A genda

1. Agenda • Lecture • Nutritional States • Diet planning • Food labels • Group activity • Design a menu

2. Lecture 14: Nutritional Status and Diet Planning Will Brown 2/23/2012

3. Nutritional States • Desirable nutrition • You have enough of the nutrient to support normal function • Undernutrition • Intake is less than needed for normal function • Prior to symptoms you can have subclinical deficiency • Anemia • This can be long term • Clinical symptoms can eventually develop unless undernutrition is addressed

4. Nutritional States • Overnutrition • Consuming a nutrient beyond what is needed • Excess fiber leading to intestinal irritation • Most common in America is calories • Can happen quickly with certain vitamins and minerals when taking suppements

5. How do we determine what we need? • 5 areas to assess to understand one’s nutritional status • Anthropometric test-body measurements such as body weight, wrist circumference • Biochemical-measures biochemical function related to a nutrient’s function; ie: enzymatic activity • Clinical-examination by doctor • Dietary assessment-analyze diet over the course of many days • Environmental assessment-background information such as weekly food budget, living conditions, education level, etc. • Your book calls these the ABCDEs nutritional assessment

6. Nutritional Assessment and Reality • Clinical symptoms can lag behind malnutrition • B-12 deficiency can develop over years • Heart attack might be the first symptom of cardiovascular disease • Osteoporosis is a condition that can develop over decades • Most clinical symptoms can be attributed to number of different things • Diarrhea • Dizziness

7. Tools for Diet Planning • Your book talks about the food pyramid but that has been replaced with the “Choose my plate” system: http://www.choosemyplate.gov/ • Similar in idea but the choose my plate is easier to visualize • Includes the five main food groups • Grains • Vegetables • Fruits • Dairy • Protein foods • Oils are not shown on the MyPlate because they should not comprise a major part of the diet. • They are important and some are essential

9. Fruits • Along with Vegetables should be half of your plate • Eat a broad variety if possible • A serving can be fresh, frozen, canned or dried • Fresh is best with flash frozen a very close second • Remember that most of the water soluble vitamins will be taken out during processing • Most canned fruit is sterilized in some manner which can degrade vitamins that are not heat stable • Dried fruit will not have the same vitamin concentration • One serving is 1 cup • Go easy on fruit juice; concentrates calories and most often does not have the fiber

10. Fruits: Nutrients • Most fruits are naturally low in fat, sodium, and calories. None have cholesterol. • Source of many essential nutrients that are underconsumed, including potassium, dietary fiber, vitamin C, and folate (folic acid). • Potassium may help to maintain healthy blood pressure; bananas, prunes and prune juice, dried peaches and apricots, melon, and orange juice. • Dietary fiber from fruits helps reduce blood cholesterol levels and may lower risk of heart disease, bowel function; whole or cut-up fruits are sources of dietary fiber; fruit juices contain little or no fiber. • Vitamin C is important for growth and repair of all body tissues, helps heal cuts and wounds, and keeps teeth and gums healthy. • Folateinvolved in DNA sysnthesis

11. Vegetables • Again, should comprise half your plate • Eat a broad variety • Broken down into 5 sub-catagories • Dark Green – spinach and broccoli • Beans and peas – Lentils, kidney beans • Red and Orange vegetables – carrots and sweet potatoes • Other vegetatbles – cabbage, iceberg lettuce, and green peppers • Starchy vegetables – corn, potatoes, and plantains • Eat 2 ½ servings every day • One serving = 1 cup

12. Vegetables: Nutrients • Naturally low in fat and calories and no cholesterol. • Sources of many nutrients, including potassium, dietary fiber, folate (folic acid), vitamin A, and vitamin C. • Vitamin A keeps eyes and skin healthy and helps to protect against infections. • Vitamin C helps heal cuts and wounds and keeps teeth and gums healthy. Vitamin C aids in iron absorption. • Folate (folic acid) helps the body form red blood cells. • Diets rich in potassium may help to maintain healthy blood pressure. • Vegetable sources of potassium include sweet potatoes, white potatoes, white beans, tomato products, soybeans, lima beans, spinach, lentils, and kidney beans. • High in dietary fiber helps reduce blood cholesterol levels and may lower risk of heart disease. • Fiber is important for proper bowel function. It helps reduce constipation and diverticulosis.

13. Grains • Consists of any food made from wheat, cornmeal, rice, oats, barley, and other cereal grains • Includes pasta, bread, and oatmeal • Broken into 2 sub-catagories • Whole – whole wheat and brown rice • Refined – white flour and de-germed corn meal • Make at least half or your grains whole grains • Need six 1 oz servings per day

14. Grains: Nutrients • Contribute many nutrietnts; ie: dietary fiber, thiamin, riboflavin, niacin, folate, Iron, magnesium, and selenium • The B vitamins thiamin, riboflavin, and niacin play a key role in metabolism • Folate(folic acid) involved in DNA synthesis. • Iron is used to carry oxygen in the blood; whole and enriched refined grain products are major sources of non-heme iron in American diets. • Whole grains are sources of magnesium and selenium. • Magnesium is a mineral used in building bones and releasing energy from muscles. • Selenium protects cells from oxidation. It is also important for a healthy immune system.

15. Protein Foods • Meat, poultry, seafood, beans, peas, seeds, nuts, soy, and eggs • Meat based protein considered higher quality than plant based protein • Need 5 ½ oz daily • Meat eaters • Try to eat lean cuts of meat and poultry • Try to make 8 oz a week seafood • Try to vary your sources to include beans, legumes and seeds • Be aware that processed meats like bacon, sausage, peperoni and ham can increase sodium intake • Vegetarians • Make sure you vary your sources; most plant based protein is deficient in one essential amino acid • Make sure to pay attention to iron sources since non-heme iron has lower bioavailability

16. Protein Foods: Nutrients • Supply protein, B vitamins (niacin, thiamin, riboflavin, and B6), vitamin E, iron, zinc, and magnesium. • Proteins function as building blocks for bones, muscles, cartilage, skin, and blood. • Can be used as an energy source • Iron is used to carry oxygen in the blood. • Heme-iron is ready for use • Eat non-hemeiron containing foods along with a food rich in vitamin C • Magnesium is used in building bones and in releasing energy from muscles. • Zinc is necessary for biochemical reactions and helps the immune system function properly. • Omega-3 fatty acids found in varying amounts in seafood.

17. Diet Planning Basics • Eat a variety of different foods • Balance your choices between each of the food groups • Pay attention to portion size • Eat nutrient dense foods • Be cautious of energy dense foods

18. My Plate Things to Remember • Does not apply to infants and children under 2 • No one food is absolutely essential to good nutrition • No one food group provides all essential nutrients in adequate amounts • Variety, Variety, Variety • Foods within a group can have very different calories and nutrients

19. Food Labels • Must include the following information • Product name • Manufacturers name and address • Amount of product in package • Ingredients listed in descending order by weight • Food constituents – ie; protein and carbs • The following components must be listed • Total calories (kcal) • Calories from fat • Total fat • Saturated fat • Trans fat • Cholesterol • Sodium • Total carbohydrates • Fiber • Sugars • Protein • Vitamin A • Vitamin C • Calcium • Iron

20. Food Labels • May also include • Polyunsaturated and monounsaturated fat • Potassium and other minerals • Listing these is required when the item is fortified • Percentages and daily % are arbitrary • Based on a 2000 kcal diet • Daily % are not always the RDA • Serving sizes must be consistent within a food group – ie: all chips will have a 1 oz serving size

21. Food Labels: Exceptions and Health Claims • Exceptions • Fresh foods (fruits, vegetables and meat) are not required to have food labels but many do • Protein values are only mandatory on food specifically for children under 4 years • Health Claims – see page 2-9 in your book • Primarily used as a marketing tool • FDA has legal oversight on most food products and permits claims within certain guidelines

22. Food Labels: Health Claims • 4 categories of claims • Health claim • Closely regulated by FDA • “Diets high in calcium may prevent osteoporosis.” • Preliminary health claim • Closely regulated by FDA but little supporting evidence • “A diet low in fat may reduce risk for some cancers.” • Nutrient claims • Closely regulated by FDA • “Fat Free” must be less than 0.5 g of fat/serving • Structure/Function claims • Not regulated by FDA • Not always valid • “Ginseng helps keep you focused.” • Claims can be made along with a disclaimer that says “evidence is not conclusive.” • Claims can’t be made on foods deemed unhealthy-candy bars

23. Group Activity • Break up into groups of 3 or 4 • Develop a one day menu for an “average American” and a vegetarian • Must include all of the food groups with the daily servings • The vegetarian menu must include protein choices to cover all essential amino acids. • Limit calories to 2000 ± 200 • Include 3 meals and at least 1 snack • Do not use one from the book