Chapter 3

Dietary Reference Intakes

1. Include EARs, RDAs, AIs, ULs, and EERs 2.Developed by the Food and Nutrition Board of the Institute of Medicine 3.Adjusted as new information becomes available

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

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

requirements for certain nutrients

1. Sufficient to prevent deficiency disease 2.May vary based on age, sex, health status, physical activity, use of medications

Meat- Foods in this group have a wide range of fat content

1. Very lean (e.g., low-fat cottage cheese, white meat of turkey) 2. Lean (e.g., ground beef with <15% fat, tuna) 3.High-fat (e.g., pork sausage, bacon, regular cheeses, hot dogs)

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

Applying nutrient standards

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 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 5.Nutrition experts develop dietary guides, which translate scientific information from DRIs into meal planning tools that can be used by consumers

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

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

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

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

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)

Fruits- Nutrient profile:

1.Low in fat 2.Phytochemicals 3.Macronutrients: carbohydrate 4.Micronutrients: potassium, vitamin C, folate 5.Fiber

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

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

Brief history of USDA food guides

1943 - first guide, based on RDAs, 7 food categories, designed to help Americans plan nutritious menus despite food shortages during WWII 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 1979 - "Hassle-Free Guide to a Better Diet", added 5th category to Basic Four to address fats, sweets, and alcoholic beverages 1992 - Food Guide Pyramid incorporated knowledge about health risks and benefits associated with dietary patterns, ranked foods according to their emphasis in menu planning 2005 - MyPyramid is based on Dietary Guidelines for Americans 2005 2011 - MyPyramid Plan was replaced with MyPlate, another interactive dietary and menu planning guide accessible at a website.

Meat and meat substitutes

Examples: beef, pork, lamb, fish, shellfish, liver, poultry, beans, eggs, nuts, and seeds; Recommendations: limit saturated fat and cholesterol Serving size = "1 ounce"- 1 ounce of meat, poultry, or fish, ¼ c cooked dry beans or peas, 1 egg, 1 tablespoon of peanut butter, ½ ounce nuts or seeds, ¼ cup of tofu

Oils

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

Examples: fresh, cooked, canned, frozen, dried/dehydrated vegetables, 100% vegetable juice (some dietary guides also include dried beans and peas) Serving size = "1 cup"-1 cup of raw or cooked vegetables, 1 cup of vegetable juice, 2 cups of uncooked leafy greens

Fruits

Examples: fresh, dried, frozen, sauced, and canned fruit, 100% fruit juice; Recommendations: use whole fruit in place of fruit juice because whole fruits contain more fiber and fewer calories Serving size = "1 cup"- 1 cup of fruit, 1 cup of fruit juice, ½ cup of dried fruit

Milk and milk products

Examples: milk and products made from milk that retain their calcium content Serving size = "1 cup"-1 cup of milk, 1 cup of yogurt, frozen yogurt, or pudding, 2 cups of cottage cheese, 1.5 ounces of natural cheese, 2 ounces of processed cheese

Grains

Examples: products made from wheat, rice, oats, and some corn products Serving size = "1 ounce"-1 slice of bread, 1 cup of ready-to-eat cereal, ½ cup of cooked rice, pasta, or cereal

Major food groups

Grains, Dairy foods, protein rich foods, fruits, vegetables, oils

true

Many chronic diseases are associated with lifestyle practices including poor diet and lack of physical activity; Promote adequate nutritional status, good health, and reduce the risk of several chronic diseases

true

Minerals are generally better absorbed from animal foods than from plant foods

Vegetables- Nutrient profile:

a. Macronutrients: carbohydrate, some protein b.Micronutrients c.Fiber d.Phytochemicals e.Low in fat and calories

Moderate alcohol consumption

a.1 drink/d for women, b.2 drinks/d for men

Estimated Average Requirement (EAR)

a.Amount of the nutrient that should meet the needs of 50% of healthy people in a particular life stage/gender group b.Established based on a measurable physiological marker that reflects proper functioning

Estimated Energy Requirement (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

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)

Adequate Intakes (AIs)

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

Grains- 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

MyPlate Limitations

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

Milk and milk products- 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

Tolerable Upper Intake Level (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

Milk products- Foods in this group have a wide range of fat and sugar contents

a.Ice cream, pudding, frozen yogurt, and ice milk are often grouped with milk and milk products, but they have high sugar and fat contents b.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

Meat and meat substitutes-Nutrient profile:

a.Macronutrients: protein b.Micronutrients: iron, zinc, B vitamins c.Foods in this group have a wide range of fat content

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"

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

Acceptable Macronutrient Distribution Ranges (AMDR)

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

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

Recommended Dietary Allowances (RDAs)

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

Avoid high risk foods

a.Unpasteurized juices and milk products b.Raw or undercooked eggs, meat, and poultry c.Raw spouts

enrichment

addition of iron and certain B vitamins to cereal grain products

fortification

addition of nutrients to food

Dietary Reference Intakes (DRIs)

are a set of energy and nutrient intake standards that are used to make dietary recommendations

empty calorie allowance

daily amount of energy remaining after a person consumes recommended amounts of foods that contain little or no solid fats and added sugars from the major food groups

Exchange system

method of classifying foods into numerous lists based on macronutrient composition

requirement

smallest amount of a nutrient that maintains a defined level of nutritional health.

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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

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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

true

Empty calorie foods or beverages supply many calories relative to their micronutrient contents (e.g., candy, regular soft drinks, jelly, solid fats, cream, cream cheese, alcoholic beverages); Recommendations are to choose a variety of foods from within each food group