Chapter 2 - Tools of a Healthy Diet PDF

CHAPTER 2 – TOOLS OF A HEALTHY DIET CHRIS COMSTOCK MS, RD, LN CHAPTER OUTLINE – NUTRITION TOOLS 1. Dietary Reference Intakes (DRIs) 2. Daily Values 3. Nutrient Composition Tables 4. Dietary Guidelines for Americans (2020 – 2025) 5. MyPlate Study Tip: Know these 5 tools including what they are, w...

CHAPTER 2 – TOOLS OF A HEALTHY DIET CHRIS COMSTOCK MS, RD, LN CHAPTER OUTLINE – NUTRITION TOOLS 1. Dietary Reference Intakes (DRIs) 2. Daily Values 3. Nutrient Composition Tables 4. Dietary Guidelines for Americans (2020 – 2025) 5. MyPlate Study Tip: Know these 5 tools including what they are, who creates them, and what function they serve. TOOL #1: THE DIETARY REFERENCE INTAKES (DRI)  Dietary Reference Intake (DRI) is a generic term for a set of reference values used to plan and assess nutrient intakes of healthy people. These values, which vary by age and sex, include the:  Estimated Average Requirement (EAR)  Recommended Dietary Allowance (RDA)  Adequate Intake (AI)  Tolerable Upper Intake Level (UL)  Chronic Disease Risk Reduction Intake (CDRR)  The DRIs are developed and published by the Food and Nutrition Board of the National Academy of Medicine (NAM)  The NAM was formerly called the Institute of Medicine (IoM)  DRIs are used widely in:  Designing and evaluating research studies and results  Developing dietary guidelines and food guides  Planning and tracking nutrition-related public health programs and diets for military personnel  Creating patient and consumer counseling and educational programs ESTIMATED AVERAGE REQUIREMENT (EAR)**  The EAR is the average daily nutrient intake level that is estimated to meet the needs of half (50%) of the individuals in a particular life stage and gender group.  Must have a measurable functional marker – usually a blood test – to establish an EAR!  The EAR is adjusted for the amount of the ingested nutrient that is thought to pass through the digestive tract unabsorbed  At this intake level, 50% of the population would not be getting enough of the nutrient to meet their needs!  Because of this, the EAR is increased by about 20% to calculate a value called the RDA (see next slide)  This number can only be used to assess the dietary adequacy of groups, not individuals RECOMMENDED DIETARY ALLOWANCE (RDA)**  The level of intake of a nutrient that is sufficient to meet the needs of nearly all individuals (97-98%) in particular life stage  Dietitians and health professionals use this number when planning diets and meal plans. The general public can use it for that purpose as well.  How is the RDA calculated?  EAR x 1.2 = RDA  Therefore, we can only set an RDA if there is an EAR…  Example: Let’s pretend the EAR for Calcium for adults ages 18-21 is 1,000 mg. The RDA would then be 1,000 mg x 1.2 = 1,200 mg Calcium. At this level of intake, 97-97% of healthy 18-21 year old individuals would have enough calcium in their diet. ADEQUATE INTAKE (AI)**  Assigned to nutrients for which there is not enough evidence in the literature to assign an EAR  Adequate intakes are based on observed or experimentally determined estimates of the average nutrient intake that appears to maintain a defined nutritional status (e.g., normal growth, adequate bone health, etc.) in a specific life stage and gender group  AIs are set for all nutrients for infants 1 serving of cereal and 2 servings of ice cream)  1 slice of bread = 1 serving  Remember, the serving size listed on a food label isn’t a recommendation for how much you should eat or drink.  A portion is the amount of food that you actually eat.  Your portion might consist of more than 1 serving HOW ARE AMERICANS DOING?  Very few Americans meet the recommendations for fruits, vegetables, and whole grains.  In the vegetable category, potatoes are one of the most common vegetables consumed  In 2019:  39.2% of SD adults consumed fruit less than one time daily  47.9% of SD students in grades 9-12 consumed fruit less than one time daily  17.4% of SD adults consumed vegetables less than one time daily  41.8% of SD students in grades 9-12 consumed vegetables less than one time daily  See: https://nccd.cdc.gov/dnpao_dtm/rdPage.aspx?rdR eport=DNPAO_DTM.ExploreByLocation&rdRequest Forwarding=Form WHAT IS HEALTHY EATING?  Variety, variety, variety Difference Between Portion Size and Serving Size  Every food provides different nutrients in differing amounts  Portion size is the amount of a single food item  Color served in a single eating occasion, such as a meal or  Moderation and portion control a snack.  Portion size is the amount offered to a person in a  Eliminating favorite foods from a person’s diet doesn’t usually work long term because most people will go crazy when they “cheat” on restaurant, the amount offered in the packaging of their diet prepared foods, or the amount a person chooses to put on his or her plate.  Drink lots of water  Serving size is a standardized unit of measuring  It’s not uncommon for the body to confuse dehydration with hunger! foods—for example, a cup or ounce—used in dietary  Focus on whole, minimally processed foods guidance, such as MyPlate or the Dietary Guidelines for Americans.  Keep healthy foods on hand  Example: Bagels and muffins are often sold in sizes  Don’t go grocery shopping when you’re hungry that constitute at least 2 servings, but consumers  Drink responsibly often eat the whole thing, thinking that they have  eaten 1 serving. They do not realize that they have Be mindful of your eating – When you eat, eat. selected a large portion size that was more than 1 serving. A FINAL NOTE ON PORTION SIZES  Gas tank philosophy  Just like a car, your body needs adequate fuel.  Too little fuel, and you’ll run out of gas (energy)  Too much fuel, and that excess will spill over (and be stored as fat)  People usually underestimate the amount they eat, and overestimate the number of calories they burn through exercise/activity  Fast food “supersize” trend  It might not cost much to supersize a meal, but the long-term costs of overeating can be very expensive!  Check out these links:  Health and Economic Costs of Chronic Disease in America – https://www.cdc.gov/chronicdisease/about/costs/index.htm  Food Portion Sizes Have Grown – A Lot – https://abcnews.go.com/WN/food-portion-sizes-grown-lot/story?id=129685  The Contribution of Expanding Portion Sizes to the US Obesity Epidemic – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447051/ A FINAL NOTE ON PORTION SIZES  People eat more when they’re given more!  A study by Rolls et al. (See: https://pubmed.ncbi.nlm.nih.gov/12450884/) tested how adults responded to meals on different days of four different portion sizes of macaroni and cheese.  They found that the bigger the portion, the more participants ate. Participants consumed 30% more energy (162 kcal) when offered the largest portion (1000 g) compared to the smallest portion (500 g). They also reported similar ratings of hunger and fullness after each meal despite the intake differences. After the study, only 45% of the subjects reported noticing that there were differences in the size of the portions served.  Another study by Rolls et al. (See: https://pubmed.ncbi.nlm.nih.gov/14993858/) gave the same subjects different size sandwiches on several occasions to look at the effect on energy intake of increasing the portion size of a food served as a discrete unit (sandwich).  Men and women who were offered different size (6-, 8-, 10-, and 12­inch) sub sandwiches for lunch on four different days ate significantly more as the size of the sandwich offered became larger.  A study by Diliberti et al. (See: https://pubmed.ncbi.nlm.nih.gov/15044675/) in a restaurant setting showed that when a pasta entrée was served in different portion sizes on different days, people ate larger amounts when they were given larger portions.