Diet-Planning: Adequacy and Balance

• The foods consumed provide nutrients that are needed to maintain bodily functions
• The choice of foods consumed over time significantly impacts health
• Food diversity is important to achieve healthy nutrition because no single food provides all the nutrients needed

Diet-Planning Principles

• Six basic concepts should be considered when planning a diet which include: adequacy, balance, kCalorie (energy) control, nutrient density, moderation, and variety

Adequacy

• An adequate diet ensures that the body has the nutrients it needs for growth, maintenance, and tissue repair
• Key nutrients include carbohydrates, lipids, proteins, water, vitamins, and minerals
• A diet lacking appropriate nutrients can lead to deficiencies

Balance

• A balanced diet provides foods in correct proportions to each other and in relation to the body's needs
• A balanced diet includes a variety of foods from several sources
• Meats, fish, and poultry are rich in iron but low in calcium
• Milk and milk products are rich in calcium but low in iron
• Whole grains, vegetables, and fruits contain various other nutrients

kCalorie (energy) control

• Energy balance is an equal intake and output of energy
• Changes in energy balance result in weight gain or loss

Nutrient Density

• Nutrient density measures the nutrients a food provides relative to its energy content
• Higher nutrient density means more nutrients with fewer kcalories
• Achieve consumption of required nutrients without overeating by choosing foods high in nutrients and low in calories
• 43 grams of cheddar cheese offer the same calcium as 1 cup fat-free milk (300 mg Ca), but the cheese offers twice as much food energy (calories)
• Fat-free milk is more calcium dense, giving the same calcium for half the calories when compared to cheddar
• Success in diet depends on consuming many nutrients for each calorie
• Nutrient-dense choices like fruit instead of cola help meet daily needs on a lower energy budget
• A bowl of grapes and cola have roughly the same calories, but grapes have far more nutrients
• Empty-calorie foods give energy but little or no protein, vitamins, or minerals

Moderation

• Moderation includes avoiding excessive nutrient consumption, without completely restricting certain foods
• Strict limitations cause people to have trouble sticking to their plans
• Some foods are for occasional consumption, as others can be taken freely
• It contributes to adequacy, balance, and calorie control

Variety

• Variety pertains to selecting from major food groups
• A monotonous diet is boring even if it meets nutrient needs
• A variety allows enjoyment of different tastes and textures
• Foods contain different levels of nutrients, even within the same food groups
• It increases the chance of getting sufficient nutrition
• Reduces risk of consuming toxic food substances in excess

Achieving Variety

• Select foods from each food group
• Add a variety of vegetables for color
• Avoid repeating the same food in different meals or forms
• Use different cooking methods such as baking, boiling, or frying for texture
• Try using garnishes and accompaniments

Food Groups to Consider

• Fruits
• Vegetables
• Grains (cereals), roots, and tubers
• Meat and legumes
• Milk

Steps in Meal Planning

• Recommended Dietary Allowances (RDA), Making a food list, planning the menu.

Recommended dietary allowances (RDA)

• Knowing the RDA, is the first step in meal planning for different groups
• The RDA shows the average amount of nutrients daily that is adequate for the needs of most healthy people

Making a food list

• Preparing a food list (quantities of various food groups) is the next step
• The diet should be balanced and meet the RDA through the selection of foods form the five food groups by deciding the quantities accordingly

Planning the menu

• The final step is to convert the foods that are listed, into recipes and distribute them in various meals like breakfast, lunch and dinner

Food Labels

• Helps consumers to make healthier choices
• All packaged food must include ingredients in descending order
• Labels must identify serving sizes and nutrient information per serving
• Consumers should compare serving sizes to what they consume and calculate accordingly

Nutrition Facts

• Nutrition Facts panels include nutrient information in quantities (grams) and percentages of Daily Values
• Nutrition Facts must include total food energy (calories), food energy from fat (calories), and total fat (grams and % Daily Value)
• Nutrition Facts panels include saturated fat (grams and % Daily Value), trans fat (grams), cholesterol (milligrams and % Daily Value), and sodium (milligrams and % Daily Value)
• Panels also list total carbohydrate (starch, sugar, fiber in grams/% Daily Value), dietary fiber (grams/% Daily Value), and sugars (naturally present and added, in grams)

Nutrition Facts also include vitamins and minerals

• Vitamin A
• Vitamin C
• Iron
• Calcium

Daily Values

• The FDA developed guidelines to compare nutrient amounts to a standard
• Daily Values show dietary recommendations of important nutrients and dietary components relationship to health
• Compares key nutrients in a serving to the goals for a 2000-calorie diet
• 2000-calorie diet is right for younger sedentary women, active older women, and sedentary older men
• 2500-calorie diet is good for many men, teenage boys, and active younger women
• Daily Values help consumers determine if a food has "a little" or "a lot" of a nutrient

Nutrient Claims

• Statements that characterize the amount of a nutrient in a food
• Claims can only be used on labels that meet regulatory definitions
• "Cholesterol-free" items have less than 2mg cholesterol and no more than 2g saturated/trans fat combined per serving

Health Claims

• Statements between a food nutrient or substance's relationship to a disease
• The FDA has two categories of health claims

Unqualified Health Claims

• Claims that stand alone with no extra explanation or qualification (Claims graded A)

Qualified Health Claims

• These require explanation and are based on limited scientific evidence (Claims graded “B,” “C,” or “D”)

Structure-Function Claims

• Statements that characterize the relationship between a nutrient's effect on the body
• Unlike health claims, structure-function claims do not need approval

Vegetarian Diets

• Vegetarians exclude meat or animal-based foods for reasons such as health, environmental concerns, philosophical or ethical issues, religious beliefs etc.
• A well-balanced diet without meat or animal products should be understood

Health Benefits of Vegetarian Diets

• Weight control: vegetarian diets are high in fiber and low in fats
• Blood pressure: vegetarians tend to have lower blood pressure
• Heart disease: vegetarians generally have a lower incidence of heart disease and mortality
• Cancer: vegetarians have lower rates of cancer

Heart disease factors

• Lower in total fat
• Saturated fat
• Cholesterol

Other benefits of vegetarian diets:

• High Dietary fiber
• Antioxidant vitamins
• Phytochemicals which are all protective against heart disease

Vegetarian Diet Considerations

• Health benefits are dependent on wise diet planning
• Vegetarian nutrient requirements are the same as normal
• Vegetarians that consume milk and eggs meet most nutrient requirements
• Vegetarians that don't consume milk and eggs should include legumes, nuts, and cereals

Vegetarianism: Soy Milk

• Soy "milk" replaces milk with similar nutrients if fortified with calcium, vitamin D, and vitamin B12

Protein

• Lacto-ovo-vegetarians are able to meet their protein needs
• Make sure energy intake is adequate and the diet is varied in plant foods (to have all essential amino acids)

Iron

• Vegetarians need extra precautions while planning the iron intake
• Iron from plant sources (non-heme iron) is poorly absorbed compared to that from animal sources (heme iron)
• Iron RDAs are higher for vegetarians. Vitamin C enhances iron absorption

Zinc

• Not well absorbed from plant sources, especially from product based on soybeans
• Eat a variety of nutrient-dense foods as a vegetarian such as Whole grains, nuts, and legumes

Calcium

• Vegetarians who don't consume milk and dairy products are at risk of calcium deficiency
• Calcium-rich foods include calcium-fortified juices, soy milk, and breakfast cereals
• Figs, broccoli, turnip greens, almonds, sesame seeds, and calcium-set tofu are other sources

Vitamin B12

• Vitamin B12 is only found in animal-derived foods
• It is important for Vegetarian, (particularly vegans) to take vitamin B12, as they are at risk if deficiency
• Vegans must consume vitamin B12-fortified foods or supplements

Nausea and Vomiting

• Nausea and vomiting can be caused by medications, food-borne illnesses, pregnancy, and motion (some people experience nausea when moving by car)
• A brief period of nausea and vomiting often requires no special treatment
• Prolonged vomiting can lead to issues like esophagitis, fluid imbalance, and electrolyte imbalance
• Malnutrition may result as well

Dietary strategies to improve nausea

• Meals should be small and frequent to meet calorie and nutrient requirements
• Beverages should be avoided during meal, and drank in between meals
• Consume dry, starchy foods which may help to reduce nausea
• Vomiting should be avoided from foods such as fatty, greasy, or fried foods and spicy foods or with strong odor
• Cold foods or foods at room temperature may be better tolerated than hot foods

Constipation

• Infrequent bowel movements or difficult defecation for a long time
• Having fewer than three bowel movements per week can be an indication of constipation

Other symptoms of constipation:

• Hard or dry stools
• Bloating
• Incomplete stool evacuation

Contributory Factors for Constipation

• Low fiber consumption
• Low level of physical activity
• Pregnancy
• Medical conditions such as diabetes mellitus and hypothyroidism
• Delaying going to the toliet as that results in an increase stool transit time
• Use of medications such as antacids with aluminum or calcium, antihistamines, antidepressants, narcotics, diuretics, antispasmodics, and tranquilizers

Constipation Management

• Gradually increase fiber consumption to at least 20-25 grams a day in the case of people consuming low levels of fiber
• Fiber supplements may be used
• Increase fluid intake helps produce more frequent defecation 1.5 to 2 liters/day
• Avoid foods that contain none or little fiber
• Regular exercise can lead to improved bowel motility

Diarrhea

• Frequent passage of watery, loose stools
• Diarrhea can result in dehydration and electrolyte imbalance
• Chronic Diarrhea for 2-4 weeks leads to malnutrition and weight loss

Diarrhea Classifications

• Osmotic
• Secretory
• Exudative
• Rapid intestinal transit

Osmotic diarrhea

• Results from the presence of solutes in GI tract
• Caused by lactose intolerance, fat malabsorption, or the consumption of sugars that are poorly absorbed

Secretory Diarrhea

• Results from excessive fluid secretion in intestinal cells
• Illness or inflammation can cause Secretory Diarrhea

Exudative Diarrhea

• Exudative occurs when there is damage to the intestinal mucosa
• This causes an increase in fluid content of stools, resulting in diarrhea

Rapid Intestinal Transit Diarrhea

• Certain conditions such as stress, irritable bowel syndrome, or gastric and intestinal resections leads to a more rapid movement

Diarrhea Management

• Consume low-fat, low-fiber, lactose-free foods
• throughout the day, consume frequent small meals
• Increase fluid intake to replace water and electrolyte loss
• Avoid beverages with caffeine as it increases Gl motility
• Consume Apple pectin or banana flakes to thicken stool