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Questions and Answers

Which of the following nutrients are predominantly contributed by grains?

Vitamin C and calcium

Folate, niacin, and fiber (correct)

Protein and vitamin B12

Omega-3 fatty acids and vitamin D

What is the recommended proportion of whole grains in grain selections?

At least half (correct)

All grains must be whole

No specific recommendation

At least one-quarter

Which of the following is NOT considered a whole grain?

White rice (correct)

Quinoa

Brown rice

Barley

What is a beneficial protein source recommended to be consumed twice a week?

Seafood Signup and view all the answers

Which of these foods is rich in protein but is considered vegetarian?

Tofu Signup and view all the answers

What is a health consideration when selecting grain foods?

Limiting grains that are processed with solid fats and sugars Signup and view all the answers

Which of the following is an example of a protein food that provides essential fatty acids?

Egg Signup and view all the answers

What amount of cooked legumes qualifies as one ounce of protein foods?

1/4 cup Signup and view all the answers

Which type of foods should be selected to build healthy eating patterns?

Nutrient-dense foods and beverages Signup and view all the answers

What is a recommended protein source to include in a balanced diet?

A variety of protein foods, including seafood Signup and view all the answers

What should a consumer look for on food labels regarding whole grains?

Ingredients that list whole grains as one of the first items Signup and view all the answers

To ensure food safety, one should follow which of the following practices?

Always keep perishable foods refrigerated Signup and view all the answers

Which characteristic is true about vegetarian diets?

They can vary from no restrictions to flexible consumption of meats Signup and view all the answers

Which of the following grains is considered a whole grain?

Whole wheat Signup and view all the answers

What does dietary fiber primarily contribute to in a healthy diet?

Enhanced digestion and regularity Signup and view all the answers

How can individuals successfully incorporate more whole grains into their diet?

Replace refined grains with whole grains whenever possible Signup and view all the answers

What percentage of healthy people does the RDA aim to meet or exceed?

97-98% Signup and view all the answers

Which nutrient standards are used to evaluate the nutritional adequacy of a population's diet?

DRIs Signup and view all the answers

Which group of foods is NOT classified as protein-rich?

Pasta Signup and view all the answers

Which of the following is true regarding whole grains compared to refined grains?

They offer more fiber and micronutrients. Signup and view all the answers

What is the primary macronutrient found in grains?

Carbohydrates Signup and view all the answers

Which food is NOT included in the dairy group due to low calcium content?

Cream cheese Signup and view all the answers

Which process refers to the replacement of some nutrients lost during the processing of grains?

Enrichment Signup and view all the answers

Which of the following is the best source of calcium among the dairy products?

Milk Signup and view all the answers

Study Notes

Planning a Healthy Diet - Chapter 2

This chapter covers planning a healthy diet.

Section 3.1 From Requirements to Standards

Learning Outcomes:
- Explain the difference between a dietary requirement and a dietary allowance.
- Identify various dietary standards and explain their use.

What is a Nutrient Requirement?

Requirement: The smallest amount of a nutrient needed to maintain a defined level of nutritional health.
This amount is typically enough to prevent or cure deficiency disease.
Factors influencing requirements include age, sex, health status, physical activity, and medication use.

Dietary Reference Intakes (DRIs)

DRIs: A set of energy and nutrient intake standards used by nutrition experts in the US for dietary recommendations.
Components of DRIs (as shown in Figure 3.1):
- Tolerable Upper Intake Level (UL)
- Recommended Dietary Allowance (RDA)
- Adequate Intake (AI)
- Estimated Average Requirement (EAR)
- Estimated Energy Requirement (EER)

DRIs: Summary

EAR (Estimated Average Requirement): The daily amount of a nutrient needed to meet the needs of 50% of healthy people in a specific life stage and sex group.
EER (Estimated Energy Requirement): The average daily energy intake necessary for a healthy person to maintain their weight.
RDA (Recommended Dietary Allowance): Standards for recommended daily intakes of several nutrients that meet the needs of nearly all (approximately 98%) healthy people.
AI (Adequate Intake): Dietary recommendations for nutrients when insufficient data exists to establish an RDA.
UL (Tolerable Upper Intake Level): The highest average amount of a nutrient that is unlikely to be harmful when consumed daily.

How RDAs Are Established

Scientists add a margin of safety to the EAR to account for individual variation in nutrient needs.
As a result, the RDA is high enough to meet the needs of 97-98% of healthy people.

RDAs, AIs, and ULs (Figure 3.3)

Intake levels of a nutrient define the risk levels in the diet.
Low intake increases the risk of deficiency.
A sufficient intake (RDA/AI) reduces the risk of deficiency.
High intake increases the risk of toxicity.

Applying Nutrient Standards

Use of nutrient standards:
- Plan nutritious diets for groups of people.
- Evaluate the nutritional adequacy of population diets.
- Develop specific food products.
- Establish standards for nutritional labeling (Daily Values).
- DRIs are instrumental in evaluating individual diets.

Major Food Groups

Learning Outcome: List major food groups and identify foods typically classified in each group.
General groupings are: grains, dairy, protein-rich foods, fruits, and vegetables.
Other food categories exist including oils and foods high in unhealthy fats.

Grains

Grains: Products made from wheat, rice, and oats.
Primary macronutrients are carbohydrate and protein, but refined grains undergo enrichment and fortification (incorporation of lost or additional nutrients).
Enrichment: replacement of lost nutrients (iron & B vitamins)
Fortification: Addition of any nutrient to boost the level of a nutrient.
Whole grains provide more fiber and micronutrients than refined grains.

Dairy

Dairy: Milk and milk products that retain high calcium after processing.
Cream products (cream cheese, cream, butter) are generally excluded as they contain low or no calcium and are often high in fat.
Dairy products are excellent sources of calcium, protein, phosphorus, and riboflavin.

Protein-Rich Foods

Protein-rich foods: include beef, pork, lamb, fish, shellfish, liver, poultry, dry beans, peas, eggs, nuts, and seeds.
This group contains excellent sources of iron, zinc, and B vitamins.

Fruits

Fruits: Fresh, dried, frozen, canned, sauced fruit, and 100% fruit juice.
Generally good sources of phytochemicals, potassium, folate, and vitamin C.
Whole fruits typically contain more fiber than juices.

Vegetables

Vegetables: fresh, cooked, canned, frozen, dried/dehydrated vegetables, and 100% vegetable juice.
Some guides include dry beans and peas within the vegetable category to indicate their micronutrient, fiber, and phytochemical contributions.

Other Foods

Oils: frequently a source of fat-soluble vitamins.
Foods high in "healthy fats" such as fatty fish, peanuts, walnuts, sunflower seeds, avocados, and olives are sometimes clustered together.
Solid fats (beef fat, butter fat, stick margarine, and shortening) include saturated fat.

Diet-Planning Principles

Basic principles of diet planning:
- Adequacy (sufficient energy and nutrients)
- Balance (enough but not too much of different food types)
- Calorie control (energy in = energy out)
- Nutrient density (most nutrients for least calories)
- Moderation (low in solid fats and added sugars)
- Variety (among and within food groups)

Principles and Guidelines (Adequacy)

Sufficient energy for healthy people.
Adequate nutrients for healthy people.

Principles and Guidelines (Balance)

Enough of different food types.
Balance prevents single nutrient-dense foods from overshadowing other foods.

Principles and Guidelines (kCalorie Control)

Maintaining balanced energy intake and expenditure.
High nutrient density foods have more nutrients per calorie.

Principles and Guidelines (Nutrients Density)

Focus on maximizing nutrient intake with minimal calories.
Nutrient dense foods have high amounts of nutrients for the number of calories it provides.

Principles and Guidelines (Moderation)

Food selections low in solid fats and added sugars.

Principles and Guidelines (Variety)

Choosing a variety of foods enhances nutrient adequacy and reduces the risk from contaminants.

Estimated Energy Needs for Sedentary Adults

Charts provide energy needs (Calories) based on age and gender for sedentary adults.

Section 3.3 Dietary Guidelines

Learning Outcomes:
- List 4 overarching guidelines of the 2020-2025 Dietary Guidelines for Americans and recommendations.
- Identify features of a healthy eating pattern.
- Apply Dietary Guidelines to improve nutritional quality of diets.

Dietary Guidelines for Americans

Evidence-based advice to attain and maintain healthy weight, reduce risk of chronic disease, and promote overall health.
Reviewed and revised every five years.

Overarching Guidelines of the Dietary Guidelines

Purpose: To provide evidence-based advice on food and nutrition for optimal health.
Review Cycle: Updated every five years to incorporate new research while maintaining continuity with previous editions.
Current Focus: Emphasis on eating patterns—combination of foods and beverages consumed over time.
Conclusion: Framework for individuals to promote overall health, prevent chronic diseases, and sustain healthy body weight.

Guideline 1 - Follow a Healthy Dietary Pattern at Every Life Stage

Includes: variety of vegetables, fruits, especially whole fruits, grains especially whole grains, fat-free or low-fat dairy produce, variety of protein foods, oils.
Limits: Saturated fats, trans fats, added sugars, and sodium. (Table 3.3 details)

Guideline 2 - Focus on Meeting Food Group Needs Within Calorie Limits

To meet nutritional needs within calorie limits, choose varied nutrient-dense foods from each food group in recommended amounts.

Focus on Variety, Nutrient Density, and Amount of Food

Consume fat-free or low-fat dairy, variety of protein foods (including seafood), and consume oils.

Guideline 3 - Limit Foods and Beverages

Consume <10% of daily calories from added sugars and saturated fats and <2300mg of sodium per day.

Specific Population Groups (Women)

Consume 8-12 ounces of seafood per week, avoiding certain types of large fish (due to mercury).
Intake of iron-rich foods/supplements may be indicated by healthcare provider.
Avoid alcohol consumption and obtain 400 mcg of folic acid.

Major Topic Areas

Major topics include balancing kcalories, limiting and choosing foods, nutrient intake, and building healthy eating patterns.

Selected Messages from Dietary Guidelines

Consume more nutrient-dense vegetables.
Choose lower fat versions of milk, yogurt, and cheese.
Drink water instead of sugary drinks
Maintain a healthy body weight

Section 3.4 Food Guides (MyPlate)

Learning Outcomes:
- Use MyPlate to develop nutritionally adequate daily menus.
- Compare MyPlate with the Exchange System.

Diet-Planning Guides

Incorporate tools and knowledge for planning an ideal diet.
USDA Food Patterns use five major food groups (fruits, vegetables grains, protein, milk).
Recommended daily amounts of each group are also provided.

USDA Food Patterns: Recommended Daily Amounts

Dietary recommendations for daily amounts of foods vary based on the number of kcalories.

USDA Food Patterns: Fruits and Vegetables

List of recommended fruits (fresh/dried/frozen/canned)
List of recommended vegetables (dark green/red/orange/legumes/starchy)

USDA Food Patterns: Grains and Protein Foods

Grains: Whole or refined.
Protein foods: Seafood, lean meats/poultry twice per week.

USDA Food Patterns: Milk and Milk Products, and Oils

Milk & milk products: Fat free or low fat.
Oils: Unsaturated fats (as needed)
Limits on solid fats

Discretionary kCalories in a 2000-kCalorie Diet

Illustration of how kcals can be distributed to maintain a specific weight.

Serving Equivalents

Use cups for fruits, vegetables, and milk; ounces for grains and protein foods.

Ethnic Food Choices

List of ethnic food choices for grains, vegetables, fruits, and protein foods.
Milk and milk products vary among groups.

MyPlate

USDA tool combining food patterns and dietary guidelines for personal planning.
Includes food, nutrition, and physical activity resources based on guidelines.
MyPlate focuses on five groups (fruits, vegetables, protein foods, grains and dairy).
Fats and oils not a group, yet USDA acknowledges the importance of some fat for good health.

MyPlate Shortcomings

Limited information given as content relies on website.
Can disadvantage those with limited access to the internet.
Doesn't differentiate equal quality foods in food groups (e.g., fish sticks and broccoli).

Most Current USDA Food Guide

Current USDA food guide - MyPlate.
Five food groups are detailed (Fruits, Vegetables, Protein Foods, Grains & Dairy).
Not a separate "fats and oils" category. USDA recognizes fat is essential for good health.

MyPlate has various healthy daily food patterns ranging from 1000-3200 kcals. These patterns can be individualized.
Remaining kcals can be supplemented with foods high in empty calories or healthy, nutrient-dense foods.

Other Food Guides

List of other food guides.
Various guides exist besides USDA Food patterns. (Latin American/Mediterranean/Asian Diet Pyramids/Canada Food Guide)

Do Americans Follow Dietary Recommendations?

American diets often lack fruits, vegetables, and low-fat dairy.
American Diets often contain too much added sugars, solid fats, and sodium.

Recommended and Actual Intakes Compared

Differences in whole/refined grains and other food groups.
Intake of seafood consistently below recommendations.

Recommendations vs. Actual Intakes

Consumers generally don't follow dietary recommendations well.
The problem is high intake of unhealthy foods and insufficient intake of many foods.

Healthy Eating Index (HEI)

An assessment tool to measure how well diets align with dietary guidelines based on consumption.
Higher/lower intake scores based on specific components and their relationships to the categories.

Healthy Eating Index (HEI) Recommendations

To improve HEI scores, focus on decreasing kcals from solid fats and added Sugars, increasing intake of Fruits, vegetables, and milk products, maintaining the quantity of grains but focus on increasing whole grain consumption, and decrease sodium intake.

What Is the Exchange System?

A meal planning technique organizing foods into 3 groups (carbohydrates, meat/meat substitutes, fats).
Useful for people with diabetes or those trying to lose weight.
Less commonly used now compared to carbohydrate counting.

Exchange Lists

Help control calories and promote moderation.
Originally developed for diabetes, but it can be helpful for anyone trying to plan and control a diet.
Unlike the USDA food patterns, the exchange lists categorize foods based on their energy and nutrient content, which may place a food in an unexpected category.

Exchange Lists - Examples of Grouping

Cheeses: Grouped with meats due to energy contributions.
Starchy vegetables: Carbohydrate-rich items included separately.
Olives: Grouped with fats due to the high concentration.
Other items (cream cheese) may be grouped together by their significant fat content.

Putting the Plan Into Action

Familiarize yourself with each food group.
Assign each food group to meals.
Progress from guidelines to groceries.
Include foods you enjoy in the plan, and gradually and methodically incorporate desired changes.
Process foods should be added gradually and methodically as improvements are made.

Diet-Planning Using the 2000-kCalorie USDA Food Pattern

Detailed kcalorie tables for different food groups, from 1600 kcal to 3000 kcal, based on USDA food patterns.

Diet-Planning Using the 2000-kCalorie USDA Food Pattern (Example)

Examples of recommended amounts of each food group for a 2000-kCalorie daily diet, broken down into breakfast, lunch, dinner, and snack components.

Grocery Shopping

Tips for grocery shopping, specifically for grains, fruits, protein foods, vegetables, and milk products
Discuss the need to choose wisely when considering specific foods

A Wheat Plant

Structure of a wheat plant (bran, endosperm, germ). Note the nutritional differences between refined and whole grain products.

Nutrients in Bread

Graph comparing nutrient composition and percentages in unenriched, enriched, and whole-grain bread.

Food Labels

Reasons for food label use
Not all products require food labels.
Voluntary use of labels is prevalent.
Restaurant food labeling is also detailed (portions are often larger than serving sizes.)

Example of a Food Label

Explain different elements of a food label; serving size, calories, total fat, total carbs, sodium and sugars.

Ingredient List

The ingredient list is listed in order of predominance by weight.
Nutritional facts panel and serving sizes is done by the FDA

Nutrient Quantities

Summary of the nutrients to look for when reading a food label.

Daily Values

Daily values as percentages with regard to their relation to health.
"Ballpark" estimate of nutrients based on 2000 kcals. Need depends on age, activity, etc.

Daily Values for Food Labels

Specific calculation factors for calculating daily values.

Front of Package Labels

Simplify the information on the food labels—presented right on the front of the package
Nutritional content is presented for a better view of each food's contents.

Claims on Labels

Classify nutrient claims (fat-free, less sodium).
Describe health claims (relationship to conditions or disease, e.g., reduced risk).
Detail structure/function claims (body structure or function, e.g., supports immunity).

Consumer Education

Coordinating of USDA food patterns, dietary guidelines, and food labels.

Balancing kCalories to Maintain Weight

Dietary Guidelines: Manage kcalories to maintain a healthy weight. Using USDA food patterns/MyPlate resources.
Select recommended amounts of food from appropriate food groups.
Limit kcals from solid fats and added sugars. Use appropriate portion sizes.

Foods to Reduce

Food choices with low salt/sodium.
Lean, low fat or fat-free options; reduced sugars, and fats.

Foods to Increase

Make half the plate fruits and vegetables.
Choose a variety from subgroups; whole fruits; whole grains; low-fat milk; variety of protein choices (seafood, poultry).

Building Healthy Eating Patterns

Recommendations on selecting foods to build a healthy eating pattern.

Vegetarian Diets

Choices from a spectrum from no animal products to limited amounts of animal products.

Vegetarian Diets, Continued

Vegetarian classifications
Motivations for choosing vegetarian diets
Foods excluded from diet

Health Benefits of Vegetarian Diets

Benefits associated with vegetarian lifestyles, such as lower risk of obesity, diabetes, hypertension, heart disease, and certain cancers.

Tasks and Tools

Tasks/Tools to maintain healthy body weight include using various resources such as USDA food patterns, MyPlate.

Vegetarian Diet Planning

Focuses on sources of protein, calcium (alternative foods), Vitamin B12, Vitamin D, Omega-3 fatty acids , Iron, & Zinc, as they are commonly lacking from a vegetarian diet.

Recommended Weekly Amounts of Protein Foods

Summary Table of protein-based foods

Healthy Food Choices

Vegetarian diets can provide lower risks of mortality from chronic diseases.
Variety is key to nutritional adequacy.
Example of an additional pattern - Macrobiotic diet.

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