HUN 4296 Nutrition & Health Issues
Week 1 Day 1 Part 1
Foundations to sort Facts from Fads
Based on Chapter 1: Nutrition: Concepts & Controversies, 12e Sizer/Whitney
Our “practice environment” …
Controversy → Competition
Where do people get their
nutrition advice?
What makes nutrition a
fertile field for controversy?
 Nutrition Science
 Active, changing, and growing body of
knowledge
 The scientific approach
 Systematic , methodical, slow
 Scientific challenges
 Paradigm shifts to respected theories
 Evidence-based v Practice-based
What’s at stake?
Four of the top 10
causes of death are
directly related to
nutrition.
• Accidents are
related to drinking
alcohol.
Bottom line: the Standard American Diet is killing us.
Lifelong impact of nutrition
 Chosen foods have a cumulative effect
 Your body continuously renews itself
 Best foods
 Support your body’s growth & maintenance
 No “good” or “bad” foods – depends on
circumstance and individual
 Malnutrition
 Deficiencies, imbalances, and excesses
Genetics and Individuality
 Genetics and nutrition affect diseases to
varying degrees
 Human genome
 DNA
Impact of genetics
Genetics play a role in 9 of the 10 leading
causes of death, including:
 Cancer
 Heart disease
 Stroke
 Diabetes
 Alzheimer’s disease
National Nutrition Surveillance
 National Health and Nutrition Examination
Surveys (NHANES)
 Recording of health status and intake
 Behavioral Risk Factor Surveillance System
(BRFSS)
 Telephone survey of adults 18 y.o. and older
 Continuing Survey of Food Intakes by
Individuals (CSFII)
 What people eat for two days
 Comparing foods eaten with recommendations
Our national health agenda:
The evolution of Healthy People 2020
Target Year
1990
Overarching • Decrease
Goals
mortality:
infants–adults
• Increase
independence
among older
adults
2000
2010
• Increase span • Increase
of healthy life
quality and
• Reduce health
years of
disparities
healthy life
• Achieve access • Eliminate
to preventive
health
services for all
disparities
2020
• Attain high-quality, longer lives
free of preventable disease
• Achieve health equity; eliminate
disparities
• Create social and physical
environments that promote good
health
• Promote quality of life, healthy
development, healthy behaviors
across life stages
# Topic Areas
15
22
28
39*
# Objectives/
Measures
226/NA
312/NA
467/1,000
>580/1200
* With objectives
Selected Nutrition and Body
Weight Objectives from HP 2020
Obesity Trends* Among U.S. Adults
BRFSS, 1990, 2000, 2010
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
2000
1990
2010
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
Bottom line: Despite our best efforts, the epidemic continues…
≥30%
Reviewing the basics…
 Your body uses energy that comes
indirectly from the sun
 Six kinds of nutrients
 Four are organic (contain carbon)
 Three provide energy
Nutrient Basics
 Human body & food
 Same materials
 Different
arrangements
Nutrient Basics
 Energy-yielding nutrients
 Carbohydrates – 4 cal/g
 Fats – 9 cal/g
 Proteins – 4 cal/g
 Vitamins and minerals
 Provide no energy
 Some are essential
 Scientists calculate needs
Quiz!
The 20 oz. “Activator” from Smoothie King has
• 1g Fat
• 105 g CHO
• 19g Pro
 How many total calories?
 How many calories would it be if you drank only 16 oz?
 If you had 3 CHO / starch exchanges, how much could
you drink?
 Under what circumstances would this be a good choice
to drink?
Can I Live on Just Supplements?
 Elemental diets
 Administered to severely ill people
 “Real food” is superior to supplements
 Nutrient interactions
 Phytochemicals
 Physical contributions
 Psychological contributions
The Abundance of Foods to
Choose From
 Whole foods
 Typical
consumption
 Fruits
 Vegetables
 Types of foods
 Fast, processed,
functional, staple
Recognizing a Nutritious Diet
 Five characteristics
 Adequacy
 Balance
 Calorie control
 Intakes should
not exceed need
 Moderation
 Not abstinence
 Variety
A Way to Judge Which Foods Are
Most Nutritious
Knowledge is not enough
 Factors influencing food-related choices
 Traditional and ethnic foods
 Convenience
 Physical factors
 Psychological factors
 Social factors
 Philosophical factors
A Guide for Behavior Change
 Behavior change takes substantial effort
 Six stages of change
 Assessment and goals
 Realistic goals
 Obstacles to change
 Competence
 Confidence
 Motivation
Stages of Behavior Change
Sorting the Imposters from the
Real Nutrition Experts
Controversy 1
Can I Trust the Media to Deliver
Nutrition News?
 Training of news media
 Sensationalism
 Be a trend watcher
 Read news with an educated eye
 Published in peer-reviewed journal
 Description of research methods & subjects
 Findings presented in context of previous
research
Information Sources & Costs of
Wrong Choices
 Quackery
 Sources of nutrition information
 Television and magazines
 Nutrition-related products and services
 Billions in customer dollars
 Identifying quackery
Earmarks of Nutrition Quackery
Identifying Valid Nutrition
Information
 Characteristics of scientific research
 Properly designed scientific experiments
 Inadequacy of anecdotal evidence
 Animal findings applied to humans
 Careful with generalizations
 Report of findings in scientific journals
Credible Source of Nutrition
Information
 American Dietetic Association
 www.eatright.org
 National Council Against Health Fraud
 www.ncahf.org
 American Council on Science and health
 www.acsh.org
Nutrition on the Net
 Judging website credibility
 Who is responsible for the site?
 Do the names and credentials of information
providers appear?
 Are links with other reliable information sites
provided?
 Is the site updated regularly?
 Is the site selling a product or service?
 Does the site charge a fee to gain access?
True Nutrition Experts
 American Dietetic Association (ADA)
 Registered dietitian (RD)
 Certified diabetes educator
 Public health nutritionist
 Dietetic technician
 Dietetic technician registered
True Nutrition Experts
 Credentials
 Accredited
institution
 Licensing
Dietetics and Nutrition Practice Act
Title XXXII
REGULATION OF PROFESSIONS
AND OCCUPATIONS
Chapter 468
MISCELLANEOUS PROFESSIONS
AND OCCUPATIONS
PART X
DIETETICS AND NUTRITION
PRACTICE (ss. 468.501-468.518)
http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=04000499/0468/0468PARTXContentsIndex.html
468.502
Purpose and intent
The Legislature finds that:
• the practice of dietetics and nutrition or nutrition
counseling by unskilled and incompetent practitioners
presents a danger to the public health and safety.
• it is difficult for the public to make informed choices
about dietitians and nutritionists
• the consequences of wrong choices could seriously
endanger the public health and safety.
• The sole legislative purpose in enacting this part is to
ensure that every person who practices dietetics and
nutrition or nutrition counseling in this state meets
minimum requirements for safe practice.
468.503 Definitions
• “Dietetics” means the integration and
application of the principles derived from the
sciences of nutrition, biochemistry, food,
physiology, and management and from the
behavioral and social sciences to achieve and
maintain a person’s health throughout the
person’s life. It is an integral part of
preventive, diagnostic, curative, and
restorative health care of individuals, groups,
or both.
“Dietetics and nutrition practice”…
…shall include assessing nutrition needs and status
using appropriate data; recommending appropriate
dietary regimens, nutrition support, and nutrient
intake; improving health status through nutrition
research, counseling, and education; and
developing, implementing, and managing nutrition
care systems, which includes, but is not limited to,
evaluating, modifying, and maintaining appropriate
standards of high quality in food and nutrition care
services.
• “Nutrition assessment” means the evaluation
of the nutrition needs of individuals or groups,
using appropriate data to determine nutrient
needs or status and make appropriate
nutrition recommendations.
• (9) “Nutrition counseling” means advising
and assisting individuals or groups on
appropriate nutrition intake by integrating
information from the nutrition assessment.
468.504 License required
No person may engage for remuneration in
dietetics and nutrition practice or nutrition
counseling or hold himself or herself out as a
practitioner of dietetics and nutrition practice or
nutrition counseling unless the person is
licensed in accordance with the provisions of
this part.
468.505 Exemptions; exceptions.
• Those licensed in Chapters 457-466, 480, 490, or
491 and rendering services within the scope of
their practice
• Persons employed in government, cooperative
extension home economist, a student or trainee
under supervision, someone from out of state
taking a course of study… an educator in the
employ of a not-for-profit,, employed by a
hospital, nursing home, assisted living facility, or
is a dietetic technician
Also exempted:
 g) A person who markets or distributes food, food materials, or
dietary supplements, or any person who engages in the explanation
of the use and benefits of those products or the preparation of
those products, if that person does not engage for a fee in dietetics
and nutrition practice or nutrition counseling.
 (j) Any person who provides weight control services or related
weight control products, provided the program has been reviewed
by, consultation is available from, and no program change can be
initiated without prior approval by a licensed
dietitian/nutritionist, a dietitian or nutritionist licensed in another
state that has licensure requirements considered by the council to
be at least as stringent as the requirements for licensure under this
part, or a registered dietitian.
468.516 Practice requirements.—
A licensee under this part shall not implement a
dietary plan for a condition for which the patient is
under the active care of a physician licensed under
chapter 458 or chapter 459, without the oral or
written dietary order of the referring physician. In
the event the licensee is unable to obtain
authorization or consultation after a good faith
effort to obtain it from the physician, the licensee
may use professional discretion in providing
nutrition services until authorization or consultation
is obtained from the physician.