Chapter2

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Chapter2

  1. 1. Nutritional Assessment and Dietary Planning Chapter 2
  2. 2. What Do We Mean by “Nutritional Status”? • Nutritional status • Undernutrition • Too little of a nutrient • Nutritional toxicity • Malnutrition • Primary • Secondary • Nutritional adequacy
  3. 3. Nutrient Intake Largely Determines Nutritional Status & Contributes to Health
  4. 4. How Is Nutritional Status Assessed? • Critical during times of growth and development • ABCD methods of nutritional assessment • Anthropometry • Physical dimensions and composition – height, weight, circumferences – Body composition
  5. 5. How Is Nutritional Status Assessed? • ABCD methods of nutritional assessment • Biochemical measurements • Blood and urine – Biological markers • Clinical assessments • Medical history • Visible signs of illness • Symptoms of disease or malnutrition
  6. 6. How Is Nutritional Status Assessed? • ABCD methods of nutritional assessment • Dietary assessment • Retrospective dietary assessment – 24-hour recall – Food frequency questionnaire • Prospective dietary assessment – Diet record • Tools • Food composition tables & dietary analysis software
  7. 7. How Much of a Nutrient is Adequate? • Dietary Reference Intakes (DRIs) • United States and Canada • Influential factors • Sex, life stage, genetics, medications, lifestyle choices, and environmental influences • Nutrient requirement • DRIs are estimates in a healthy population
  8. 8. Dietary Reference Intakes (DRI) Standards
  9. 9. How Much of a Nutrient is Adequate? • Estimated Average Requirements (EARs) • Meet requirements of half the healthy individuals in each life stage and sex • There are not EAR values for all nutrients • Inappropriate to use EAR for individuals
  10. 10. How Much of a Nutrient is Adequate? • Recommended Dietary Allowances (RDAs) • Nutrient-intake goals for individuals • 97% of healthy individuals in specified life stage and sex • Purposes • Prevent nutrient deficiencies and promote optimal health • Built in safety margin • Can only be established for nutrients with EARs
  11. 11. EARs Compared with RDAs
  12. 12. How Much of a Nutrient is Adequate? • Adequate Intake (AI) • Nutrient intake goals for individuals • Lack of research to support RDA because not EAR • No RDAs for infants 0 to 6 months of age; only AIs
  13. 13. How Much of a Nutrient is Adequate? • Tolerable Upper Intake Levels (UL) • Highest level of usual daily nutrient intake likely to be safe • Not all nutrients have an UL • Insufficient research
  14. 14. Using EARs, RDAs, and ULs to Assess Dietary Adequacy
  15. 15. How Much of a Nutrient is Adequate? • Evaluating energy intake • Estimated Energy Requirements (EERs) • Mathematical equations • Age, sex, weight, height, and physical activity level • Acceptable Macronutrient Distribution Ranges (AMDRs) • Distribution of energy sources • Current recommendations
  16. 16. Effects of Age and Activity Level on EERs
  17. 17. How Can You Easily Assess and Plan Your Diet? • USDA Food Patterns • Categorization of foods into groups • Currently 5 groups • Dietary Guidelines for Americans • Revised every 5 years • MyPlate
  18. 18. How Can You Easily Assess and Plan Your Diet? • 2010 Dietary Guidelines for Americans • Two important facts • Diet and physical activity • Acquisition of adequate food • Overarching goals • Maintain energy balance over time • Focus on consuming nutrient-dense foods • Underlying premise • Consume food, not supplements
  19. 19. How Can You Easily Assess and Plan Your Diet? • 2010 Dietary Guidelines for Americans • Balance calories to manage weight • Obesity epidemic • Suggested strategies • Reduce certain foods and food components • Sodium, saturated fats, cholesterol, trans fatty acids, solid fats, added sugars, and refined grains • Suggested strategies
  20. 20. How Can You Easily Assess and Plan Your Diet? • 2010 Dietary Guidelines for Americans • Increase certain foods and nutrients • Nutrients of concern – Potassium, dietary fiber, calcium, vitamin D – Iron, folate, and vitamin B12 for certain groups • Build healthy eating patterns • Establish the current food patterns • Focus on nutrient density • Remember that beverages count
  21. 21. Amounts of Each Food Group Recommended by the USDA Food Guide and MyPlate
  22. 22. Examples of the Calories in Related Nutrient-Dense and Non-Nutrient Dense Food Choices
  23. 23. How Can You Easily Assess and Plan Your Diet? • 2010 Dietary Guidelines for Americans • “Call to Action” • Ensure all Americans have access • Facilitate individual behavior change • Set the stage for lifelong healthy eating, physical activity, and weight management
  24. 24. How Can You Easily Assess and Plan Your Diet? • MyPlate • Visual guide • 12 different sets of dietary patterns • Themes • Build a healthy plate • Cut back on certain foods • Eat the right amount of calories • Be physically active your way • Food tracker
  25. 25. How Can You Easily Assess and Plan Your Diet? • Healthy People 2020 • Overall health objectives for the nation • Helps policy makers • Four overarching goals • 39 topic areas
  26. 26. Many Private and Federal Groups Work Together to Keep Us Healthy
  27. 27. How Can You Use Food Labels to Plan a Healthy Diet? • Food labels • Food and Drug Administration (FDA) • Required components • Recent addition • Other elements that may be presented on a food label
  28. 28. How Can You Use Food Labels to Plan a Healthy Diet? • Nutrition Facts Panel • Required elements • Daily values • Recommended intake goals – Vitamins and minerals • Upper limits – Total fat, saturated fat, cholesterol, sodium, and total carbohydrates • “Good source” of particular nutrients
  29. 29. How Can You Use Food Labels to Plan a Healthy Diet? • Various claims • Nutrient-content claims • FDA regulation • Structure/function claims • Not approved by the FDA • Health claims • Types • FDA approval
  30. 30. FDA-Approved Nutrient Content Claims
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