chapter 1.pdf

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1
Overview of
Nutrition and
Health
Copyright © 2017 Cengage Learning. All Rights Reserved.

© Cengage Learning 2017
Introduction
• Daily choices:
– Affect physical health and wellness
• Healthcare professionals:
– Are responsible to self and clients in
behaviors and daily choices
• Nutritional choices:
– Impact health and disease

The Health Line

• Preference
• Habit
• Associations
• Ethnic heritage and
regional cuisines
• Values
• Social interaction
• Emotional state
• Availability,
convenience, and
economy
• Age
• Body weight and
image
• Medical conditions
• Health and nutrition
Food Choices

The Nutrients
• Six classes of nutrients
– Water, carbohydrates, fats, proteins, vitamins,
minerals
– Essential nutrients: those that must be
obtained from food
– Carbohydrates, fats, and proteins
• Organic nutrients (contain carbon)
• Energy-yielding nutrients

The Nutrients (cont’d.)
• Six classes of nutrients
– Vitamins, minerals, and water
• Vitamins are organic; minerals and water are
inorganic
• Vitamins facilitate the release of energy
• Minerals help regulate energy release and serve
other roles
• Water: medium for all body processes

• kCalories: a measure of energy
– Kilocalorie (kcalorie, kcal): 1000-calorie metric
unit for measuring heat energy; commonly
called “calorie”
– Carbohydrates and protein provide 4 kcal of
energy per gram
– Fat provides 9 kcal of energy per gram
• Greater energy density (kcal per gram)

• kCalories: a measure of energy
– Energy nutrients in foods
• Most foods have a mixture of all three energy-
yielding nutrients
– Energy storage in the body
• Excess energy-yielding nutrient intake results in
weight gain
– Alcohol, not a nutrient
• Contributes energy (7 kcal per gram)

Nutrient Recommendations
• Dietary Reference Intakes
– Sets of values for the dietary nutrient intakes
of healthy people in the United States and
Canada
– Used to plan and assess diets of individuals
and populations

Nutrient Recommendations:
Dietary Reference Intakes (cont’d.)
• Setting nutrient recommendations: RDA
and AI
– Recommended Dietary Allowances (RDA):
daily amounts of nutrients adequate to meet
needs of practically all healthy people in a
particular life stage and gender group

• Setting nutrient recommendations: RDA
and AI
– Adequate Intakes (AI): guides for nutrient
intakes used when evidence is insufficient to
set an RDA
– Used to assess the diets of individuals

• Facilitating nutrition research and policy:
EAR
– Estimated Average Requirements (EAR):
average daily nutrient intake levels estimated
to meet needs of half of healthy individuals in
a given age and gender group
– Used by public health officials to assess
intakes of populations and make
recommendations

Nutrient Intake Recommendations

• Establishing safety guidelines: UL
– Some nutrients are hazardous when
consumed in excess
– Tolerable Upper Intake Levels (UL): highest
average daily nutrient intakes that are likely to
pose no toxicity risk to individuals in a life
stage and gender group

• Using nutrient recommendations
– Values are safe, not minimum, intakes
– Reflect average daily intakes over time
– Chosen in reference to specific indicators of
nutrient adequacy (not just deficiency
prevention)
– Designed for healthy people
– Specific for gender, age, and life stage

Views of Nutrient Intakes

• Setting energy recommendations
– Estimated Energy Requirement (EER): energy
intake level predicted to maintain energy
balance in a healthy adult of a defined age,
gender, weight, and physical activity level
– Energy balance is the key

Nutrient Recommendations (cont’d.)
• Acceptable Macronutrient Distribution
Ranges (AMDR)
– Ranges of intakes for the energy-yielding
nutrients that are adequate and reduce
chronic disease risk
– 45–65% of kcal from carbohydrate,
– 20–35% of kcal from fat,
– 10–35% of kcal from protein

National Nutrition Surveys
• Coordinating nutrition survey data
– National Nutrition Monitoring Program:
coordinates the many nutrition-related
activities of various federal agencies
• National Health Goals
– Healthy People: identifies nation’s health
priorities; guides policies to promote
health/prevent disease
– The 2020 objectives (Table 1-2)

Dietary Guidelines and Food Guides
• Dietary concerns: overnutrition and
undernutrition
• Dietary excesses contribute to chronic
diseases
– Especially energy, sodium, certain fats,
alcohol
• Sound nutrition depends on overall eating
pattern (customary choices over time)

(cont’d.)
• Dietary ideals
– Adequacy: providing enough of all essential
nutrients, fiber, and energy
– Balance: providing foods in proportion
– kCalorie (energy) control: management of
food energy intake

(cont’d.)
• Dietary ideals
– Nutrient density: measure of nutrients relative
to energy
– Moderation: provision of enough, but not too
much, of dietary substances
– Variety: consumption of a wide selection of
foods within and among food groups

(cont’d.)
• Dietary guidelines for Americans
– USDA’s Dietary Guidelines for Americans
2015 (Table 1-4)
– The guidelines promote health
• Balancing energy intake, eating a variety of
nutrient-dense foods/beverages, and regular
physical activity promote health
– How does the U.S. diet compare to the
guidelines?

Recommended and Actual Intakes Compared

(cont’d.)
• Fitness guidelines
– Physical activity provides many physical and
psychological benefits
– Minimum amounts of activity necessary for
health benefits depends on aerobic intensity
– American College of Sports Medicine (ACSM)
guidelines (Table 1-6) are designed to
develop and maintain fitness

(cont’d.)
• The USDA Food Intake Patterns
(Figure 1-5)
– Major food groups: fruits, vegetables, grains,
protein foods, and milk and milk products
• Vegetables and protein foods have subgroups
– Oils: not a food group; contribute vitamin E
and essential fatty acids
– Recommended amounts (Tables 1-7 & 1-9)

Dietary Guidelines and Food Guides:
The USDA Food Intake Patterns (cont’d.)
• Notable nutrients (Figure 1-5)
– Legumes can count as vegetables or protein
foods
– People need more vegetables, fruits, whole
grains, seafood, fat-free or low-fat milk and
milk products
– Less sodium, saturated fat, and trans fat, and
fewer refined grains and foods and beverages
with solid fats and added sugars

• Nutrient-dense choices
– Healthy eating pattern emphasizes nutrient-
dense options within each food group
– Limits low-energy-density foods
• Solid fats, added sugars, and alcohol
reduce nutrient density
– Solid fats: milk fat, meat fat, added fats
– Added sugars: kcaloric sweeteners

• Cup and ounce equivalents (Figure 1-5)
– To estimate portions, visualize the size of a
common object
• Mixtures of foods
• Vegetarian food guide
– Vegetarian diets are plant-based eating
patterns (Nutrition in Practice 5)
• Ethnic food choices (Table 1-1)

MyPlate

Food Labels
• The ingredient list
– All packaged foods must list all ingredients on
the label in descending order of
predominance by weight

Original and Proposed Nutrition Facts Panel

Food Labels
• Nutrition Facts panel
– The Food and Drug Administration (FDA) has
proposed significant changes (Figure 1-7)
– Serving sizes
• Labels must use serving sizes established by FDA
• FDA has proposed updating these serving sizes to
match typical portions (making them larger)
• May require a package to = 1 serving if people
typically consume it all in one sitting

Food Labels:
Nutrition Facts Panel (cont’d.)
• Daily Values: reference values developed
by FDA for use on food labels
– Adequacy or moderation standards
– Proposed updates: calcium, potassium,
sodium, dietary fiber, and vitamin D
• Nutrient quantities
– Presented as quantities (g, mg) and/or %
Daily Values

Food Labels:
Nutrition Facts Panel (cont’d.)
• Front-of-package labels
– Major food industry associations created a
standardized “Facts Up Front” panel

Food Labels (cont’d.)
• Claims on labels
– Nutrient claims: characterize the quantity of a
nutrient in a food
• May be used only if the claims meet FDA
definitions
• Terms used on food labels (Table 1-12)

Food Labels (cont’d.)
• Claims on labels
– Health claims: characterize the relationship
between a food substance and a disease/
health-related condition
• Require FDA authorization
• Reliable health claims (Table 1-13)
– Structure-function claims: describe how a
product may affect a body structure/function
• Do not require FDA authorization

Nutrition in Practice:
Finding the Truth about Nutrition
• Why do nutrition news reports and product
claims often seem contradictory?
• Identifying valid nutrition and health info.
– Reliable info. on the Internet
• Nutrition experts: RDNs/RDs, PhDs
• Other health care professionals
– Roles in nutrition care

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