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THE BASIS OF A HEALTHY DIET
CHAPTER OVERVIEW
Included in the “Nutrition Basics” section of the text, this chapter introduces keys to healthful diet
planning, nutrient needs and labeling standards, and tools that can facilitate meal planning. The Dietary
Reference Intakes (DRIs), nutrient recommendations developed by the Food and Nutrition Board of the
National Academy of Sciences, include four sets of standards: Estimated Average Requirements (EARs),
Recommended Dietary Allowances (RDAs), Adequate Intakes (AIs), and Tolerable Upper Intake Levels
(Uls). Learners next explore food labeling standards and several dietary planning tools, including The
Food Guide Pyramid, The Dietary Guidelines for Americans, food labeling (Nutrition Facts panel, health
claims), and The Exchange System. The chapter concludes with the Nutrition Perspective entitled, “Ethnic
Influences on the American Diet.”
CHAPTER OBJECTIVES
By the end of this chapter, the student should be able to:
1.
Identify the three components of a healthful diet.
2.
Understand the concept of nutrient density.
3.
State the four sets of dietary standards of the DRIs and define each.
4.
Read and interpret the nutrition labels.
5.
Describe several dietary planning tools in menu planning.
6.
Plan daily menus using the Food Guide Pyramid and the Exchange System for various population
groups.
LECTURE NOTES
I.
A Food Philosophy that Works
A. Variety Contributes to Diet Adequacy
1. Phytochemicals –
a. Definition
b. Current Research
c. Food Sources
B. Balance Means Not Overconsuming Any One Food
1. Select foods from five major food groups:
a. Milk, yogurt, and cheese
b. Meat, poultry, fish, dry beans, eggs, and nuts
c. Vegetables
d. Fruit
e. Bread, cereal, rice and pasta
C. Moderation Refers Mostly to Portion Size
D. Nutrient Density Can Also Help Guide Food Choice
1. Definition
E. Energy Density Especially Influences Energy Intake
1. Definition
2. Influence on Satiety
II.
Setting Nutrient Needs – Dietary Reference Intakes (DRIs)
A. Estimated Average Requirements (EARs)
1. Definition
2. Role of Functional Markers
3. Limitation
B. Recommended Dietary Allowances (RDAs)
1. Definition
2. Vitamin C as an Example
a. Setting the RDA
b. Putting the RDA to Use
3. Setting RDAs for Energy Needs
C. Adequate Intakes (AIs)
1. Definition
D. Tolerable Upper Intake Levels (ULs)
1. Definition
2. Usage
E. Appropriate Uses of the DRIs
1. Diet Planning
III.
Daily Values (DVs): The Standards Used for Food Labeling
A. Definition of Daily Values
B. Reference Daily Intakes (RDIs)
1. For Vitamins and Minerals
2. How Set
C. Daily Reference Values (DRVs)
1. Dietary Components Covered
2. How Set
D. Daily Values in Perspective
IV.
From Nutrient Recommendations to Food Choices
A. The Food Guide Pyramid – A Menu Planning Tool
1. Components of the Food Guide Pyramid
a. 2 servings from milk, yogurt and cheese group
b. 2 to 3 servings from meat, poultry, fish, dry beans, eggs, and nuts group (5 to 7
ounces total)
c. 3 to 5 servings from the vegetable group
d. 2 to 4 servings from the fruit group
e. 6 to 11 servings from the bread, cereals, rice, and pasta group
2. Menu Planning with the Food Guide Pyramid
a. Foundations of a Healthful Diet
3. Evaluation of the Current American Diet Using the Food Guide Pyramid
a. Fruits/vegetables Underrepresented
b. Fats, Oils, and Sweets Overconsumed
4. Criticisms of the Food Guide Pyramid
a. Inappropriate for Lactose Intolerant People
V.
VI.
VII.
VII.
b. Whole Grains not Emphasized
c. Plant Fats Not Distinguished from Animal Fats
5. How Does Your Current Diet Rate?
B. Dietary Guidelines – Another Tool for Menu Planning
1. Published by USDA and DHHS
a. Aim for Fitness
b. Build a Healthy Base
c. Choose Sensibly
2. Practical Use to the Dietary Guidelines
a. Boost Vitamin/Mineral Intake
b. Reduce Chronic Disease Risks
3. The Dietary Guidelines and You
a. Consider Current Health and Family History
Expert Opinion: What Should I Eat to Live Longer?
What Do Food Labels Have to Offer in Diet Planning?
A. Requirements
B. Exceptions to Food Labeling
1. Produce
2. Meats
3. Protein
C. Health Claims on Food Labels
1. FDA Limits and Requirements
Exchange System: A Final Menu Planning Tool
A. Definition
B. Origin
C. Becoming Familiar with the Exchange System
1. Foods and Serving Sizes
2. Primarily Concerned with Macronutrients
D. Using the Exchange System to Develop Daily Menus
Ethnic Influences on the American Diet
A. Contributing Cultures
1. Native Americans
2. Hispanic-Americans
3. Northern European-Americans
4. African-Americans
5. Asian-Americans
6. Italian-Americans
B. Ethnic Diets and Present Trends
1. Eastern European Fare
2.
Southeast Asian Fare
ACTIVITIES, EXERCISES AND ASSIGNMENTS (Additional Activities in Text)
1.
With the dietary records collected in the previous assignment, ask students to analyze their food
intake by sorting individual foods into the various 5-food groups and comparing them to the Food
Guide Pyramid, using the textbook Take Action assignment on pages 58 and 59.
2.
If the menus do not meet the recommendations, the students should suggest foods and/or amounts to
meet the Food Guide Pyramid.
3.
Using one menu from the previous assignment, have students sort foods into the various Exchange
Lists and estimate kilocalories. Introduce students to Appendix A and complete the student
assignment for estimating a calorie count for 24 hour intake.
4.
Have students select one or more nutrition labels from a food product and compare the nutrients per
serving to their own nutritional needs.
5.
At this point in the course it will be necessary to explain the conversions of International Units to
retinol equivalents, milligrams, and micrograms.
6.
Compare and contrast the four Dietary Reference Intake standards. Have students understand the
definitions and applicability of EARs, RDAs, AIs and ULs.
7.
Have students bring a food label and complete the student assignment for reading food labels.
8.
Choosing a healthy diet when dining out can be difficult. Allow students to discover the nutritional
value of a favorite meal at a fast food restaurant by completing the student assignment on fast food.
Using FoodWorks computer software they can analyze their menu selections.
9.
Prepare a listing linking current health claims with diet. Have students list food sources that underlie
each health claim, e.g., calcium and osteoporosis; calcium rich food - milk, tofu, cheese, leafy
greens.
10.
Ask students to list nutrition research topics they would like to have addressed. (The instructor
should supply lists of publications in campus libraries that provide updates on current nutrition
research).
a.
Tufts University Diet and Nutrition Letter (PO Box 57857 Boulder, CO 80322-7857)
b.
Nutrition and the MD (Raven Press, Dept.1B 1185 Avenue of the Americas, New York, NY
10036)
c.
Nutrition Action Healthletter (Center for Science in the Public Interest, Suite 300, 1875
Connecticut Ave., NW, Washington, DC 20009-5728)
d.
FDA Consumer, The magazine of the US Food and Drug Administration (Superintendent of
Documents, Government Printing Office, Washington, DC 20402)
e.
At The Center (NCND, 216 West Jackson Blvd, Suite 800, Chicago)
f.
NCAHF Newsletter (PO Box 1276, Loma Linda, CA 92354)
11. Have students bring in a nutritional research article from a peer-reviewed journal. Discuss
validity/credibility of research, methodology, etc., its possible impact on nutrient intake and diet
practices.
12. Ask students to complete the student assignment on label reading for practice in selecting nutritional
foods.
STUDENT ASSIGNMENT
Label Reading
Labels can help you make wise food choices. Select two (2) food labels from similar foods. (Attach both
labels.) Compare the label information:
1.
Brand
Brand A
_________________
Brand B
_________________
2.
Serving size
_________________
_________________
3.
Servings per container
_________________
_________________
4.
Calories
_________________
_________________
5.
Calories from fat
_________________
_________________
6.
% of fat
_________________
_________________
7.
Protein
_________________
_________________
8.
Carbohydrate
_________________
_________________
9.
Sodium
_________________
_________________
10.
Sugar
_________________
_________________
11.
Dietary fiber
_________________
_________________
12.
Cholesterol
_________________
_________________
13.
% Vitamin A
_________________
_________________
14.
% Vitamin C
_________________
_________________
15.
% Iron
_________________
_________________
16.
% Calcium
_________________
_________________
17.
Ingredient listing:
_________________
_________________
_________________
_________________
_________________
_________________
_________________
_________________
1.
Which brand or food label offers the most healthful product? Explain. (Compare % of fat, sodium,
protein, etc.)
2.
The new regulations of the Nutritional Labeling and Education Act (NCEA) of 1990 provide
definitions and specific conditions as to which specific nutrient descriptors can be used. The following
nutrient content claims are defined per serving below. Does your serving of food qualify for any of the
following claims?
3.
LOW:
low calorie = 40 kcal or less
low fat = 3 g or less
low saturated fat = 1 g or less
low cholesterol = 20 mg or less
low sodium = 140 mg of less
very low sodium = 35 mg or less
What information on the food label has helped you in making your food selection? Why?
STUDENT ASSIGNMENT
Fast Food Restaurant_________________
Select a fast food restaurant and list the menu items that you frequently choose.
Menu Item
Portion
Calorie
s
Fat
Chol
Sodium Vit A Vit C
Calcium
Totals
Recommended
Difference
(+ or -)
1. What food selections would help make this meal healthier? (Example: add 1c milk to increase the
calcium 300 mg)
2. What have you learned by completing this fast food analysis?
STUDENT ASSIGNMENT
24-Hour Patient Calorie Count
Using the Exchange System (Appendix D), estimate the total calories, grams of carbohydrate, protein and
fat in a 24 hour food recall.
Portion
Food Item
%
eate
n
CHO
Gram
s
PRO
grams
FAT
grams
x4
x4
x9
TOTAL (grams)
kcalories per gram x4 x4 x9
kcalories
Total kcalories for 24-hour intake ________
ANNOTATED REFERENCES AND READINGS (Annotated References in
Text)
1.
Welsh S (1996): Nutrient Standards, Dietary Guidelines, and Food Guides. In Ziegler EE and Filer
LJ (eds.), Present Knowledge in Nutrition. International Life Sciences Institute, Washington, DC pp.
630-646.
2.
Dwyer J: Health Claims under the Nutrition Labeling and Education Act. Annual Editions: Nutrition
98/99 (Cook-Fuller, 10/e, 1998).
3.
Kurzer MS and Xu X (1997): Dietary Phytoestrogens. Annu. Rev. Nutr. 17:353-81.
4.
Phytochemicals: Drugstore in a Salad? Consumer Reports on Health, Dec. 1995, pp. 133-35.
5.
“Eating Well” by M. Burros, July 22, 1992, The New York Times, page B4.
6.
Lewis, JL and EA, Yetley: Focus group sessions on formats of nutrition labels, Journal of the
American Dietetic Association; 92: 62-66, 1992.
7.
The New Food Label and You. Food News For Consumers, Vol.10, No.1-2, Spring-Summer 1993.
USDA Food Safety and Inspection Service.
8.
Nutrition and Your Health: Dietary Guidelines for Americans, Third Edition, 1990, U.S.
Department of Agriculture/U.S. Department of Health and Human Services.
MEDIA RESOURCES
Films:
1.
Basic Nutrition: Let's Make a Meal. Professional Research, 12960 Coral Tree Place, Los Angeles,
CA 12960
2.
Look Before You Eat. Churchill Films, 662, N. Robertson Blvd. Los Angeles, CA 90069
3.
Diet for All Reasons. Churchill Films, 662 N. Robertson Blvd., Los Angeles, CA 90069
4.
Lifesteps: Nutrition and Your Busy Lifestyle. National Dairy Council, 6300 N. River Rd., Rosemont,
IL 60018-4233.
Video:
1.
Supermarket Savvy Tour Video. Nutrition Counseling/Education Services, P.O. Box 3018, Olathe,
KS 66062-3018
2.
Healthy Meal Planning. Nutrition Counseling/Education Services, P.O. Box 3018, Olathe, KS
66062-3018.
3.
Eat Well, Be Well. Metropolitan Life Insurance Co., One Madison Avenue, New York, NY 10010
4.
Selecting an Adequate Diet (MVCS-0456). Audio-Visual Services Center, The Pennsylvania State
University, University Park, PA 16803.
5.
Healthy Meal Planning. CC Hammer, 524 Sherman Dr., Marshall, MI 49068-9227.
6.
Diabetes Exchange System--Diabetes and Food: The Challenge of Choices. Oracle Film and Video,
1820 14th St, Suite 203, Santa Monica, CA 90404.
7.
The Food Guide Pyramid. National Health Video, Inc., 1993, NCES, 1904 East 123rd St., Olathe,
KS 66061-5886.
8.
How to Read the NEW Food Label. National Health Video, Inc., 12021 Wilshire Blvd., Suite 550,
Los Angeles, CA 90025.
Slides:
1.
Super Market Savvy Slide Show. Nutrition Counseling/Education Services, P.O. Box 3018, Olathe,
KS 66062-3018