"Planning a Healthy Diet" Richard T. Patton, MA, MPH, RD/LN, CHES Changes 1980-2000 Increase in Prevalence (%) of Overweight (BMI >or= 25), Obesity (BMI >or=30) and Severe Obesity (BMI >or=40) Among U.S. Adults. Overweight (BMI >or= 25) Obesity (BMI >or= 25) Severe Obesity (BMI >or= 40) 1999 to 2000 64.5 30.5 4.7 1988 to 1994 56.0 23.0 2.9 1976 to 1980 46.0 14.4 No Data On any given day in the United States... 815 billion calories are consumed (200 billion more than needed) 47 million hot dogs 4 million pounds of bacon 60 million pounds of red meat 170 million eggs On any given day in the United States... 3 million gallons of ice cream 10 million pounds of candy 16 million gallons of beer and ale 1.5 million gallons of hard liquor (enough to make 26 million people drunk!) Obesity: Risk Factors Genetics Family history of obesity Psychological factors Social and cultural factors Medical Illnesses Medications Alcohol consumption Smoking Cessation “Bummer of a birthmark, Hal” Dietary Energy Blood sugar Carbohydrates Protein Fat Amino acids all Body Protein Body Fat Use Brain Metabolism Physical Activity Energy Balance •Type of energy •Amount at one time •Timing of meals •Energy stored in body •Metabolism •Daily Activity •Exercise-type and intensity •Thermal effect of meals Energy INTAKE Energy Expenditure Dietary Reference Intakes (DRI) . Dietary reference intakes are used to plan and evaluate diets for healthy people Establishing Nutrient Recommendations 1. Estimated Average Requirement (EAR) defines the requirement of a nutrient that supports a specific function in the body for half of the healthy population. 2. Recommended Dietary Allowances (RDA) use the EAR as a base and include sufficient daily amounts of nutrients to meet the known nutrient needs of practically all healthy populations. This recommendation considers deficiencies. 3. Adequate Intakes (AI) reflect the average daily amount of a nutrient without an established RDA that appears to be sufficient. 4. Tolerable Upper Intake Level (UL) is a maximum daily amount of a nutrient that appears safe for most healthy people and beyond which there is an increased risk of adverse health effects. Diet-Planning Principles Adequacy (dietary)—providing sufficient energy and essential nutrients for healthy people 2. Balance (dietary)—consuming the right proportion of foods 3. kcalorie (energy) control—balancing the amount of foods and energy to sustain physical activities and metabolic needs 4. Nutrient density—measuring the nutrient content of a food relative to its energy content a. Empty-kcalorie foods denote foods that contribute energy but lack nutrients. 5. Moderation (dietary)—providing enough but not too much of a food or nutrient 6. Variety (dietary)—eating a wide selection of foods within and among the major food groups 1. Dietary Guidelines for Americans 1. Adequate nutrients within energy needs a. Consume foods from all food groups and limit foods that can be detrimental to health. b. Consume a balanced diet. 2. Weight management a. Maintain a healthy body weight. b. Prevention of weight gain Dietary Guidelines for Americans 3. Physical activity a. Increase energy expenditure and decrease sedentary activities. b. Include cardiovascular conditioning, stretching, and resistance exercises. 4. Food groups to encourage a. Choose a variety of fruits, vegetables, milk and milk products, and whole grains. Dietary Guidelines for Americans 5. Fats a. Limit saturated fat, dietary cholesterol, and trans fats. b. Choose monounsaturated and polyunsaturated fat sources. c.Choose lean, low-fat, or fat-free foods. 6. Carbohydrates a. Choose those that are high in fiber. b. Choose products with a minimal amount of added sugar. c.Decrease the risk of dental caries. Dietary Guidelines for Americans 7.Sodium and potassium a.Choose foods that are low in salt and high in potassium. 8.Alcoholic beverages a.Drink in moderation. b.Some should not consume alcohol. 9.Food safety a.Wash and cook foods thoroughly and keep cooking surfaces clean. b.Avoid raw, undercooked, or unpasteurized products. Exchange Lists Exchange Lists help to achieve kcalorie control and moderation. 1.Foods are sorted by energynutrient content. 2.Originally developed for those with diabetes 3.Portion sizes vary within a group 4.Food groupings may not be logical "Planning a Healthy Diet" The name, slogan, and website present a personalized approach. The multiple colors of the pyramid illustrate variety: each color represents one of the five food groups, plus one for oils. Different widths of colors suggest the proportional contribution of each food group to a healthy diet. A person climbing steps reminds consumers to be physically active each day. The narrow slivers of color at the top imply moderation in foods rich in solid fats and added sugars. The wide bottom represents nutrientdense foods that should make up the bulk of the diet. Greater intakes of grains, vegetables, fruits, and milk are encouraged by the width of orange, green, red, and blue, respectively. GRAINS VEGETABLES FRUITS OILS MILK MEAT & BEANS Fig. 2-3, p. 47 Plan Meals thru the Day Think about what you are going to eat instead of eating by habit or impulse! Eat more earlier when more active Eat less later when less active i.e. a little often vs. a lot at once Plan Meals thru the Day Most (about 85%) 0f the calories people consume are by habit or impulse Most (about 65%) of the calories people consume are in the latter day Plan Meals thru the Day Most (about 85%) 0f the calories people consume are by habit or impulse Most (about 65%) of the calories people consume are in the latter day Sumo Wrestler meal planning Eat a Variety of Foods (at Each Meal) Provides more nutrition Each member of the family can choose what they want at that time Controls eating one food in excess Exposes a person to different foods Makes a better meal p. 38 Table 2-7, p. 48 Fig. 2-7, p. 52 Center Meals around the Carbohydrate Foods Answers the question “What am I supposed to eat”? Provides the best source of energy. Provides a lot of most nutrients, (including fiber) Low in fat, and has the ‘good’ type and contains no cholesterol. Most have protein, certainly enough. Are not fattening--fats are! Minimize FATS and SUGAR Fats are fattening Fats can lead to other health problems ‘Minimize’ fat intake, don’t eliminate it Sugar in large amounts is a problem Sugar is an enjoyable taste and may displace foods with more nutrition and be concentrated Fat and Sugar mix well with each other: the real problem “you’re eating too much sugar.” Your fired, Jack. Your lab results just came back, and you tested positive for Coke ‘WHAT CAN I DO ABOUT THESE BAD HANGOVERS I GET, DOCTOR’? ‘YOU CAN STOP DRINKING ALCOHOLIC BEVERAGES’! “NO SERIOUSLY, WHAT CAN I DO”? Don’t worry about PROTEINS Important for growth (height) and development Needed in smaller amount than most people think (.8 grams/kilogram BW) Can be gotten from a variety of carbohydrate foods as well as the protein foods (meat, dairy) Use as a part of the meal, not as the meal (eat lean, less and last) Thought of the day Give a man a fish and he will eat for a day. Teach him how to fish, and he will sit in a boat and drink beer all day. Fig. 2-8b, p. 54 The serving size and number of servings per container kCalorie information and quantities of nutrients per serving, in actual amounts Quantities of nutrients as “% Daily Values” based on a 2000kcalorie energy intake Daily Values reminder for selected nutrients for a 2000- and a 2500kcalorie diet kCalorie per gram reminder The ingredients in descending order of predominance by weight Fig. 2-8b, p. 54 Table 2-10, p. 59 “Leroy thinks nothing is like a brisk walk, so that’s what he does, nothing” Physical Activity Include: cardiovascular conditioning, stretching, resistance exercises or calisthenics for muscle strength and endurance Three more, two more, one more, okay!...Five million leg lifts right leg first! Ready “the only stretching Leroy does is when he yawns” I see no reason why you should not engage in strenuous activity Physical Activity Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and healthy body weight … Physical Activity Weight management – 60+ minutes of above while not exceeding intake requirement Sustain weight loss – 60 to 90 minutes of above … Reduce risk of chronic disease in adulthood by doing 30+ minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of week Health Claims Nutrition Related Health Claims allowed on Food Labels Calcium and Osteoporosis Sodium and Hypertension Dietary fat and Cancer Saturated fat & Cholesterol and heart disease Fiber foods and Cancer Soluble fiber foods and Heart Disease Fruits and vegetables and Cancer Oats and Heart Disease Folic Acid and Neural Tube Defects Thought of the day If at first you don't succeed, skydiving is not for you. Questions?