Ingrid K. Richards Adams, PhD RD LD LDE

• I view teaching as an extraordinary opportunity to make a difference in the lives of individuals by stimulating cognitive and emotional growth, encouraging the love of knowledge, and by empowering individuals to strive for excellence.

• I believe preparing individuals to solve societal problems. This means develop critical thinking and problem-solving skills in individuals.

• Explain the relationship between nutrition and chronic disease
• Explains what happens to the food we eat
• Describe the role of macronutrients in promoting health and wellness
• Identify myths related to macronutrients

• Develop skills in evaluating nutrition claims by using nutrition research
• Build self-efficacy in disseminating sound nutrition advice to the public

•
Provide basic nutrition information
•
Why follow certain nutrition recommendations
• What’s in the news

The Obesity Epidemic

Lack of Physical Activity

• Poor eating habits associated with 4 of the
10 leading causes of death: heart disease, some types of cancers, stroke, and type 2 diabetes
• Death from any cause can be eliminated in
16% men and 9% women by adopting recommended dietary behavior
Source: Kant et al. (2004). Dietary patterns predict mortality in a national co-hort. The
National cohort: The National Health Interview Surveys, 1987 and 1992. Journal of
Nutrition.

?
 Poor diet is associated with 4 of 10 leading causes of death:
Heart disease
-Some types of cancer
-Stroke
-Type 2 diabetes
 Adequate diet plus regular exercise may reduce your chances of developing these serious chronic diseases.

• Heart disease, cancer, diabetes for 70% of all deaths in the US—1.7 million deaths each year
• As of January 19, -87,601 people have died from chronic disease this year.
• January 20- 91,910 (4,309/day)

• 7 out of 10 deaths are from chronic diseases.
• Heart disease, cancer and stroke account for more than 50% of all deaths each year.
1
• In 2005, 133 million Americans – almost 1 out of every 2 adults – had at least one chronic illness.

Nutrition is the study of:
• Food and how it functions in the body.
• Factors (physiological, social, cultural, economic, and technological) that influence the food choices we make.
• The biological processes by which we consume food and utilize the nutrients it contains
Source: Smolin and Grosvenor, 2003

• Food is any solid or liquid which when eaten nourishes the body
• Nutrients- substances found in food that are used in the body for growth, repair and protection

• Macronutrients
– Carbohydrates
– Protein
– Lipids/fats
– Water
• Micronutrients
– Vitamins
– Minerals

• Energy yielding nutrients (needed in gram amounts)
• Carbohydrate (130g/day)
• Protein (0.8g/kg)
• Fat (20-35% E)
• Non-energy yielding nutrients
• Water (3.7L, 2.7L)
• Vitamin – needed in small amounts (ug)
• Mineral -- needed in small amounts (ug)

•
Grains
•
Legumes
•
Fruits
•
Vegetables
•
Milk
•
Sweets
Starch is a common carbohydrate. It is made up of linked glucose units .

•
Oils
•
Margarines and butter
•
Nuts and seeds; nut butters
•
Full fat dressings (e.g., mayonnaise)
•
Meats, poultry, fish—high fat versions (sausages, bacon)
•
Eggs
•
Milk and milk products—full fat versions
•
Avocado

Common Sources:
•
Egg
•
Milk and milk products
•
Meat, fish
---------------------
•
Grains
•
Legumes
•
Nuts/seeds
•
Vegetables
Source: National Nutrient Database
Vegetable sources of protein in 100g of food, raw- green peas (5.42g), spinach
(2.86g), kale (4.28g), mushroom (1.49 g – 3.12g ), alfalfa sprouts (3.99g)

Nutrient Food source
Vitamin A Fruit/Veg/Diary/Fat
Vitamin D Dairy/fish/eggs
Vitamin E Fats/vegetables
Vitamin K Vegetables
Folate Vegetables/fruits
Vitamin C Vegetables/fruits
Niacin Grains
Thiamine Grains
Nutrient Food Source
Riboflavin Grains/dairy
Vitamin B12 Animal foods
Vitamin B6 Meats/beans
Calcium
Iron
Dairy/vegetables
Grains/meats/beans/veg
Zinc
Potassium
Grains/meats/beans
Vegetables/fruits
Chromium Grains/meats/beans

Function Nutrient
Energy Carbohydrate
Example
Blood glucose; provides energy for cells
Structure
Regulations
Lipid
Protein
Lipid
Protein
Minerals
Lipids
Fats- concentrated form of energy – stores energy
Excess protein used for energy in body
Cell membranes mostly made up of lipid
Connective tissue; holds bones together and muscles to bones
Ca and P makes bones and teeth hard
Estrogen, a lipid hormone regulates reproductive cycle
Protein
Water
Vitamins
Leptin, regulates body fat
Water regulates body temperatures
B vitamins regulates the use of macronutrients for energy

Essential
•Must be supplied by the food we eat
•Cannot be made in the body or made in the amounts needed
•If missing in the body a deficiency disease occurs
•Situation resolved when nutrient added back
Non-essential
•Substances not essential to maintain life but they confer health benefits

Macro nutrients Vitamins
Carbohydrates A,D, E, K
Fats/Lipids
(fats that contain linoleic and alphalinolenic acid)
Water
B complex: thiamine, riboflavin, niacin, pantothenic acid, biotin, folic acid,
B6, B12
Vit C
Minerals
Calcium, Iron
Phosphorus,
Magnesium,
Iodide, copper, potassium, zinc, chloride, sulfur, manganese
Chromium
Molybdenum
Phosphorus
Selenium
Sodium
Others
Possibly Essential :
Arsenic, lithium, nickel, silicon, boron, vanadium
Amino Acids
Leucine,
Methionine
Histidine, Valine
Tryptophan,
Phenylalanine
Isoleucine, Lysine

Fiber – soluble and insoluble
Phytochemical:
•Plant chemicals that are not essential nutrients but are biologically active and can prevent diseases.
•Found in all foods of plant origin, even herbs and spices
Antioxidants:
•Prevents cells from damage by oxidation

Phytochemical
Beta-Carotene
Lycopene
Lutein
Proposed benefit
Immune System
Vision
Skin Health
Bone Health
Cancer
(Prostate)
Heart Health
Eye Health
Cancer
Heart Health
Pumpkin
Sweet potato
Carrots
Winter squash
Apricots
DGLV
Tomatoes
Pink Grapefruit
Red pepper
Watermelon
Tomato products
Collards
DGLV
Broccoli
Fun Facts
Think orange and dark green leafy vegetables
The heating process makes lycopene easier for the body to digest
The phytochemical is found in the macula of the eye
Source: Fruit and Veggie Matters More: http://www.fruitsandveggiesmorematters.org/what-are-phytochemicals

Phytochemical
Resveratrol
Anthocyanidins
Isoflavones
Proposed Benefits
Heart Health
Cancer
Lung Health
Inflammation
Blood Vessel Health
Red Wine
Peanuts
Grapes
Berries
Plums
Red onion
Red potatoes
Red Radishes
Soybeans Menopause
Cancer (Breast)
Bone Health
Joint
Inflammation
Lowers Cholesterol
Fun Facts
1 cup of red grapes can have as much as
1.25mg resveratrol
Think red and purple berries
½ cup of boiled soybeans offers
47mg of isoflavones
Source: Fruit and Veggie Matters More: http://www.fruitsandveggiesmorematters.org/what-are-phytochemicals

Unit 1: Powerhouse Vegetables
– Introduction: 5 pages
– Facilitator Guide contains rationale for program; objectives; priority indicators, lesson outline, activities, evaluation; marketing information (20 pages).
– PowerPoint (44 slides)
Unit 2: Environment for Offering
Vegetables
– Facilitator Guide contains rationale for program; objectives; priority indicators, lesson outline, activities, evaluation; marketing information (10 pages).
– PowerPoint (26 slides).

• Dietary supplements include vitamins and minerals, herbals, botanicals, amino acids, enzymes, and animal extracts.
Source: U.S. Food and Drug Administration

• Some dietary supplements are well understood and established, but others need further study.
Source: U.S. Food and Drug Administration

• Unlike drugs, dietary supplements are not preapproved by the government for safety or effectiveness before marketing.
• Also, unlike drugs, supplements are not intended to treat, diagnose, prevent, or cure diseases.
• Can help assure that you get an adequate dietary intake of essential nutrients; others may help you reduce your risk of disease.
Office of Dietary Supplements

• How do you know you are eating a healthy diet?
• How do we know what nutrients we should eat each day? And in what quantities?
• How do we know which foods to choose to optimize health?

• Developed and published by the Institutes of Medicine (IOM).
• Represent the most current scientific knowledge on nutrient needs of healthy populations.
• Individual requirements may be higher or lower than the DRIs.

• A set of four reference values for the intake of nutrients and food components that can be used for planning and assessing the diets of healthy people in the U.S. and Canada
• Estimated Average Requirements (EARs)
• Recommended Dietary Allowances (RDA)
• Adequate Intakes (AIs)
• Tolerable Upper Intake Level (UL)

• Recommended Dietary Allowance (RDA): The average daily dietary nutrient intake level sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy individuals in a particular life stage and gender group.
•
Tolerable Upper Level Intake (UL): The highest average daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population

•
Adequate Intake (AI): The recommended average daily intake level based on observed or experimentally determined approximations or estimates of nutrient intake by a group (or groups) of apparently healthy people that are assumed to be adequate-used when an RDA cannot be determined.

•
Estimated Average Requirement (EAR):
The average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage and gender group.

• The DRI tool - Calculates daily nutrient recommendations for dietary planning
• Represent the most current scientific knowledge on nutrient needs, developed by the National Academy of Science’s Institute of Medicine.
• Individual requirements may be higher or lower than the DRIs.

• Plan and assess the adequacy of diets
• Make judgments about excessive intakes
• Determine standards for food labeling
• To develop practical tools for diet planning

• Cannot identify with certainty that a specific person has a nutritional deficiency or excess
• Do not tell how much foods should be chosen or eaten to meet recommendations for nutrients

• Guide for planning diets that meet the requirements and recommendations for health and disease prevention.
• Shape represents the relative contributions of various food groups.

History 1980 – 2010
1980 1990
1985 1995
2000
2005
2010

•
Overweight, obesity, and other dietrelated chronic diseases (are prevalent across the entire U.S. population, but are more pronounced in low-income populations, creating critical health disparities that must be addressed.

•
Less than optimal dietary patterns in the
United States , which contribute directly to poor population health and high chronic disease risk. On average, current dietary patterns are too low in vegetables, fruit, whole grains, and low-fat dairy, and too high in refined grains, saturated fat, added sugars, and sodium.

•
Food insecurity , a condition in which the availability of nutritionally adequate foods, or the ability to acquire acceptable foods in socially acceptable ways, is limited or uncertain. More than 49 million people in the United States, including nearly 9 million children, live in food insecure households.


Executive Summary

Chapter 1. Introduction

Chapter 2. Balancing Calories to Manage
Weight

Chapter 3. Foods and Food Components to Reduce

Chapter 4. Foods and Nutrients to Increase

Chapter 5. Building Healthy
Eating Patterns

Chapter 6. Helping Americans Make
Healthy Choices

Appendices


Describes purpose, uses, and major concepts
 Includes individuals at high risk of chronic disease new

Identifies two overarching concepts new
• Maintain calorie balance over time to achieve and sustain a healthy weight
• Focus on consuming nutrient-dense foods and beverages
 Lists all Key Recommendations

Under consumption relative to EAR: vitamin
A, vitamin D, vitamin E, folate, vitamin C, calcium, and magnesium
•Iron by adolescent and premenopausal females, including women who are pregnant.
•Potassium and fiber are underconsumed relative to the AI.

• Sodium and saturated fat are over consumed relative to the UL or other standards for maximal intake.

1. Find out What you eat and drink.
2. Find out What to eat and drink. Get a personalized Daily Food Plan -- just for you -- to help guide your food choices.
3. Make better choices. Everyone is different.
Compare what you eat and drink to what you should eat and drink.

• Keep a log
•
Get an idea of the quality of your diet
•
Food Plans

Gender/
Activity level
Male/
Sedentary
Male/ Mod
Active
Male/
Active
Age
5
10
19-20
31-35
51-55
76+
1,200
1,600
2,600
2,400
2,200
2,000
1,400
1,800
2,800
2,600
2,400
2,200
Female/
Sedentary
Female/ Mod
Active
Female Active
1,600
2,200
3,000
3,000
2,800
2,400
Calories
1,200
1,400
2,000
1,800
1,600
1,600
1,400
1,800
2,200
2,000
1,800
1,800
1,600
2,000
2,400
2,200
2,200
2,000

1. Most naturally occurring foods are mixtures of nutrients
2. Eating a variety of foods can help ensure the nutritional adequacy of a diet
3. There are no “good” or “bad” foods
4. Enjoy eating all foods in moderation
5. Food is the best source of nutrients and phytochemicals

7.
There is no “one size fits all” approach to planning a nutritionally adequate diet
8. Food and the nutrients they contain are not cure-all
9. Malnutrition includes under nutrition as well as over nutrition.

Graphics: Microsoft Online, USDA Food and Nutrition Services
Ingrid Adams, Ph.D., R.D. L.D.
Associate Professor , Nutrition and Food Science, University of Kentucky
Extension Specialist for Physical Activity and Weight Management
Date: February 27, 2015
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