Nutritional Guidelines and Assessment Thomas Edison • “The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.” Hippocrates • “Everyone has a doctor in him or her; We just have to help it in its work. The natural healing force within each one of us is the greatest force in getting well. Our food should be our medicine. Our medicine should be our food.” Linking Nutrients, Foods, and Health • Eating foods with all the essential nutrients prevents nutritional deficiencies. • Nutritional deficiencies are relatively rare in the United States. • Americans suffer from chronic diseases such as heart disease, cancer, hypertension and diabetes. All of these diseases are linked to overconsumption and lifestyle choices. Moderation • Moderation means not too much or too little of anything. • A balanced diet typically avoids extremes. • Substances that are healthful in small quantities can be dangerous in large quantities. Variety • Variety means foods from different food groups such as fruits, vegetables, and grains. • It also means different foods within a group. • Variety in the diet balances the positive and negative interactions among food components. Variety • Variety balances the overall availability of nutrients to the body. • Variety adds interest and prevents boredom in the diet. • Variety helps to assure that you get all of the nutrients that your body needs. Balance • Healthful food choices require a balance of food groups, energy sources (carbohydrate, protein, and fat), and other nutrients. • Balance means moderation in your choice of food. Balance • Balance means matching the amount of energy (calories) you intake via foods with the amount you expend in daily activities and exercise. Japan’s Dietary Guidelines • 1. Obtain well-balanced nutrition with a variety of foods; eat 30 foodstuffs a day; take staple food, main dish, and side together. • 2. Take energy corresponding to daily activity. Japan’s Dietary Guidelines • 3. Consider the amount and the quality of the fats and oils you eat: avoid too much; eat more vegetable oils than animal fat. • 4. Avoid too much salt, not more than 10 grams a day. • 5. Happy eating makes for happy family life; sit down and eat together and talk; treasure family taste and home cooking. Dietary Guidelines for Americans • The U.S. Departments of Agriculture (USDA) and Health and Human Services (DHHS) released the first edition of the Dietary Guidelines for Americans in 1980. • It is revised every five years, taking into consideration new scientific information. Basic Messages of the Dietary Guidelines for Americans • Aim for Fitness – Weight control – Exercise is an important factor – 30 minutes of physical activity daily. • Build a Healthy Base – Grains (especially whole grains), fruits, and vegetables should be the foundation of a healthful diet. • Choose Sensibly – Limit the amount of fat, sugar, salt, and alcohol. Dietary Guidelines Pyramids Food Group 1916 Food Group 1916 Recommended Percentage of Energy Meats and other protein-rich foods 20% (10% milk, 10% other) Cereals and other starchy food 20% Vegetables and fruit 30% Fatty Foods 20% Sugars 10% USDA Food Guide Pyramid Bread, Cereal, Rice, and Pasta Group • 6-11 Servings: To get the fiber you need, choose several servings a day of foods made from whole grains. • Choose most often foods that are made with little fat or sugars, like bread, english muffins, rice, and pasta. Bread, Cereal, Rice, and Pasta Group • Go easy on the fat and sugars you add as spreads, seasonings, or toppings. • When preparing pasta, stuffing, and sauce from packaged mixes, use only half the butter or margarine suggested; if milk or cream is called for, use lowfat milk. Vegetable Group • 3-5 Servings: Different types of vegetables provide different nutrients. Eat a variety. • Include dark-green leafy vegetables and legumes several times a week--they are especially good sources of vitamins and minerals. Vegetable Group • Legumes also provide protein and can be used in place of meat. • Go easy on the fat you add to vegetables at the table or during cooking. • Added spreads or toppings, such as butter, mayonnaise, and salad dressing, count as fat. Fruit Group • 2-4 Servings: Choose fresh fruits, fruit juices, and frozen, canned, or dried fruit. • Go easy on fruits canned or frozen in heavy syrups and sweetened fruit juices. Fruit Group • Eat whole fruits often--they are higher in fiber than fruit juices. • Count only 100 percent fruit juice as fruit. Punches, ades, and most fruit "drinks" contain only a little juice and lots of added sugars. Milk, Yogurt, and Cheese • 2-3 Servings: Choose skim milk and nonfat yogurt often. They are lowest in fat. Milk, Yogurt, and Cheese • 1 1/2 to 2 ounces of cheese and 8 ounces of yogurt count as a serving from this group because they supply the same amount of calcium as 1 cup of milk. • Choose "part skim" or lowfat cheeses when available and lower fat milk desserts, like ice milk or frozen yogurt. Read labels. Meat, Poultry, and Fish • 2-3 Servings: Choose lean meat, poultry without skin, fish, and dry beans and peas often, they are the choices lowest in fat. Meat, Poultry, and Fish • Prepare meats in lowfat ways: Trim away all the fat you can see. Remove skin from poultry. Broil, roast, or boil these foods instead of frying them. • Nuts and seeds are high in fat, so eat them in moderation. Fats, Oils, and Sweets • Use Sparingly. • Go easy on fats and sugars added to foods in cooking or at the table--butter, margarine, gravy, salad dressing, sugar, and jelly. Choose fewer foods that are high in sugars--candy, sweet desserts, and soft drinks. Fats, Oils, and Sweets • The most effective way to moderate the amount of fat and added sugars in your diet is to cut down on "extras" (foods in this group). • Also choose lower fat and lower sugar foods from the other five food groups often. What Counts As One Serving? • It is important to know what counts as one serving if you are following the U.S. food pyramid as a guide. • The following slides show quantities that count as a serving for the various food groups. Milk, Yogurt, Cheese • 1 cup of milk or yogurt • 1 1/2 ounces of natural cheese • 2 ounces of process cheese Meat, Poultry, Fish, Fry Beans, Eggs, Nuts • 2-3 ounces of cooked lean meat, poultry, or fish • 1/2 cup of cooked dry beans • 1 egg • 2 tablespoons of peanut butter count as 1 ounce of lean meat Vegetables • 1 cup of raw leafy vegetables • 1/2 cup of other vegetables, cooked or chopped raw • 3/4 cup of vegetable juice Fruits • 1 medium apple, banana, orange • 1/2 cup of chopped, cooked, or canned fruit • 3/4 cup of fruit juice Bread, Cereal, Rice, and Pasta • 1 slice of bread • 1 ounce of ready-to-eat cereal • 1/2 cup of cooked cereal, rice, or pasta Mediterranean Food Guide Pyramid Asian Food Guide Pyramid Native American Food Guide Pyramid Latin American Food Guide Pyramid Vegetarian Food Guide Pyramid Food Label Guidelines • The FDA implemented rules for what information is required to appear on food labels. • These rules are part of the Nutrition Labeling and Education Act of 1990 (NLEA). • Meat and poultry products regulated by the USDA are not covered by the NLEA Information Provided on Food Labels • Information is provided on the amount per serving of saturated fat, cholesterol, dietary fiber, and other nutrients of major health concern. • Nutrient reference values, expressed as % Daily Values, that help consumers see how a food fits into an overall daily diet. Information Provided on Food Labels • Uniform definitions for terms that describe a food’s nutrient content – such as “light”, “lowfat”, and “high fiber”– to ensure that such terms mean the same for any product. • Claims about the relationship between a nutrient or food and a disease or healthrelated condition, such as calcium and osteoporosis. Information Provided on Food Labels • Standardized serving sizes for easier comparisons of similar products. • Declaration of total percentage of juice in juice drinks. Food Label Components Nutrition Facts Manufacturers Must Supply • • • • • • • Total Calories Calories from fat Total fat Saturated fat Cholesterol Sodium Total carbohydrate Nutrition Facts Manufacturers Must Supply • • • • • • • Dietary fiber Sugars Protein Vitamin A Vitamin C Calcium Iron % Daily Value • Declaring nutrients as a percent of the Daily Values is intended to prevent misinterpretations that arise with quantitative values. • The % Daily Value listings are based on a 2,000 calorie diet. Nutrient Content Claims • Free – This term means that a product contains no amount, or only trivial or “physiologically inconsequential” amounts of one or more of these components: fat, saturated fat, cholesterol, sodium, sugars, and calories. • i.e. “calorie-free”, “fat-free”, “sugar-free”. Nutrient Content Claims • Low – This term can be used on foods that can be eaten frequently without exceeding dietary guidelines for one or more of these components: fat, saturated fat, cholesterol, sodium, and calories. • Synonyms for low include “little”, “few”, “low source of”, and “contains a small amount of”. Nutrient Content Claims • The descriptors are defined as follows: – Low-fat: 3 g or less per serving. – Low-saturated fat: 1g or less per serving. – Low-sodium: 140 mg or less per serving. – Very low sodium: 35 mg or less per serving. – Low-cholesterol: 20 mg or less and 2 g or less of saturated fat per serving. – Low-calorie: 40 calories or less per serving. Nutrient Content Claims • High – This term can be used if the food contains 20 percent or more of the daily value for a particular nutrient or serving. • Good source – This term means that one serving of a food contains 10 – 19 percent of the Daily Value for a particular nutrient. Nutrient Content Claims • Reduced – This term means that a nutritionally altered product contains at least 25% less of a nutrient or of calories than the regular, or reference product. • Less – This term means that a food, whether altered or not, contains 25% less of a nutrient or of calories than the reference food. “Fewer” is an acceptable synonym. Nutrient Content Claims • Light – This descriptor can mean two things: – A nutritionally altered product contains one-third fewer calories or half the fat of the reference food. – The sodium content of a low-calorie, low-fat food has been reduced by 50 percent. Nutrient Content Claims • More – A serving of food, whether altered or not, contains a nutrient that is at least 10 percent of the Daily Value more than the reference food. Ingredient Labeling • Ingredient declaration is required on all foods that have more than one ingredient. • Because people may be allergic to certain additives and to help them better avoid them, the ingredient list must include, when appropriate: – FDA-certified color additives – Sources of protein hydrolysates (flavors) – Caseinate as a milk derivative. Nutrition Assessment Methods • There are many indicators of nutritional health. • Nutrients play many roles in the body, so measure of nutritional status must look at many factors. ABCDs of Nutrition Assessment ASSESSMENT METHOD WHY IT’S DONE Anthropometric Measure Measures growth in children; shows change in weight that can reflect diseases; monitors progress in fat loss. Biochemical Tests Measures blood and / or urine for nutrients or metabolites that indicate infection or disease. Clinical Observations Assesses change in skin color and health, hair texture, fingernail shape, etc. Dietary Intake Evaluate diet for nutrient (i.e. fat, calcium, protein) or food (i.e. number of fruits and vegetables) intake.