Chapter 2 健康的飲食指標 Concepts

1. Chapter 2 健康的飲食指標Concepts There are manytypes of nutrition recommendations designed to promote health The Dietary Reference Intakes are a set of reference values for the amounts of calories, nutrients, and food components needed in healthy diets The Food Pyramid is a tool to plan diets that meet nutrition recommendations Food labels provide information about the nutrient content of individual foods and how they fit into an overall healthy diet Dietary Guidelines for Americans are a set of nutrition and lifestyle recommendations that help consumers reduce the risks of chronic disease The Exchange lists is a food group system for planning and evaluating diets Nutritional status can be assessed by evaluating your food intake, body size, and medical history Chapter 2: Guidelines for a Healthy Diet

2. Nutrition Recommendations Promote a Healthy Population • There are many different guidelines regarding what we should eat • Many are made by government agencies responsible for promoting the well-being of people in the population • Governments have been making nutrition recommendations for 150 years • Some of the earliest nutrition recommendations were made in England in the 1860s Chapter 2: Guidelines for a Healthy Diet

3. There are many types of nutrition recommendations in the Unites States • The original dietary standard in the U.S. was the Recommended Dietary Allowances (RDAs) 建議攝取量 • The first RDA was published in 1943 in response to the widespread food limitations from WW II • Overt nutrient deficiencies are now rare in the U.S., while the incidence of diet-related chronic diseases has increased • In response to these changes in our diet and health, the original RDAs have been replaced by Dietary Reference Intakes(DRIs) • DRIs are a set of reference values for intake of nutrients and food components 膳食營養素參考攝取量 • A set of standards called the Daily Values has been established for use on food labels • Daily Value is a nutrient reference value used on food labels to help consumers see how foods fit their overall diets

4. Dietary Reference Intakes Are Nutrient Intake Standards • The current standard for nutrient intake in the U.S. and Canada is the DRI • The DRIs include several types of recommendations designed for different purposes • Values have been set for each gender and for various life-stage groups • Life-stage groups are groupings of individuals based on stages of growth and development, pregnancy, and lactation that have similar nutrients needs • DRI values that recommend specific amounts of nutrients for individuals include the RDAs and Adequate Intakes (AIs) 足夠攝取量 • Estimated Average Requirements (EARs) are intakes that meet the estimated nutrient needs of 50% of individuals in a gender group and life-stage group 平均需要量 • Tolerable Upper Intake Levels (ULs) are maximum daily intakes that are unlikely to pose risks of adverse health effects 上限攝取量

5. The DRIs recommend proportions of carbohydrate, fat, and protein • Acceptable Macronutrient Distribution Ranges (AMDRs) is a range of intake for carbohydrate, fat, or protein, expressed as a percentage of total energy intake • According to the AMDRs a healthy diet for an adult can contain from 45 to 65% of calories from carbohydrate, 20 to 35% from fat, and 10 to 35% from protein. Chapter 2: Guidelines for a Healthy Diet

6. The DRIs estimate energy requirements for weight maintenance • The recommendations for energy intake established by the DRIs are called Estimated Energy Requirements (EERs) • EERs provide equations that can be used to calculate the number of calories needed to keep weight stable in a healthy person • Factors in EERs calculations are based on the individual’s age, gender, weight, height, and level of physical activity • You can use the DRIs to make sure your diet is healthy

7. 飲食形態：三大營養素所佔熱量百分比

8. Abkhazia 阿布哈西亞

9. The Food Pyramid Is a Tool for Diet Planning • The Pyramid is built around five food groups: • Bread, Cereal, Rice, and Pasta • Vegetable • Fruit • Milk, Yogurt, and Cheese • Meat Poultry, Fish, Dry Beans, Eggs and Nuts • The Pyramid’s shape indicates the relative contributions of each food group • Serving size recommendations ensure enough and not too much • Large serving sizes that Americans have become accustomed to are thought to be one of the reasons for the growing rate of obesity in the U.S.

10. 金字塔

11. Following the Pyramid selection tips helps you choose a varied, nutrient-dense diet • Just choosing a specified number of servings from each group of the Food Guide Pyramid will not ensure an optimal diet if wise choices are not made • If you pay attention to the selection tips provided along with the Pyramid, you will be choosing a varied, nutrient-dense diet • Choosing a varied diet is also important because there are positive or negative interactions between different foods and nutrients • The Pyramid meets individual needs and preferences • Because each food group contains a huge variety of food choices, a diet planned using the Pyramid can suit the preferences of people from diverse cultures and lifestyles

14. Chapter 2: Guidelines for a Healthy Diet

15. Many different choice

16. The Pyramid is being revised to promote better choices • The Food Guide Pyramid is not the first food guide to be used in the U.S. • The first one was published in 1917 and was called “How to Select Foods” • Today, incidence of nutrition-related diseases are on the rise and nutrition surveys reveal that Americans are not following the recommendations of the Pyramid • A revised Pyramid is expected to be released in 2005

17. Revised pyramid

18. 飲食指南 1975 五大食物分類 1980 動物性食品份量最多 1995 奶類自成一類 強調五穀根莖類

19. Food Labels Can Help You Make Wise Food Choices • Standardized food labels provide information about the nutrient composition of foods and about how a food fits into the overall diet • These labels must appear on almost all packaged foods • Raw fruits, vegetables, fish, meat, and poultry are not required to carry labels • Most food labels contain a “Nutrition Facts” panel and a list of the food’s ingredients

21. Food Labels • The “Nutrition Facts” list the amounts of calories and nutrients per serving • The serving size on the label is followed by the number of servings per container, total calories, and the calories from fat in each serving • Daily Values tell you how one foods fits into your total diet • The Daily Values are a set of standards developed for food labels to compare the amount of a nutrient in a food to recommendations for the amount of that nutrient in a healthy diet • The ingredient list tells you what’s in your food

23. Chapter 2: Guidelines for a Healthy Diet

24. Food labels may include claims about nutrient content • Food labels often highlight specific characteristics of a product that might be of interest to the consumer, such as “high in fiber” • Standard definitions for these descriptors have been established by the Food and Drug Administration (FDA) • Food labels may show health claims • Food labels are permitted to include a number of health claims if they are relevant to the product • Health claims refer to a relationship between a nutrient or a food and the risk of a disease or health-related condition • All health claims are reviewed by the FDA • Food labels can help you choose a healthy diet

25. 宣稱的量化標準

26. 宣稱的量化標準

27. Chapter 2: Guidelines for a Healthy Diet

28. The Dietary Guidelines for Americans Tie It All Together • The Dietary Guidelines for Americans is a set of recommendations on diet and lifestyle designed to promote health, support active lives, and reduce chronic disease risks • The Dietary Guidelines for Americans, 2000, has 3 tiers: • Aim for Fitness • Build a Healthy Base • Choose Sensibly Chapter 2: Guidelines for a Healthy Diet

29. Chapter 2: Guidelines for a Healthy Diet

31. Dietary Guidelines for Americans Tiers • Aim For Fitness • Aim for a healthy weight • Be physically active each day • Build a healthy base • Recommends a diet based on the Food Guide Pyramid and emphasizes variety • Keep food safe to eat • Choose sensibly • Choose a diet low in saturated fat and cholesterol and moderate in fat • Choose beverages and foods that limit your intake of sugars Chapter 2: Guidelines for a Healthy Diet

33. Chapter 2: Guidelines for a Healthy Diet

34. 飲食指標 中華民國飲食指標1989國民飲食指標1995 一、維持標準體重一、維持標準體重 二、多攝食各類新鮮的食物二、均衡攝食各類食物 三、多選用五穀根莖的食物三、三餐以五穀為主食 四、多食取高纖維的食物四、儘量選用高纖維食物 六、避免進食過量的食鹽或鈉五、少油、少鹽、少糖的飲食原則 （少吃太鹹或調味過重的食物） 七、避免進食過量脂肪和膽固醇食物六、多攝食鈣質豐富的食物 八、多與家人在家進餐七、多喝白開水 五、盡量少喝酒八、飲酒要節制

35. Exchange Lists Focus on Energy and Macronutrients • The Exchange Lists is a food group system that is useful in planning and evaluating diets • This system was developed in 1950 • The Exchange Lists divide foods into 3 main groups based on their macronutrient content • Carbohydrate group • Meat and meat-substitute group • Fat group • The exchange are designed so that each serving within a list contains approximately the same number of calories and grams of carbohydrate, protein, and fat

37. There Are Many Other Guidelines for Health Promotion • The Healthy People Initiative is a set of public health objectives • U.S. Public Health Service, along with hundreds of private and public organizations, has developed a set of public health objectives called Healthy People • The purpose of Healthy People 2010 is to promote health and prevent illness, disability and premature death • Other recommendations are designed to reduce risks for particular diseases • The American Heart Association and the American Institute for Cancer Research have published guideline for groups at risk for heart disease and cancer, respectively

38. Are You Meeting Your Nutritional Needs? • Nutritional assessment can evaluate an individual’s nutritional health • Assessing nutritional status can help determine whether the dietary choices you are making are meeting your nutrient needs and minimizing your risks of chronic disease • Nutritional status is determined by doing an individual nutritional assessment, which requires a review of past and present dietary intake, body size assessment, physical exam, medical history, and lab tests

40. Compare your intake to recommendations to see if your diet is adequate • A good place to start when evaluating your nutritional status is to determine what you typically eat • This requires recording everything you eat and drink, including descriptions of cooking methods and product brand names • Once you have a record of what you ate, you can compare your intake to recommendations • For a more complete analysis of your diet, you can use food composition tables or a computer database to calculate your intake of energy and nutrients

41. Nutritional Health • Compare your body size to standards to see where you fit • Evaluating nutritional health also involves assessing your height and weight • Your nutrient needs are affected by your current health and medical history • The optimal diet for you depends on who you are, what your genetic background is, and how healthy you are • Nutrient needs change throughout your life cycle • Your genetic background affects your risk for nutrition-related diseases • Laboratory tests can measure nutrient levels and assess risk of chronic disease • Measures of nutrients, by their by-products, or their functions in your blood, urine, and body cells can help detect nutrient deficiencies and excesses

42. Assessment can also evaluate the nutrition health of the population • By surveying the food supply and the population, we can find out what foods are available to the population and what foods are consumed • This information can be used to identify possible nutrient deficiencies and excesses in the population Chapter 2: Guidelines for a Healthy Diet

43. 飲食與疾病之間的關係 因果關係 (Cause and effect relationship)：消除原因 =====> 改變結果 缺維生素 C ====> 壞血病 細菌感染 =====> 發炎 相關性 (Association)：為機率性，非因果關係 高脂飲食，高血壓，抽煙 ++++++ 心血管疾病 危險因子(Risk factor) 疾病營養性危險因子 心血管疾病、動脈硬化高動物性油脂、高膽固醇、肥胖 糖尿病肥胖 肝硬化酒精過量、營養不良 不孕症體重過輕、肥胖、鋅缺乏（男性） 生長遲緩熱量、蛋白質、鐵、鋅攝取不足 蛀牙糖份 便秘膳食纖維、水不足 肥胖熱量過剩 高血壓高鈉、高鹽、酒精過量、肥胖 骨質疏鬆症鈣、維生素D 不足 神經管缺陷葉酸缺乏