Download HLTH 1050 Week 1

HLTH 1050
Week 1
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The science of foods and the nutrients and
other substances they contain and of their
actions within the body
◦ Including ingestion, digestion, absorption,
transport, metabolism and excretion.
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A broader definition includes the social,
economic, cultural, and psychological
implications of food and eating.
Source: Understanding Normal and Clinical Nutrition. S.R. Rolfes,
K. Pinna, and E. Whitney. Thomson Wadworth Publishers, 2009,
Eighth Edition
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Chemical substances obtained from food and
used in the body to
◦ Provide energy, structural materials, and regulating
agents to support growth, maintenance, and repair
of the body’s tissues.
◦ Nutrients may also reduce the risks of some
diseases
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Nutrients a person must obtain from food
because the body cannot make them for itself
in sufficient quantity to meet physiologic
needs.
Source: Understanding Normal and Clinical Nutrition. S.R. Rolfes, K.
Pinna, and E. Whitney. Thomson Wadworth Publishers, 2009, Eighth
Edition
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Nutrients for which specific biological
functions have been identified and which the
body cannot synthesize in sufficient
quantities to meet our biological needs.
Essential nutrients must be provided through
the diet.
Thompson JL, Manore MM, Vaughan LA. The Science of
Nutrition. Pearson Education, Inc. 2009.
Energy-Yielding
(Macronutrients)
(organic)
Non-EnergyYielding
(Micronutrient)
Carbohydrates
Vitamins
(organic)
Lipids (Fats)
Minerals
Protein
(inorganic)
Fluid
Water
(inorganic)
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Macronutrients: nutrients needed by the
body in large amounts (grams)
◦ Carbohydrates, protein, lipids
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Micronutrients: nutrients needed by the body
in small amounts (milligrams or micrograms)
◦ Vitamins and minerals
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Organic nutrients: contain carbon-to-carbon
or carbon-to-hydrogen bonds
◦ Carbohydrates, protein, lipids, vitamins
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Inorganic nutrients: do not contain carbon
◦ minerals
2010 U.S. Dietary Guidelines
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Calories are the units by which energy is
measured, however,
A ―calorie‖ is a very small unit of energy.
◦ Most foods contain tens of thousands of them.
◦ To ease calculations, energy is expressed in 1000metric units known as kilocalories or kcal.
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When popular books, magazines or food
labels state that a food provides ―100
calories‖, it actually means 100 kcalories.
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Also known as ―kcalorie‖ or ―kcal‖
One kilocalorie is the amount of heat
necessary to raise the temperature of 1
kilogram (kg) of water 1° C.
The scientific use of the term kcalorie is the
same as the popular use of the term calorie.
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A measure of energy that food provides
relative to the amount (weight) of food
Kcalories per gram of food
Examples
◦ Green beans (cooked from frozen) provide 0.26
kcal/gram
◦ French fries (typical fast food serving) provide 3.19
kcal/gram
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2010 U.S. Dietary Guidelines
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A measure of the nutrients a food provides
relative to the energy it provides. The more
nutrients and the fewer calories, the higher
the nutrient density. Low nutrient dense
foods supply calories but relatively small
amounts of micronutrients, sometimes none
at all.
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Nutrient-dense — or "nutritionally rich" —
foods include:
Brightly colored fruits and 100% fruit juices
Vibrant colored vegetables and potatoes
Whole, fortified and fiber-rich grain foods
Low-fat and fat-free milk, cheese and yogurt
Lean meat, poultry, fish, eggs, beans and
nuts
www.nutrientrichfoods.org
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Estimated Average Requirements
Recommended Dietary Allowances
Adequate Intakes
Tolerable Upper Limits
Estimated Energy
Requirements
Acceptable Macronutrient Distribution
Range
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Establishing Nutrient Recommendations
◦ Estimated Average Requirement (EAR)
 defines the requirement of a nutrient that
supports a specific function in the body for
half of the healthy population. Used to set the
RDA.
◦ Recommended Dietary Allowances (RDA)
 use the EAR as a base and include sufficient
daily amounts of nutrients to meet the known
nutrient needs of practically all healthy
populations. This recommendation considers
deficiencies.
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Establishing Nutrient Recommendations
◦ Adequate Intakes (AI)
 reflect the average daily amount of a nutrient
consumed by healthy people that appears to
be sufficient. More tentative than an RDA
because scientific evidence is lacking.
◦ Tolerable Upper Intake Level (UL)
 is a maximum daily amount of a nutrient that
appears safe for most healthy people and
beyond which there is an increased risk of
adverse health effects.
Estimates of energy & nutrient intakes
apply to healthy people
 Recommendations are NOT minimum
requirements
 Recommendations are NOT optimal
for all people
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Recommendations should be met by
consuming a varied diet
 Recommendations apply to average
daily intakes
 Each DRI category serves a unique
purpose
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DRI’s for vitamins & minerals (RDA & AI)
provide a generous ―margin of safety‖ and are
established to meet the needs of almost all
healthy people.
2010 U.S. Dietary Guidelines
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DRIs for energy (EER) do not provide this
―margin of safety‖. Because obesity is such a
public health concern, the standards are set
at the ―average‖ for the population group.
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Estimated Energy Requirement (EER)
◦ Represents average daily energy
intake to maintain energy balance
and good health for population
groups.
◦ Excess energy cannot be excreted, it
is stored as fat
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EER (kcal/day)
Different EER formulas for age, gender
PA = physical activity factor
Adult EER Formula:
 Men age 19 and older
 EER = [662 – (9.53 x age)] + PA x [(15.91 x wt) +
(539.6 x ht) (± 200 kcal for most men)
 Women age 19 and older
 EER = [354 – (6.91 x age)] + PA x [(9.36 x wt) +
(726 x ht)] (± 160 kcal for most women)
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Interactive DRI for Healthcare Professionals
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Enter gender
◦ Females – enter pregnancy status
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Enter age
◦ You have to check either years or months
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Enter height, weight, & select an activity level
Check ―Body mass index‖, ―Daily Calorie
Needs‖ and anything else you are interested
in
Click ―Submit‖ to get a personal report
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DRIs for carbohydrate and protein (RDA) are
established to prevent deficiencies of these
two macronutrients.
DRIs for energy nutrients (AMDRs) are set to
provide a balance of energy from
macronutrients that will reduce the risk of
chronic disease
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The AMDR for carbohydrate is set to ensure
appropriate balance between carbohydrate
and fat to reduce risks for coronary heart
disease and obesity
The RDA for protein for adults represents
about 10% of energy intake; the AMDR for
protein was set at 10-35% of energy intake to
complement the AMDRs for carbohydrate and
fat and to ensure a nutritionally adequate
diet.
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Acceptable Macronutrient Distribution
Range (AMDR)
◦ range of intakes for energy nutrients that
provide adequate energy and nutrients
and reduce risk of chronic disease.
Macronutrient
Carbohydrate
Fat
Protein
Recommended % of total kcal
45-65%
20-35%
10-35%
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First published in 1980
Shared responsibility
◦ United States Department of Agriculture (USDA)
◦ United States Department of Health and Human
Services
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Since 1990, the government is required, by
law, to review and update the Guidelines
every 5 years
Dietary Guidelines for Americans 2010 were
issues January 31, 2011
2010 U.S. Dietary Guidelines
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The Guidelines provide authoritative
advice for people two years and older
about how good dietary habits can
promote health and reduce risk for major
chronic diseases.
They serve as the basis for Federal food
and nutrition education programs.
http://www.health.gov/dietaryguidelines
2010 U.S. Dietary Guidelines
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Two overarching concepts
1. Maintain calorie balance over time to
achieve and maintain a healthy weight
2. Focus on consuming nutrient-dense
foods and beverages.
2010 U.S. Dietary Guidelines
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Balancing calories to manage weight
◦ Prevent and/or reduce overweight and obesity
through improved eating and physical activity
behaviors
◦ Control total calorie intake to manage body weight.
For people who are overweight or obese, this will
mean consuming fewer calories from food and
beverages
◦ Increase physical activity and reduce time spent in
sedentary activities
◦ Maintain appropriate calorie balance during each
stage of life – childhood, adolescence, adulthood,
pregnancy and breastfeeding, and older age.
2010 U.S. Dietary Guidelines
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Food and Food Components to Reduce
◦ Reduce daily sodium intake to less than 2,300
milligrams (mg) and further reduce intake to 1,500
mg among persons who are 51 and older and those
of any age who are African American or have
hypertension, diabetes, or chronic kidney disease.
◦ The 1,500 mg recommendation applies to about
half of the U.S. population, including children, and
the majority of adults.
2010 U.S. Dietary Guidelines
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Foods and Food Components to Reduce
◦ Consume less than 10 percent of calories from
saturated fatty acids by replacing them with
monounsaturated and polyunsaturated fatty acids
◦ Consume less than 300 mg per day of dietary
cholesterol
◦ Keep trans fatty acid consumption as low as
possible by limiting foods that contain synthetic
sources of trans fats, such as partially
hydrogenated oils, and limiting other solid fats
2010 U.S. Dietary Guidelines
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Foods and Food Components to Reduce
◦ Reduce the intake of calories from solid fats and
added sugars (SoFAS).
◦ Limit the consumption of foods that contain refined
grains, especially refined grain foods that contain
solid fats, added sugars, and sodium
◦ If alcohol is consumed, it should be consumed in
moderation – up to one drink per day for women
and two drinks per day for men – and only by adults
of legal drinking age
2010 U.S. Dietary Guidelines
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Food and Nutrients to Increase
◦ Increase vegetable and fruit intake
◦ Eat a variety of vegetables, especially dark green
and red and orange vegetables and beans and peas
◦ Consume at least half of all grains as whole grains.
Increase whole-grain intake by replacing refined
grains with whole grains
◦ Increase intake of fat-free or low-fat mik and milk
products, such as milk, yogurt, cheese, or fortified
soy beverages
2010 U.S. Dietary Guidelines
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Foods and Nutrients to Increase
◦ Choose a variety of protein foods, which include
seafood, lean meat and poultry, eggs, beans and
peas, soy products, and unsalted nuts and seeds
◦ Increase the amount and variety of seafood
consumed by choosing seafood in place of some
meat and poultry
◦ Replace protein foods that are higher in solid fats
with choices that are lower in solid fats and calories
and/or are sources of oils
2010 U.S. Dietary Guidelines
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Foods and Nutrients to Increase
◦ Use oils to replace solid fats where possible
◦ Choose foods that provide more potassium, dietary
fiber, calcium and vitamin D, which are nutrients of
concern in American diets. These foods include
vegetables, fruits, whole grains, and milk and milk
products.
2010 U.S. Dietary Guidelines
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Building Healthy Eating Patterns
◦ Select an eating pattern that meets nutrients needs
over time at an appropriate calorie level
◦ Account for all foods and beverages consumed and
assess how they fit within a total healthy eating
pattern
◦ Follow food safety recommendations when
preparing and eating foods to reduce the risk of
foodborne illnesses
2010 U.S. Dietary Guidelines
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Combination of foods & beverages that
constitute an individual’s complete dietary
intake over time, e.g., a description of a
customary way of eating
A combination of foods recommended for
eating, e.g.
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USDA Food Patterns
Dietary Approaches to Stop Hypertension (DASH)
Mediterranean diet
Vegetarian and vegan patterns
◦ Dietary Guidelines for Americans 2010
2010 U.S. Dietary Guidelines
Adequacy
Variety
Balance
Moderation
2010 U.S. Dietary Guidelines
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Adequacy
◦ Obtaining enough energy, vitamins, minerals, fiber,
and fluid to maintain a person’s health
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Balance
◦ Consuming a combination of foods that provide the
proper proportions of nutrients
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Moderation
◦ Eating the right amount of food to maintain a
healthy weight and optimize the body’s metabolic
processes
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Variety
◦ Eating many different foods from different foods
groups on a regular basis
2010 U.S. Dietary Guidelines
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http://choosemyplate.gov
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Tested in clinical trials - shown to lower blood
pressure, improve blood lipids, and reduce
cardiovascular risk compared to typical US
diets
Emphasizes vegetables, fruits, & low-fat milk &
milk products
Includes whole grains, poultry, seafood & nuts
Lower in sodium, red & processed meats,
sweets & sugar-containing beverages than
typical US diets
Dietary Guidelines for Americans 2010
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Traditional eating patterns throughout the
Mediterranean region, especially in Crete during
the 1960’s, are associated with a low risk of
cardiovascular diseases.
No one eating pattern and no single set of
criteria for what constitutes a traditional
Mediterranean eating pattern
Generally, it emphasizes vegetables, fruits &
nuts, olive oil & whole grains. It includes only
small amounts of meats and full fat milk & milk
products. It often includes wine with meals and
has a high mono-unsaturated fat to saturated fat
ratio
Dietary Guidelines for Americans 2010
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Vary widely
◦ Vegan diets – contain no animal products
◦ Lacto-ovo-vegetarian diets – no meat, fish or
poultry but do contain milk, milk products, and
eggs
◦ Some vegetarian diets contain mostly plant foods
with small amounts of meat, fish and/or poultry
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Associated with improved health outcomes
◦ Lower levels of obesity
◦ Reduced risk of cardiovascular diseases
◦ Lower total mortality
Dietary Guidelines for Americans 2010
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Make Your Calories Count - Use the Nutrition
Facts Label for Healthy Weight Management:
Preface
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The Ingredient List
◦ All ingredients listed
◦ Descending order of predominance by
weight
◦ Example – A can of Beef Stew: Ingredients:
Ingredients: Beef Gravy (Water, Beef, Tomatoes [Water, Tomato
Paste], Corn Flour, Salt, Modified Cornstarch, Caramel Color,
Sugar, Flavoring), Potatoes, Beef, Carrots.
 The ingredient present in the largest amount
by weight is beef gravy.
 The ingredient present in almost the least
amount by weight is beef. (Only carrots are
present in a smaller amount.
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Serving Sizes
◦ Facilitate comparisons among foods
◦ Do not necessarily match the USDA Food
Guide
◦ Established by FDA for some foods, e.g,
ice cream (1/2 cup); beverages (8 fluid
ounces)
◦ Need to compare to quantity of food
actually eaten
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Nutrition Facts panel
◦ Listed by quantity and percentage of
standards per serving, called Daily Values
◦ Daily Values (DV) reference values developed
by the FDA specifically for use on food labels
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Calories*
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Fat
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Cholesterol
Sodium
Carbohydrate
◦ listed as total calories and calories from fat
◦ listed by total fat, saturated fat, and trans fat
◦ listed by total carbohydrate, starch, sugars, and fiber
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Protein
Vitamin A, vitamin C, iron, and calcium & other
micronutrients
are listed in % DV only.
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*Remember ―calories‖ are actually kcalories!
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The Daily Values (DV)
◦ Estimate of an individual food’s
contribution to a total diet
◦ Based on 2000-kcalorie diet
◦ Help consumers compare foods
◦ Special Note: The DV on most food labels is for individuals
4 years of age and older. There is also a DV for infants and
children younger than 4 years which is used for foods
specifically intended for infants and very young children.
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Three types of claims allowed on a food label
◦ Nutrient claims – statements that characterize the
quantity of a nutrient in a food; FDA regulations
place some restrictions on how these claims can be
made to prevent confusion for or intentional
misleading of consumers
◦ Health claims – statements that characterize the
relationship between a nutrient or other substance
in a food and a disease or health-related condition;
FDA requires label disclaimers when evidence for
the claim is limited or not conclusive.
Manufacturers won the right to make these claims,
with the disclaimers, in court decisions upholding
their right to ―free speech‖.
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Nutrient Claims
◦ Must meet FDA definitions and include
conditions of use
◦ No implied claims
 E.g., claims that a product ―contains no oil‖
which implies it is fat free, can only be made
for a product that is truly fat free.
◦ Energy terms include
 ―kcalorie-free‖ ( < 5 kcal/serving)
 ―low kcalorie‖ (40 kcal or less/serving)
 ―reduced kcalorie‖ (25% fewer kcal/serving
than the comparison food)
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Nutrient Claims
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General terms include
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―free‖ (synonyms include: ―without‖, ―no‖,
―zero‖)
―good source of‖ (10-19% of DV for a given
nutrient/serving
―healthy‖ (low in fat, saturate fat, cholesterol &
sodium, and contains at least 10% DV/serving
for Vitamin A, Vitamin C, iron, calcium, protein,
or fiber,
―high‖ (20% or more of DV for a given
nutrient/serving; synonyms: ―rich in‖,
―excellent source of‖)
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Nutrient Claims
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―less‖ (at least 25% less of a given nutrient or
kcalories than the comparison food; synonyms
include ―fewer‖ and ―reduced‖)
―light‖ or ―lite‖ (1/3 fewer kcalories OR 50% or
less of the fat or sodium of the comparison
product. Any other use must define what it
refers to, e.g., ―light in color‖, ―lite in texture‖.
―low‖ (synonyms ―few‖, ―low source of‖)
―more‖ (at least 10% more of the DV for a given
nutrient than the comparison product)
―organic‖ (95% of food’s ingredients grown &
processed according to USDA regulations for
―organic‖ labeling).
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Health Claims
◦ ―A‖ List Heath Claims – Significant scientific
agreement- these claims do not require disclaimers
◦ ―B‖ List Health Claims – There is evidence
supporting the claim but the evidence is not
conclusive
◦ ―C‖ List Health Claims – Evidence is limited and not
conclusive
◦ ―D‖ List Health Claims – there is little scientific
evidence supporting the claim
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Structure-Function Claims
◦ Claims made without FDA approval
◦ Cannot make statements about diseases
◦ May be confusing or deceptively similar to
health claims
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Food Allergen Labeling and Consumer
Protection Act (FALCPA)
◦ Went into effect January 2006
◦ Requires food manufactures to
 Declare the top 8 food allergens
 Declare allergens in colors, flavors & spices
 Describe allergens in simple terms (milk vs
casein)
 List specific food products (i.e., almonds, cod
or shrimp vs nuts or fish)
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Eight top allergens required to be
declared on food labels
◦ Milk
◦ Eggs
◦ Peanuts
◦ Tree nuts
◦ Fish
◦ Shellfish
◦ Wheat
◦ Soy
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FALCPA Requirement
◦ You may see the following on a food label
 Ammonium caseinate (milk), semolina (wheat),
stone ground corn, maltodextrin… OR
 Ammonium caseinate, semolina, stone ground
corn, maltodextrin. Contains milk and wheat.
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Voluntary Information
◦ You may see the following on a food label
 May contain traces of…
 Manufactured on shared equipment with….
 Manufactured on a line that
produces…products
 Manufactured in a facility that uses….
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Statements such as ―may contain‖ are
voluntary. There are no laws, regulations or
guidelines for the use of these statements.
Some manufacturers provide this information
to alert you to possible allergens in a product;
do not ignore them.
Information adapted from:
◦ Food Allergy News, April-May, 2007, pg 4
◦ Published by the Food Allergy & Anaphylaxis Network
(FAAN)
◦ Web site: www.foodallergy.org
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Enrichment: adding nutrients to a food that
were lost during processing so that the food
will meet a specified standard.
Fortification: adding nutrients to a food that
were not originally present or were present in
insignificant amounts. Can be used to
prevent a widespread nutrient deficiency or to
balance the total nutrient profile of a food.
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In the early 1900’s, refining & milling of
grains & removing the bran & germ caused
a loss of many nutrients.
◦ Nutrient deficiency diseases such as beriberi and
pellegra (Chapter 10) were prevalent in many
areas.
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In the1940’s the US government mandated
enrichment of bread & cereal products
made from milled grains that crossed state
lines
◦ thiamine, riboflavin & niacin were added;
◦ iron was also added.
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In 1998, the FDA required all enriched
bread, flour, corn meal, pasta, rice and
other grain products must be fortified with
folic acid as well. This was done to prevent
neural tube defects (a birth defect).
◦ Legislation passed in 1996
◦ Fortification mandated in 1998
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Production of highly refined grain products
also removes fiber, Vitamin B6, magnesium
and zinc.
Enrichment does not replace these
nutrients.
For this reason, whole grains are still a vital
part of a healthy diet.