and strongest scientific information to improve the health of all Americans age 2 and older Assist health professionals in designing healthy dietary patterns Used in development of public policy and consumer health messages Follow a healthy eating pattern across the lifespan Focus on variety, nutrient density, and amount Limit calories from added sugars and saturated fats and reduce sodium Shift to healthier food and beverage choices Support healthy eating patterns for all

1. What do variety, proportionality, and moderation mean, and how do they work together to result in a healthy diet?

Healthy diet planning requires variety, proportionality, and moderation. Variety involves choosing different foods within each food group. Proportionality, also referred to as balance, is eating more nutrient-dense foods and beverages such as fruit, vegetables, whole grains, fat-free or low-fat milk products and less of foods high in certain types of fat, sugars, cholesterol, salt and alcohol. Moderation implies limiting portion sizes with each food choice, so that the diet is not excessive in calories or any particular nutrient.

Many Other Meal-Planning Guides are Available

Mediterranean Diet Pyramid and other "heritage pyramids" from Oldways Preservation Trust Harvard Healthy Eating Plate MyPlate for Older Adults (Tufts University) and other guides for specific population groups Choose Your Foods Food Lists for Diabetes Food Lists for Weight Management

1. How do the concepts of nutrient density and energy density differ?

Nutrient density of a food is determined by comparing its protein, vitamin, or mineral content with the amount of calories it provides. Nutrient-dense foods, such as fat-free milk, fruits, vegetables, and whole-grain breads and cereals, supply many nutrients without contributing excessive calories. Energy density is a measurement that best describes the calorie content of a food. Energy density of a food is determined by comparing the calorie (kcal) content with the weight of food. Consuming foods of low energy density, such as fruits and vegetables, may also help in weight control, because they promote satiety with relatively few calories.

Adequate Intake (AI)

Nutrient intake amount set for any nutrient for which insufficient research is available to establish an RDA. AIs are based on estimates of intakes that appear to maintain a defined nutritional state in a specific life stage. Not enough information on some nutrients, such as chromium, to set RDA standard DRIs include an Adequate Intake category

Recommended Dietary Allowance (RDA)

Nutrient intake amount sufficient to meet the needs of 97% to 98% of the individuals in a specific life stage An intake slightly above or below the RDA for a nutrient on any given day is no concern Nutrient deviation below (about 70%) or above (about three times or more for some nutrients) RDA for an extended time can result in a deficiency or toxicity

1. What are the ABCDE steps used in assessing nutritional status?

Nutritional state can be assessed by using anthropometric, biochemical, clinical, dietary, and economic assessments (ABCDEs).

Moderation Refers Mostly to Portion Size

Pay attention to portion sizes Plan your day's diet so that you do not overconsume any nutrients Energy density =kcal content/weight of food

Diet Planning with Labels

Plan meals using MyPlate Evaluate total diet with reference to Dietary Guidelines for Americans Use Nutrition Facts panel to identify Nutrient-dense foods Energy-dense foods

How Should These Nutrient Standards Be Used?

RDAs and related standards are intended for diet planning Diet plan should aim to meet the RDA or AI Not to exceed the UL over the long term

Evaluating Nutrition Information

Apply basic nutrition principles Utilize 2015 - 2020 Dietary Guidelines Are there inconsistencies? Reliable supporting references? Beware of: Testimonials about personal experience Disreputable publication sources Promises of dramatic results (rarely true) Lack of evidence from other scientific studies Examine the source Professionals Organizations Publications Beware of bogus claims Ignores possible disadvantages Cure-all Bias against medical community Breakthrough Note the size, type, and duration of any study What population was studied: women, men, country, race? Do they represent you? Marketing hype Megadoses Clear labeling

How Does Your Plate Rate?

Assess your diet SuperTracker NutritionCalc Plus Which food groups are too low? Which food components are too high?

1. How do the definitions of RDA and AI differ?

Standards for nutrient intake are included in the broad category of Dietary Reference Intakes (DRIs). The Recommended Dietary Allowances (RDAs) are the amounts of each nutrient that will meet the needs of healthy individuals within specific gender and age categories. If not enough information is available to set an RDA, an Adequate Intake (AI) value is used.

1. What are three of the major goals of the 2010 Dietary Guidelines for Americans?

The 2010 Dietary Guidelines for Americans aim to improve the health of all Americans, ages 2 and older. Three major goals include: (1) balancing calories with physical activity to manage weight; (2) increasing intake of fruits, vegetables, whole grains, fat-free and low-fat dairy products, and seafood; and (3) reducing intake of foods with sodium, saturated fats, trans fats, cholesterol, added sugars, and refined grains.

1. Which DRI category includes the highest amounts of a nutrient unlikely to cause adverse health effects?

Tolerable Upper Intake Levels (ULs) are the highest amounts of a nutrient unlikely to cause adverse health effects. ULs have been set for some vitamins and minerals.

Physical Activity Guidelines for Americans

U.S. Department of Health and Human Services issued Physical Activity Guidelines for Americans in 2008 Provide measurable physical activity standards for Americans age 6 and older Adults: health benefits occur with at least 150 minutes per week of moderate-intensity physical activity Adults accumulate activity throughout week in a variety of ways Children/adolescents should include 60 minutes of physical activity per day

MyPlate

Visual representation of the advice contained in the 2010 Dietary Guidelines for Americans Aids in dietary planning for individuals ages 2 and older Cannot stand alone as dietary advice Diet quantity Diet quality Snacking between meals