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CHAPTEr 3 O PR O E EC TE D PA G WHY IS THIS IMPOrTANT? Nutrition is one of the most important factors affecting the health and individual human development of Australia’s youth. Adequate nutrition is required for many aspects of youth development. Nutrition has a direct relationship to aspects of individual human development such as bone and organ development. It also affects development indirectly by, for example, providing energy that allows the youth to concentrate at school, thereby promoting intellectual development. In recent decades, the nutritional status of Australia’s youth has declined and is contributing to health and developmental issues. To develop a deep knowledge of these issues, it is important to learn about the nutrients, the roles they play in optimising health and development, and the short- and long-term consequences of nutritional imbalance. A range of food selection models exist to assist youth in food selection. Understanding these models can assist youth in achieving a balanced nutrient intake and in achieving optimal health and individual human development. FS Nutrition during youth U N C O R R KEY KNOWLEDGE 2.1 the function of major nutrients for the development of hard tissue, soft tissue, blood tissue and energy (pages 74–94) 2.2 the consequence of nutritional imbalance in a youth’s diet on shortand long-term health and individual human development (pages 95–8) 2.3 food selection models as tools to promote healthy eating during youth (pages 99–104). KEY SKILLS • explain the functions of major nutrients for the development of hard tissue, soft tissue, blood tissue and energy during youth • explain the possible consequences of nutritional imbalance in a youth’s diet on short- and long-term health and individual human development • explain how food models can be used as a tool to promote health. 80 FIgUrE 3.1 As youths gain independence, their food choices become particularly important for future health and development. UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 80 1 July 2015 7:54 PM KEY TERM DEFINITIONS U N C O R R EC TE D PA G E PR O O FS anaemia a condition characterised by a reduced ability of the body to deliver enough oxygen to the cells due to a lack of healthy red blood cells basal metabolic rate (BMR) the amount of energy required to sustain basic functioning of the human body bone matrix the structure of bone that allows calcium and phosphorus to be deposited, therefore making the tissue hard. The bone matrix consists mainly of collagen. cartilage connective tissue that protects and cushions the joints, and provides structure and support to various body tissues cell differentiation the process in which body cells take on their specialised function (e.g. skin cells or muscle cells) cell membrane the outer layer of a cell that provides structural support for the cell and allows nutrients, gases and waste into and out of the cell cellular respiration the process whereby oxygen and fuel are converted into energy cholesterol a type of fat required for optimal functioning of the body that in excess can lead to a range of health concerns including the blocking of arteries (atherosclerosis). Can be ‘bad’ low-density lipoprotein (LDL) or ‘good’ high-density lipoprotein (HDL). co-enzyme usually a vitamin or mineral that binds with protein to allow chemical reactions such as metabolism to occur collagen fibrous protein found in connective tissue that is the main component of cartilage, ligaments, tendons, bone and skin connective tissue tissue that is involved in the structure and support of body cells and systems dental caries decay of teeth caused by a breakdown in the tissues making up the tooth discretionary foods includes foods and drinks not necessary to provide the nutrients the body needs, but that may add variety. However, many of these are high in saturated fats, sugars, salt and/or alcohol, and are therefore described as energy dense. fortified having a nutrient artificially added to increase nutritional value glycaemic index (GI) a scale from 0 to 100 indicating the effect on blood glucose of foods containing carbohydrates haemoglobin a component of blood, largely consisting of iron and protein, that transports oxygen throughout the body hard tissue tissues in the body that form hard substances such as bones, teeth and cartilage kilojoule (kJ) a unit for measuring energy intake or expenditure macronutrients nutrients that are required in large amounts (protein, carbohydrates and fats) micronutrients nutrients that are required in small amounts (vitamins and minerals) ossification the process whereby bones are hardened by laying down the minerals calcium and phosphorus osteoporosis a condition characterised by a reduction in bone mass that makes bones more likely to break and fracture peak bone mass the maximum bone mass (i.e. density and strength) reached in early adulthood soft tissue organs and tissues in the body that connect, support or surround other structures. They include skin, muscles, tendons, ligaments, collagen and organs. vegan a type of vegetarianism that excludes foods of animal origin including eggs and dairy c03NutritionDuringYouth 81 1 July 2015 7:54 PM 3.1 Introduction to the nutrients required during youth: carbohydrates, protein and fats KEY CONCEPT Understanding the major nutrients required during youth TE D PA G E PR O O FS When we eat, the foods are broken down in the process of digestion to release the nutrients. These nutrients are then used by the body for many functions related to health and development including the production of energy and blood and the development of hard and soft tissues. EC Figure 3.2 Eating a range of foods is the best way to ensure adequate nutrition. U N C O R R Some foods have more nutrients in them than others, and some have nutrients that other foods may not have at all. The best way to maintain a balanced diet is to eat a wide variety or many different types of foods (figure 3.2). There are six categories of nutrients that are needed for optimal health and individual human development. They are: • carbohydrates (including fibre) • protein • fats • vitamins • minerals • water. Carbohydrates, protein and fats are needed by the body in large amounts and are often called macronutrients, while vitamins and minerals are called micronutrients because they are only needed in very small quantities. Regardless of the quantity needed by the body, each nutrient has a different role to play and all are important for health and individual development. Carbohydrates Interactivity: Time Out: ‘Food sources of nutrients’ Searchlight ID: int-1423 The main function of carbohydrates is to provide fuel for energy. As youth are growing at a rapid rate, a lot of energy is required for metabolism and growth. Glucose is the preferred fuel for energy in the human body and carbohydrates are rich in glucose, and as a result should provide the majority of an individual’s energy 82 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 82 1 July 2015 7:54 PM FS O PR O needs. Carbohydrates allow an individual to maintain high activity levels, which can provide opportunities to develop motor skills and also the energy to concentrate at school and therefore develop intellectually. Carbohydrates are broken down and the glucose molecules are absorbed into the bloodstream, from where they are taken into the cells and stored, ready for use. In terms of energy production, one gram of carbohydrates will produce 16 kJ of energy. Glucose (and therefore carbohydrates) that is not used by the body is stored as adipose (or fat) tissue. If a person eats too much carbohydrate, they can gain weight because this increases the amount of glucose stored as fat. This process can be reversed if glucose is needed by the body. Most carbohydrates are found in foods of plant origin. Common examples are vegetable (including potatoes), rice, pasta, most breakfast cereals and fruit (figure 3.3). However, carbohydrates are also found in sugar and foods containing added sugar such as soft drinks, cordial, lollies and chocolate. These foods contain few other nutrients besides carbohydrates so are not considered to be good food sources of this nutrient. PA G E FIgUrE 3.3 Pasta is a good source of carbohydrates. Fibre U N C O R R EC TE D Fibre is a type of carbohydrate that is required for the optimal health and individual human development of youth. Found in all foods of plant origin, fibre does not get absorbed by the body. Rather, it travels through the digestive system, acting like a cleaner as it moves. The benefits of fibre in the diet are numerous for youth: • Fibre acts to reduce the amount of glucose that is absorbed by the digestive system, thereby reducing the energy provided by the foods eaten. It also provides a feeling of fullness (satiety), so decreases the amount of energy consumed from other foods. Both of these characteristics of fibre assist in weight maintenance. • Fibre reduces the amount of cholesterol that is absorbed by the body, which reduces the risk of cardiovascular disease later in life. • Foods containing fibre are generally high in a range of vitamins and minerals, which improves overall nutrient intake. This is particularly important for youth as their nutritional requirements increase due to the growth they experience. • Fibre absorbs water, which adds bulk to the faeces. This assists in regular bowel movements, which decreases the chances of becoming constipated. According to the National Health and Medical Research Council, youths should be consuming around 22–28 grams of fibre per day. Examples of foods that contain fibre are: • 3/4 cup bran flake cereal (4.5 grams of fibre) • two slices wholemeal bread (4.5 grams of fibre) • one apple and one orange (5.5 grams of fibre) • two cups mixed raw vegetables (10 grams of fibre) • 1/4 cup baked beans (3 grams of fibre). As fibre absorbs water, increased fibre intake should be accompanied by increased water consumption. FIgUrE 3.4 Grains and seeds are an excellent source of fibre. Nutrition during youth • CHAPTEr 3 c03NutritionDuringYouth 83 83 1 July 2015 7:54 PM 3.1 Introduction to the nutrients required during youth: carbohydrates, protein and fats Protein O R R EC TE D PA G E PR O O FS Protein has two main functions in the body. Its main function (and probably the most important for youth development) is to build, maintain and repair body cells. This includes the cells required to build soft tissues such as muscles and organs, hard tissue such as bone and the production of blood tissue (figure 3.5). The second function of protein is to act as a fuel for producing energy. If a person does not have enough glucose (from carbohydrates) to use for energy production, protein can be used as a secondary source of energy. In times of starvation, muscle and other body cells may be broken down so the protein contained within them can be used for energy. Protein yields about 17 kJ per gram when being used for energy. If eaten in excess, protein may be stored as adipose or fat tissue and can contribute to obesity in the long term. Protein is made up of smaller building blocks called amino acids. There are 20 different types of amino acids that humans need to function properly. Eleven of these, called the non-essential amino acids, can be synthesised (or made) in the body from other amino acids. The other nine, called essential amino acids, cannot be synthesised in the body and must therefore be consumed (figure 3.8). To ensure that all amino acids are being consumed regularly, protein Figure 3.5 Protein is a key component of all body tissues, like these from a range of different sources should be eaten. muscle fibres. Many people get much of their protein requirements from meat, which is often rich in essential amino acids. Vegetarians must ensure they consume a large variety of non-meat protein sources to ensure that their nutritional needs are being met. These foods include nuts, beans, lentils and tofu. Some food sources are termed ‘complete proteins’ because they contain all the essential amino acids in the quantities required for individual human development. They are usually found in vast amounts in animal products (figure 3.6). Some proteins can also be found in many foods of plant origin (figure 3.7). These are usually incomplete proteins and need to be eaten with other protein sources to ensure that all required amino acids are consumed. Protein content of selected foods of animal origin (g of protein per 100 g of food item) U N C Protein content of selected foods of plant origin (g of protein per 100 g of food item) Beef Pork Tuna Chicken (thigh) Salmon Cheddar cheese Lamb Chicken breast Egg Milk 0 Pumpkin seeds Peanut butter Almonds Pistachios Tofu Oats Cashews Hazelnuts Lentils Wheat bread 10 20 30 g per 100 g 40 Figure 3.6 The protein content of selected foods of animal origin 0 10 20 30 40 g per 100 g Figure 3.7 The protein content of selected foods of plant origin 84 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 84 1 July 2015 7:54 PM Protein Non-essential amino acids Can be made in the body from essential amino acids O Incomplete proteins Do not contain all essential amino acids FIgUrE 3.8 Proteins can be classified as essential and non-essential amino acids. PR O Complete proteins Contain all essential amino acids FS Essential amino acids Fats Fats (lipids) U N C O R R EC TE D PA G E Fats (sometimes referred to as lipids) play a number of roles in youth health and individual human development. Although fats are often associated with negative effects on the body, they are required for adequate health and development throughout the lifespan and are an essential part of a balanced food intake. Like carbohydrates, the main function of fats is to act as a fuel for energy. Fats are a richer source of energy than carbohydrates and protein, yielding 37 kJ per gram. This is why foods packed with fat but little else are referred to as ‘energy dense’ foods. How much fat to include in the diet should be determined by the amount of energy required by the individual. Balance is the key here. Remember that most of an individual’s energy should come from carbohydrates. Fats are required for a number of other processes including the development and maintenance of cell membranes. Cell membranes form an important component of body cells and therefore blood and soft tissues. They are responsible for maintaining the structure of cells and allowing the transport of nutrients, gases and waste into and out of cells. Fats are a key component of the cell membrane and are required throughout life for adequate cell function. Fats are an important part of a balanced diet for youths, but there are different types of fats and some are healthier than others (see figure 3.9). Some fats can actually lead to poor health and should be kept to a minimum in the diet. Monounsaturated Omega-3 Polyunsaturated Saturated Trans Omega-6 FIgUrE 3.9 There are four different categories of fats. Nutrition during youth • CHAPTEr 3 c03NutritionDuringYouth 85 85 1 July 2015 7:54 PM 3.1 Introduction to the nutrients required during youth: carbohydrates, protein and fats Interactivity: Time Out: ‘Which fat?’ Searchlight ID: int-1424 Based on their chemical make-up, fats can be classified into four broad categories: monounsaturated, polyunsaturated, saturated and trans fats. Total fat intake should account for around 25 per cent of the total energy requirement (with carbohydrates and protein making up the other 75 per cent). Of this 25 per cent, the majority should come from monounsaturated fats. Approximate recommended percentages of total energy intake from the different types of macronutrients are shown in figure 3.10. O Fats 25% Monounsaturated 10% Polyunsaturated 5% Saturated 9% Trans fats 1% PA G E PR O Carbohydrates 55% FS Protein 20% TE D FIgUrE 3.10 Macronutrients (with a breakdown of fats), and the average percentage of total energy intake each should make up (approximate values only) Monounsaturated and polyunsaturated fat U N C O R R EC Monounsaturated and polyunsaturated fats are considered the ‘good fats’. They carry out the necessary functions of fats and also have some health benefits such as reducing levels of cholesterol and promoting the health of the heart and blood vessels. The greatest health and development gains for youth can be achieved by replacing saturated and trans fats with monounsaturated and polyunsaturated fats. This can help reduce the risk of diet-related diseases later in life, such as heart disease. Because all fats contain 37 kJ of energy per gram, the total fat intake should not increase because all types will lead to weight gain and the associated effects on health if eaten in excess. FIgUrE 3.11 Nuts are a great source of the ‘good’ fats. 86 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 86 1 July 2015 7:54 PM FS O PR O Monounsaturated fats are liquid at room temperature and begin to solidify if placed in the refrigerator. Foods rich in monounsaturated fats include olive oil, avocado, canola oil and canola-based margarine, nuts such as peanuts, hazelnuts, cashews and almonds, peanut butter and other nut butters. There are two main categories of polyunsaturated fats: omega-3 and omega-6. Polyunsaturated fats are generally liquid at room temperature and when refrigerated. Food sources for these fats include: • omega-3 — fish (particularly oily fish such as mackerel, trout, sardines, tuna and salmon), canola and soy oils, and canola-based margarines • omega-6 — mainly nuts such as walnuts and Brazil nuts, seeds and oil made from corn, safflower and soy. Many people in Western countries consume too many omega-6 fats which, like all fats, can increase the risk of obesity and associated conditions including heart disease. Saturated and trans fats Figure 3.12 Fats that come from animals and are solid at room temperature are normally saturated. This pork fat is one example. U N C O R R EC TE D PA G E Saturated and trans fats are sometimes known as ‘bad fats’ because they increase cholesterol levels in the blood and can therefore contribute to heart disease in the long term. Although consuming saturated and trans fats will satisfy the energy and other requirements provided by other types of fats, they should be replaced where possible. Saturated fats are generally found in foods of animal origin (figure 3.12) and are often solid at room temperature. You can see saturated fat in fatty cuts of meat as the marbling throughout the meat or the fat that forms along the ends of cuts of red meat. Other foods containing high levels of saturated fat include full-cream milk, cream and cheese, some fried takeaway food, and most commercially baked goods such as pastries and biscuits. Although small amounts of trans fats are found naturally in certain foods, most trans fats are created when liquid oil is converted into solid fat by a process called hydrogenation. For this reason, they are generally found in processed foods such as pies, pastries and cakes (figure 3.13). Margarines and solid spreads made for cooking are sometimes high in trans fats, as are the products made from them. Figure 3.13 Trans fats are often present in baked goods such as doughnuts, biscuits and cakes. Nutrition during youth • CHAPTER 3 87 c03NutritionDuringYouth 87 1 July 2015 7:54 PM 3.1 Introduction to the nutrients required during youth: carbohydrates, protein and fats APPLY your knowledge PR O O FS 10 Explain how eating insufficient carbohydrates could affect the physical, social, emotional and intellectual development of youth. 11 Discuss the possible short- and long-term effects on a youth who does not consume adequate amounts of fibre. 12 Using mind mapping software, or by copying figure 3.14, complete a mind map summarising information relating to the functions and food sources of carbohydrates, including fibre. 13 Create a table that summarises the health and individual human development impacts of carbohydrates (including fibre), protein and fat. TE D PA G 1 What are the six categories of nutrients? 2 List the main function of carbohydrates. 3 How much energy does one gram of carbohydrate produce? 4 Outline the main functions of fibre. 5 Does fibre contribute to energy intake? Explain. 6 (a) What is the main function of protein? (b) How can protein enhance the physical development of youth? 7 (a) Is fat required in the diet? Explain. (b) Which fats are considered the ‘good’ fats? Why? (c) Which fats are considered the ‘bad’ fats? Why? 8 Why should overall fat intake be limited? 9 (a) What percentage of energy should come from each of the macronutrients? (b) Explain why most of our energy needs should come from carbohydrates instead of fats and protein. E TEST your knowledge Function Functions Fibre Carbohydrates Food sources FIgUrE 3.14 Concept map summarising the functions and food sources of carbohydrates (including fibre) U N C O R R EC Food sources 88 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 88 1 July 2015 7:54 PM 3.2 Introduction to the nutrients required during youth: water, calcium and iron KEY CONCEPT Understanding the major nutrients required during youth O U N C O R R EC TE D PA G E PR O Although it has no nutritional value, water is the most important nutrient for human survival. Water makes up around 55 to 75 per cent of body mass and is needed for numerous functions within the body, including: • as a medium for all chemical reactions required to provide energy and produce soft tissue • as a key component of many cells, tissues and systems • as a key component of blood. Being adequately hydrated allows chemical reactions in the body to occur effectively, which is important for periods of rapid development such as the youth stage of the lifespan. Sufficient water intake allows the body’s systems to function adequately and the body as a whole to function properly. This means an individual can effectively go about their day-to-day activities. Water intake can also assist in weight maintenance as it helps to reduce hunger while contributing no kilojoules or energy. When dehydrated, a person will often lack alertness and the ability to concentrate. They may not have the energy to participate in physical activities, which can impact on motor skill development. They may not be able to concentrate at school, which can directly impact on intellectual development. All foods have some water content (figure 3.15) and contribute to total water intake, as do fluids such as milk. Water should also be consumed in its pure form (i.e. from the tap or in bottled form) to meet hydration needs. Although they contain a large percentage of water, softdrinks and sports drinks often contain high amounts of sugar and other additives, so their consumption should be limited. FS Water Figure 3.15 Foods such as fruits and vegetables have a high water content, but water should also be consumed in its pure form. Nutrition during youth • CHAPTER 3 89 c03NutritionDuringYouth 89 1 July 2015 7:54 PM 3.2 Introduction to the nutrients required during youth: water, calcium and iron Calcium PA G TE D U N C O R R EC Figure 3.16 Changes in bone mass with age E Bone mass PR O O FS Calcium is one of the key nutrients required for the building of bone and other hard tissues (such as teeth and cartilage) and is therefore extremely important during periods of rapid growth such as during youth. The youth stage signifies the greatest increase in bone density and contributes significantly to achieving optimal peak bone mass. It is therefore vital that youth get enough calcium during these years to build as much bone density as possible. The greater the bone density during this stage, the less chance the individual will have of developing osteoporosis later in life (figure 3.16). Calcium is found in most dairy products (figure 3.17). Milk, cheese and yogurt are all rich sources of calcium. Other sources include sardines and salmon (with bones), green leafy vegetables (broccoli, spinach), fortified soy milk, tofu made with calcium sulfate and fortified Men orange juice. Women Oxalic acid is present in spinach and binds to the calcium molecules, preventing all of the calcium from being absorbed. In fact, if oxalic acid is present when calcium is eaten, only 5 per cent of the available calcium may be absorbed. For this reason, it is important to obtain calcium from other sources as well, such 20 40 60 80 100 as dairy (which does not contain Age (in years) oxalic acid). Figure 3.17 Dairy products such as milk are a rich source of calcium and help to build peak bone mass. 90 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 90 1 July 2015 7:54 PM Case study TE D FS O PA G When Tracy Spark’s daughter shed 15 kilograms in four months her mother knew something was drastically wrong. The teenager’s school results had gone downhill because she couldn’t concentrate, her hair had begun to fall out and she was icy to touch. The physical effects of anorexia were shocking, but it was only when routine blood tests were carried out during treatment that Ms Spark learnt the full horror of what was happening to her daughter, then 14, on the inside. Tests showed the girl’s bones were being leached of calcium to feed a body deprived of the essential mineral. ‘At a time when she should have been laying down calcium in her bones for later on, her body was actually taking calcium out of her bones to survive,’ Ms Spark said. ‘I work in the field and I was lost. I assumed eating disorders were an issue when you became skeletal. I didn’t realise people get very ill a long time before they get to that stage.’ On the eve of National Healthy Bones Week, Ms Spark, now a nutrition coordinator for Healthy PR O By Angela Thompson Cities Illawarra, is telling her daughter’s story in the hope it will help arrest a worrying trend towards poor nutrition among a body image-conscious generation of adolescent girls. According to Wollongong nutritionist Anita Needham, those who fail to achieve peak bone mass during adolescence are more likely to develop osteoporosis. ‘While we’re young it’s good to stockpile the calcium we get from dairy products so that you offset the effect of ageing on bone loss and therefore you reduce the risk of osteoporosis,’ she said. ‘Unfortunately many people exclude dairy foods when trying to lose weight, and in doing so miss out on valuable sources of calcium and other essential nutrients.’ ‘Recent clinical studies show that including three dairy serves in a weight-reducing diet may in fact result in more weight and body fat loss,’ she said. At the Sparks household, it was a lesson learnt the hard way. ‘She does focus on eating healthily now,’ Ms Sparks said of her daughter, who did not want to be named. ‘I’m a big believer in your body knowing what it needs and she absolutely adores dairy food.’ E Strong bones key to health EC Case study review Source: Illawarra Mercury, 2 August 2008. C U N Iron O R R 1 How was the development of Ms Sparks’ daughter affected by not consuming enough calcium? 2 Why do a lot of people cut dairy products out of their diet? 3 Explain why getting adequate calcium in the diet is very important during the youth stage of the lifespan. Iron is an essential part of blood. As blood volume increases during youth, iron is needed in greater quantities (figure 3.18). Iron forms the ‘haem’ part of haemoglobin, which is the oxygencarrying part of blood. A person who does not get enough iron may develop anaemia, a condition characterised by tiredness and weakness. Individuals with anaemia struggle to generate enough energy to complete daily tasks such as school work, sport and socialising. Red meat is a rich source of iron but it often contains high levels of saturated fat. As a result, leans cuts of meat should be chosen and iron should also be gained from other sources. A balanced, varied diet is the best way to get adequate amounts of iron. Figure 3.18 As blood volume increases during the youth stage of the lifespan, iron is required in higher amounts to make red blood cells. Nutrition during youth • CHAPTER 3 91 c03NutritionDuringYouth 91 1 July 2015 7:54 PM 3.2 Introduction to the nutrients required during youth: water, calcium and iron PR O O FS Foods providing iron include: • lean red meat • turkey and chicken • fish, particularly oily fish (e.g. mackerel, sardines and pilchards), fresh, frozen or canned • eggs • nuts (including peanut butter) and seeds • brown rice • tofu • bread, especially wholemeal or brown bread • leafy green vegetables, especially curly kale, watercress and broccoli. Iron from meat is usually absorbed best, although vegetarians can still get enough iron if they eat a variety of foods. Vitamin C changes the chemical make-up of iron from non-meat sources and increases the amount absorbed. Vitamin C should therefore be eaten if iron absorption needs to be maximised. U N C O R R EC TE D Anaemia is a condition characterised by a deficiency in the number or quality of red blood cells. Red blood cells are responsible for transporting oxygen to cells around the body to allow them to carry out their normal functions. One of the components of red blood cells is a protein called haemoglobin. Each red blood cell contains a haemoglobin molecule and it is this molecule that gives red blood cells their red colour. When transported to the lungs, oxygen molecules attach themselves to the haemoglobin and are carried through the network of blood vessels until they are absorbed by a cell. Anaemia occurs when there is a reduced level of red blood cells or haemoglobin in the blood. In those with anaemia, the heart pumps harder in an attempt to ensure adequate levels of oxygen are delivered to the cells. During exercise, meeting the demands of the cells becomes increasingly difficult and the individual can become exhausted. Anaemia isn’t a disease itself, but the result of a malfunction somewhere in the body. Females are particularly susceptible to anaemia, with some estimates suggesting that around one in five menstruating females and half of all pregnant females are anaemic. Youth experiencing puberty are also at an increased risk as blood volume increases, which increases the demand for red blood cells and haemoglobin. How are blood cells produced? Blood cells are constantly being produced in the bone marrow, at a rate of millions per second. Bone marrow is a spongy tissue in the cavities of bones that is responsible for generating the key components of blood, including red blood cells. Bone marrow requires certain nutrients, including iron, folate and vitamin B12, to be able to create red blood cells. In Australia, iron deficiency is one of the most common causes of anaemia. If there is not enough iron in the diet, the body will use stored supplies from the liver. Once this reserve is used up, the bone marrow will not be able to make enough haemoglobin and anaemia may result. PA G A close up on anaemia E Case study What causes anaemia? Anaemia can have many causes, and although commonly associated with a deficiency in iron, folate and/or vitamin B12, anaemia can also occur as the result of: • malabsorption — this occurs when the nutrients that are consumed are not able to be used. It can be caused by conditions such as coeliac disease. • inherited disorders — some blood disorders such as thalassaemia and sickle cell disease can be inherited from parents and can lead to anaemia • chronic conditions — conditions such as rheumatoid arthritis and tuberculosis can contribute to anaemia • bone marrow conditions — such as cancer or infection • blood loss — due to injury, surgery, cancer, stomach ulcers, heavy periods or giving blood frequently • rapid growth or times during which large amounts of energy are required — such as puberty or while pregnant. 92 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 92 1 July 2015 7:54 PM PR O O FS How can anaemia be prevented? Anaemia caused by deficiencies in dietary intake can be prevented by making sure that certain foods are consumed on a regular basis, including lean meats, nuts and legumes, fruit and vegetables and dairy products. Those who do not consume any animal products (known as vegans) may have to increase their intake with fortified foods or vitamin and mineral supplements. Anaemia caused by an underlying health condition may not be able to be prevented as it is caused by a fault in the cell-making process. Treatments are available to relieve the symptoms in these cases. PA G How is anaemia treated? Treatment for anaemia depends on the severity and the cause of the condition. In any case, the cause must be addressed in addition to treating the symptoms. Vitamin and mineral supplements may be required in the case of dietary deficiency. Iron injections may be required if iron levels are particularly low. Note that iron supplements should be used only under the direction of a doctor. The human body does not excrete iron efficiently, which can contribute to iron poisoning if the dose is not monitored. E What are the symptoms of anaemia? Depending on the severity, the symptoms of anaemia can include: • pale skin • tiredness • weakness • shortness of breath • blood pressure drops on standing up suddenly — sometimes caused by blood loss, such as during a heavy menstrual period • headaches • fast pulse • irritability • difficulty concentrating • cracks or redness of the tongue • appetite loss • strange food cravings (including the desire to eat dirt or rice, a condition known as pica). TE D Case study review Source: Adapted from www.betterhealth.vic.gov.au. O R R EC 1 Briefly explain anaemia. 2 Discuss haemoglobin and the role it plays in the body. 3 How might someone know if they are anaemic? 4 Research the blood disorders that can cause anaemia and prepare a brief summary of each. 5 Explain how anaemia could impact on the health and development of youth. 6 Discuss why female youth are more susceptible to anaemia than male youth. 7 Discuss why youth is a higher risk lifespan stage for anaemia than adulthood. C TEST your knowledge U N 1 (a) List three functions of water. (b) Why would it be a good idea to replace most drinks with plain water? 2 Why is calcium required in the body? 3 (a)List three foods that contain high levels of calcium. (b) Even though spinach has a lot of calcium, it is not considered the best food source of dietary calcium. Explain why this is so. 4 Describe the role of iron in the body. 5 Why is iron required in greater amounts during the youth stage of the lifespan? 6 Refer to figure 3.16. (a) Identify two trends evident in the graph. (b) Use the graph to help you explain a possible difference in health outcomes between males and females in older age. APPLY your knowledge 7 Explain how being dehydrated could affect the four dimensions of development in youth. 8 List the likely symptoms of not getting enough calcium. 9 Which other stages of the lifespan would require higher rates of: (a)calcium? (b)iron? Nutrition during youth • CHAPTER 3 93 c03NutritionDuringYouth 93 1 July 2015 7:54 PM 3.3 Introduction to the nutrients required during youth: vitamins A, B, C and D KEY CONCEPT Understanding the major nutrients required during youth Vitamin A FS Vitamin A is required for cell division and is therefore an important aspect of any growth that occurs in the body. There are many aspects of physical development that involve growth during the youth stage of the lifespan, so requirements for vitamin A increase at this time. Skin, muscle, organ, bone and blood cells all divide rapidly during youth and therefore require vitamin A. Vitamin A also plays a role in cell differentiation. Due to the rapid speed of growth during youth, cell differentiation occurs at a rapid rate and contributes to the increased need for this vitamin. Vitamin A has also been shown to promote the development of bones. Vitamin A assists with the development of immune system function by promoting mucus development in the lungs and airways. This lining of mucus is a defence mechanism against bacteria and viruses. Vitamin A also helps in the development of antibodies required to fight infection. The best sources of Vitamin A can be found in red, yellow and orange coloured fruits and vegetables including raw carrots, sweet potatoes, squash, spinach and rockmelon (figure 3.19). TE D PA G E PR O O Interactivity: Time Out: ‘Vitamins and folate’ Searchlight ID: int-1425 Figure 3.19 Yellow, orange and red fruit and vegetables are good sources of vitamin A. Vitamin D U N C O R R EC The main role of vitamin D is in the absorption of calcium from the intestine into the bloodstream. Lack of vitamin D can lead to low levels of calcium being absorbed and bones becoming weak. Most Australians get enough vitamin D from exposure to sunlight (figure 3.20), during which UV rays are converted to vitamin D in the skin. However, there is growing evidence to suggest that some groups in Australia are deficient in vitamin D because they rarely go out into the sun. Youth with dark skin or those who always cover up when outdoors can become deficient in vitamin D. While moderate exposure without any degree of sunburn is healthy, excessive exposure leading to sunburn is a major risk factor for skin cancer and should always be avoided. In terms of food sources, fish (particularly tuna, salmon, mackerel, sardines and herring) is the best source of vitamin D. Small amounts can also be found in beef liver, cheese and egg yolks. Some brands of milk, breakfast cereals and orange juice are fortified with vitamin D, Figure 3.20 Most Australians get enough vitamin D from exposure to sunlight, but those with restricted access to sunlight might be deficient. but it is important to check the packaging. 94 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 94 1 July 2015 7:54 PM O U N C O R R EC TE D PA G E PR O Vitamin C is important for the structure of tissues within the body and is required for building collagen. Collagen is a protein that is required for the formation of skin, scar tissue, connective tissue, bone, tendons, ligaments, and blood vessels (figure 3.21). In this role, vitamin C allows the other components of tissues to be held together. Vitamin C is important in promoting the absorption of iron and is therefore an important nutrient in the production of blood. Humans can neither make their own vitamin C in the body nor store it effectively (as other animals can do). Therefore, a daily intake of vitamin C is important for normal individual human development and functioning. Vitamin C is found in many fruits and vegetables including kiwi fruit, broccoli, blackcurrants, citrus fruits such as oranges, and strawberries. It is easily destroyed when exposed to heat and air, so fresh fruit and vegetables provide the best source of vitamin C. FS Vitamin C Figure 3.21 Collagen is a key component of these tendons. Nutrition during youth • CHAPTER 3 95 c03NutritionDuringYouth 95 1 July 2015 7:54 PM 3.3 Introduction to the nutrients required during youth: vitamins A, B, C and D B-group vitamins Vitamins B1, B2 and B3 Folate (vitamin B9) E Folate is a B-group vitamin that is essential for growth and development. It plays an important role in DNA synthesis and is therefore required for cells to duplicate in periods of growth. (It also occurs in periods of maintenance, but not to the same degree.) Folate also plays a role in the development of red blood cells, and a deficiency in folate can lead to anaemia. Note that anaemia can be caused by a deficiency in iron (called iron-deficiency anaemia) or in folate (called folate-deficiency anaemia). Anaemia is characterised by tiredness, so the youth might no longer participate in daily activities. This in turn can affect all types of individual human development (figure 3.23). Folate is found in green leafy vegetables, citrus fruits, poultry and eggs. Many cereals, breads and fruit juices are fortified with folate. The form of folate added to foods is a synthetic form of folate known as folic acid. EC Figure 3.23 A lack of folate can lead to folate-deficiency anaemia and therefore tiredness. This can have numerous effects on the development of youth. TE D PA G Figure 3.22 Vegemite is one of the world’s richest sources of B-group vitamins. PR O O FS The B-group vitamins include vitamins B1, B2 and B3 (also known as thiamine, riboflavin and niacin respectively). These vitamins are essential in the process of metabolising or converting the fuels (carbohydrates, fats and protein) into energy. A lack of these nutrients can lead to a lack of energy. As energy is essential for growth, a lack of the B-group vitamins can contribute to slowed growth of hard and soft tissues. Rich sources of the B-group vitamins include Vegemite, wholegrain cereals and breads, eggs, meats, fish, dark-green leafy vegetables and milk. The B-group vitamins are very delicate and easily destroyed through cooking and processing. Getting enough of these vitamins from whole grains and unrefined sources is the best way to ensure that the recommended intake is met. Vitamin B12 U N C O R R Vitamin B12 is another B-group vitamin that is required for adequate development during youth. Although it has a number of roles in the body, its main function during the youth stage is for the formation of red blood cells. It works with folate in this capacity, ensuring the red blood cells are not only the correct size but also the correct shape to enable oxygen to be transported throughout the body. A deficiency of vitamin B12 can increase the chance of becoming anaemic. Having this condition can prevent youths from participating in normal activities and therefore have a wide range of effects on their development. Most foods of animal origin contain some vitamin B12 but particularly good sources include meat, eggs and cheese. Because vitamin B12 is found only in food sources of animal origin, vegans are at particular risk of being deficient in Figure 3.24 Foods from animal sources are good sources of vitamin B12. this vitamin. 96 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 96 1 July 2015 7:54 PM APPLY your knowledge 1 (a) What is cell differentiation? (b) Explain the difference between cell differentiation and cell division. 2 What is the main role of vitamin D in the body? 3 Why are vegans at particular risk of vitamin B12 deficiency? 4 Explain the role of the following nutrients and why each is important for youth health and/or development: (a) vitamin A (b) vitamin C (c)folate (d) vitamins B1, B2 and B3. 5 Describe the effects on development of youth who are deficient in: (a) vitamin A (b) vitamin D (c) vitamin C (d) B-group vitamins. 6 Create a mind map that summarises the function and food sources of the vitamins covered in this chapter. U N C O R R EC TE D PA G E PR O O FS TEST your knowledge Nutrition during youth • CHAPTER 3 97 c03NutritionDuringYouth 97 1 July 2015 7:54 PM 3.4 The interrelationship of major nutrients KEY CONCEPT The function of major nutrients for the development of hard tissue, soft tissue, blood tissue and energy PR O O FS Although all the key nutrients have their specific functions, they must work together or interrelate to carry out four major processes in the body: 1.provision of energy 2.production of blood 3.formation of soft tissue 4.formation of hard tissue. Each nutrient is like a piece of the puzzle, so although its role may be minor in the process, without it, the process cannot be carried out effectively. The four major processes and the nutrients required for each will be explored in more detail in the following section. Provision of energy O R R EC TE D PA G E Energy is required in all cells so they can carry out their functions. Cells without energy — like cells without oxygen — will die. As well as being needed for physical activity, energy is essential to sustain life and keep body systems functioning adequately. The amount of energy needed to sustain life (i.e. to keep the major organs functioning) is known as the basal metabolic rate (BMR). About 70 per cent of an individual’s total energy expenditure is devoted to BMR requirements such as temperature controll and cell replacement. The other 30 per cent is needed for physical activity and digestion. A number of factors influence BMR. They include: • age — BMR generally decreases with age, mainly due to lower muscle mass. The effect of ageing decreases BMR by about 2 per cent per decade after the age of 20. • growth — individuals undergoing growth (such as in youth) require more energy to build tissues and increase blood volume. • body size — larger people have a higher BMR as they have more cells which in turn require more energy to maintain their function. • body type — muscle requires a higher BMR than fat as muscle cells are more active and therefore require more energy to maintain their function. • dieting — can cause the body to conserve energy. This lowers the BMR. • sex — males tend to have a higher BMR. The higher muscle mass in most males contributes to this difference. • environmental temperature — the body has to work harder to maintain temperature in hot or cold environments, therefore raising the BMR. In Australia, energy is measured in kilojoules (kJ). A kilojoule contains one thousand joules. The exact meaning of a joule is quite technical but some examples of how much energy is used in specific activities will help put it into perspective. The approximate amount of energy used in certain activities is shown in table 3.1. As the energy required for physical activity only makes up a fraction of a person’s total energy requirement, it is useful to look at total energy requirements. The approximate total energy requirement per day (kJ) based on an individual with moderate physical activity levels is shown in table 3.2. The amount of energy contained in food is also measured in kilojoules. This makes it easier to compare energy intake with energy output. The amount of energy contained in certain foods is shown in table 3.3. If more energy is consumed than is needed for metabolism, digestion or physical activity, it is stored as fat and contributes to weight gain. If more energy is used than is consumed, the individual will lose weight. In either case, health and individual human development are affected. U N Activity C Table 3.1 The energy used in selected activities (kJ per kg per hour) Energy (kJ/kg/h) Sitting quietly 1.7 Writing 1.7 Standing relaxed 2.1 Driving a car 3.8 Vacuuming 11.3 Walking rapidly 14.2 Running 29.3 Swimming (4 km/hour) 33.0 Rowing in a race 67.0 Source: Better Health Channel, www.betterhealth.vic.gov.au. 98 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 98 1 July 2015 7:54 PM Females Energy requirement Age Energy requirement 13 11 200 13 10 000 14 11 900 14 10 300 15 12 600 15 10 600 16 13 200 16 10 700 17 13 700 17 10 800 18 14 000 18 10 900 Approximate kilojoules Food White bread (1 slice) 290 Wholemeal bread (1 slice) 270 Egg (boiled) 330 Egg (Fried) 417 Skim milk (250 mL) Yoplait Creamy Original Yogurt (175 g) Butter (1 tsp) Source: Adapted from www.nhmrc.gov.au. Hamburger mince (1 patty) TE D EC R Blood production R O C 120 1070 1050 Chicken breast (with skin, roasted without fat, 100 g) 920 1 medium T-bone steak (trimmed of fat) 960 E 605 Sausages (pork, grilled) Lettuce (1 cup) 1015 20 Broccoli (1/2 cup) 115 Carrot (1 medium) 170 Potatoes (boiled, 100 g) 340 Apple (1 medium) 230 Banana (1 medium) 390 Popcorn (air-popped, no oil, 1 cup) 115 Ice-cream (vanilla, 1 scoop) 375 Snickers Bar (1 bar) 1175 Potato chips (50 g) 990 Pasta (1 cup, cooked) French fries (small serve, 100 g) Blood needs to be produced on a constant basis and even more 1 sausage roll so when growth is occurring at a rapid rate. As youths are in a Domino’s Supreme Deep Pan Pizza period of rapid growth, their need for the nutrients required for (1 slice) blood production increase significantly. Blood is made up of three McDonald’s Big Mac main components: Hungry Jack’s Whopper Cheese • plasma — makes up approximately 55 per cent of blood and KFC nuggets (6 pieces) contains clotting material and transports nutrients, gases, Subway (six inch sub, roasted chicken) hormones and waste Drinks • red blood cells — make up around 44 per cent of blood and contain haemoglobin, which carries oxygen, carbon dioxide and Cola softdrink (375 mL) other gases Apple juice (125 mL) • white blood cells — make up around 1 per cent of blood and are Orange juice (250 mL) important for fighting disease and infection. Water (250 mL) Blood cells are made in the bone marrow, which is a spongy tissue found inside the large bones of the legs, hip, spine and skull. Protein forms a major part of all three components of blood. In the case of red blood cells, iron binds with protein to form haemoglobin. Haemoglobin makes up around 33 per cent of the weight of red blood cells and is responsible for carrying oxygen around the body. U N 380 745 Chicken breast (no skin, roasted without fat, 100 g) PA G The provision of energy involves two groups of nutrients — those nutrients required for fuel (the sources of energy), and those nutrients that enable the fuel to be converted or changed into energy. As discussed earlier in this chapter, carbohydrates, fats and protein are the fuel or sources of energy. These fuels are broken down into simpler forms and then transported to the cells for immediate use or stored in various sites around the body (e.g. the liver and fat cells). The nutrients needed for energy production to occur are shown in figure 3.25 (page 90). Thiamine, riboflavin and niacin (the B-group vitamins) form co-enzymes that bind to other substances and convert the fuels into forms that can be used by the cells. The B-group vitamins are transported to the cells by water, and many of the chemical reactions that occur in producing energy take place in water. Oxygen is required in the process of energy production. It is transported to the cells by haemoglobin, which is largely made up of iron and protein. The process whereby energy is released and used by the body is known as cellular respiration. PR O Roast beef (lean, 150 g) O Males Age Table 3.3 The approximate energy content of selected foods FS Table 3.2 Average energy requirements for individuals of selected ages, by sex and based on moderate physical activity levels 830 1510 1500 835 2060 3184 1090 1240 655 210 335 0 Nutrition during youth • CHAPTER 3 99 c03NutritionDuringYouth 99 1 July 2015 7:54 PM 3.4 The interrelationship of major nutrients Carbohydrates, fats and protein Are the fuel for energy PR O O FS B-group vitamins Allow the release of energy PA G E Iron Forms a part of haemoglobin, essential for carrying oxygen around the body R EC TE D Water Transports the B-group vitamins and is also required for chemical reactions to take place U N C O R FIgUrE 3.25 The nutrients required for energy production 100 c03NutritionDuringYouth Vitamin C plays a number of roles in blood formation. It helps in the absorption of iron from plant sources, making more iron available for haemoglobin production. It is also important in the formation of healthy blood cells. Red blood cells live for only 100 to 120 days and therefore require constant regeneration. The human body produces around two million new red blood cells per second. In order for this volume of red blood cells to be produced, cell division must occur at a rapid rate. Vitamin A is essential for cell division and is therefore required for this process. When a cell divides, the DNA must be replicated so each cell has a complete set of DNA. Although a mature red blood cell does not contain DNA (as it has no nucleus), immature blood cells do contain DNA. Folate and vitamin B12 are required for DNA synthesis and so are vital for red blood cell development. Water is the main component of blood plasma and many of the chemical reactions that produce the components of blood need water. The nutrients required for the production of blood are outlined in figure 3.26. UNIT 1 • The health and development of Australia’s youth 100 1 July 2015 7:54 PM Protein Main building material for blood components and also forms the ‘globin’ part of haemoglobin FS Vitamin C Assists in iron absorption PR O O Fats Required for the formation of cell membranes E Plasma 55% PA G Vitamin A Required for cell division Red blood cells 44% EC TE D Iron Required for ‘haem’ part of haemoglobin production Water The main component of blood FIgUrE 3.26 The components of blood and the nutrients required for blood production U N C O R R B6, folate and B12 Required for DNA synthesis and red blood cell formation White blood cells 1% Formation of soft tissue Soft tissue includes skin, muscles, tendons, ligaments, collagen and organs. They are categorised as soft tissue because they are soft compared to the other tissues that make up the human body (hard tissue). The development of soft tissue needs many nutrients for maintenance throughout the lifespan but, when the size of the soft tissue expands during times of growth, greater amounts of nutrients are needed. These nutrients are summarised in figure 3.27. Protein is the main building material for soft tissue, as it is for all body cells. Protein is broken down into amino acids through the process of digestion and then rebuilt into protein required by the body. This process requires the nutrient folate. Nutrition during youth • CHAPTEr 3 c03NutritionDuringYouth 101 101 1 July 2015 7:54 PM 3.4 The interrelationship of major nutrients Protein Main building material O FS Folate Promotes cell division and tissue growth E Muscles TE D PA G Fats Maintains and develops cell membranes PR O Vitamin C Forms connective tissue R R EC Vitamin A Required for cell division Water Medium for chemical reactions and present in soft tissue cells Organs Tendons Ligaments Skin U N C O FIgUrE 3.27 The nutrients required for soft tissue formation Vitamin C plays an important role in the process of soft tissue development by providing collagen. Collagen is like glue for the body’s cells and tissues, holding them together and giving them structure. Fats are required for the maintenance and development of cell membranes, which are the outer layer of all human cells. When soft tissues grow, more cells are created, thus increasing the need for fats. Vitamin A is required for cell division. It is therefore required for the generation of new soft tissue cells. Formation of hard tissue Hard tissue includes bones, teeth and cartilage, which contain minerals and vitamins. Hard tissue can break if it is not strong enough. 102 c03NutritionDuringYouth UNIT 1 • The health and development of Australia’s youth 102 1 July 2015 7:54 PM The body cannot store all of the nutrients needed to make hard tissue, so these nutrients are required throughout the lifespan. They are needed in greater amounts during periods of growth such as during youth. The nutrients required for hard tissue development are summarised in figure 3.28. O FS Protein Main building material PR O Vitamin C Forms connective tissue PA G E Vitamin A Required for cell division TE D Calcium Works with phosphorus (another mineral) to produce the hardening material for hard tissues EC Vitamin D Required for the absorption of calcium Teeth Cartilage R Bones R FIgUrE 3.28 The nutrients required for hard tissue formation U N C O Protein, vitamin C and vitamin A play similar roles in hard tissue development as they do in soft tissue development. Protein is the main building material for hard tissue development and, with vitamin C, forms collagen, which is the main component of the bone matrix (sometimes referred to as the collagen matrix). The bone matrix is like a framework for the bone structure. On its own, the bone matrix is spongy and would not support the weight of a person, but it provides the shape of the bone and allows the hardening agents to provide the structure with strength. Once the bone matrix has formed, calcium and phosphorus bind together to form calcium phosphorus, the hardening agent for the bone matrix. Crystals of calcium phosphate attach to the matrix, making the tissue strong and hard. This process is known as ossification. Ossification is much like dipping a sponge into a bucket of plaster. The once-soft sponge maintains its shape but becomes very hard as the plaster dries. The matrix is like the sponge and the calcium phosphate is like the plaster. They are both needed for adequate bone formation (figure 3.29). Vitamin D assists the absorption of calcium in the small intestine. A lack of this vitamin can result in weak bones. Calcium phosphate Bone matrix FIgUrE 3.29 The bone matrix provides the form of the bone and calcium phosphate provides the strength. Nutrition during youth • CHAPTEr 3 c03NutritionDuringYouth 103 103 1 July 2015 7:54 PM 3.4 The interrelationship of major nutrients The 24-hour intake of food and drink for Chris, a 17-year-old male, is shown below. • 2 fried eggs on white toast with 2 tsp of butter • 175 g yogurt • 250 mL orange juice • 1 sausage roll • 500 mL water • 1 Big Mac • 1 small serving French fries 375 mL cola 1 apple 300 mL water 2 slices of leftover pizza 1 medium T-bone steak 200 g potatoes 1 carrot 1 banana 250 mL apple juice 2 scoops of vanilla ice-cream O • • • • • • • • • • PR O Energy FS Case study Case study review C O R R EC TE D PA G E 1 Using table 3.3, calculate the total energy intake for Chris. 2 Chris weighs 70 kilograms, has a BMR of around 7200 kJ/day and uses around 1200 kJ/day for digestion. Using table 3.1, calculate the extra energy that Chris will expend by engaging in each of the activities below in one day. You will need to multiply the amount of energy the activity uses (in kJ/kilogram/hour) by Chris’s weight (in kg) by the amount of time he performed the activity (in hours). An Excel spreadsheet can be used to do this. (a) Writing at school and at home for a combined total of four hours (b) Running around at football training for one hour (c) Sitting at home quietly for a total of five hours (d) Walking rapidly to and from school for a total of 30 minutes (e) Taking a one-hour driving lesson 3 Calculate the total energy requirement for Chris for this day. 4 Calculate the energy balance for Chris during this day (subtract the energy used from the energy consumed). 5 (a)If 37 000 kJ result in around one kilogram of excess weight, calculate how much weight Chris would lose/add if he maintained this intake and expenditure of energy for a full year. (b) Discuss how this weight gain/loss might affect Chris’s health and development. U N TEST your knowledge 1 (a)Which nutrients are required for more than one process in the body? (b) Do they play the same role in all processes? 2 (a)Design a silly sentence or acronym to remember the nutrients required for energy provision, blood production and hard and soft tissue formation. (b) Share your response with other students and decide on the best ones. APPLY your knowledge 3 Which lifespan stages would require higher amounts of the nutrients needed for each of the following processes? Explain each answer. (a) Energy provision (b) Blood production (c) Soft tissue formation (d) Hard tissue formation 4 In small groups, select one of the processes (hard tissue, soft tissue, energy or blood production) and design a poster, multimedia presentation or video that could be used to educate youth about the nutrients required for the process and examples of foods that may supply these nutrients. 5 Use the Bone mass links in the Resources section of your eBookPLUS to find the weblink and questions for this activity. 104 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 104 1 July 2015 7:54 PM 3.5 Consequences of nutritional imbalance TE D O PA G E PR O Youth is the third-fastest period of growth in the lifespan. During the adolescent growth spurt, the average female youth can expect to grow 16 centimetres in height and gain 16 kilograms in weight, and the average male youth can expect to grow 20 centimetres and put on 20 kilograms in weight. For this physical development to occur, all of the nutrients required for the four processes — soft and hard tissue formation and the production of energy and blood — must be eaten in appropriate proportions. When nutrient intake is balanced (figure 3.30), appropriate levels of nutrients are available to carry out these processes effectively and the development of youth is optimised. FS KEY CONCEPT Understanding the consequence of nutritional imbalance in a youth’s diet on short- and long-term health and individual human development EC FIgUrE 3.30 A balanced diet doesn’t mean eating the same amount of everything. U N C O R R The importance of food intake during youth is not limited to ensuring that optimal individual human development occurs. Balanced nutrient intake also plays a significant impact in promoting the health of youth. If the nutritional intake of youth is not balanced and nutrients are not consumed in appropriate proportions, the risk of a range of consequences for health and individual human development increases. These consequences can occur as a result of the over- or under-consumption of specific nutrients and can occur in both the short and long term. Short-term consequences The consumption of a variety of nutrients is required regularly to carry out various processes including the production of energy. If these nutrients are not present, or are in incorrect proportions, these processes may not occur effectively. Carbohydrates are broken down and the glucose molecules that result are absorbed into the bloodstream, from where they are taken into the cells and stored, ready for use. The amount of glucose contained within carbohydrate-rich foods, and how much such foods affect the levels of blood glucose, is measured using a system called the glycaemic index (GI). The glycaemic index rates foods from 1 to 100 based on how quickly they cause blood-glucose levels to rise. Foods that cause blood glucose to increase sharply are called high GI (with a score of more than 70) while those that have a more sustained impact on blood glucose are called low GI Nutrition during youth • CHAPTEr 3 c03NutritionDuringYouth 105 105 1 July 2015 7:54 PM 3.5 Consequences of nutritional imbalance (with a score less than 55). Those in-between these numbers are termed medium GI. Eating foods with a low GI rating gives a more sustained energy release and can therefore assist in carrying out the biological processes required during the day. In contrast, high GI foods give a quick rush of glucose that then drops off just as quickly (figure 3.31). As blood glucose levels decrease, hunger increases. As a result, high GI foods can contribute to overeating. In addition to carbohydrates, B-group vitamins and iron also contribute to the production of energy. If these nutrients are not 0 1 2 3 consumed on a regular basis, energy levels may decrease, impacting Time after meal (hours) physical health. Reduced energy levels also impact on an individual in many ways such as not having the energy to: Figure 3.31 The effect on blood • socialise — which impacts social health glucose of high and low GI foods • exercise — affecting fitness, an aspect of physical health • concentrate at school — affecting intellectual development. Fibre is a type of carbohydrate made up of the indigestible parts of plant matter. Fibre assists in regulating bowel movements and providing feelings of fullness. Adequate fibre intake can reduce the risk of constipation and overeating in the short term. Fibre also reduces the absorption of glucose and cholesterol into the blood stream. This acts to decrease blood glucose and blood cholesterol levels in the short term. Water is essential for the optimal functioning of body systems throughout the lifespan. Dehydration can affect many processes within the body and contribute to a range of short-term impacts as a result. Common symptoms of dehydration include thirst, dry mouth, headaches, decreased blood pressure, dizziness, fainting, tiredness and constipation. In the most severe cases, dehydration can lead to unconsciousness and death. TE D PA G E PR O O FS Blood glucose level High GI Low Gl Figure 3.32 Foods like cakes, biscuits and donuts have a high GI that gives a quick rush of glucose. Long-term consequences U N C O R R EC As well as contributing to short-term consequences, nutrient imbalance is associated with many long-term consequences impacting on health and development, including dental caries; underweight, overweight and obesity; chronic conditions such as cardiovascular disease, colorectal cancer and osteoporosis; slowed growth; anaemia; and increased risk of infection. Sugars are a type of carbohydrate found naturally in some foods such as fruit and honey, and added to many processed foods such as cakes and soft drinks. As well as providing a fuel for energy production, sugars provide a food source for bacteria in the mouth. These bacteria produce acids which can contribute to dental decay and the development of dental caries. Dental caries can impact mental health as a result of reduced self-esteem if the individual’s appearance is altered. Intellectual development may also be affected if the individual misses school as a result of ongoing treatment. If left untreated, diseases such as periodontitis can occur. Periodontitis is a condition characterised by inflammation and infection of the tissues that support the teeth. In the long term, periodontitis can lead to the loosening and loss of teeth. Although required as a fuel for energy production, if eaten in excess, carbohydrates, fats and protein are stored as adipose (fat) tissue. Over time, this can lead to weight gain, overweight and/or obesity. The most immediate consequences of overweight and obesity in youth are social discrimination (associated with poor self-esteem and depression), negative body image and eating disorders. Overweight youth are more likely to develop sleep apnoea, have a reduced ability to exercise, and show early signs of metabolic consequences, such as hypertension, high blood glucose and high blood cholesterol. 106 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 106 1 July 2015 7:54 PM Overweight and obesity rates have been steadily increasing for youth over time (see figure 3.33). Overweight youth are more likely to be overweight or obese as adults, which increases the risk of a range of conditions including type 2 diabetes, cardiovascular disease, some cancers and arthritis. 30 Obese Overweight FS 25 O PR O Per cent 20 15 E 10 0 1985 1995 Males 2011–12 1995 Females 2011–12 TE D * Figures are for 12–17 years 1985 PA G 5 Figure 3.33 Prevalence of overweight and obesity among males and females aged 7–15 years, 1985, 1995 and 2011–12 EC Source: Adapted from Australian Institute of Health and Welfare 2004, Risk factor monitoring, a rising epidemic: obesity in Australian children and adolescents and ABS, Australian health survey: updated results, 2011–12. U N C O R R When consumed in excess, protein can reduce the ability of the body to absorb calcium. This can contribute to reduced bone density and osteoporosis later in life. Fibre provides feelings of fullness without contributing significantly to energy intake. As a result, adequate fibre intake can assist with weight management in the long term. It also assists with regulating bowel movements and has been linked to lower rates of colorectal cancer in the long term. Saturated and trans fat increase the process of atherosclerosis by increasing levels of low density lipoprotein (LDL) in the blood. Low density lipoprotein is a type of cholesterol that can stick to the walls of blood vessels which causes the blood vessels to narrow. This process can eventually restrict blood flow or stop it completely. Atherosclerosis is the underlying cause of many types of cardiovascular disease, including heart attack and stroke. Monounsaturated and polyunsaturated fats work to reduce levels of LDL cholesterol in the blood and can therefore assist in reducing the risk of cardiovascular disease in the long term. Like all fats, however, over-consumption can contribute to obesity and its associated effects. Although overweight and obesity are significant issues for youth, underweight is also a concern. Underweight often indicates undernourishment in which the nutrients required for optimal health and development are not present. Severe undernourishment, as occurs in many individuals with an eating disorder, can contribute to long-term developmental problems. Growth may be slowed as the nutrients required for hard tissue formation are not present. Although peak bone mass is not reached until early adulthood, bone density increases significantly during youth. Calcium, phosphorus and vitamin D are all essential nutrients for Nutrition during youth • CHAPTER 3 107 c03NutritionDuringYouth 107 1 July 2015 7:54 PM 3.5 Consequences of nutritional imbalance EC TE D PA G E PR O O FS this process. If intake is deficient in these nutrients, weakened bones may be the result. In many cases, this will develop into osteoporosis later in life. Soft tissues are constantly repaired and replaced, and nutritional balance is needed to ensure the nutrients required to carry out this process are present in appropriate levels. Protein, vitamin C, vitamin A, folate, fats and water are all required for the growth and repair of soft tissues. Without adequate amounts of these nutrients, muscles and organs may not develop to their full potential. As blood cells are produced constantly, adequate intake of the nutrients required to make blood, such as iron, folate and vitamin B12, are required to ensure the amount of blood produced meets the needs of the growing youth. Vitamin C is also important as it assists with iron absorption. If these nutrients are under-consumed, anaemia can occur. Anaemia is characterised by an inability of the blood to carry adequate oxygen around the body. Symptoms of anaemia include tiredness and weakness, so the youth might no longer be able to participate in daily activities. Anaemia may affect development by creating: • an inability to participate in the weight-bearing activities that are needed to increase bone density, which can result in reduced bone mass • an inability to participate in physical activity, which can impair motor skill development • insufficient energy to have a part-time job, which can affect social development such as learning the role of an employee • constant feelings of tiredness, which may generate a range of negative emotions such as helplessness and isolation. As well as providing energy and aiding in the formation of hard tissue, soft tissue and blood, nutrients are required to keep all bodily systems functioning correctly. The immune system, for example, requires a nutritional balance to function effectively. Protein and vitamin A are key nutrients in immune system function. If a person is deficient in protein or vitamin A, their immune system may not function correctly, increasing the risk of disease or infection. APPLY your knowledge 1 (a) Explain the glycaemic index. (b) Outline the consequences that a high GI diet can have on the health of youth. 2 (a)Discuss how nutritional imbalance may contribute to low energy levels. (b) Explain three ways in which this could impact on youth health and/or development. 3 Outline the role that fibre can play in optimising health in the short term. 4 (a)Explain how nutritional imbalance may contribute to dental health problems among youth. (b) Discuss how dental caries could impact on youth: i.health ii.development. 5 Explain anaemia. 6 Explain how carbohydrate, protein and fat intake can contribute to obesity. 7 Discuss how youth could reduce the risk of developing osteoporosis in later life. 8 Explain how being underweight could impact on youth health and development. 9 Discuss how anaemia could impact on youth health and development. 10 Design a poster or short video outlining the possible short- and long-term effects of nutritional imbalance among youth. U N C O R R TEST your knowledge 108 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 108 1 July 2015 7:54 PM 3.6 Food selection models as tools to promote healthy eating during youth KEY CONCEPT Understanding food selection models as tools to promote healthy eating during youth O PR O The Australian Dietary Guidelines and the Australian Guide to Healthy Eating FS To assist youth in consuming a balanced diet and reducing the risk of short- and long-term consequences associated with nutritional imbalance, a number of food selection models have been produced. Food selection models are tools that help youth to select foods that will meet their nutritional needs, without consuming too many energy dense foods. Examples include the Australian Guide to Healthy Eating and the Healthy Eating Pyramid. TE D PA G E The Australian Dietary Guidelines and the Australian Guide to Healthy Eating are federal government initiatives that provide nutrition advice with the aim of reducing the short- and long-term consequences associated with nutritional imbalance. The guidelines are targeted towards health professionals, including dietitians, nutritionists, general practitioners (GPs), nurses, educators, government policy makers, the food industry and other interested parties. Guidelines 2 and 3 provide advice on which foods should be consumed regularly and which ones should be consumed in moderation. GUIDELINE 2 O GUIDELINE 3 R R EC Enjoy a wide variety of nutritious foods from these five groups every day: • Plenty of vegetables, including different types and colours, and legumes/beans • Fruit • Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley • Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans • Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat And drink plenty of water. U N C Limit intake of foods containing saturated fat, added salt, added sugars and alcohol. a. Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks. • Replace high fat foods which contain predominantly saturated fats such as butter, cream, cooking margarine, coconut and palm oil with foods which contain predominantly polyunsaturated and monounsaturated fats such as oils, spreads, nut butters/pastes and avocado. b.Limit intake of foods and drinks containing added salt. • Read labels to choose lower sodium options among similar foods. • Do not add salt to foods in cooking or at the table. c. Limit intake of foods and drinks containing added sugars such as confectionary, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks. d.If you choose to drink alcohol, limit intake. Serving numbers and sizes from each of the five food groups and healthy fats and oils are included in the Australian Dietary Guidelines to assist youth in planning their daily food intake (table 3.4). Nutrition during youth • CHAPTER 3 109 c03NutritionDuringYouth 109 1 July 2015 7:54 PM 3.6 Food selection models as tools to promote healthy eating during youth Table 3.4 Australian Dietary Guidelines recommended serves from the five food groups for 12–18 year olds Recommended number of serves per day Age (years) Vegetables and legumes/ beans Fruit Grain (cereal) foods per day, mostly wholegrain and/or high cereal fibre varieties Lean meats, poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans Milk, yoghurt, cheese and/or alternatives mostly reduced fat 12–13 14–18 5½ 5½ 2 2 6 7 2½ 2½ 3½ 3½ Females 12–13 14–18 5 5 2 2 5 7 2½ 2½ 3½ 3½ Pregnant (up to 18 years) 5 2 8 3½ Breastfeeding (up to 18 years) 5½ 2 9 2½ FS Males O 3½ 4 PR O Note: Additional amounts of the Five Food Groups or unsaturated spreads and oils or discretionary food choices are needed only by people who are taller or more active to meet additional energy requirements. 14–18 2 12–13 1½ 14–18 2 Pregnant (up to 18 years) 2 Breastfeeding (up to 18 years) 2 C U N 75 g (½ cup) cooked green or Brassica or cruciferous vegetables 75 g (½ cup) cooked orange vegetables 75 g (½ cup) cooked dried or canned beans, chickpeas or lentils, no added salt 75 g (1 cup) raw green leafy vegetables 75 g starchy vegetables (e.g. ½ medium potato, or equivalent of sweet potato, taro, sweet corn or cassava) EC 1½ O Girls 12–13 Fruit R Boys Vegetables and legumes/beans 75 g other vegetables, e.g. 1 medium tomato 150 g (1 piece) of medium-sized fruit, e.g. apple, banana, orange, pear 150 g (2 pieces) of small fruit, e.g. apricots, kiwi fruit, plums 150 g (1 cup) diced, cooked or canned fruit 125 mL (½ cup) 100% fruit juice Grain (cereal) foods per day, mostly wholegrain and/ or high cereal fibre varieties 1 slice of bread or ½ a medium roll or flat bread (40 g) R Age (years) Unsaturated spreads and oils per day Table 3.6 Examples of single serves TE D Table 3.5 Australian Dietary Guidelines recommended fat intake for youth PA G E Fats play an important part in many processes such as the development of cell membranes, fuel for energy production and regulation of cholesterol. Unsaturated fats are the healthiest options and should be included in the food intake of youth. The amount of unsaturated fats recommended by the guidelines for youth are shown in table 3.5. Information is also included in the guidelines to provide youth with examples of foods that make up a single serve (table 3.6). 30 g dried fruit, e.g. 4 dried apricot halves, 1½ tablespoons of sultanas ½ cup cooked rice, pasta, noodles, barley, buckwheat, semolina, polenta, bulgur or quinoa (75–120 g) ½ cup cooked porridge (120 g), 2/3 cup wheat cereal flakes (30 g) or ¼ cup muesli (30 g) 3 crispbreads (35 g) 1 crumpet (60 g) or 1 small English muffin or scone (35 g) ¼ cup flour (30 g) Lean meats, poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans 65 g cooked lean red meats (e.g. beef, lamb, pork, venison or kangaroo) or ½ cup of lean mince, 2 small chops, 2 slices of roast meat (about 90–100 g raw weight) 80 g cooked poultry (about 100 g raw weight) e.g. chicken, turkey 100 g cooked fish fillet (about 115 g raw weight) or 1 small can of fish, no added salt, not in brine 2 large eggs (120 g) 1 cup (150 g) cooked dried beans, lentils, chickpeas, split peas, or canned beans 170 g tofu 30 g nuts or seeds or nut/seed paste, no added salt* 110 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 110 1 July 2015 7:54 PM Milk, yoghurt, cheese and/ or alternatives, mostly reduced fat 1 cup (250 mL) milk — fresh, UHT long life or reconstituted powdered 1/2 cup (120 mL) evaporated unsweetened milk 3/4 cup (200 g) yoghurt 40 g (2 slices or 4 x 3 x 2 cm piece) hard cheese, e.g. cheddar 1/2 cup (120 g) ricotta cheese 1 cup (250 mL) soy, rice or other cereal drink with at least 100 mg of added calcium per 100 mL FS 10 g polyunsaturated spread 10 g monounsaturated spread 10 g tree nuts, peanuts or nut pastes/butters 7 g polyunsaturated oil, e.g. olive or canola oil PR O O Unsaturated spreads and oils per day U N C O R R EC TE D PA G E The Australian Guide to Healthy Eating is a food selection model that provides a visual representation of guidelines 2 and 3 from the Australian Dietary Guidelines. Presented in poster form (see figure 3.34), the main section of the Australian Guide to Healthy Eating is a pie chart that shows the proportions of foods that should be consumed from each of the five food groups according to Australian Dietary Guideline number 2 — vegetables, fruit, grain, lean meats (or alternatives), and milk, yoghurt and cheese products. Grain foods such as bread, cereal, rice and pasta should account for around 30–35 per cent of total daily food intake. These foods are high in carbohydrates, which provide fuel for energy production, and high in fibre, which assists with weight management and maintains digestive health. Vegetables and legumes/beans are the second biggest section and should account for around 30 per cent of daily food intake. These foods include fresh, frozen and tinned vegetables, legumes such as lentils and chickpeas, and beans such as kidney beans. These foods are high in vitamins and minerals, which assist in promoting optimal health and development among youth. They are also high in fibre and low in energy, which can assist with weight management. Meats and meat alternatives should account for around 15 per cent of total food intake. These foods provide much of the protein that is required for the development of hard tissues, soft tissue, energy and blood. They also contain iron and vitamin B12, which are required for the production of red blood cells. Although fruit contains many of the vitamins and minerals required for optimal health, it can also contain high amounts of high GI carbohydrates that can contribute to weight gain if not used for energy. As a result, fruit should make up around 10–12 per cent of total food intake. Milk and other dairy products should also account for around 10–12 per cent of total food intake. These foods are rich in calcium and are required for optimal bone development. The Australian Guide to Healthy Eating recommends that people consume plenty of water, represented in the poster by a glass being filled from a tap. Water is required for many body processes but does not contribute any energy and so can assist in maintaining healthy body weight. The healthier fats are shown in the bottom left corner of the Australian Guide to Healthy Eating poster and include foods such as margarine and canola spray. These foods contain monounsaturated and/or polyunsaturated fats and can assist in reducing the risk of cardiovascular disease. Figure 3.34 The Australian Guide to Healthy Eating Nutrition during youth • CHAPTER 3 111 c03NutritionDuringYouth 111 1 July 2015 7:54 PM 3.6 Food selection models as tools to promote healthy eating during youth O FS Discretionary foods are shown in the bottom right corner of the Australian Guide to Healthy Eating poster and consumers are advised to use these foods only sometimes and in small amounts. They are not necessary to provide the nutrients the body needs, but may add variety. Many of these foods are high in saturated fats, sugars, salt and/or alcohol, and are therefore described as energy dense. Examples of discretionary foods include pies and other pastries, cakes, processed meats, soft and sports drinks, cordial, alcohol, potato chips, chocolate and biscuits. With the information provided by the Australian Dietary Guidelines and the Australian Guide to Healthy Eating, it is possible to evaluate the daily food intake of an individual. PR O Applying the Australian Dietary Guidelines and the Australian Guide to Healthy Eating TE D PA G E If the food and drinks consumed in a 24-hour period are recorded, it is possible to evaluate that particular day’s intake against the recommended number of serves within the Australian Dietary Guidelines. This information can then give some indication as to the adequacy of both the amount of food consumed and the proportion of different food groups consumed. It is important to remember that individual differences exist and the foods eaten in a 24-hour period do not necessarily reflect overall dietary patterns. The following foods were consumed by Scott, a 16-year old male, in a 24-hour period: Table 3.7 Scott’s food consumption for one day Morning tea Lunch Afternoon tea Bowl of wheat flake cereal (60 g) with full-cream milk (1 cup). ¾ cup of yoghurt 1 medium roll with salad (75 g total) Cooked pasta dish (1½ cups of cooked pasta) 3 slices of roast meat 75 g mashed potato 2 slices of bread with monounsaturated margarine (20 g total) 75 g of cooked peas 75 g of cooked carrots 2 slices of toast with monounsaturated margarine (20 g), and 2 slices of cheese Small can of tuna 1 vanilla slice Milkshake (3 cups of full cream milk, chocolate topping) Fruit salad (150 g) 250 mL freshly squeezed orange juice 1 can of soft drink Water 1 apple 250 mL pineapple juice U N C O R R EC Breakfast Dinner 1 banana These foods can be broken down into their parts in order to classify them into the five food groups. Creating a table like table 3.8 can be useful for doing this. Refer to table 3.6 to see how many serves are present in each food item. For example, the bowl of wheat cereal with milk would contribute two serves to the ‘grain’ group and one serve to the ‘milk’ group. Including a column for unsaturated fats and discretionary food items is important as, even though these foods are not considered a food group, they can have significant impacts on health. The breakdown for Scott’s 24-hour food intake is shown in table 3.8. 112 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 112 1 July 2015 7:54 PM Instead of having to write each food in the table (as was done in table 3.8), ticks or marks can be placed under each food group as you go through each item consumed (as shown in table 3.9). Table 3.8 Scott’s food consumption, broken down into the five food groups Grain (cereal) foods per day, mostly wholegrain and/ or high cereal fibre varieties Fruit Lean meats, poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans Milk, yoghurt, cheese and/or alternatives, mostly reduced fat Unsaturated spreads and oils margarine from toast salad from roll orange juice wheat flake cereal small can of tuna full-cream milk from cereal 2 mashed potato orange juice wheat flake cereal roast meat cheese slices from toast 3 peas banana toast roast meat (1/2 serve) yoghurt margarine from bread 4 carrots apple toast full-cream milk from milkshake margarine from bread 7 fruit salad pasta 9 pasta bread from dinner 11 bread from dinner Total serves 4 7 11 R Grain (cereal) foods per day, mostly wholegrain and/or high cereal fibre varieties 2½ Lean meats, poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans 6 Milk, yoghurt, cheese and/or alternatives, mostly reduced fat 4 3 Unsaturated spreads and oils Discretionary foods O R Fruit EC Table 3.9 Vegetables and legume/ beans full-cream milk from milkshake TE D 10 chocolate topping full-cream milk from milkshake pasta 8 PR O pineapple roll from lunch juice vanilla slice E 6 margarine from toast soft drink PA G pineapple roll from lunch juice O 1 5 Discretionary foods FS Vegetables and legume/ beans U N C In order to do this accurately, you need to know how much of each food group was in each item. If no amounts are given, you can base your judgements on what an average serve might be (but some accuracy will be sacrificed). You may be able to do this more accurately for foods that you have eaten yourself. Once the number of serves from each group has been estimated, they can be compared with the recommendations for someone of Scott’s age (males, 14–18, from table 3.4). Table 3.10 Scott’s intake compared to the recommended intake from the Australian Dietary Guidelines Vegetables and legume/ beans Fruit Grain (cereal) foods per day, mostly wholegrain and/or high cereal fibre varieties Lean meats, poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans Milk, yoghurt, cheese and/or alternatives, mostly reduced fat Unsaturated spreads and oils Discretionary foods Males 14–18 5½ 2 7 2½ 3½ 2 ‘Limit intake’ Scott’s intake 4 7 11 2½ 6 4 3 Nutrition during youth • CHAPTER 3 113 c03NutritionDuringYouth 113 1 July 2015 7:54 PM 3.6 Food selection models as tools to promote healthy eating during youth PA G E PR O O FS Although Scott’s diet is varied, he may be consuming too many of some food groups. Some specific observations include: • he ate adequate amounts from the meat group • he consumed only 4 serves of vegetables and should be consuming 5½ • he consumed 7 serves of fruit and should be consuming 2 serves • he consumed 11 serves from the grain group, which is 4 serves above the recommended amount • he consumed 6 serves of dairy foods instead of the recommended 3½ serves • he consumed more unsaturated fats than recommended for someone his age • he may be consuming too many ‘discretionary’ foods. Some advice regarding Scott’s diet could include: • ensure that the amount of foods from the meat group is not decreased • increase the amount of vegetables consumed • reduce the amount of fruit being consumed — even though fruit contains many important nutrients, it also has a relatively high amount of natural sugar, which adds to the total kilojoules • drink water instead of fruit juice in the morning and with dinner • replace soft drink with a glass of water • replace the vanilla slice at lunch with carrot and celery sticks • replace the discretionary food items with healthier alternatives. U N C O R R EC TE D The Healthy Eating Pyramid FIgUrE 3.35 The Healthy Eating Pyramid © The Australian Nutrition Foundation Inc. 114 c03NutritionDuringYouth The Healthy Eating Pyramid was developed by Nutrition Australia, a nongovernment organisation. Based on the Australian Dietary Guidelines, the pyramid represents foods from the five basic food groups and arranges them into four levels, indicating the proportion of different types of food that should be consumed (see figure 3.35). The Healthy Eating Pyramid promotes youth health and development by encouraging food variety and a diet with minimal fat, adequate fibre, limited salt and sufficient water. The ‘foundation’ layers (the bottom two layers) contain food of plant origin: vegetables and legumes, fruits and grains. These foods should make up the majority of any meal. These foods are nutrient dense and low in fat. They assist in providing youth with optimal amounts of carbohydrates, fibre, vitamins and minerals. The middle layer includes the milk, yoghurt, cheese (and alternatives) and lean meat, poultry, fish, eggs, nuts, seeds and legumes food groups. These foods provide protein, minerals (particularly calcium and iron) and B-group vitamins. The top layer presents foods that contain monounsaturated and polyunsaturated fats, which youth should consume in small amounts to support heart health and brain function. Health benefits can occur when consumers choose foods that contain these healthier fats instead of foods that contain saturated fats and trans fats. UNIT 1 • The health and development of Australia’s youth 114 1 July 2015 7:54 PM O FS The pyramid encourages individuals to drink water because it provides the best source of hydration for the body without adding extra sugar and therefore energy to the diet. It also recommends that salt intake should be limited. Salt is a rich source of sodium, which is an essential nutrient, but many Australians consume excess amounts and this can contribute to hypertension. The Health Eating Pyramid provides youth with a simple visual tool that promotes healthy food intake. However, serving sizes and provisions for composite foods (such as pizza or casserole) are not included, and this may make following the model difficult. Consider the following food intake of Dallas, a 13-year-old female. Snack: 1 banana 1 glass of water PA G Breakfast: Lunch: A toasted sandwich (2 pieces of bread, 2 slices of cheese, 10 g of monounsaturated margarine) 1 can of soft drink E Food intake PR O Case study Snack: 1 small carton of yoghurt (200 g) 3 tablespoons of sultanas Dinner: ½ cup of cooked rice with 65 g of cooked beef, 1 cup of cooked vegetables and 7 g of olive oil 1 cup of fruit salad EC Case study review TE D 2 pieces of toast with 10 g of monounsaturated margarine 1 cup of orange juice U N C O R R 1 Complete a table similar to table 3.8 for Dallas’ food intake. 2 Compare Dallas’ intake to the guidelines given in tables 3.4 to 3.6. 3 (a)Of which food groups did Dallas consume the optimal amount? (b) Explain how consuming an optimal amount of these foods might promote Dallas’ health. 4 (a)Which food groups did Dallas not consume enough of? (b) Explain how not consuming enough of these foods might affect Dallas’ health. 5 (a)Of which food groups did Dallas consume too much? (b) Explain how consuming too much of these foods might affect Dallas’ health. 6 Why might it be more accurate to assess food intake over three days instead of only one? 7 Explain the changes Dallas could make to her diet to more closely reflect the recommendations of the Australian Guide to Healthy Eating and the Australian Dietary Guidelines. TEST your knowledge APPLY your knowledge 1 Explain what is meant by a ‘food selection model’. 2 Identify two food selection models that can be used by youth to promote health and individual human development. 3 Explain the similarities and differences between the Australian Guide to Healthy Eating and the Healthy Eating Pyramid. Nutrition during youth • CHAPTER 3 115 c03NutritionDuringYouth 115 1 July 2015 7:54 PM 3.6 Food selection models as tools to promote healthy eating during youth PR O O FS (b) Prepare an analysis of your intake. Be sure to include the following: i.Identify food groups where intake was adequate. ii.Identify food groups where consumption was deficient. iii.Identify food groups where consumption was excessive. iv.Discuss the possible short- and long-term consequences of your diet if it continued over time. v.Suggest changes that could be made to minimise the risk of any short- or long-term consequences identified in part iv. (c) i.Discuss any difficulties you had in classifying each food item. ii.Explain how these challenges could be overcome. U N C O R R EC TE D PA G E 4 (a)Identify the five food groups identified in the Australian Guide to Healthy Eating. (b) Identify the key nutrients provided by each group. (c) Explain how these nutrients can impact on youth health and development. 5 Outline the short- and long-term consequences that may occur for Scott if he continues consuming the foods shown in table 3.7 on a daily basis. 6 Describe how one of the food selection models discussed in this chapter could promote healthy eating among youth. 7 Explain how the Australian Guide to Healthy Eating could reduce the short- or long-term consequences of nutritional imbalance among youth. 8 Record your own food and drink intake over a 24-hour period. (a) Estimate the number of serves consumed from each food group using a similar method to that outlined in table 3.8. 116 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 116 1 July 2015 7:54 PM KEY SKILLS Nutrition during youth KEY SKILL Explain the functions of major nutrients for the production of hard tissue, soft tissue, blood tissue and energy during youth FIgUrE 3.36 How energy is produced in the body + O PR O + Iron — forms a part of haemoglobin, essential for carrying oxygen around the body Water — transports the Bgroup vitamins and is also required for chemical reactions to take place = Energy production E + B-group vitamins — allow the release of energy PA G Carbohydrates, fats and protein — provide the fuel for energy FS This key skill requires knowledge of the nutrients needed to carry out different functions in the body, namely the development of hard and soft tissue, blood production and the provision of energy. As well as knowing which nutrients are required for these processes, knowledge of the role each one plays is essential. Visual tools such as concept maps, flow charts and equation diagrams can be used to consolidate this information. The following example relates to the production of energy: R EC TE D In the following example, the nutrients required to produce bone (a hard tissue) and the role each plays are outlined: Protein❶: the main building material for hard tissue. Protein binds with vitamin C to produce the collagen matrix, the outline for hard tissues.❷ Vitamin C: binds with protein to form the collagen matrix. Vitamin A: assists in the division of the new cells needed by both the collagen matrix and the hardening materials. Calcium and phosphorus: bind together to form calcium phosphate, the hardening material for bones. Vitamin D: assists in the absorption of calcium in the small intestine. A lack of this vitamin can result in weak bones.❸ ❶ The nutrient is named. ❷ The function of the nutrient is outlined and its role in the development of hard tissue is identified. ❸ The roles of a range of nutrients required for hard tissue development are discussed. R PrACTISE the key skills U N C O 1 Devise a summary diagram outlining the roles of the major nutrients required for soft tissue production. 2 Discuss the roles of the nutrients required for blood production. KEY SKILL Explain the possible consequences of nutritional imbalance in a youth’s diet on short- and long-term health and individual human development Each nutrient has a role to play in the body, but both under- and over-consumption of nutrients can contribute to a range of short- and long-term consequences for youth. It is important to understand the effect that too little, or too much, of each nutrient can have on the body. By understanding the role of the nutrients, predictions can be made about the likely consequences on health and development. Most of the short-term effects will be on physical health and development; it will then be possible to predict the potential impact of these effects on the other areas of health and development. For example, insufficient carbohydrates (which are a Nutrition during youth • CHAPTEr 3 c03NutritionDuringYouth 117 117 1 July 2015 7:54 PM Key skills Nutrition during youth Possible short- and long-term consequences of over-consumption O Nutrient Possible short- and long-term consequences of underconsumption FS fuel for energy) could make an individual feel tired (physical health). Feeling tired can have other implications for health and development, such as not wanting to go to school (intellectual development and social health could be affected by this). Long-term consequences can occur in all areas of health and development, as a result of nutritional imbalance over an extended period of time. The role the nutrients play in these consequences must be understood. A summary table can be useful for brainstorming the possible short- and long-term consequences of nutrient imbalance. PR O Consider the following example, which discusses the possible short- and longterm consequences on the health and development of youth who consume a diet high in fibre. Fibre assists in the removal of waste products in the digestive tract and promotes regular bowel movements. In the short term❹, this can prevent constipation (physical health). If an individual is not constipated, they may be able to concentrate better at school, which can enhance intellectual development.❺ Fibre is made up of the indigestible parts of plant matter. As a result, fibre provides feelings of fullness without adding excess kilojoules. In the short term, this can prevent overeating. In the long term❻, this can assist with weight management and prevent the risk of overweight and obesity. Decreased risk of obesity can enhance self-esteem (mental health). Individuals of optimal body weight may be more able to exercise and promote fitness (physical health) and motor skill development (physical development). Fibre has also been shown to decrease the risk of colorectal cancer in the long term (physical health).❼ ❹ Short-term consequences are ❺ Possible consequences for development are included. ❻ Long-term consequences are also included. TE D ❼ Consequences on different areas PA G E addressed. of health and development are explored. 3 Explain the possible short-term consequences of a high-GI diet on youth health and development. 4 Explain the possible long-term consequences of a low-GI diet on youth health and development. 5 Explain the possible short- and long-term consequences on health and development for a youth consuming low levels of: (a)iron (b)calcium. U N C O R R EC PRACTISE the key skills KEY SKILL Explain how food models can be used as a tool to promote health In order to become proficient in this skill, knowledge of different food selection models is necessary. The Australian Guide to Healthy Eating and the Healthy Eating Pyramid are two food selection models that can be used by youth as tools to promote health. Understanding how they can be used is an important aspect of this skill. Using these tools to analyse and plan food intake can assist in developing a deeper understanding of each model. A typical scenario in which food selection models could be used to assist in promoting the health of youth is explored in the following case study. ‘Simon is a 16 year old who enjoys playing football. He recently made the representative side in his region and is now committed to training three nights a week and playing 118 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 118 1 July 2015 7:54 PM FS ❽ The food selection model is O identified. ❾ The food selection model is explained in greater detail. ❿ Key aspects of the Australian Guide to Healthy Eating are included. It is important to avoid being too general and to provide examples specific to Simon where possible. ⓫ Aspects of the model that may limit Simon’s ability to follow it are also discussed. ⓬ Ways of increasing Simon’s understanding of the model and so improve his diet. U N C O R R EC TE D PA G E PR O every Sunday. He also trains in the gym at school twice a week. He has been purchasing his lunch from the school canteen most days of the week and buys food from takeaway outlets on his way home from football training. Simon is unsure whether he is consuming all the foods he should be to provide the nutrients he needs to maintain optimal health and development’. To discuss a possible solution to Simon’s eating challenges, one approach might be to identify a food selection model, describe it, and then discuss how it could be used to assist Simon in consuming a healthy food intake. An initiative established to promote healthy eating is the Australian Guide to Healthy Eating.❽ The Australian Guide to Healthy Eating is a food selection model devised by the federal government. It is comprised of a poster that breaks the five food groups into the proportions in which they should be consumed on a daily basis. The largest section of the graph, and therefore the food group that should be consumed in the greatest proportion, is the grain group. This includes food items such as cereals, breads and rice. Around a third of all foods should come from this group. The next section is the vegetables and legumes/beans group. Around a third of all foods should come from this group. The third group is the lean meats and poultry, fish and eggs. Around one-seventh of all foods should come from this group. The fruit group and dairy products such as milk, yoghurt and cheese are the final two food groups. Each of these should account for around one-eighth of all foods consumed. The guide recommends drinking plenty of water, using only small amounts of healthy fats such as canola and olive oils, and limiting discretionary foods such as those containing alcohol or high levels of saturated fat, salt and/or sugar.❾ The Australian Guide to Healthy Eating can assist Simon in adopting a healthy diet, but some of his circumstances may reduce his ability to follow it closely. The guide is in graphical form, which might make it easier for Simon to understand it and make changes to his diet.❿ The Australian Guide to Healthy Eating does not include serving sizes, which might make it hard for Simon to consume adequate amounts from each food group.⓫ He would have to consult the Australian Dietary Guidelines to access this information. As Simon purchases a lot of his foods, he will have to learn to break composite foods down into their parts so he can classify them into one of the five food groups. He may be able to do this by keeping a food diary of all the food and drink he consumes. He can then take some time to practise breaking these items down to their primary components. If Simon gains an understanding of the components of different items available from the canteen and takeaway outlets, he may be able to choose foods that more closely reflect the proportions outlined in the guide.⓬ PRACTISE the key skills 6 Identify two similarities between the Australian Guide to Healthy Eating and the Healthy Eating Pyramid. 7 Obesity rates among youth in Australia have been steadily increasing over the past 20 years. Explain how the Healthy Eating Pyramid could be used to assist individuals in reducing their energy intake. 8 Jackie is 14 and has just become a vegetarian. Identify one food selection model and explain how it could assist Jackie in consuming foods that will provide her with the nutrients she needs to maintain optimal health and human development. Nutrition during youth • CHAPTER 3 119 c03NutritionDuringYouth 119 1 July 2015 7:54 PM CHAPTER 3 review Chapter summary • There are six categories of nutrients required for optimal health and individual human development; carbohydrates, protein, fats, water, vitamins and minerals. Interactivities: Chapter 3 crossword Searchlight ID: int-2895 • Youth require a balance of the six categories of nutrients in order to maintain optimal health and individual human development. Chapter 3 definitions Searchlight ID: int-2896 • Fibre is a type of carbohydrate that is indigestible. It has numerous health benefits, such as reducing hunger, and decreasing cholesterol and glucose absorption. This can assist in weight maintenance. Fibre also acts to clean the digestive system and reduce the chance of colorectal cancer later in life. O FS • The main function of carbohydrates is as an energy source. PR O • Protein is required for the growth, maintenance and repair of body cells and structures. It can also be used as an energy source. • The main function of fats is as a fuel for energy production. They are also a key component of cell membranes. • Monounsaturated and polyunsaturated fats are a better choice than saturated and trans fats because the latter increase the risk of cardiovascular disease. PA G E • Water is required for many body processes, including functioning as a medium for all chemical reactions in the body and forming an important part of blood and soft tissues. • Calcium is an important component of hard tissues and is required to achieve optimal peak bone mass. • Iron is required for haemoglobin in blood and a deficiency can lead to anaemia. • Vitamin A is required for cell division and cell differentiation. TE D • Vitamin D is required in order for calcium to be absorbed in the small intestine and therefore assists in building hard tissue. • Vitamin C is required for collagen production and assists with the absorption of iron. • The B-group vitamins are required to release energy from carbohydrate, protein and fat. • The key nutrients interact to produce energy, blood, hard tissue and soft tissue. EC • If energy intake and expenditure are not roughly the same, weight gain or loss will result. U N C O R R • Nutrient imbalance can result in a range of short- and long-term consequences for youth. • Short-term consequences include lack of energy, a spike in blood glucose levels, overeating and constipation. • Long-term consequences include dental caries, periodontitis, overweight and obesity, type 2 diabetes, cardiovascular disease, sleep apnoea, arthritis, osteoporosis, colorectal cancer, anaemia and increased risk of infection. • The short- and long-term consequences can impact on all areas of the health and development of the individual. • Food selection models can be used as tools to assist youth in preventing nutritional imbalance. • The Australian Guide to Healthy Eating presents the five food groups in the proportions in which they should be consumed. • The Healthy Eating Pyramid contains four layers relating to the proportions of different foods that should be consumed. 120 UNIT 1 • The health and development of Australia’s youth c03NutritionDuringYouth 120 1 July 2015 7:54 PM Food sources APPLY your knowledge U N C O R R EC TE D PA G 3 Prepare a booklet that outlines the considerations for youth food intake, with a focus on providing the nutrients required for the production of hard tissue, soft tissue, energy and blood. 4 Comment on the likely short- and long-term consequences that may occur if youth consume too much/too little of the key nutrients. FS Function/s O Nutrient PR O 1 What is the difference between macronutrients and micronutrients? 2 Draw up a table similar to the one below and complete it for each key nutrient. 5 Play a game of ‘nutrient celebrity head’. Three players are selected and assigned a nutrient each (the nutrient can be written above their head if they sit with their back to the whiteboard) but are not told which nutrient they have. They then take turns at asking questions. Each time the answer to the question is ‘no’, they lose their turn and the next player asks a question. Play continues until a correct guess is made. Incorrect guesses are counted as a ‘no’ and the player loses their turn. 6 (a)Conduct a survey of current nutritional intake and trends in your school. (b) Collate the results and comment on the nutritional adequacy of the sample group’s diet. (c) What are the possible short- and long-term consequences if these trends continue? (d) Use a food selection model to suggest changes that the students could make to improve their diet. E TEST your knowledge Nutrition during youth • CHAPTER 3 121 c03NutritionDuringYouth 121 1 July 2015 7:54 PM