Nutrition and Dietary Guidelines

In this course we will focus on physical health, which includes nutrition and physical activity.
Wellness is about prevention of disease, or at least minimizing the risk of chronic diseases such as heart disease, diabetes, cancer, obesity, and osteoporosis.
Credible Nutrition Information
Where do you get your information about Nutrition. Are your sources for nutrition information trustworthy? Is the information accurate or is there a small amount of truth which is twisted to what we want to hear? Have you ever heard the expression, if it sounds too good to be true, it probably is. There is so much information about nutrition in the media and over the internet, but can you trust it? I like to use the term nutrition “mythinformation” to describe what people believe about nutrition that has no scientific basis for it. (Urban legends so to speak)
Be sure to get your nutrition information from a credible website such as those listed at the end of each chapter. National Nutrition Month occurs every year in March. In March 2013, The Academy f Nutrition and Dietetics announced to registered dietitians nationwide that they could refer to themselves as registered dietitian nutritionist (RDN)
Nutrients and their Classifications
Nutrients are the chemical substances in the foods we eat. Our bodies use these nutrients for energy and to support growth, maintenance, and repair of tissues. Essential nutrients are those which our bodies need and must be provided through the foods we eat. There are six major groups of nutrients.

Macronutrients provide energy so they are needed in greater amounts. The macronutrients are carbohydrates (CHO), proteins (PRO), and lipids (fats).
Micronutrients are needed in smaller amounts. This group includes vitamins and minerals. Vitamins and minerals are needed to process (metabolize) the carbohydrates, proteins, and lipids to obtain energy from them. Have you ever heard anyone say, "These new vitamins give me so much energy?" They don't really, but if that person were deficient in something, he or she probably couldn't metabolize as well the macronutrients that do provide energy. OR it was a placebo effect (they just think they feel better).
Vitamins are divided into water-soluble and fat-soluble groups. Fat-soluble vitamins can be stored in the body and water-soluble cannot. Therefore, fat-soluble vitamins may be toxic if large doses are taken for a period of time.

Minerals are divided into major or trace minerals, depending on the amount needed by the body. A trace mineral is only needed in "trace" amounts.

Water is the sixth nutrient/ group. It is vital for survival because it supports all body functions. Water is essential in regulating body temperature. It is also necessary to regulate nerve impulses and muscle contractions, as well as for nutrient transport, and excretion of wastes.
Note: Alcohol provides 7 kcal /g. It is not considered a nutrient because it provides ONLY energy (kilocalories). Large doses can be harmful.
Nutrient Intake
Originally, the RDA's (Recommended Dietary Allowances) were developed to make recommendations for each nutrient to prevent deficiency diseases. For example, during the Great Depression in the 1930's when some of the vitamins were being discovered and people were not getting enough to eat because there were no jobs, this was an important focus. In recent years, we have social programs available to assist those in need, and we have also shifted from problems with under eating to problems with overeating. Our focus has shifted as well to wellness which is about chronic disease prevention � mostly the result of over consumption.

We now use reference values known as Dietary Reference Intakes (DRIs) which are standards for healthy people. The DRIs for most nutrients consist of four values: * EAR (Estimated Average Requirement): average daily intake level to meet needs of half of healthy individuals in an age group * RDA (Recommended Dietary Allowance): average daily level that meets the need of 97% to 98% of individuals in an age group * AI (Adequate Intake): estimation used when evidence to determine RDA is not available * UL (Tolerable Upper Intake Level): highest daily level not likely to harm anyone � intake above this level may be toxic

Different standards are used for energy and the macronutrients. EER (Estimated Energy Requirement) is the average dietary intake predicted to maintain energy balance in an individual. It is based on age, gender, height, weight, and level of physical activity. AMDR (Acceptable Macronutrient Distribution Ranges) is expressed as a percentage of total energy (kcal). The range has an upper and lower limit and is associated with reduced risk of chronic disease while still providing an adequate intake of essential nutrients.
Using the DRIs together with MyPyramid or the Dietary Guidelines for Americans will help ensure an individual consumes a diet that is nutritionally adequate and healthful.
Nutrition Assessments
Nutrition professionals use what is called a nutrition assessment in order to make a professional recommendation to any client. The assessment looks at the client's current nutritional status, height, weight, ratio of lean tissue /body fat, foods eaten, food preferences, etc.
The nutritional status could show that a person has malnutrition, undernutrition, or overnutrition. * Malnutrition: an individual is either getting too much or not enough of a particular nutrient over a significant period of time * Undernutrition: too little energy or too few nutrients are consumed over time, causing significant weight loss or a deficiency disease * Overnutrition: too much energy or too much of a nutrient is consumed over time leading to conditions such as obesity, heart disease, or nutrient toxicity
Overnutrition is currently the number one nutrition problem in the U.S.

A physical examination may be conducted by a physician, physician assistant, nurse or nurse practitioner. This examination would include a medical history, disease symptoms, and/or laboratory tests. A registered dietitian would perform the nutrition assessment.
A registered dietitian (RD) is a professional designation that requires a bachelor's or master's degree in nutrition, followed by a supervised internship, a passing grade on a national exam, and maintenance of registration with the American Dietetic Association. It is important to realize that a "nutritionist" is not necessarily an RD. The term nutritionist has no definition or laws governing it.
What do we mean by a healthful diet?
A healthful diet is one that will sustain an individual's lifestyle and reduce the risk of many chronic diseases. Planning a healthful diet can be confusing. This is due in part because nutrition is a fairly new science, and in part, because the popular press often report random isolated findings. An experiment must be able to be repeated multiple times with the same results to be considered credible information. In addition, advertisers and many websites provide all kinds of information just to sell a product. The tools we will discuss in this unit are based on sound scientific evidence.
A healthful diet has four components: It is adequate, moderate, balanced, and varied.
Being adequate means the diet provides enough nutrients, energy, and fiber to maintain health. A diet that is adequate for one person may not be adequate for another. For example, an athlete needs a greater number of Calories (energy) than a sedentary person. A person who doesn't like vegetables may have a diet that is inadequate in fiber, vitamins and minerals.
Being moderate means that one eats the right amount of foods in each group to maintain a healthful weight and get the right amount of fiber and other nutrients needed for metabolic processes. Too much sugar or too much fiber in one's diet can both create problems.
Balance refers to the proper combination of foods. Foods in each food group have similar amounts of proteins, carbohydrates, vitamins and minerals, etc. Each food group provides nutrients that may not be obtained in any other group.
Being varied means that we need to eat a variety of foods within each food group. There is no such thing as the perfect food - no one food can provide all the nutrients we need. A greater number of different fruits and vegetables, and variety of colors eaten in a given week provide the best quality diet.
Dietary Guidelines for Americans
The Dietary Guidelines for Americans (DGA) are evidence-based guidelines created to help us make healthier food choices to reduce the risk of many chronic diseases. They are revised every five years based on the most recent findings. Ther basic messages also include one pertaining to safe food handling.
The 2010 DGA were published in January 2011, one year later than scheduled. This was due to the efforts that went into getting Americans to eat more fruits and vegetables as previous attempts were not successful. The 2010 DGA also used the word avoid for the first time in many years. The concept ‘get off your SoFAs’ was added to encourage Americans to avoid solid fats and added sugars. Empty calories replaced discretionary calories.
For more information visit http://www.health.gov/DietaryGuidelines/
© Carol Bradley 2013
MyPyramid and MyPlate
The USDA revised the Food Guide Pyramid in 2005 to help get a better visual perspective of the Dietary Guidelines and called it MyPyramid. It was intended to be more interactive and personalized than the original food guide pyramid.
For example, the individual on the steps represents: * making changes gradually in steps * that we are individuals * and physical activity.

Moderation is represented by the narrowing at the top of each food group
The differing widths of the bands represent the proportion of that food group compared to the other groups.

The use of the term Discretionary Calories was a new concept in 2005 and means the amount of kilocalories that may be consumed once an adequate number of healthful food choices have been made. The number of discretionary calories is based on age, size and physical activity level of the individual. Figure 2.7 summarizes the number of servings and portion sizes of foods in each group. One criticism of MyPyramid is that the portion sizes listed may not coincide with the serving sizes on some food labels.

�As mentioned previously, the main nutritional concern in the United States at this time is "overnutrition." One cause of this is that portion sizes have increased dramatically over time. We have "supersized" many common foods. Fig 2.8 provides a couple of examples.
Figure 2.8

In April 2011, the MyPlate icon was introduced to help us understand how to eat a more balanced diet. While MyPyramid made recommendations for daily requirements, MyPlate breaks those requirements down meal-by-meal. Make half your plates fruits and vegetables at every meal is the main point of MyPlate.
Food Labels
Food labels are one of several tools we can use to help us make wiser food choices.� Table 2.1 lists the current legal definitions for nutrient claims. These definitions are regulated by the FDA (Food and Drug Administration) to protect us from false claims. Note for example, there is no such thing as "low carb" so several food manufacturers were fined during the "low carb" craze a few years ago for making false claims on their labels. Healthful Choices When Eating Out
How many times a week do you 'drive-thru' to get your meals because you are in a hurry? Do you 'Super size' your order? Have you ever asked for one of the nutrition facts brochures to see what you are actually getting? Depending on the meal, you can usually get 1,200 � 2,000 kcal/meal at a fast food restaurant or even in a traditional restaurant. How about your favorite latte or other coffee beverage?
You can make healthful choices when dining out. First, avoid all-you-can-eat buffets. Second, choose lower-fat dairy servings whether it's in your latte or dairy items and try steamed vegetables without butter.� Other choices include grilled or baked vs. fried meats or fish, broth-based vs. cream soups, salads with dressing on the side, creamy sauces on the side, and avoiding sugar-sweetened beverages. Over a decade ago, restaurant portions went from 10" plates to 12" plates. Split a meal with a friend or try eating half and taking the other half home for another meal, if you will be able to store it in the refrigerator promptly upon leaving the restaurant. If you choose dessert, share it. Like mom always said, sharing is good.
Nutrition is the science of food and how food nourishes our body and impacts health. Nutrition is just one component of wellness. Nutrients are chemical substances in foods and are divided into six groups, based on their function in the human body. The macronutrients are needed in large enough quantities to provide energy, while the micronutrients are needed in lesser amounts to help with metabolic processes, including energy production. Nutritional problems can be discovered through nutrition assessment so that appropriate interventions can restore nutritional balance. Good sources of reliable nutrition information include individuals such as registered and licensed dietitians, and those with advanced degrees in nutrition. In addition, there are several reliable websites from various government agencies and health care professions which provide easily accessible information.
The four characteristics of a healthful diet are: adequacy, moderation, balanced, and variety. Together these provide the proper combination of energy and nutrients to sustain an individual's lifestyle.
Among the tools available to help plan a healthful diet are The Dietary Guidelines for Americans, MyPlate, and The Nutrition Facts Panel on food labels, to name a few. The Nutrition Facts Panel provides adequate information to make wiser food choices. The Dietary Guidelines and MyPyramid can be used together to plan for a more adequate diet and exercise plan. It is important for each individual to design a diet that most closely fits his/her lifestyle.
After reading the corresponding chapter in your textbook, take the quiz that follows this section. fter reading the lecture material and completing the module quiz, you should now be able to:

* Define the term nutrition * Identify the six classes of nutrients essential for health * Describe the process for assessing an individual's health * Define the components of a healthful diet * Describe the Dietary Guidelines for Americans and discuss how these guidelines can be used to design a healthful diet * Identify the food groups, number of servings, and serving sizes in MyPyramid * Read a food label and use the Nutrition Facts Panel to determine the nutritional adequacy of a given food * List credible sources of reliable and accurate nutrition information �

1. Which of the following foods contains all six nutrient groups
Strawberry ice cream creamy tomato soup
An egg salad sandwich all of the above

2. An adequate diet
Provide enough of the energy, nutrients, and fiber necessary to maintain a person’s health

3. The dietary guidelines for Americans recommend which of the following?
Being physically active each day

4. My plate recommends
Eating more dark green and orange vegetables

5. The nutrition facts panel on packaged foods provides information about the micronutrients
Vitamin a, vitamin c, sodium, iron, and calcium

6. Fat soluble vitamins provide energy
False vitamins don’t provide energy

7. The recommended dietary allowance represents the average daily intake level that meets the requirements of almost all healthy individuals in a give life stage or gender group
True

8. Alcohol can be part of a healthful diet
True

9. Eating a variety of foods ensures that your diet is healthful
False

10. The serving size listed on a nutrition facts panel is based on the amount people typically eat of that food
True