Home Economics
Eating for Life
Higher/Advanced Higher
6814
Spring 2000
HIGHER STILL
Home Economics
Eating for Life
Higher/Advanced Higher
Support Materials
Higher Still Development Programme
Note to Teachers in charge of Home Economics Departments and to Education
Authority representatives
The video ‘Eating for Life’, on which this pack is based, is held in many Home
Economics departments. However, if your department does not own a copy, the Higher
Still Development Unit has made the following arrangements with SHARP:
• Schools should inform their adviser or education officer and state that they wish to
receive a copy of the video
• The education officer will send one authority order to SHARP (address is given at the
front of the pack)
• SHARP will invoice the Higher Still Unit for payment.
Please note:
• All orders must be with SHARP by 31st May 2000. Payment for orders received after
this date will be the responsibility of the Authority or the individual school making
the order.
• Only authority orders will be paid for by the HSDU. Individual orders from schools
will be the responsibility of the school who will be required to pay the full price for
the video.
Home Economics: Eating for Life (H/AH)
1
The “Eating For Life” pack has been produced to support teaching and learning in Home Economics
at Higher and Advanced Higher level in the contexts of Health and Food Technology, and Lifestyle
and Consumer Technology.
These materials are an extension of the concepts and principles embedded in the video “Eating For
Life” (Scottish Heart and Arterial Risk Prevention).
Financial support for the project came from North Lanarkshire Council Education Department,
Lanarkshire Health Board (Health Promotion Department) and the Institute of Home Economics.
SHARP has provided financial support, copyright for access to the video and assistance with
distribution costs.
Project Team
Eileen Mullen
-
Adviser, North Lanarkshire Council
Karen Walker
-
Assistant Head Teacher, Taylor High School
Dr. Shirley McEwan MBE
-
Chairman and Medical Administrator, SHARP, Senior
Research Fellow, Dept. of Medicine, University of Dundee
Professor Annie Anderson
-
Centre for Applied Nutrition Research, University of Dundee
Contributions to the project were made by:
Dr. Alan G Begg
-
General Practitioner
Ruth Tweedie
-
Public Health Nutritionist, Lanarkshire Health Board
Cara Brember
-
Senior Dietitian, Tayside University Hospitals TRUST
Dr. Fergus Daly
-
Senior Research Fellow, University of Dundee
Alison Reid
-
Lecturer, School of Management and Consumer Studies University of Dundee
Information Technology support was provided by Christopher Walker.
Publication and distribution has been coordinated by the Higher Still Development Unit (HSDU).
Contents
Student Study Guide
1.
2.
3.
4.
5.
Background
Coronary Heart Disease
Reducing CHD Risk: Tackling Foodstyles
Reducing CHD Risk: Changing Diet
Reducing CHD Risk: Eating for Life
Appendix
1:
2:
Doctor’s Fact Sheet
Dietitian’s Fact Sheet
Glossary
Recommended Resources
Teacher Guide:
Health and Food Technology
Lifestyle and Consumer Technology
SQA Specimen Questions
Study Guide
This pack aims to encourage you to
•
•
•
research into the issue of coronary heart disease (CHD)
apply knowledge to address some of the problems associated with this disease
identify changes to lifestyle required to reduce coronary heart disease risk
| OBJECTIVES
This pack will allow you to extend your knowledge of the following
•
•
•
•
•
•
current targets for public health
coronary heart disease and associated risk factors.
the impact of technological innovation on food choice, and product development and
sensory analysis of food.
foodstyles - influences on contemporary food preparation
changing diet - the role of fats, fruits, vegetables and antioxidants
eating for life - the basis of a healthy diet and meal patterns
| SOURCES OF INFORMATION/RESOURCES
Before you begin, you will require the following resources
• Eating For Life Video (VCR/TV)
• Higher Essential Knowledge pack -
Health and Food Technology
Lifestyle and Consumer Technology
• A selection of Nutritional Textbooks [ - see recommended list at end of pack.]
• Variety of recipes, food order forms and time plans for practical work.
• You will require to arrange a visit to a local supermarket or conduct your investigation using a
selection of labels.
• Computer
| ASSESSMENT
Your teacher will arrange internal assessment as appropriate. The topics in the pack cover essential
knowledge content from several units of the Higher course in Health and Food Technology, and
Lifestyle and Consumer Technology.
A self assessment questionnaire has been included to test the level of your knowledge and
understanding of topics covered before and after using the pack. This should be used twice, once
before starting work on the pack and again when you have completed it.
√√
This symbol is used to indicate where you are required to carry out a task or investigation.
While working through the pack your answers to the questions/tasks/investigations should reflect
the information given in the essential knowledge pack:
Health and Food Technology
Resource Management
Consumer Studies
Coronary Heart Disease p32
Choice of Foods p35
Current dietary advice p64
Fat Replacers p41-3
Fats and fatty acids p33
Freezing p15
Sensory analysis p55
Food Consumption at home p35
How we live p20
Social Trends p25
Self Assessment
Before you start working through the pack, rate your knowledge of the following topics as
good/some/little.
Current targets for public health
1.
Targets for better health proposed by white
paper Towards a Healthier Scotland.
CHD and risk factors
2.
3.
The role of atherosclerosis in coronary heart disease.
Risk factors in CHD.
Foodstyles
4.
5.
Changing lifestyles and effects on food choice.
Dietary value of convenience foods.
Changing diet
6.
7.
8.
9.
10.
Functions of fat in the diet.
Chemical structure of fats.
Role of essential fatty acids.
The process of hydrogenation of fats in dairy
products.
The fat content of dairy products.
Eating for life
11.
12.
13.
14.
Socio-economic factors which may affect
dietary choices.
Nutritional requirements of teenagers.
The nutritional importance of breakfast.
Current dietary targets.
GOOD
SOME
LITTLE
Eating For Life
1 Background
The government white paper “Towards a Healthier Scotland” Scottish Office 1999 set out
proposals for better health in Scotland, acting on 3 levels
•
improving life circumstances
including poverty, unemployment,
poor housing, limited educational
achievement
•
tackling lifestyles
less smoking, drug and alcohol abuse,
a healthier diet, more physical activity
•
tackling health topics
including coronary heart
disease/cancer
1.1 A number of health targets were set out including
•
coronary heart disease
-
reduce early deaths by 50%. (from 143 to 72
deaths per 100,000 population)
•
cancer
-
reduce early deaths by 20%. (From 188 to 150
deaths per 100,00 population)
•
dental health
-
Reduce dental disease so that 60% of 5 year
olds have no experience of dental disease by
2010.
1.2 Eating Better -
diet is recognised as a major factor in the prevention of
disease.
“Next to smoking, our diet is the single most significant cause of our poor health. Poor diet
contributes to a range of serious illnesses including CHD, cancers, strokes, osteoporosis and
diabetes. The poor diet of deprived communities is a major reason why they experience such poor
health.” - (Towards A Healthier Scotland, p 13)
1.3 Coronary Heart Disease - CHD
The challenge of preventing CHD remains a major issue for Scots from all backgrounds.
“Reducing the number of early deaths and illness from CHD and the associated problem of stroke,
remains a huge challenge for Scotland. Common contributing causes are smoking, poor diet and lack
of activity.” - (Towards A Healthier Scotland, p 20 )
2. Coronary Heart Disease
This disease is associated with a build up of cholesterol plaques within the interior wall of the
arteries which results in a reduced supply of the blood to the heart muscles. This is known as
Atherosclerosis - See Doctor’s fact sheet for more detailed information. - (Appendix 1)
CHD is most commonly diagnosed as angina or coronary thrombosis (heart attack)
• angina
a medical condition characterised by pain in the chest which may radiate to other areas such as the
arms and the jaws. This normally occurs during physical activity, but may also occur during rest,
and is due to insufficient oxygen reaching the heart muscle.
• heart attack (myocardial infarction)
a heart attack occurs when an atherosclerotic plaque ruptures and a blood clot (thrombus) forms.
The resulting blockage of the affected artery cuts off the blood supply to the relevant area of heart
muscle and if large enough may cause the death of the individual.
2.1 Risk Factors
Many factors contribute to heart disease. These are known as risk factors. The likelihood of an
individual being affected depends on the number and/or severity of factors.
“I’ve had eight heart attacks, so I’ve got to eat healthily!”
2.1 (cont.)
Risk factors are classified as
•
•
unmodifiable modifiable
-
which cannot be changed
which can be changed
The following are unmodifiable risk factors
•
gender
-
men develop the damage at an earlier age than women,
who seem to be protected by their hormones until the
menopause.
•
age
-
atherosclerosis starts in childhood and progresses with
advancing years so a healthy lifestyle is important
from a very early age.
•
genetic predisposition
-
some people have an inherited tendency to premature
atherosclerosis, passed on from their parents in their
genetic make-up.
From the reference materials available to you, complete the chart below summarising the
factors which contribute to heart disease, including dietary and general factors.
modifiable factors
unmodifiable factors
Why do these factors matter?
ONE
SCOT
DIES
EVERY
HOUR
DUE
TO
SMOKING
3. Reducing CHD Risk: Tackling Foodstyles
3.1 Our lifestyles are dependent on a range of factors including family and cultural backgrounds,
disposable income, household composition, employment and leisure activities. Early in the century
domestic activities dominated the lives of many women but social change, equality of opportunity
and the economic climate have resulted in food styles which reflect contemporary life.
How we live has changed over the past 2-3 decades.
3.2 During the same period technological advances in food production allowed manufacturers to
respond to the changing demands of consumers. The number of meals eaten away from home and
the number of ready prepared and convenience meals consumed has risen dramatically.
Make a list of any significant changes in lifestyle over the past 20-30 years.
From your list, choose 1 or 2 changes noted and discuss how food manufacturers/retailers have
responded in terms of product development.
“Processed foods are now basic to many people’s daily diets but with careful
choices a healthy balance can be maintained.”
3.3 Time spent on food preparation at home has dropped over this period of time. The result of
this has been a greater use of convenience products in meal production, with fewer fresh foods being
prepared and cooked. The modern consumer now relies greatly on food manufacturers to decide on
the fat, sugar, salt and fibre content of their products. To achieve the dietary targets proposed for
fat, sugar, salt, fibre, fruit and vegetables, consumers require access to better food labelling,
ingredients of appropriate composition and the skills to make informed decisions on choice of
foods.
3.4
Choose a convenience sauce, cook in/pour over/stir fry and combine this with fresh
ingredients to create a main course dish. Evaluate it’s contribution to the healthy diet of a young
working couple, who have limited time and skills for meal preparation.
Discuss, in a group, the significance of your findings.
What recommendations would you propose to food manufacturers and food retailers?
74% OF BRITISH HOUSEHOLDS OWN A MICROWAVE (26% IN 1987)
2,000,000,000 PREPACKAGED SANDWICHES ARE EATEN EACH YEAR IN THE UK
McDONALDS OWN 153 OUTLETS IN THE UK, 23,000 WORLDWIDE
3.5 Achieving the dietary target of 5 portions of fruit and vegetables every day.
The UK is one of the largest consumers of frozen foods in Europe; these products are readily
available and require little or no preparation. Many consumers now own freezers and microwaves.
In terms of meeting dietary targets to increase fruit and vegetables intake to 5+ portions a day,
frozen products can have a vital role. Nutritionally, frozen fruits and vegetables have at least as
many nutrients as fresh and often more since fresh fruits and vegetables lose nutrients as they age.
Manufacturers use only the very best crops - only a few hours old and full of nutrients.
Canned fruits (in fruit juice rather than syrup) and vegetables provide another alternative to fresh.
These products may contain reduced amounts of nutrients due to heating during the canning
process, and can contain high amounts of salt.
Both frozen and tinned fruits and vegetables allow consumers to increase the number of portions in
the daily diet without spending time on preparation.
Plan a day’s intake of fruits and vegetables for a student on a low income. Use a mixture of
fresh and convenience sources; provide a costing for the day’s intake.
“Frozen vegetables can be as good as fresh, they’re quick and
convenient with little waste and they are easy to cook.”
4 Reducing CHD Risk: Changing Diet
The major dietary recommendation for reducing heart disease is to decrease the total energy from fat
to no more than 35%, and decrease energy from saturated fat to no more than 11%.
4.1 The physiological functions of fat in the diet include
•
•
•
providing a concentrated source of energy
assisting in the transporting and absorption of the fat soluble vitamins
manufacturing hormones and cell membranes
Fat also contributes to the flavour and texture of our food.
It was thought that because fat is digested more slowly than other nutrients, it helps to satisfy our
appetite and delay the return of hunger. This belief is now being challenged.
4.2 Types of Fat
All fats are made up of fatty acids, which can be saturated or unsaturated according to the way in
which their carbon and hydrogen atoms are arranged.
Using the information available to you, investigate the difference between the following
types of fat (see Dietitian’s Fact Sheet)
•
saturated fat
•
monounsaturated fat
•
polyunsaturated fat
Summarise your investigations by recording the following for each type of fat
•
chemical structure
•
nature at room temperature
•
sources
•
health risks/current dietary advice
4.3 Saturated Fats
Eating too much saturated fat is linked to raised blood cholesterol levels and therefore with increased
risk of heart disease, the most common cause of death in the UK. Fats such as in meat, cheese, milk,
cream, coconut and palm oils all contain a high proportion of saturated fats. Coconut and palm oils
are often used in the commercial preparation of cakes and biscuits as they extend the shelf life of
these products. Because use of these ingredients is difficult to detect (invisible fats) consumers
often forget that they are present at all. Other examples of invisible fat in our food are nuts, pastry,
fried foods, egg yolks and marbling in lean meat. Visible fat, which is usually solid at room
temperature, is easily detected: such as the fat on meat, butter, margarine, cooking fats.
4.4 Essential Fatty Acids
Essential fatty acids (EFAs) are polyunsaturated fatty acids which cannot be made by the body.
They are found mainly in vegetable and vegetable seed oils, margarine and spreads, and oil rich fish.
Omega-3 fatty acids have been shown to play an important role in the prevention of heart disease.
Benefits of these fatty acids may also extend to the slowing down of tumour growth, psoriasis and
rheumatoid arthritis.
The EFAs have several functions including
•
•
important role in the structure of cell membranes
blood clotting
Recent dietary advice has recommended that we should reduce our total fat intake to no more than
35% of food energy. This should be made up of poly and monounsaturates with no more that 11%
of total food energy being contributed by saturated fats.
“Oil rich fish are very beneficial in the fight against heart disease.”
4.5 Spreads and Manufactured Fats
When vegetable oils are hardened (hydrogenated) to make margarine and cooking fats, some of the
unsaturated fats are converted to saturated fats. Some of the remaining unsaturated fat also changes
it’s structure into a ‘TRANS’ fat rather than the normal ‘CIS’ form of fatty acids. For the purpose
of dietary recommendation trans fatty acids should be considered to be the equivalent of saturated
fats.
Sales of butter, hard and regular margarine have been falling in recent years. Due to the consumer
demand for low fat alternatives and technological advances a vast range of spreads which are low in
saturates have been developed.
Food manufacturers have responded to the advice that people should reduce the amount of fat
eaten. A variety of low and reduced fat products are available. Consumers must read the nutritional
information on these products carefully as many may have an increased sugar content.
Find out the name, source and uses of at least two fat replacers currently in use.
“Shopping for low fat dairy products can be quite a task when you look at the
range of products to choose from. It’s best to read labels carefully and choose
one with the lowest fat content.”
4.6
Carry out an investigation into oils, fats and spreads by completing the chart below:
Product Name
Olive Oil
Fat Content per 100g
Total
Saturate
100g
14.3
Uses
Monounsaturate Polyunsaturate
73
8.2
X
X
√
X
√
Butter
From your investigation recommend a fat, oil, spread for the following
• the elderly man in the video with a history of heart disease.
• the family featured in the video who prepare a lot of meals and packed lunches at home and bake
on a regular basis.
Give detailed reasons for your choices and state the percentage of fat content as shown on
the EU Categories of fats and spreads table in your essential knowledge pack.
When preparing dishes at home consumers have the opportunity to reduce the fat content of many
dishes, and meet the current dietary targets.
Conduct a series of investigations using basic recipes for pastry, cakes and sauces and
reducing the fat content of basic recipe. A control item should be produced for each dish using the
basic recipe then one or two reduced fat adaptations should be made, eg. 50% and 25% fat reduction
of basic recipe.
Carry out a sensory evaluation of all items produced. [refer to page 55 in your Higher Health and
Food Technology Essential Knowledge pack.]
Comment on the following for each item
• flavour
• colour
• texture
• keeping qualities
5 Reducing CHD Risk: Eating for Life
“It’s a big mistake to skip breakfast.”
Following a period of overnight fast, breakfast as the first meal of the day plays an important role in
preparing the body to cope with the day ahead.
Changes in working life have had an impact on breakfast with an increasing number of adults eating
this meal away from home - on the way to work/a breakfast meeting at work. Many children and
teenagers however choose to skip breakfast altogether; this can affect their ability to concentrate
during the morning. This may have a detrimental effect on their health in later life.
Suggest possible solutions which may encourage more teenagers to eat breakfast.
Investigate any “breakfast clubs” operating in your local area.
Discuss the factors which may cause teenagers to miss breakfast. Describe the dietary
consequences of such action, and how their behaviour may be affected.
5.1 Eating habits of a lifetime
“Eating habits established early in childhood can last a lifetime.
Make chocolate or crisps a treat.
It’s amazing how quickly young children develop a taste for foods high in
fat, sugar and salt.”
Develop a series of packed lunch menus which contribute to meeting the current dietary
targets for two schoolchildren. The children are a boy, aged 9, and a girl, aged 13.
Both parents work full time.
5.2 “Cooking for one can be a chore.”
The number of one person households in the UK continues to increase. Many of these households
are elderly people who face specific problems in the buying and preparation of meals.
Discuss the socio-economic factors which may affect the dietary intake of an elderly person.
• Discuss the potential of advances in domestic technology to enhance dietary choice in older adults.
• What conclusion do you draw from your discussions?
• What are the consequences for the individual and the community where they live?
5.3
“Lunch is a meal where many teenagers are free to make their own
choices as to where and what to eat.”
Many teenagers fail to act on the dietary and health advice given over the past decade. The diet of
this fourteen year old boy is not unusual, but may have serious long term health consequences.
Compare his intake for breakfast and lunch against his recommended daily intake for total
energy Fat, Carbohydrate (Starch and Sugar), Protein, Non Starch Polysaccharide (NSP), Calcium,
Vitamin C and D.
Discuss the possible consequences of this diet to a growing teenager.
“ This is my lunch, it’s usually chips, a can of coke and a pickled onion. I
didn’t have any breakfast, I had a snack... a Mars bar.”
List the social and economic factors which may influence a school pupil making decisions
about lunch.
School meals providers have a very important role to play in the nutrition of young people.
Develop a series of dishes which meet current dietary advice which would be suitable for
serving in a school canteen.
Carry out a sensory evaluation of your chosen dishes.
DOCTOR'S FACT SHEET
APPENDIX 1
ATHEROSCLEROSIS
WHAT IS ATHEROSCLEROSIS?
Atherosclerosis, or atheroma as it is sometimes called, is often described as hardening of the arteries.
While arteries do sometimes become hard and inflexible, more often what is understood by this is
that they become blocked thus slowing down and sometimes even stopping the flow of blood.
HOW DOES ATHEROSCLEROSIS OCCUR?
To understand this, it helps to know what the heart does and what an ordinary artery looks like.
The heart and circulation
The heart is a pump made up of muscle. It contains 4 valves and is driven by an electrical system
controlled by chemicals in the body. The heart pumps blood along arteries to every organ in the
body. The body needs oxygen to provide fuel and this reaches all the tissues via the bloodstream.
Red blood cells pick up oxygen in the lungs and after giving up the oxygen to the tissues pick up
carbon dioxide and other waste products in the tissues carrying them back to the lungs, liver and
kidneys for disposal. The heart muscle itself also needs oxygen and energy and receives this
through the coronary arteries.
Arteries
Arterial walls have 3 layers.
• The innermost is the intima - lined with a layer of cells called endothelial cells, the endothelium.
• The middle layer is the media - made up of muscle cells.
• The outer layer is the adventitia - containing nerves and small blood vessels.
The endothelium is a single layer of endothelial cells and in the newborn and in early childhood this
is smooth like a newly surfaced road but by puberty damage is beginning to occur rather like
potholes in a road. Just as in potholes in a road, debris gathers in deficiencies in the surface. So, in
the lining of arteries, fat carried in white blood cells is able to penetrate through damaged areas into
the muscle layer and build up swellings under the endothelium called atheromatous plaques which
bulge into the lumen or cavity of the arteries. This causes slowing down of the blood flow and
therefore reduces the supply of oxygen to the tissues. Sometimes the endothelium covering these
plaques where they bulge into the lumen may rupture releasing substances which make the blood
more sticky and thus a clot or thrombosis forms and may completely block the artery.
What are the causes of atherosclerosis?
There are many causes, usually called risk factors, and they can be divided into those which cannot
be changed (unmodifiable risk factors) and those which are alterable (modifiable risk factors).
The major important ones are:
Unmodifiable risk factors
Increasing age
Gender
Heredity
Diabetes
Modifiable risk factors
Smoking
High blood pressure
Unhealthy diet
Lack of exercise
Unmodifiable risk factors
Age
As we get older, arteries become increasingly damaged by all the other factors. Even
by the late teenage years there is already a considerable degree of atheroma.
Gender
Men develop arterial damage much earlier, usually at least 10 years earlier, than
women who seem to be protected by their hormones until the menopause.
Heredity
The tendency to premature arterial disease is transmitted in the genes in some
families and therefore it is important to choose your parents carefully!
Diabetes
Diabetics are 2-3 times more likely to develop problems and therefore have to be
even more careful than other people to avoid the modifiable risk factors.
Modifiable risk factors
Smoking
There is overwhelming evidence that both active (your own) and passive
(inhaling the smoke of other people) lead to atherosclerosis, mainly by
damaging the endothelium. As well as causing damage to arteries, smoking
leads to cancer of the lungs and other tissues including throat, stomach,
bladder and neck of the womb and also leads to stomach ulcers.
High blood pressure Blood pressure is needed to send the blood around the body. When the
pressure is higher than normal it is called hypertension. We are frequently
unable to explain why this happens in some people and it is therefore called
“essential hypertension”. This extra pressure damages the endothelium.
Unhealthy diet
The main constituents of a diet which are unhealthy are those derived from
animal fats. The one most commonly talked about is cholesterol which is
actually needed by the body to make the walls of cells and also to make
hormones but when we have too much in the blood it combines with certain
blood cells called macrophages and is carried through the damaged
endothelium to form the basis of plaques. However, for cholesterol to enter
the artery in this way, it is firstly oxidised. This process can be prevented
by substances called antioxidants, many of which are derived from fruit and
vegetables. Therefore an unhealthy diet is one which not only contains too
much animal fat but does not contain enough fruit and vegetables to prevent
oxidation of the fat and also does not contain enough fibre to carry fat out of
the system.
Lack of exercise
Exercise has several beneficial effects. As well as creating a feeling of wellbeing, exercising burns up energy and therefore fat and in this way helps to
reduce weight. It also makes the blood less sticky, reduces blood pressure
and increases a special kind of lipid in the body called HDL cholesterol which
carries cholesterol away from the tissues to the liver to be excreted. It
follows, therefore, that lack of exercise has the opposite effect and allows
atherosclerosis to progress.
WHY DOES ATHEROSCLEROSIS MATTER?
If arteries are partially blocked, tissues are deprived of oxygen and if they are totally blocked and no
oxygen gets through tissues will die. This leads to the following cardiovascular problems in various
regions of the body.
Coronary arteries
Blockages in coronary arteries deprive the heart muscle of oxygen. Pain in the oxygen starved
muscle is called angina. When a plaque ruptures and a thrombosis occurs, this constitutes a
coronary thrombosis or heart attack.
Cerebral arteries
When damage occurs to arteries in the brain either a small temporary stroke, called a transient
ischaemic attack, occurs or if a larger vessel is affected then a major stroke will result.
Peripheral arteries
When arteries in the lower limbs (from the pelvis down) are affected, the leg muscles are starved of
oxygen and pain arises in the muscles. This is called claudication. When this progresses it can lead
to gangrene and result in amputation.
All of these diseases together are called cardiovascular disease.
CARDIOVASCULAR DISEASE
Cardiovascular disease is the leading cause of premature death in Scotland where a third of all deaths
are due to coronary heart disease (heart attacks). Stroke leads to another 10% of deaths and deaths
due to other arterial diseases mean that more than half of all premature deaths are due to this group
of conditions. Death is not the only problem as poor health can also arise. For example, one man in
3 and one woman in 4 will have evidence of heart disease before they retire which will affect their
quality of life when they leave work and have more free time.
Atherosclerosis is, therefore, an extremely important condition, particularly in Scotland, which still
has one of the worst records in the world for premature illness and death. It is therefore really
important for everyone to adopt as healthy a lifestyle as possible so that they may feel better and
live longer.
Dietitian’s Fact Sheet
Appendix 2
Lipids in the diet
Dietary fats and oils are largely made up of triglycerides. These are composed of 3 fatty acids
attached to glycerol.
Fatty acids can be saturated (ie. all carbon atoms joined by single bands, ie. palmitic 16:0).
Unsaturated fatty acids contain carbon atoms joined by double bands. Where there is one double
band these are called monounsaturated (eg. oleic acid 18:1), where there are two or more double
bands they are called polyunsaturated (eg. linoleic acid 18:2)
Saturated fatty acids (sats) are mainly found in animal foods and high dietary intakes (> 11%
dietary energy) are associated with raised blood cholesterol.
H H H H H H
H-C-C-C-C-C-C -Glycerol
H H H H H H
Sources
Butter
Milk
Cheese
Cream
Suet
Lard
Cakes
Biscuits
Chocolate
Monounsaturated fatty acids (MUFA) are largely found in vegetable foods and tend to be
associated with lower blood cholesterol (especially LDL cholesterol)
H H H H H H H H
H-C-C-C=C-C-C-C-C
H H
H H H H
Sources
Olive oil
Rapeseed oil
Soft margarine (labelled high in monounsaturates)
Polyunsaturated fatty acids (PUFA) are also largely found in vegetable foods and tend to be
associated with lower blood cholesterol.
H H H H H H H H H
C=C-C-C-C=C-C=C-C
H
H H
Sources
Sunflower oil
Soft Margarine (labelled high in polyunsaturates)
Some nuts and seeds
Fish oils are also a source of PUFAs. In particular Omega 3 - fatty acids (the 3 refers to the
position of the first double bond on the carbon chain) such as alpha linoleic acid.
Fish oils may lower blood LDL cholesterol and triglycerides. In addition they appear to help reduce
inflammation and the likelihood of thrombosis (blood clotting).
Good Sources
mackerel
herring
sardines
pilchards
trout
salmon
Note: Canned tuna contains only a small amount of Omega 3 fatty acids
The Diet and Reinfarction Trial (Burr et al, 1989) showed that high intakes of oil-rich fish were
useful for secondary prevention of coronary heart disease.
Cholesterol is derived from the diet and from the body’s own production (endogenous synthesis).
The effect of dietary cholesterol on cholesterol in the blood is low compared to the effect of high
dietary intakes of saturated fats.
Lipids in the bloodstream
Cholesterol - Raised levels are an important risk factor for coronary heart disease. Acceptable
cholesterol levels are less than 5.2mm/litre. The Scottish Heart Survey (1997) reported that 62% of
Scottish adults have raised levels of cholesterol
Cholesterol is carried in the blood in 2 main components:
LDL Cholesterol - Low Density Lipoprotein carries most of the cholesterol in the blood. A High
LDL level is associated with increased risk of atherosclerosis.
HDL Cholesterol - High Density Lipoprotein helps carry cholesterol back to the liver for removal
from the body. HDL cholesterol helps to prevent atherosclerosis. A Low HDL level is associated
with increased risk of atherosclerosis.
Triglycerides (TG) are the form in which fat is stored in the body. TGs may be raised in diabetics as
well as in people who are overweight and sedentary, who drink excess alcohol or have a diet high in
fat or sugar. Raised TGs often occur with a high LDL cholesterol or low HDL cholesterol.
HEALTHY EATING
Remember
-
Reduce Intake
Increase Intake
Full cream milk
Butter
Full fat cheese
Hard fat (lard, margarine)
Cakes, pastries, biscuits
Cream
Fish or poultry
Low fat milk
Polyunsaturate spreads
Low fat cheese
Unsat. vegetable oils
Fruit and vegetables
As fat intake decreases, complex carbohydrate intake should increase
(eg. bread, potatoes, pasta, rice, etc.)
GLOSSARY
ABSORPTION
the process by which nutrients enter the tissues
of an animal or plant
ADVENTITIA
the outermost layer of an arterial wall
AMPUTATION
removal of a limb
ANGINA
the pain felt when the heart muscle is
deprived of oxygen
ANTIOXIDANTS
substances which ‘mop up’ harmful oxygen
products
ATHEROMA
abnormal deposit of fat in the wall of an
arterial disorder characterised by plaques of
atheroma leading to thickening of the walls and
narrowing of the artery.
ATHEROSCLEROSIS
a common arterial disorder characterised by
plaques of atheroma leading to thickening of the
walls and narrowing of the lumen
ARTERY
a hollow blood vessel through which blood
flows from the heart to all body tissues
CARDIOVASCULAR DISEASE
disease of the heart and blood vessels
CHOLESTEROL
an essential fat in the body which in excess
causes atherosclerosis
CLAUDICATION
reduced blood supply to the leg muscles causing
pain on walking
CORONARY ARTERY
a blood vessel which carries blood to the heart
muscle
CORONARY THROMBOSIS
a blood clot in a coronary artery which causes a
heart attack
DETRIMENTAL
damaging
ENDOTHELIUM
the cells lining the lumen of an artery
ESSENTIAL HYPERTENSION
high blood pressure where cause is not known
(95% of all high blood pressure)
GANGRENE
lack of oxygen leading to the death of tissue
HDL CHOLESTEROL
'good' cholesterol which collects harmful
cholesterol from the tissues and carries it back to
the liver to be disposed of.
HORMONES
a chemical produced by the body which
controls some organ functions
HYPERTENSION
high blood pressure
INTIMA
the innermost lining of an arterial wall
LUMEN
the hollow passage through an artery
MACROPHAGES
large blood cells with many functions
MEDIA
the middle or muscle layer of an arterial wall
NUTRIENT
a substance that produces nourishment
OXIDISED
a change in chemical structure due to exposure
to oxygen
PASSIVE SMOKING
inhaling the smoke of other people smoking
PHYSIOLOGICAL
the process and functions of all or part of the
body
PLAQUE
a localised swelling in the wall of an artery
which bulges into the lumen
STROKE
a reduction of the blood supply to an area of
the brain which damages brain tissue
SOCIO-ECONOMIC
involving social and economic factors.
TECHNOLOGICAL
the application of practical or mechanical
sciences to industry or commerce
THROMBOSIS
blood clot
TRANSIENT ISCHAEMIC ATTACK
a temporary reduction in blood flow to the
brain which does not leave permanent damage
Recommended Resources
VIDEO
Eating For Life
SHARP
Look At The Label
Food Sense
BOOKS/PUBLICATIONS
Towards A Healthier Scotland
The Scottish Office
Examining Food Technology
A Barnett
-
Heinemain
Nutrition - An Introduction
W Doyle
-
Holder & Stoughton
Cooking Explained
J Davies & B Hammond - Longman 3rd Edition
Skills in Home Economics - Food
J. Ridgwell
-
Heinemain
Manual Of Nutrition
Cooking Skills And Health
Health Education Authority
Food for Thought
Cathy Street & Peter Kenway
Breakfast Clubs and Their Challenges
New Policy Institute
INTERNET
SHARP Website
SQA Website
http://www.dundee.ac.uk/sharp
http://www.sqa.org.uk
Teacher Guide
The aim of the pack is to encourage students to extend their knowledge of Coronary Heart Disease
and the various issues which may affect consumer choice in the purchase and preparation of food
through
•
•
encouraging research into the issue of coronary heart disease
application of knowledge to problem solving situations associated with this
disease.
Teachers may use the pack in the following ways to meet the needs of their students
•
•
•
•
as an insert in a teaching unit on this topic
as revision at the end on a unit
as homework to complement and extend classroom learning
as a supported study package
Essential Knowledge grids included in the teacher pack show where ‘Eating for Life’ can make
contributions to coverage of knowledge in specific units of Higher courses in Health and Food
Technology and Lifestyle and Consumer Technology
| SOURCES OF INFORMATION/RESOURCES
The following resources should be accessible
• Eating For Life Video (VCR/TV)
• Higher Essential Knowledge pack Health and Food Technology
Lifestyle and Consumer Technology
• a selection of nutrition textbooks [ - see recommended list at end of pack. ]
• variety of recipes, food order forms and time plans for practical work.
• a visit to a local supermarket is recommended to conduct an investigation on nutritional labelling.
• computer
| ASSESSMENT
Some assessment items from SQA sample external examination questions have been included in the
teacher guide to be used as appropriate. Answers to questions/tasks/investigations should reflect the
information given in Essential Knowledge packs.
A self assessment questionnaire has been included to determine the level of existing knowledge and
understanding of the topics covered in the pack. This should be completed twice - once before
starting the pack and once on completion of the pack.
Health and Food Technology
Unit - Consumer Studies : Related Essential Knowledge
Context
Students should be able to demonstrate
knowledge and understanding when
proposing solutions to problems
concerning the impact of technological
innovation on consumer choice of food.
Content
Developments in food technology to
improve keeping qualities.
....concerning the implications of changes in Social trends relating to the purchasing and
social trends and manufacturers response
composition of foods.
to these changes.
...impact of technological innovation on
consumer choice.
Recent increase in the number and range of
ready meals being produced by
manufacturers
...changes in social trends and
manufacturer’s response to these changes
Social trends relating to the purchasing,
preparation and consumption of foods.
Changing pattern of food consumption at
home.
Current developments in food production
which are responding to consumer trends.
Lifestyle and Consumer Technology
COURSE CONTENT
Resource Management
CONTEXT
CONTENT
ELABORATION
(UNDERPINNING KNOWLEDGE FOR
PRACTICAL ACTIVITIES
• Students should be able to demonstrate
knowledge and understanding when proposing
solutions to problems concerning:
• individuals’ needs for clothing and food in
different domestic/community settings
• needs to be considered will take account
of: age, gender, body size, health,
occupation/unemployment; available
income, activities, interests and skills
• the relationship between diet, lifestyle and health
• analysis of the diets of groups of people
who live in a family or community
setting
• in relation to infants, young
children, teenagers, adults,
elderly and pregnant women
to include:
nutritional needs
the importance of exercise in
relation to health.
• use of Dietary Reference Values
for the above groups relating to
the intake of: energy; protein;
fats and fatty acids; starches and
sugar; NSP, vitamins A, B B2,
B3, C, D, E, folate, calcium,
iron, sodium
• the current health targets for population
the proposed Dietary Targets for
2005
CONTEXT
CONTENT
ELABORATION
(UNDERPINNING KNOWLEDGE FOR
PRACTICAL ACTIVITIES
Students should be able to demonstrate
knowledge and understanding when proposing
solutions to problems concerning:
• socio-economic factors affecting lifestyle and
consumer choice of goods and services
• economic circumstances
• influence of cultural factors
• available income from individuals
or members of the family group
who share expenses
• limited choice due to
poverty/increased choice due to
affluence
• on food choices
CONTEXT
CONTENT
ELABORATION
(UNDERPINNING KNOWLEDGE FOR
PRACTICAL ACTIVITIES
• socio-economic factors affecting lifestyles and
consumers choice of goods and services (contd.)
• education
• the implications of change in social trends on
individuals and families.
• social trends relating to:
purchasing of food
• purchasing of clothing
consumption of food
• advances in technology
(students should use statistics and
information from Social Trends HMSO)
• provision of school meals/school
meal
replacements
• growth of pre-prepared
foods/convenience
foods
increase in snack products
brand names
• fashion trends, peer pressure
increased snacking by children
and teenagers
fast food.
• innovations in food processing,
equipment, clothing
CONTEXT
CONTENT
ELABORATION
(UNDERPINNING KNOWLEDGE FOR
PRACTICAL ACTIVITIES
• the relationship between diet, lifestyle and
health
(cont’d)
• the needs for dietary targets
• how the effects of deprivation can
lead to malnutrition and under
nutrition with particular
reference to those who may face
problems in obtaining a balanced
diet to enjoy good health and
well-being, to include:
• the elderly
large families
• the causes and effects of certain
medical conditions in relation to:
• coronary heart disease (CHD)
CONTEXT
CONTENT
ELABORATION
(UNDERPINNING KNOWLEDGE FOR
PRACTICAL ACTIVITIES
• the relationship between diet, lifestyle and health
(cont’d)
• food choices to meet the current dietary
targets
• action to prevent the above
medical conditions through
appropriate choice of food and
cooking methods
• proposals for implementing the
health targets for a range of meal
provisions within the
family
feeding the family:
children, teenagers, adults,
elderly
• product development
• develop feasible and imaginative
products to meet needs using a range of
food resources
• school meals
examples
• the use of a range of resources to
develop imaginative ways to
encourage toddlers and children
to eat
• ways to stimulate the appetite of
the elderly
SPECIMEN QUESTIONS
The following questions are taken from Scottish Qualifications
Authority (SQA) specimen questions for external assessment
of Health and Food Technology (Questions 1 & 4)/Lifestyle
and Consumer Technology (Questions 2 & 3) at Higher Level
Home Economics.
These questions do not give coverage of either course and
therefore should not be used as evidence of such.
Marks
1.
(a)
(b)
Devise a set of five detailed guidelines to prevent obesity which could be
included as part of a school health policy.
(i)
5
School meals supervisors need to conserve nutrients when preparing
meals in advance of consumption.
Identify two vitamins which are easily lost when preparing, cooking
or storing foods.
(ii)
(c)
For each vitamin, describe and explain two ways the school
meals’ supervisor could help preserve these vitamins.
Breakfast is an important start to the day. Two breakfasts menus have
been suggested for a 16 year old girl. Study the menus and the dietary
information provided on the opposite page.
Using your knowledge and all the information provided, evaluate the
suitability of both menus for a 16-year old girl in terms of the total
nutritional value.
(d)
5
6
The star profile below shows the results of tasting new tomato-based
snack food.
Evaluate the suitability of this snack for a 3-5 year old child.
4
garlicky
_ 5
chunky
_ 4
tomatoey
_ 3
_ 2
rich
_1
fruity
sweet
spicy
salty
1. (Continued)
Breakfast Menu Analysis
Weight
(g)
Light breakfast 1
Cornflakes
Sugar
Milk, whole
White bread (1 large thin slice)
Margarine, polyunsaturated
Marmalade
Milk (whole) in 2 cups of tea
30
10
100
31
7
15
50
Protein
(g)
Fat
(g)
Saturated
fatty acids
(g)
Fibre
(g)
Sodium
(mg)
Vitamin C (mg)
461
168
275
287
213
167
138
108
39
66
67
52
39
33
2.4
0.0
3.2
2.4
0.0
0.0
1.6
0.2
0.0
3.9
0.4
5.7
0.0
2.0
Tr
0.0
2.4
0.1
1.1
0.0
1.2
0.3
0.0
0.0
0.5
0.0
0.1
0.0
333
0
55
164
56
3
28
0.0
0.0
1.0
0.0
0.0
1.5
0.5
1709
404
9.6
12.2
4.8
0.9
639
3.0
30
10
100
44
7
15
60
333
168
195
402
112
167
117
78
39
46
95
27
39
28
4.2
0.0
3.3
4.0
0.4
0.0
2.0
1.0
0.0
1.6
1.1
2.8
0.0
1.0
0.2
0.0
1.0
0.2
0.8
0.0
0.6
7.3
0.0
0.0
2.6
0.0
0.1
0.0
270
0
55
242
46
3
33
0.0
0.0
1.0
0.0
0.0
1.5
0.6
120
184
43
0.6
0.1
0.0
0.1
12
46.8
1678
395
14.5
7.6
2.8
10.1
661
49.9
Total
Light breakfast 2
All bran
Sugar
Milk, semi-skimmed
Wholemeal bread (thick slice)
Low fat spread
Marmalade
Milk (semi skimmed) in 2 cups of
tea
Orange juice, small glass
Energy
(kJ) (kcal)
Total
Estimated Average Requirements for Energy in the UK (per day)
15-18 years (female)
MJ
kcal
8.83
2110
Reference Nutrient Intakes for Selected Nutrients for UK (per day)
Female
15-18 years
Protein
(g)
Calcium
(mg)
Iron
(mg)
Zinc
(mg)
Vit A
(ug)
Thiamin
(mg)
Vit B6
(mg)
Folic Acid
(ug)
Vit C
(mg)
45.0
800
14.8
7.0
600
0.8
1.2
200
40
Marks
2.
(a)
Identify and discuss four socio-economic factors which may affect
the dietary intake of the elderlyor the rest of their lives.
6
(b)
Despite three ways the apetite of an elderly person could be stimulated.
3
(c)
A variety of marketing techniques is used by food manufacturers to target
consumers.
Consider the following marketing strategy for a new range of single portion
main meals designed for the elderly.
MARKETING STRATEGY
Single Portion Main Meals for the Elderly
Select a limited number of
meals from the new range
Produce a TV advertisement showing
elderly people cooking and eating
these meals
Use photographs from the TV advertisement for
insertion in local and
national newspapers
Distribute the new range to retail
outlets around the country
Evaluate how effective this strategy would be in marketing this new range.
Include, with reasons, any appropriate modifications or changes to the
strategy.
3.
(a)
(b)
Identify and discuss four factors which have brought about changes in
family lifestyles during the last twenty five years.
4
6
“Nutrition in the early years of life is a major determinant of growth and development. It also
influences adult health.”
(Eating for Health, A Diet Action Plan for Scotland, Scottish Office department of Health 1996)
Identify and explain four factors which parents should consider when
weaning their children.
6
4.
(a)
Market research suggests that there has been a marked change in the
number and range of ready meals consumed by households over the
past 10 years.
Identify and discuss four factors which have influenced this trend.
(b)
6
Read the following case study.
The following foods often feature in an elderly man’s diet.
· Cornflakes with whole milk and sugar
· Plain scones and white bread with butter and marmalade or
raspberry jam.
· Cups of tea with whole milk and sugar
· Tinned macaroni and cheese with peas
· Fried cod in batter with chips and beans
· Jelly and custard
(i) Evaluate the nutritional suitability of this type of diet for an elderly
man.
6
(ii) Identify and explain how Scottish dietary targets for the year 2005
could be used to improve this diet.
4