Diet & Nutrition
The current Dietary Guidelines for Americans released in 2005 (Box 1-3) emphasize (1)
smart choices from every food group, (2) a balance between food and activity, and (3)
getting the most nutrition from calories.52 They give helpful advice for choosing foods
rich in important nutrients but low in fat and sodium. Older, at-risk women who adhered
to these Guidelines slowed the progression of their coronary artery disease.53 (The 2005
Dietary Guidelines will remain in effect until the 2010 Guidelines are released. See the
Evolve website for the new guidelines when they become available.)
BOX 1-3 2005 Dietary Guidelines For Americans—Key Recommendations
Adequate Nutrients Within Calorie Needs


• Consume a variety of nutrient-dense foods and beverages within and among the
basic food groups while choosing foods that limit the intake of saturated and trans
fats, cholesterol, added sugars, salt, and alcohol.
• Meet recommended intakes within energy needs by adopting a balanced eating
pattern, such as the USDA Food Guide (MyPyramid) or the Dietary Approaches
to Stop Hypertension (DASH) Eating Plan.
Recommendations for Specific Population Groups




• People over age 50. Consume vitamin B12 in its crystalline form (i.e., fortified
foods or supplements).
• Women of child-bearing age who may become pregnant. Eat foods high in
heme-iron and/or consume iron-rich plant foods or iron-fortified foods with an
enhancer of iron absorption, such as vitamin C–rich foods.
• Women of child-bearing age who may become pregnant and those in the first
trimester of pregnancy. Consume adequate synthetic folic acid daily (from
fortified food or supplements) in addition to food forms of folate from a varied
diet.
• Older adults, people with dark skin, and people exposed to insufficient
ultraband radiation (i.e., sunlight). Consume extra vitamin D from vitamin D–
fortified foods and/or supplements.
Weight Management


• To maintain body weight in a healthy range, balance calories from foods and
beverages with calories expended.
• To prevent gradual weight gain over time, make small decreases in food and
beverage calories and increase physical activity.
Recommendations for Specific Population Groups





• Persons who need to lose weight. Aim for a slow, steady weight loss by
decreasing calorie intake while maintaining an adequate nutrient intake and
increasing physical activity.
• Overweight children. Reduce the rate of body weight gain while allowing
growth and development. Consult a health care provider before placing a child on
a weight-reduction diet.
• Pregnant women. Ensure appropriate weight gain as specified by a health care
provider.
• Breastfeeding women. Moderate weight reduction is safe and does not
compromise weight gain of the nursing infant.
• Overweight adults and overweight children with chronic diseases and/or
medication. Consult a health care provider about weight loss strategies before
starting a weight-reduction program to ensure appropriate management of other
health conditions.
Physical Activity






• Engage in regular physical activity and reduce sedentary activities to promote
health, psychological well-being, and a healthy body weight.
• To reduce the risk of chronic disease in adulthood, engage in at least 30 minutes
of moderate-intensity physical activity, above the usual activity, at work or home
on most days of the week.
• For most people, increased health benefits can be obtained by engaging in
physical activity of more vigorous intensity or extended duration.
• To help manage body weight and prevent gradual, unhealthy body weight gain
in adulthood, engage in approximately 60 minutes of moderate- to vigorousintensity activity on most days of the week while not exceeding caloric intake
requirements.
• To sustain weight loss in adulthood, participate in at least 60 to 90 minutes of
daily moderate-intensity physical activity while not exceeding caloric intake
requirements. Some people may need to consult with a health care provider before
participating in this level of activity.
• Achieve physical fitness by including cardiovascular conditioning, stretching
exercises for flexibility, and resistance exercises or calisthenics for muscle
strength and endurance.
Recommendations for Specific Population Groups


• Children and adolescents. Engage in at least 60 minutes of physical activity on
most, preferably all, days of the week.
• Pregnant women. In the absence of medical or obstetric complications,
incorporate 30 minutes or more of moderate-intensity physical activity on most, if
not all, days of the week. Avoid activities with a high risk of falling or abdominal
trauma.


• Breastfeeding women. Be aware that neither acute nor regular exercise adversely
affects the mother's ability to breastfeed successfully.
• Older adults. Participate in regular physical activity to reduce functional
declines associated with aging and to achieve the other benefits of physical
activity identified for all adults.
Food Groups to Encourage




• Consume a sufficient amount of fruits and vegetables while staying within
energy needs. Two cups of fruit and 2½ cups of vegetables per day are
recommended for a reference 2000-calorie intake, with higher or lower amounts
depending on the calorie level.
• Choose a variety of fruits and vegetables each day. In particular, select from all
five vegetable subgroups (dark-green, orange, legumes, starchy vegetables, and
other vegetables) several times a week.
• Consume three or more ounce-equivalents of whole-grain products per day, with
the rest of the recommended grains coming from enriched or whole-grain
products. In general, at least one half the grains should come from whole grains.
• Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.
Recommendations for Specific Population Groups

• Children and adolescents. Consume whole-grain products often; at least one
half the grains should be whole grains. Children 2 to 8 years of age should
consume 2 cups per day of fat-free or low-fat milk or equivalent milk products.
Children 9 years of age and older should consume 3 cups per day of fat-free or
low-fat milk or equivalent milk products.
Fats




• Consume less than 10% of calories from saturated fatty acids and less than 300
mg/day of cholesterol, and keep trans fatty acid consumption as low as possible.
• Keep total fat intake between 20% and 35% of calories, with most fats coming
from sources of polyunsaturated and monounsaturated fatty acids, such as fish,
nuts, and vegetable oils.
• When selecting and preparing meat, poultry, dry beans, and milk or milk
products, make choices that are lean, low fat, or fat free.
• Limit intake of fats and oils high in saturated and/or trans fatty acids, and
choose products low in such fats and oils.
Recommendations for Specific Population Groups

• Children and adolescents. Keep total fat intake between 30% and 35% of
calories for children 2 to 3 years of age and between 25% and 35% of calories for
children and adolescents 4 to 18 years of age, with most fats coming from sources
of polyunsaturated and monounsaturated fatty acids such as fish, nuts, and
vegetable oils.
Carbohydrates



• Choose fiber-rich fruits, vegetables, and whole grains often.
• Choose and prepare foods and beverages with little added sugars or caloric
sweeteners, such as amounts suggested by the USDA Food Guide (MyPyramid)
and the DASH Eating Plan.
• Reduce the incidence of dental caries by practicing good oral hygiene and
consuming sugar- and starch-containing foods and beverages less frequently.
Sodium and Potassium


• Consume less than 2300 mg of sodium (approximately 1 tsp of salt) per day.
• Choose and prepare foods with little salt. At the same time, consume potassiumrich foods, such as fruits and vegetables.
Recommendations for Specific Population Groups

• Individuals with hypertension, African Americans, and middle-aged and older
adults. Aim to consume no more than 1500 mg of sodium per day, and meet the
potassium recommendation (4700 mg/day) with food.
Alcoholic Beverages



• Persons who choose to drink alcoholic beverages should do so sensibly and in
moderation—defined as the consumption of up to one drink per day for women
and up to two drinks per day for men.
• Alcoholic beverages should not be consumed by some individuals, including
those who cannot restrict their alcohol intake, women of childbearing age who
may become pregnant, pregnant and lactating women, children and adolescents,
individuals taking medications that can interact with alcohol, and those with
specific medical conditions.
• Alcoholic beverages should be avoided by individuals engaging in activities that
require attention, skill, or coordination, such as driving or operating machinery.
Food Safety

• To avoid microbial foodborne illness, do the following:
o •Clean hands, food contact surfaces, and fruits and vegetables. Meat and
poultry should not be washed or rinsed.
o •Separate raw, cooked, and ready-to-eat foods while shopping, preparing,
or storing foods.
o •Cook foods to a safe temperature to kill microorganisms.
o •Chill (refrigerate) perishable food promptly, and defrost foods properly.
o
•Avoid raw (unpasteurized) milk or any products made from
unpasteurized milk, raw or partially cooked eggs or foods containing raw
eggs, raw or undercooked meat and poultry, unpasteurized juices, and raw
sprouts.
Recommendations for Specific Population Groups


• Infants and young children, pregnant women, older adults, and persons who are
immunocompromised. Do not eat or drink raw (unpasteurized) milk or any
products made from unpasteurized milk, raw or partially cooked eggs, raw or
undercooked meat and poultry, raw or undercooked fish or shellfish,
unpasteurized juices, and raw sprouts.
• Pregnant women, older adults, and persons who are immunocompromised. Only
eat certain deli meats and frankfurters that have been reheated to steaming hot.
Note: For detailed information on food selection and food sources of specific nutrients,
see the complete Dietary Guidelines for Americans 2005, available at
www.health.gov/Dietary Guidelines/.
From U.S. Department of Health and Human Services, U.S. Department of Agriculture:
Dietary guidelines for Americans 2005, ed 6, Washington, DC, 2005, U.S. Government
Printing Office. See the Evolve website for the 2010 Dietary Guidelines when they
become available.
Although the Dietary Guidelines provide positive goals for food selection, they do not
include a daily food pattern that tells consumers the specific items of food they should eat
and how much. Offering help with meal planning is the role of the third type of nutrition
guide—the food guides.
Food Guides
Food guides are intended to help individuals with day-to-day meal planning. They give a
practical interpretation of nutrition standards and dietary guidelines useful in daily food
selection. Most food guides group foods based on their nutrient content and recommend a
certain number of servings from each group. The most commonly used food group guides
are the MyPyramid developed by the USDA and USDHHS and Choose Your Foods:
Exchange List for Diabetes from the American Diabetes Association and the American
Dietetic Association. These guides group foods differently and serve different needs.
USDA Food Guides
The USDA issued its first food guide in the 1940s, and, over time, food guides evolved to
various shapes and formats. MyPyramid: Steps to a Healthier You, the current USDA
food guidance system, provides one-stop shopping for advice on both food intake and
physical activity.54
MyPyramid Food Guidance System
MyPyramid promotes a personalized approach to healthy eating and physical activity
(Figure 1-4).55 The pyramid symbol reminds consumers to make healthy food choices
and be
FIGURE 1-4 MyPyramid: Steps to a Healthier You. The MyPyramid graphic emphasizes
activity, moderation, personalization, proportionality, variety, and gradual improvement.
(From Center for Nutrition Policy and Promotion: MyPyramid food guidance system
mini-poster, Washington, DC, 2005, U.S. Department of Agriculture. Retrieved July 29,
2009, from www.mypyramid.gov/downloads/MiniPoster.pdf.)
physically active every day. The vertical food bands include grains, vegetables, fruits,
milk, oils, and meat and beans. Consumers are reminded to eat servings from different
categories of food that supply specific nutrients (Table 1-2), although, for the general
public, food should remain the fundamental unit in nutrition.56
TABLE 1-2 Major Nutrients Supplied by the Mypyramid Food Groups
Food Group
Major Nutrients*
Serving Equivalents
Food Group
Fruit group (color code
red)
Major Nutrients*
Vitamin C
Folate
Potassium
Serving Equivalents
1 cup fruit or 1 cup 100% fruit juice or
½ cup dried fruit equals 1 cup from
the fruit group
Fiber
Vitamin A
Vitamin C
Vitamin E
Vegetable group (color
code green)
Vitamin B6
Folate
1 cup raw or cooked vegetables or 1
cup vegetable juice or 2 cups raw
leafy greens equal 1 cup from the
vegetable group
Potassium
Fiber
Thiamin
Riboflavin
Grains group (color code
Niacin
orange)Enriched grains
Folate
Whole grains
1 slice of bread, 1 cup ready-to-eat
cereal, or ½ cup cooked rice, pasta, or
cooked cereal equals 1 oz from the
grains group
Iron
Zinc, magnesium and
fiber in addition to the
nutrients in enriched
grains
Protein
Thiamin
Meat, poultry, fish, eggs,
Riboflavin
beans, and nut group
(color code purple)
Niacin
Vitamin B6
1 oz lean meat, poultry, or fish, 1 egg,
1 tbsp peanut butter, ¼ cup cooked
dry beans, or ½ oz nuts or seeds
equals 1 oz from the meat and beans
group
Food Group
Major Nutrients*
Vitamin B12†
Serving Equivalents
Iron
Zinc
Vitamin E (nuts)
Protein
Vitamin A
Riboflavin
Milk group (color code
blue)
Vitamin B12
Calcium
1 cup milk, 1 cup yogurt, 1½ oz
natural cheese or 2 oz processed
cheese equals 1 cup from the milk
group
Phosphorus
Magnesium
Vitamin E
Oils and soft margarine
(color code yellow)
Linoleic acid‡
6 tsp
Alpha-linolenic acid
Modified from Dietary Guidelines Advisory Committee, 2005: Report of the dietary
guidelines advisory committee on the dietary guidelines for Americans 2005, U.S.
Department of Agriculture, Agricultural Research Service, Beltsville, Md, 2004 (August).
* Each of the MyPyramid food groups is a major source of the nutrients listed but also
adds smaller amounts of other nutrients to the daily diet.
† Vitamin B12 is found only in animal foods.
‡ Linoleic acid and alpha-linolenic acid are the essential fatty acids that we obtain from
dietary fats.
The MyPyramid interactive website55 gives access to daily food plans ranging from 1000
kcal to 3200 kcal, intended for individuals age 2 and older (Table 1-3). Persons can view
both the types and amounts of food needed for their age, gender, and activity level.
Figure 1-5 displays the reference food intake pattern containing 2000 kcal. Attractive
nutrition aids offer help with choices within each food group, learning to vary your
veggies, and tracking the number of kcalories you eat each day. Each food plan defines
the number of discretionary calories that can be used for solid fats, added sugars, alcohol,
or added servings from any food group. However, for sedentary persons, discretionary
calories are quite limited. Note that the 2000-kcal food plan allows only 267 discretionary
calories—the equivalent of two chocolate chip cookies. The MyPyramid website has
become an enormously popular resource for the public, registering over 600 million hits
in its first 3 months of operation57 and 5.7 billion hits since then.58
TABLE 1-3 Mypyramid Food Intake Patterns For Different Kcalorie Levels
Daily Amount of Food from
Each Group
Calorie
1000 1200 1400 1600 1800 2000 2200 2400 2600 2800
Level1
1
1
1½ 1½ 2
2
2
2
2½
Fruits2
1½cups
cup cup
cups cups cups cups cups cups cups
1
1½ 1½
2
2½ 2½ 3
3
3½ 3½
Vegetables3
cup cups cups
cups cups cups cups cups cups cups
10
3 oz- 4 oz5 oz- 6 oz- 6 oz- 7 oz- 8 oz- 9 oz4
Grains
5 oz-eq
ozeq eq
eq eq eq
eq eq
eq
eq
Whole grains 1.5 2
2.5
3
3
3
3.5 4
4.5 5
Other grains 1.5 2
2.5
2
3
3
3.5 4
4.5 5
5½
6½ 6½
Meat and
2 oz- 3 oz5 oz- 5 oz6 oz7 oz4
oz-eq
ozoz- oz5
beans
eq eq
eq eq
eq
eq
eq
eq
eq
2
2
3
3
3
3
3
3
3
Milk6
2 cups
cups cups
cups cups cups cups cups cups cups
Oil7
3 tsp 4 tsp 4 tsp
3000 3200
2½
cups
4
cups
10
ozeq
5
5
2½
cups
4
cups
10
ozeq
5
5
7 oz- 7 ozeq eq
3
cups
10
5 tsp 5 tsp 6 tsp 6 tsp 7 tsp 8 tsp 8 tsp
tsp
3
cups
11
tsp
Discretionary
calorie
165 171 171
132 195 267 290 362 410 426 512 648
8
allowance
 1. Calorie Levels are set across a wide range to accommodate the needs of
different individuals. Another table found on the MyPyramid website “Estimated
Daily Calorie Needs,” can be used to help assign individuals to a particular calorie
level.
 2. Fruit Group includes all fresh, frozen, canned, and dried fruits and fruit juices:
1 cup of fruit or 100% fruit juice, or ½ cup of dried fruit, can be considered as 1
cup from the fruit group.
 3. Vegetable Group includes all fresh, frozen, canned, and dried vegetables and
vegetable juices: 1 cup of raw or cooked vegetables or vegetable juice, or 2 cups
of raw leafy greens, can be considered as 1 cup from the vegetable group.
 4. Grains Group includes all foods made from wheat, rice, oats, cornmeal, or
barley, such as bread, pasta, oatmeal, breakfast cereals, tortillas, and grits: 1 slice
of bread, 1 cup of ready-to-eat cereal, or ½ cup of cooked rice, pasta, or cooked
cereal can be considered as 1 ounce equivalent from the grains group. At least
one half of all grains consumed should be whole grains.
 5. Meat and Beans Group includes meat, poultry, fish, dry beans and peas, eggs,
Daily Amount of Food from
Each Group
Calorie
1000 1200 1400 1600 1800 2000 2200 2400 2600 2800 3000 3200
Level1
nuts and seeds: 1 ounce of lean meat, poultry, or fish, 1 egg, 1 tbsp peanut butter,
¼ cup cooked dry beans, or ½ ounce of nuts or seeds can be considered as 1
ounce equivalent from the meat and beans group.
 6. Milk Group includes all fluid milk products and foods made from milk that
retain their calcium content, such as yogurt and cheese. Foods made from milk
that have little to no calcium, such as cream cheese, cream, and butter, are not part
of the group. Most milk group choices should be fat free or low fat: 1 cup of milk
or yogurt, 1½ ounces of natural cheese, or 2 ounces of processed cheese can be
considered as 1 cup from the milk group.
 7. Oils include fats from many different plants and from fish that are liquid at
room temperature, such as canola, corn, olive, soybean, and sunflower oil. Some
foods are naturally high in oils, such as nuts, olives, some fish, and avocados.
Foods that are mainly oil include mayonnaise, certain salad dressings, and soft
margarine.
 8. Discretionary Calorie Allowance is the remaining amount of calories in a
food intake pattern after accounting for the calories needed for all food groups—
using forms of foods that are fat free or low fat and with no added sugars.
From Center for Nutrition Policy and Promotion: MyPyramid food intake patterns,
Washington, DC, 2005, U.S. Department of Agriculture. Retrieved July 30, 2009, from
www.mypyramid.gov/downloads/MyPyramid_Food_Intake_Patterns.pdf.
oz-eq, Ounce-equivalents.
FIGURE 1-5 MyPyramid food intake pattern for a 2000-kcal diet. Consumers can access
a food intake pattern based on their age, gender, and level of physical activity to assist
them in daily food selection.
(From Center for Nutrition Policy and Promotion: MyPyramid food guidance system
mini-poster, Washington, DC, 2005, U.S. Department of Agriculture. Retrieved July 29,
2009, from www.mypyramid.gov/downloads/MiniPoster.pdf.)
Although MyPyramid is not intended to provide a therapeutic diet for any specific health
condition, it is remarkably consistent with the Dietary Approaches to Stop Hypertension
(DASH) diet pattern proposed by the National Heart, Lung and Blood Institute and the
food patterns proposed by the American Heart Association and the American Cancer
Society. However, individuals must select the appropriate kcalorie level and profile of
foods within the choices provided to be compliant with these patterns.59 We will explore
the MyPyramid for Kids in Chapter 12.
Successful implementation of any food and activity plan requires an understanding of
serving size and physical activity levels, but both concepts are poorly understood by the
general public. Consumers often describe a serving size as “what I have on my plate,”60
and this confusion has contributed to weight gain across all age groups.61 MyPyramid
gives food amounts in household measures and illustrations of various serving sizes.
Advice is also offered on how to divide the ingredients of mixed dishes such as pizza into
the appropriate food group portions. Consumers might be encouraged to measure their
food servings for several meals at home to establish what standard serving sizes look like.
Figure 1-6 presents a simple tool that can be carried in a wallet or school pack to help
with serving size.
Estimating activity level—sedentary, low active, or active—is also difficult, given that
most of us think we are more physically active than we really are. MyPyramid provides
definitions and offers suggestions for increasing physical activity to at least 30 minutes
on most days. As we see in Figure 1-5, 60 minutes of daily physical activity may be
needed to prevent weight gain and more than 60 minutes daily to sustain weight loss.
When using MyPyramid, think about the stepwise progression found on the graphic.
Steps to a Healthier You supports the idea of small changes over time that will
accumulate and positively affect health.
Despite the efforts of health and nutrition professionals to develop nutrition programs to
assist individuals in planning their meals and snacks, intakes of healthy foods such as
fruit and vegetables still fall far below optimal levels. Nutrition messages that are easy to
understand, tailored to specific
FIGURE 1-6 Serving size card. This pocket-sized guide can be useful when choosing
serving sizes at home and away from home.
(From U.S. Department of Health and Human Services, National Institutes of Health,
National Heart, Lung and Blood Institute, Obesity Education Initiative: Keep an eye on
portion size, Bethesda, Md, 2004, U.S. Department of Health and Human Services.
Retrieved July 29, 2009, from http://hp2010.nhlbihin.net/portion/servingcard7.pdf.)
audiences, and make use of existing technology require the combined efforts of
behavioral and communication experts working side by side with nutrition scientists.
Government agencies and nutrition educators must join forces to produce practical
materials in formats and languages appropriate to all segments of our society.62–63
Exchange Lists for Meal Planning
The Exchange Lists for Meal Planning was introduced in 1950 by the American Diabetes
Association and the American Dietetic Association as a meal-planning tool for persons
with diabetes. The Exchange Lists group foods based on macronutrient content and
equivalent energy values, making this tool useful for planning any diet in which control
of carbohydrate, fat, protein, and total kcalories is the goal. Because the foods in each list
are equal to one another when eaten in the portions indicated, items can be freely
interchanged within each list, and food values and kcalories remain constant. The
freedom to exchange within groups promotes increased variety and satisfaction with
meals and snacks.
The most recent edition of the Choose Your Foods: Exchange List for Diabetes is found
in Appendix B.64 Foods are arranged into the following three groups:



1.Carbohydrates: includes starches (grains, starchy vegetables, crackers, snacks,
and legumes), fruits, milk, sweets, and nonstarchy vegetables
2.Meat and meat substitutes: includes animal protein foods arranged by fat
content (lean, medium fat, and high fat) and plant-based proteins
3.Fats: includes both animal and plant fats arranged by degree of saturation—
unsaturated (monounsaturated and polyunsaturated) and saturated
Serving sizes and macronutrient content for combination foods, fast foods, and free foods
are also provided. Use of the Exchange Lists in helping persons with diabetes plan their
carbohydrate intake is discussed in Chapter 22.
A safe and healthy food supply
Prevalence and Causes of Foodborne Illness
When planning your nutrient intake, an equally important issue is the safety of the food
that supplies those nutrients. Contamination can occur at any point as a food travels from
the farm to the processor to the marketplace or food service worker and finally to the
consumer, but it does not end there. How we store, prepare, or reheat food items after
they enter our home also presents opportunities for food spoilage and foodborne illness.
Between 250 million and 350 million Americans suffer acute gastroenteritis each year,
and 25% to 30% are believed to result from foodborne illness.65 Although most healthy
individuals recover after a few hours or days of distress, 5000 people die. Foodborne
illness within a household often goes unreported, whereas outbreaks involving large
numbers of people within a community or related to a national supplier are highly
publicized. Traditionally, protein foods—meat, milk, poultry, and eggs—were most
likely the source of foodborne illness, and food safety education emphasized appropriate
cooking and storage of these items. In recent years, however, national outbreaks of
foodborne illness have been traced to bottled water, fruit, and salad greens, with
contamination relating to processing and agricultural practices.
Groups particularly vulnerable to foodborne illness are elderly adults, children (especially
those under the age of 5), pregnant women, and patients with compromised immune
function as related to acquired immunodeficiency syndrome or cancer. Nursing homes
and long-term care facilities; food programs in day care centers, schools, and senior
centers; and meal delivery programs to homebound elderly persons must be especially
vigilant.
Perspective on Food Safety
The goal of a safe food supply goes beyond the control of microorganisms that cause
foodborne illness. Appropriate use of pesticides, the testing of genetically modified
plants, the evaluation and approval of food additives before their use in human or animal
foods, and the on-going monitoring of imported foods all play a role in ensuring the
overall safety of the food we eat. In our study of foods and nutrition we will address the
need for food inspection and safety education and the government agencies responsible
for their implementation.
Assessing food patterns
Personal Perceptions of Food
Each of us develops ways of eating based on our ethnic background, cultural or religious
beliefs, family habits, socioeconomic status, health status, geographic location, and
personal likes and dislikes. However, the growing ethnic and cultural diversity in our
society has brought about a greater intermingling of foods and ideas about food. How
people perceive themselves in relation to food and food patterns also plays a role in their
attitudes toward food and personal eating behavior.
A simple way to get an idea of your own food pattern (or that of a patient or client) is to
look at what you actually eat. (See the Perspectives in Practice box, “My Personal Food
Patterns—Do They Need Improvement?” for directions on keeping a food record.)
Keeping a record of everything you eat and drink for a day noting the time, place, any
related activity, and people with you gives insight to your true relationship with food.
Most of us eat by habit, according to where we are and what is available, rather than by
serious thought or plan. Evaluating food and beverage intake using the MyPyramid plan
for the appropriate kcalorie intake increases awareness of personal food patterns and
provides a rapid dietary assessment of those we counsel in community or health care
settings.
Nutritional Analysis by Nutrients and Energy Values
A comprehensive nutritional analysis of food intake is accomplished using a computerassisted nutrient analysis program, as included on the Evolve website that accompanies
this text. A computer-assisted program enables you to evaluate individual vitamins and
minerals, specific fats, fiber, and energy as compared to the DRIs. Government agencies
use such a nutritional analysis to evaluate dietary information obtained in national
surveys and identify nutrition problems among various age, gender, or ethnic groups.
To sum up
The role of nutrition in human health has evolved in response to our changing society and
food supply. As the supply of available food increased and the physical activity required
in daily living decreased, overweight and obesity emerged as major health problems in
the United States and many parts of the world. Discoveries of new substances in food that
are beneficial to health have attracted the attention of nutrition experts and food
technologists and led to the definition of functional foods. Despite the accessibility of
foods rich in vitamins and minerals, many Americans choose a diet high in sugar and fat
compromising their nutritional status. Others are chronically undernourished as a result of
illness or disease or inadequate resources for purchasing appropriate amounts or types of
food, increasing their vulnerability to infection, poor growth, and nutrition-related
disease. Resources developed by government scientists are available for use in planning
and evaluating the diets of both individuals and population groups. The DRIs intended for
use by health professionals provide the foundation for the Dietary Guidelines for
Americans and MyPyramid that offer practical guidance for meal planning. Together,
these materials build a framework for public policy that directs state and federal nutrition
programs and health education messages reaching people of all ages.
Williams' Essentials of Nutrition and Diet Therapy, 10th Edition
Ch. 1 P-13-21