•
Guidelines for Healthy Eating
Chapter 8
•
How to Choose a Healthy Diet
•
A healthy diet provides enough of all essential nutrients to avoid deficiencies but not excessive
amounts that may increase the risk of nutrient toxicities or chronic diseases
•
Four of the 10 leading causes of death in the United States are associated with dietary excesses:
–
Heart disease
–
Cancer
–
Stroke
–
Diabetes
•
How to Choose a Healthy Diet (cont’d)
•
Many other health problems are related, at least in part, to dietary excesses
–
Obesity
–
Hypertension
–
Hypercholesterolemia
•
A healthy diet has the potential to alleviate the high economic and personal costs of morbidity
and mortality associated with these diseases
•
Healthy People 2010
•
Overall goals are to increase quality and years of healthy life and eliminate health disparities
among Americans
•
Specific, measurable objectives serve as the basis for monitoring and measuring improvements
in the nation’s health over the 10-year period from 2000 to 2010
•
Primarily Professional
•
Historically, recommended dietary allowances (RDAs) advocated a level of nutrients set to
protect people from nutrient deficiency diseases
•
Old RDAs have been replaced with a new set of standards, the dietary reference intakes (DRIs),
that incorporate an expanded focus of reducing the risk of chronic diseases associated with
dietary excesses
•
Primarily for professional use because they deal with quantities of nutrients as opposed to
amounts of food
•
Dietary Reference Intakes
•
Series of 8 in-depth reports featuring a new set of references called dietary reference intakes
(DRIs)
–
Cover vitamins, minerals, the energy nutrients, cholesterol, fiber, electrolytes, and
water
–
DRI is a group name that includes 4 separate reference values that are based on the
concepts of probability and risk:
o
Updated RDAs, estimated average requirement (EAR), adequate intake (AI), and
the tolerable upper intake level (UL)
o
Dietary Reference Intakes (cont’d)
•
Each of these reference values has a specific purpose and represents a different level of intake
•
Each reference value is viewed as an average daily intake over time, at least 1 week for most
nutrients
–
Additional reference values include acceptable macronutrient distribution ranges
(AMDRs) and an estimated energy requirement (EER)
•
Dietary Reference Intakes (cont’d)
•
Recommended dietary allowances
–
Represent the average daily recommended intake to meet the nutrient requirements of
97% to 98% of healthy individuals by life stage and gender
–
Based on specific criteria indicators
–
Set high enough to account for daily variations in intake
•
Question
•
The recommended daily allowances (RDAs) are said to be primarily for professional use. Why is
this?
a. Because they are based on a variety of
recommendations by professional people
b. Because it takes a professional to truly
understand them
c. Because only professional people are concerned
about what we eat
d. Because they deal with quantities of nutrients
•
rather than amounts of food
Answer
d. Because they deal with quantities of nutrients rather than amounts of food
Rationale: Historically, the recommended dietary allowances (RDAs) in the United States and the
recommended nutrient intakes in Canada established levels of nutrients to protect people from nutrient
deficiency diseases. Therefore, professionals had to interpret them in the diet.
•
Estimated Average Requirement
•
Amount of a nutrient that is estimated to meet the requirement of half of healthy people in a
lifestyle or gender group
•
Not based solely on the prevention of nutrient deficiencies
–
Consideration for reducing the risk of chronic disease
–
Takes into account the bioavailability of the nutrient
–
EAR values are used to determine RDA values
•
Adequate Intake
•
Adequate intake (AI) is set when an RDA cannot be determined due to lack of sufficient data on
requirements
•
A recommended average daily intake level thought to meet or exceed the needs of virtually all
members of a life stage/gender group based on observed or experimentally determined
estimates of nutrient intake by groups of healthy people
•
Primary purpose of the AI is as a goal for the nutrient intake of individuals
–
Tolerable Upper Intake Level
•
Highest level of average daily nutrient intake that is likely to pose no risk of adverse health
effects to almost all individuals in the general population
•
Not intended to be a recommended level of intake
•
Acceptable Macronutrient
Distribution Ranges
•
Broad ranges for each energy nutrient
•
Expressed as a percentage of total calories consumed
•
Associated with reduced risk of chronic disease while providing adequate intakes of essential
nutrients
•
Estimated Energy Requirements
•
Similar to the EAR
•
Defined as the dietary energy intake predicted to maintain energy balance in healthy, normalweight individuals of a defined age, gender, weight, height, and level of physical activity
consistent with good health
•
How Are the DRIs Used?
•
DRIs are used by:
–
Scientists and nutritionists who work in research or academic settings
–
Dietitians who plan menus for specific populations
–
Used to assess the adequacy of an individual’s intake by comparing estimated intake
with estimated requirements
–
DRIs are not suited to teaching people how to make healthy choices
–
Conveying the Concept of a
Healthy Diet to Consumers
•
Dietary Guidelines for Americans is most prominent tool to assist Americans in making wise food
choices
•
Companion tool is MyPyramid
•
Dietary recommendations also made by:
–
American Heart Association
–
American Cancer Society
–
American Institute of Cancer Research
•
Dietary Guidelines for Americans
•
Serves as the federal policy on nutrition
•
Evidence-based recommendations on diet and physical activity to promote health and decrease
the risk of chronic diet-related diseases
•
Covers 9 major messages
–
23 key recommendations
–
18 additional recommendations are made for specific population groups
•
Dietary Guidelines for Americans (cont’d)
•
Intended to represent a pattern of eating for Americans over the age of 2 years
•
Should ideally be implemented as a whole
•
Major themes:
–
Eat fewer calories
–
Be more physically active
–
Make wiser food choices
•
Question
•
Is the following statement true or false?
The tolerable upper intake level is not intended to be a recommended level of intake.
•
Answer
True.
Rationale: The tolerable upper intake level (UL) is the highest level of average daily nutrient
intake that is likely to pose no risk of adverse health effects to almost all individuals in the general
population. It is not intended to be a recommended level of intake.
•
MyPyramid
•
Newest generation of the food guide
•
Vehicle by which the Dietary Guidelines for Americans are translated into food and activity
choices for healthy individuals over the age of 2
•
Philosophy is that nutrient needs should be met through food, not supplements
•
MyPyramid (cont’d)
•
Basic messages
–
Eat more fruit, vegetables, and whole grains
–
Eat less saturated fat, trans fat, and cholesterol
–
Limit sweets and salt
–
Use alcohol in moderation, if at all
–
Balance calorie intake with calorie expenditure
–
Be physically active most days of the week
•
MyPyramid (cont’d)
•
Designed to convey the concepts of:
–
Variety
–
Moderation
–
Proportionality
–
Gradual improvement
–
Personalization
–
Physical activity
•
Clearing Up Controversy
•
Putting knowledge into practice is difficult
•
Misunderstandings about servings and food group placement are common
–
Appropriate calorie level
o
Actually an estimate of how many calories a person of similar age and average
height and weight needs to maintain an appropriate weight
•
Clearing Up Controversy (cont’d)
•
Discretionary calories
–
Allow consumers to incorporate small amounts of calorie-dense or “empty calorie”
foods into their eating plan and still meet nutrient needs without exceeding total calorie
constraints
–
Discretionary calories may be “eaten up” by choosing foods within the existing plan that
are high in fat or added sugar
•
Clearing Up Controversy (cont’d)
•
Discretionary calories (cont’d)
–
Recommendations for the amount of food to consume are based on the “healthiest”
choices within each group
–
Selecting the “healthiest” choices from each food group is vital for achieving
appropriate calorie and nutrient recommendations
•
Clearing Up Controversy (cont’d)
•
Serving sizes
–
Quality of foods chosen influences total calorie intake, so does the quantity of foods
eaten
–
Large serving sizes contribute to overeating
–
Most effective way to downsize portion sizes may be to change a person’s environment
•
Clearing Up Controversy (cont’d)
•
Variety
–
Eating a varied diet helps ensure essential nutrients are consumed in adequate amounts
o
Guidelines and Graphics in Other Countries
•
Pyramid shape is not necessarily superior or even appropriate for food guides in other countries
•
Core recommendations are consistently similar
•
Recommendations From Health Agencies
•
Recommendations are similar to each other and to the Dietary Guidelines for Americans
–
American Plate, a campaign by the American Institute of Cancer Research to teach
Americans how to implement their diet guidelines, uses a dinner plate as a visual aid
–
Landmark report entitled Food Nutrition and the Prevention of Cancer: A global
perspective
–
Additional recommendations regarding physical activity and weight management are
offered