Chapter 02 - Nutrition Guidelines & Assessment.pdf

UTD Part 1 HLTH 1322 Human Nutrition CHAPTER 2 Nutrition Guidelines and Assessment Linking Nutrients, Foods, and Health...

UTD Part 1 HLTH 1322 Human Nutrition CHAPTER 2 Nutrition Guidelines and Assessment Linking Nutrients, Foods, and Health Linking Nutrients, Foods, and Health Planning How You Will Eat Planning How You Will – Adequacy Eat: Key Concepts for Healthful Diet Planning – Balance – Adequacy – Calorie Control – Balance – Nutrient Density – Calorie Control – Moderation – Nutrient Density – Variety – Moderation MyPlate is a web-based educational tool that helps people apply the principles of Dietary Guidelines for – Variety Americans to their eating choices. Check it out at www.choosemyplate.gov Key Concepts in Healthful Diet Planning Key Concepts in Healthful Diet Planning “ABCDMV”- a closer look: ABCDMV, cont. Nutrient Density —measuring nutrient content of a food relative to its energy content. Adequacy —providing enough energy and essential – Nutrient-dense foods have substantial amounts of vitamins and nutrients for healthy people. minerals and relatively few calories per serving Balance —consuming the right proportion of foods. – Empty-kcalorie foods contribute energy but lack significant amounts of any nutrients. – Among food groups, energy sources, other nutrients – Energy eaten with energy used in daily activities and Moderation (dietary)—providing enough but not too much of a food or exercise nutrient – Low nutrient dense and empty calorie foods don’t have to be Calorie (energy) control —balancing the amount of foods eliminated, the key is occasional or less-frequent inclusion and energy to sustain physical activities and metabolic – Can too much of a good thing apply to vitamins, minerals, as well as needs. any food?? – To maintain, allow for growth or gain, or to lose weight Variety (dietary)—eating a wide selection of foods within and among – Focus on getting the most nutrients for your calories the major food groups – Ensures meeting nutrient needs 1  From Key Concepts to Dietary Guidelines Who, what, when, why, where Dietary Guidelines for Americans (DGA)  Foundation of federal nutrition policy; developed by the US Dept Agriculture (USDA) and Dept Health and Human © Elena Shashkina/Shutterstock © Joe Gough/Shutterstock Services (DHHS)  Science-based guidelines intended to improved overall health, first released in 1980, revised every 5 years Figure 2.1 Nutrient density. Based on the amount of nutrients per  Provide a road map with simple and total calories, the plain baked potato is more nutrient dense than the clear statements about food choices same amount of French fries. to help Americans make informed food and activity decisions. The newest DGA update was released The 2015 Dietary Guidelines document and information are available at in 2015 www.dietaryguidelines.gov. The Dietary Guidelines for Americans: Dietary Guidelines for Americans: What It Is, What It Is Not 2015 Provide evidence-based Five overarching concepts: recommendations about 1. Follow a healthy eating pattern the components of a across the lifespan. healthy and nutritionally 2. Focus on variety, nutrient density, and amount. adequate diet 3. Limit calories from added sugars Focus on disease and saturated fats and reduce sodium intake prevention rather than 4. Shift to healthier food and disease treatment beverage choices. Inform Federal food, 5. Support healthy eating patterns for all. nutrition, and health The 2015 Dietary Guidelines policies and programs information is available at www.dietaryguidelines.gov. Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov. Dietary Guidelines for Americans How do DGA guidelines use core nutrition planning concepts to help us implement guidelines? – Follow a healthy eating pattern End of Part 1 that accounts for all foods and beverages. ABMV – Consume less than 10 percent of calorie/day from added sugars. CDM – Consume less than 10 percent of calories/day from saturated fats. CDM – If alcohol consumed, use moderation. BM – Meet the Physical Activity Guidelines. BC 2  Important Elements of Healthy Eating Patterns: 5 Key Recommendations 1.Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate Part 2 calorie level. A healthy eating pattern includes: A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other Fruits, especially whole fruits Grains, at least half of which are whole grains Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products Oils Inside Healthy Eating Patterns: Principles of Healthy Eating Food Groups Patterns 2. Focus on variety, nutrient density, and amount. An eating pattern represents the totality of all foods and beverages consumed “Eating an appropriate mix of foods from the food groups and – It is more than the sum of its parts; the totality of what individuals subgroups—within an appropriate calorie level—is important to habitually eat and drink act synergistically in relation to health. promote health.” Nutritional needs should be met primarily from foods Each food group and subgroup provides an array of nutrients. – Individuals should aim to meet their nutrient needs through healthy eating patterns that include foods in nutrient-dense forms. Recommended amounts reflect eating patterns associated with positive health outcomes. Healthy eating patterns are adaptable – Any eating pattern can be tailored to the individual’s socio-cultural Foods from all of the food groups should be eaten in and personal preferences. nutrient-dense forms. Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov. Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov. Inside Healthy Eating Patterns: Other Components 3. Limit calories from added sugars and saturated fats and reduce sodium intake. Consume an eating pattern low in added sugars, saturated The Dietary Guidelines recommend fats, and sodium. Cut back on foods and beverages higher in reducing intake of saturated and these components to amounts that fit within healthy eating trans fats, sodium and added sugars. patterns. Reducing alcohol intake is another Added sugars strategy. “In addition to the food groups, it is Saturated fats important to consider other food Trans fats components when making food and Cholesterol beverage choices.” Sodium Alcohol Caffeine Photos: (salt shaker) © Photodisc; (cookies) © Artistic Endeavor/ShutterStock, Inc; (white bread) © Photodisc; Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov. (beer) © Ximagination/ShutterStock, Inc. 3  Everyone Has a Role in Supporting Healthy Eating Patterns: Shifts Needed to Align With Healthy Eating Patterns: The Guidelines The Guidelines 4. Shift to healthier food and beverage choices. 5. Support healthy eating patterns for all. Choose nutrient-dense foods and beverages across and within Everyone has a role in helping to create and support healthy eating patterns in multiple settings nationwide, from home to all food groups in place of less healthy choices. Consider school to work to communities. cultural and personal preferences to make these shifts easier to accomplish and maintain. Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov. Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov. Incorporating the DGAs In Your Life: Examples of Shifts to Healthier Eating Patterns Increasing vegetables in mixed dishes while decreasing the amounts of refined grains or meats high in saturated fat and/or sodium. Incorporating seafood in meals twice per week in place of meat, poultry, or eggs. Using vegetable oil in place of solid fats when cooking, and using oil-based dressings and spreads on foods instead of those made from solid fats. Choosing beverages with no added sugars, such as water. Use caution with alcohol Using the Nutrition Facts label to compare sodium content of foods and Figure 2.0.7: A social-ecological framework for nutrition and physical activity decisions. choosing the product with less sodium. Data from Health.gov. 2015. http://health.gov/dietaryguidelines/2015/guidel ines/chapter-3/social-ecological-model/. Part 3 End of Part 2 4  From Guidelines to Planning What to Diet-Planning Guides Eat Food group plans sort foods into groups A brief history of U.S. food group plans based on nutrient content. USDA- Daily Food Guide 1916 These guides are important in selecting foods for a nutritious diet providing balance, variety, Basic 4 Food Groups 1950 adequacy and moderation. Food Guide Pyramid 1992 A combination of whole grains, vegetables, MyPyramid 2005 legumes, fruits, meats or meat alternates and MyPlate 2010 milk products is essential to a healthy diet. Examples: MyPlate, EatingWell (Canada), Exchange Lists (American Diabetes Assoc.) Using MyPlate is designed to convey 7 ChooseMyPlate high-priority key messages: in Meal Planning – Enjoy food, but eat less. – Avoid oversized portions. MyPlate replaced MyPyramid as an – Make half your plate fruits and internet-based educational tool that vegetables. helps consumers implement the principles of the Dietary Guidelines – Drink water instead of sugary drinks. for Americans and other nutritional – Switch to fat-free or low-fat (1%) standards. milk and dairy products. – Compare sodium in foods. The MyPlate icon that goes with – Make at least half your grains Source: U.S. Dept Agriculture DGA 2015 visually identifies how whole grains. http://www.choosemyplate.gov/ much room on a plate each food group should occupy. From Guidelines to Groceries: Planning What to Eat Grains – Refined foods lose nutrients during processing. – Enriched foods have nutrients added back including iron, thiamin, riboflavin, niacin, and folate. – Whole-grain products are not refined. Can you name whole grain oatmeal,_________. two examples? _________________ brown rice – Fortified breads and cereals have nutrients added that were not part of the original food. Percentage of nutrients compared to whole-grain bread 5  From Guidelines to Groceries So, just what are legumes? Vegetables – Choose fresh vegetables often. Legume Any of thousands of plant species that have seed pods that split along both – Dark green leafy and yellow-orange vegetables sides when ripe. More commonly consumed legumes: BEANS, LENTILS, are important. PEANUTS, PEAS and SOYBEANS. Others, such as clover and alfalfa, may be used as animal fodder. When the seeds of a legume are dried, – Good sources of vitamins, minerals, and fiber they're referred to as PULSES. The high-protein legumes are a staple – Be careful about added fat and salt. throughout the world. They also contain some vitamin B, carbohydrates, fats and minerals. – Legumes Lentils Economical Lens-shaped pulses that grow on an annual, bushlike plant. They have a short cooking time and a distinctive earthy flavor. A variety of lentils exist Nutrient-dense with colors that range from yellow to red-orange to green, brown or even black. There are both large and small-seeded varieties. Lentils are Low-fat, good sources of ______ protein and _____ fiber generally sold as dry seeds (pulses) From Guidelines to Groceries From Guidelines to Groceries Fruits Meat, fish and poultry – Focus on citrus and yellow-orange fruits. – Provide minerals, protein and B vitamins – Provide vitamins, minerals, fibers and phytochemicals. – Processed fruits are acceptable alternatives to fresh. – Choose lean cuts. – Fruit juices lack ______ but are considered healthy – Textured vegetable protein is processed from beverages. fiber soy protein ____ _____ and can substitute for meat in – Watch energy intakes and fruit “drinks.” recipes. – Weighing is one way to determine portion sizes. – To reduce fat intake from meats, trim cuts, drain fat and use low-fat cooking methods like: _______ roasting, ______ ______. grilling, broiling From Guidelines to Groceries Milk and Dairy – Dairy foods are often fortified with vitamins __ A and __. D – Imitation foods that resemble other foods are usually nutritionally inferior. Example: – Food substitutes are designed to replace other foods. – Many lower fat dairy products are available including fat-free, low-fat, non-fat, skim, no-fat, reduced-fat products. Table 2.6 Playing with MyPlate Portions Your Favorite Sports and Games Can Help You Visualize MyPlate Portion Sizes 6  Portion Distortion Perception that large portion sizes are appropriate Contributes to positive energy balance, leading to weight gain over time and ultimately may result in End of Part 3 obesity Take the portion distortion quiz to see how portion sizes have changed over the past 20 years! Link: Quiz! 8 oz with milk and sugar 16-oz mocha coffee Part 4 Recommendations for Nutrient Intake – Previously discussed guidelines like DGA and food guides like MyPlate deal with whole foods and food groups. What are Dietary Standards? Define healthful diets in terms of specific nutrient amounts. So, why do we need Dietary Standards?  Before choosing foods to meet specific nutrient needs, we need to know how much of each nutrient we require daily. ______________________________________________ Recommendations for Nutrient Dietary Reference Intakes (DRIs) Intake: Dietary Standards Definition: Sets of recommended intake values Framework of dietary standards to provide not only for individual nutrients adequate intakes, but also provide optimal nutrition – Apply to healthy people – Who develops them and how is it done? – Recommendations are not minimum requirements and can  U.S.A.: Food and Nutrition Board of National Academy of be adjusted for individuals by registered dietitians. Sciences – Achieved by consuming a variety of foods  Responsible for committees of nutrition scientists who – Apply to average daily intakes review scientific data about nutrients and make – Each DRI category serves a unique purpose: recommendations to determine nutrient levels Estimated Average Requirement (EAR) – The Dietary Reference Intakes (DRIs) Recommended Dietary Allowance (RDA) In 1997, replaced Recommended Dietary Allowances Adequate Intake (AI) (RDAs) that were first published in 1941. Tolerable Upper Intake Level (UL) 7  DRI Terminology The Dietary Reference Intakes (DRIs) Energy Recommendations  Estimated Energy Requirement (EER) Lots of represents the average daily energy intake to abbreviations! maintain energy balance and good health for Know meanings and population groups. applications of each one.  Acceptable Macronutrient Distribution Range (AMDR) represents the range of intakes for energy nutrients that provide adequate energy and nutrients and reduce risk of chronic disease. Dietary Reference Intakes (DRIs) Estimated Average Requirement (EAR) – Amount that meets the nutrient requirements of 50% of people in a life stage/gender group – Based on functional indicator of optimal health Recommended Dietary Allowance (RDA) – Amount that meets the needs of Table 2.6: Acceptable Macronutrient Distribution Ranges for Adults most people in a life Reproduced from Institute of Medicine, Food and Nutrition stage/gender group Board. © 2005 by the National Academy of Sciences, courtesy of the National Academies Press, Washington, DC. Dietary Reference Intakes (DRIs) Adequate Intake (AI) – Amount thought to be adequate for most people – AI used when EAR and RDA can’t be determined Tolerable Upper Intake Level (UL) – Intake above the UL can be harmful 8  How are DRIs Used? Population groups Assess adequacy of intake Plan diets Set policy and guidelines Individuals Use RDA and AI as target levels for intake Avoid intake above UL Estimated Average Requirement. Part 5 End of Part 4 Food Labels Ingredients List and Basic Information – All ingredients listed – Descending order of predominance by weight – Statement of identity – Net contents of the package – Name and address of manufacturer, packer, distributor Nutrition Facts Panel – First appeared in 1994 as a result of the Nutrition Labeling and Education Act passed by Congress in 1990 (NLEA) Figure 2.8: The five mandatory requirements for food labels. Federal regulations determine what can and cannot appear on food labels 9  The New Nutrition Facts Label The Nutrition Facts Panel: Nutrient The Nutrition Facts Panel Information Serving Sizes – Listed by quantity – Cholesterol and percentage – Facilitate comparisons among standards per – Sodium foods. serving, called – Carbohydrate listed by “Daily Values”. Total Carbohydrate, – Need to compare stated serving Starch, Sugars, and – Calories listed as size to quantity of food actually “Total Calories” Fiber eaten. and “Calories from – Protein Note number of Fat” – Vitamin A, Vitamin C, – Fat listed by Total Iron, and Calcium are “Servings Per Container” Fat, Saturated Fat, listed in % DV only. and Trans Fat The Nutrition Facts Nutrition Facts Panel Panel Daily Values – Estimate of individual Daily Values foods’ contribution to total diet – Compare amount – Based on 2000-kcalorie in one serving to diet the amount – Can also calculate recommended for personal daily values – Helps to compare foods daily consumption. and compare amount in one serving to amount recommended for daily consumption 10 Is your Serving Size the same as the one on the label? Macaroni and Cheese Serving Size: 1 cup (228 grams) Servings per container: ___ The size of the serving on the food package influences the amount of ______ and all the _____amounts listed on the top part of the label. Pay attention to the serving size, especially how many servings there are in the food package. Ask yourself, "How many servings am I consuming"? (e.g., 1/2 serving, 1 serving, or more) Food Labels: Nutrient Claims Food Label Claims – Must meet FDA definitions (see chapter for details) Health Claims – No implied claims – NLEA allows manufacturers to add health claims to food labels – General terms : free, good source of, healthy, high, less, light or lite, low, more, and organic. – Statements that link one or more dietary components to reduced risk of disease – Energy terms: kcalorie-free, low kcalorie, and reduced Examples: p. 60 calorie. “Diets high in whole-grain foods and other plant foods and – Fat and cholesterol terms: percent fat-free, fat-free, low fat, low in total fat, saturated fat, and cholestrol may help less fat, saturated fat-free, low saturated fat, less saturated reduce the risk of heart disease and certain cancers.” fat, trans fat-free, cholesterol-free, low cholesterol, less Qualified Health Claims cholesterol, extra lean, and lean. – Evidence is supportive but not at level of strength – Carbohydrate terms: high fiber and sugar-free. required for health claims – Sodium terms: sodium-free and salt-free, low sodium, and “Evidence suggests but does not prove”… very low sodium. Nutrition Assessment: Determining Food Label Claims Nutritional Health Nutritional health is the state of having all Structure-Function Claims nutrients available in amounts needed by the – Claims made without FDA approval body for overall health. Assessment measures – Cannot make statements about disease various indicators of nutritional health. treatment, prevention, cures, etc. The Continuum of Nutritional Status – Extremes of undernutrition and overnutrition Consumer Education – Region of good health between these – Government education programs Nutrition Assessment – “Healthier US Initiative” Program – Individuals – Populations 11  Table 02.T07: The ABCDs of Nutrition Assessment Nutrition Assessment Methods Nutrition Assessment Methods Anthropometric Anthropometric Measurements Measurements Biochemical Tests Biochemical Tests Clinical Clinical Observations Observations Dietary Intake Dietary Intake Guidelines and Assessment Nutrition Assessment: Key Points Summary Dietary Intake Analysis Methods Linking Nutrients, Foods and Health: – Key Concepts of Healthful Diet Planning (ABCDMV Diet History concepts) Food Record Dietary Guidelines for Americans Food Frequency Questionnaire – Two overarching concepts 24-Hour Recall – Four Key Recommendations and associated guidelines Methods of Evaluating Dietary Intake Data From Guidelines to Planning your Diet – MyPlate Food Guide and Key Messages – Comparison to Dietary Standards – Guidelines to Groceries advice – Comparison to ______ DGAs and _____. DRIs Nutrient Intake Recommendations: The DRIs Food Labels: Ingredients and Nutrient Information Nutrition Assessment: Purpose and Methods 12