Nutrition Notes PDF

Nutrition in Health Essential nutrients: vitamins, minerals, amino acids, fatty acids, and water must be obtained through food, body can't make them Plants provider fiber and a variety of compounds that have health enhancing properties in the body known as phytonutrients Current focus of nutrition...

Nutrition in Health Essential nutrients: vitamins, minerals, amino acids, fatty acids, and water must be obtained through food, body can't make them Plants provider fiber and a variety of compounds that have health enhancing properties in the body known as phytonutrients Current focus of nutrition is to reduce the risk of chronic diseases by improving overall dietary patterns Dietary Reference Intakes Collection of dietary reference standards that estimate nutrient intakes necessary to ensure that healthy populations meet nutrient needs to maintain health and prevent deficiency diseases The 4 original DRI standards are: Recommended Dietary Allowances (RDAs), Estimated Average Requirement (EAR), Adequate Intake (AI), and Tolerable Upper Intake Level (UL) Nutrients have either an RDA or an AI, not all nutrients have an UL. References that pertain to calories also include Acceptable Macronutrient Distribution Range (AMDR) and the Estimated Energy Requirement (EER) Chronic Disease Risk Reduction (CDRR)- only sodium has a CDRR Nutrient recommendations used by dietitians who plan and evaluate menus for specific populations. Also used to assess the adequacy of an individual's intake by comparing estimated intake with estimated requirements Recommended Dietary Allowances Represents the average daily recommended intake level that is sufficient to meet the nutrient requirements of 97% of healthy individuals by life stage and sex. Exceed the requirements of almost all members of the group, can not be accurately assessed if intake is inadequate Are set high enough for daily variations Are used as a starting point for health care professionals Estimated Average Requirement Values are used to determine RDA values, not used as daily intake goal. The EAR of a nutrient is the average daily intake estimated to meet nutrient needs of half of the healthy people in a life stage or gender group. Falls below the requirements Accounts for how absorption is affected by other food components Adequate intake Is set when an RDA cannot be determined due to lack of sufficient data on requirements Recommended average daily intake level that is expected to meet or exceed the needs of all members of a specific group Purpose is to be a guide for an individual's nutrient intake Difference between RDA and AI is that RDA is expected to meet the needs of almost all healthy people but it is not known what percentage of people is covered by AI Tolerable Upper Intake Level The highest level of average daily daily nutrient intake that likely poses no risk to adverse health effects to almost all individuals in the population Not intended to be a recommended level of intake. Not all nutrients have a UL Chronic Disease Risk Reduction intake Based on evidence that its beneficial to lower sodium intake for cardiovascular disease risk, hypertension, and blood pressure Acceptable Macronutrient Distribution ranges Broad ranges for each macronutrient expressed as a percentage of total calories consumed Reduced risk of chronic disease yet provide enough nutrients Intakes above or below the range may cause chronic disease or deficiency Carbohydrate: 45-65 Protein: 10-35 Fat: 20-35 Essential fatty acids: linoleic acid (n-6): 5-10; alpha linoleic acid (n-3): 0.6-1.2 Estimated Energy Requirements Dietary calorie intake predicted to maintain weight in healthy normal weight individuals based on age, sex, weight, height, and level of activity Exceeding EER may produce weight gain Nutrients from food Focus on total diet Researchers are focusing on the total diet- patterns nutrient density, and quality to study the link between diet and health promotion disease prevention Dietary patterns The combination of foods and beverages that constitutes an individual's dietary intake overtime A health eating pattern includes variety of nutrient dense foods across food groups that provide adequate amounts of nutrients within the appropriate calorie limits Eating patterns associated with positive health outcomes are high intakes of: fruits, veggies, legumes, whole grains, low or nonfat dairy, lean meats and poultry, seafood, nuts, and unsaturated vegetable oils Plant based, mediterranean and DASH diets Detrimental health outcomes are higher in the intake of red and processed meat, sugar sweetened beverages and refined grains Nutrient density Refers to foods and beverages that provide vitamins and minerals and other beneficial nutrients relative to the number of calories with little or no added sugars, saturated fats, and sodium Nutrient dense foods: veggies, fruits, whole grains, seafood, eggs, legumes, unsalted nuts and seeds, low fat and fat free dairy and lean meats and poultry prepared with little or no added sugars, saturated fat or sodium Calorie dense items: sweet beverages, baked goods, full fat yogurt and candy. Foods that are not in their most nutrient dense form whole milk compared to fat free, fried chicken compared to baked chicken Overall diet quality One way to measure diet quality is to use the healthy eating index 2015 (HEI2015) Uses a scoring tool to measure diet quality to assess how well a person's intake aligns with key diet recommendations. Dietary Guidelines for Americans: intended to help prevent diet related chronic diseases such as heart disease, cancer, diabetes Diet Quality in the US Americans aged 2 and older average HEI score 59, do not align with dietary guidelines. Age 60 and over have highest diet quality, score 63 Ages 14-18 lowest diet quality, score 51 80% americans consume low intake of fruits and vegetables and dairy Nutrition and Health WHO defines health: a state of complete physical, mental, and social wellbeing, not merely the absence of disease or infirmity. Healthy People 2030 A program under jurisdiction of the USDHHS that focus on improving the health and wellbeing of all americans Chronic Diseases Noncommunicable diseases account for 71% of al deaths worldwide Leading cause of disability 60% americans have one or more diet related chronic disease, 4 out of 10 have two or more Half premature deaths related to tobacco use, lack of activity and poor diet Lifestyle Medicine The use of therapeutic approaches, healthy eating, regular activity, adequate sleep,, stress management, avoiding risky substances, and using non drug modalities to treat, reverse and prevent chronic disease Characteristics of lifestyle and traditional medicine differ: Patients are active partner in their own care, not passive recipients Patients required to make changes Treatment is always long term Medications used along with changes Goal is primary, secondary and tertiary Future Directions Bioinformatics Enable researchers to make connections between intake and health not possible before Nutrigenomics can redefine the role of nutrition in health and disease risk in individuals Nutrigenomics The study of the interaction between nutrients and other bioactive compounds with the human genome at the molecular level Adequacy: Food Components that are Encouraged ​ Component | Standard for Minimum Score of 0 | Standard for Maximum Score ​ Total Fruits | No fruit | ≥0.8 c equivalents/1000 cal ​ Whole Fruits | No whole fruit | ≥0.4 c equivalents/1000 cal ​ Total Vegetables | No vegetables | ≥1.1 c equivalents/1000 cal ​ Greens and Beans | No dark green vegetables or beans and peas | ≥0.2 equivalents/1000 cal ​ Whole Grains | No whole grains | ≥1.5 oz equivalents/1000 cal ​ Dairy | No dairy | ≥1.3 c equivalents/1000 cal ​ Total Protein Foods | No protein foods | ≥2.5 oz equivalents/1000 cal ​ Seafood and Plant Proteins | No seafood or plant proteins | ≥0.8 c equivalents/1000 cal ​ Fatty Acids | Poly- + mono-unsaturated fatty acids/saturated fatty acids ≤1.2 | Poly- + mono-unsaturated fatty acids/saturated fatty acids ≥2.5 Moderation: Food Components that Should be Consumed Sparingly ​ Component | Standard for Minimum Score of 0 | Standard for Maximum Score ​ Refined Grains | ≥4.3 oz equivalents/1000 cal | ≤1.8 oz equivalents/1000 cal ​ Sodium | ≥2.0 g/1000 cal | ≤1.1 g/1000 cal ​ Added Sugars | ≥26% of energy | ≤6.5% of energy ​ Saturated Fats | ≥16% of energy | ≤8% of energy Chart Title: Healthy People 2030 Summary of Core Objectives for Nutrition and Healthy Eating and Overweight and Obesity Nutrition and Healthy Eating Objectives- General ​ Reduce household food insecurity and hunger ​ Eliminate very low food security in children ​ Increase fruit consumption by people aged 2 years and over ​ Increase vegetable consumption by people aged 2 years and over ​ ​ Increase consumption of dark green vegetables, red and orange vegetables, and beans and peas by people aged 2 years and over ​ ​ Increase whole grain consumption by people aged 2 years and over ​ Reduce consumption of added sugars by people aged 2 years and over ​ Reduce consumption of saturated fat by people aged 2 years and over ​ Reduce consumption of sodium by people aged 2 years and over ​ Increase calcium consumption by people aged 2 years and over ​ Increase potassium consumption by people aged 2 years and over ​ Increase vitamin D consumption by people aged 2 years and over ​ Reduce iron deficiency in children aged 1 to 2 years ​ Increase the proportion of students participating in the School Breakfast Program Infants ​ Increase the proportion of infants who are breastfed exclusively through age 6 months ​ Increase the proportion of infants who are breastfed at 1 year ​ Women ​ Increase the proportion of women of childbearing age who get enough folic acid ​ Reduce iron deficiency in females aged 12 to 49 years Overweight and Obesity-General ​ Reduce the proportion of adults with obesity ​ Increase the proportion of health care visits by adults with obesity that include counseling on weight loss, nutrition, or physical activity ​ ​ Reduce the proportion of children and adolescents with obesity ​ Heart Disease and Stroke ​ Reduce the proportion of adults with high blood pressure  ​ Reduce cholesterol in adults Overweight and Obesity ​ Reduce the proportion of women of childbearing age who are obese ​ Reduce iron deficiency in females aged 12 to 49 years