Nutritional Guidelines and Assessment

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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
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•
•
•
•
•
•
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.
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