The Role of Nutrition in Our Health Chapter 1. Test Yourself 1. A calorie is a measure of the amount of fat in a food. 2. Proteins are not a primary source

The Role of Nutrition

in Our Health

Chapter 1

Test Yourself1. A calorie is a measure of the amount of fat in

a food.

2. Proteins are not a primary source of energy for our bodies.

3. All vitamins must be consumed daily to support optimal health.

4. The Recommended Dietary Allowance is the maximum amount of a nutrient that people should consume to support normal body functions.

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What is Nutrition?

Nutrition is a relatively new discipline of science.

Nutrition: the study of food, includingHow food nourishes our bodiesHow food influences our health

Digestion Absorption Utilization Excretion

How Does Nutrition Contribute to Health?

Nutrition contributes to wellness.

Wellness: more than absence of disease

Many factors contribute to an individual’s wellness. Primary among these are:

Nutrition Physical activity


Healthful diet is part of disease prevention



Nutrition is so important it has become a national goal to promote optimal health and disease prevention.

Goals of Healthy People 2020 – this is a health promotion and disease prevention plan for the United States.

1. Increase quality and years of healthy life

2. Eliminate health disparities


Obesity is a growing problem in the U.S.

Note the states in dark “red” which indicates a prevalence of obesity >30%

What Are Nutrients?

Nutrients: chemicals in foods that our bodies use for energy and to support the growth, maintenance, and repair of our tissues. Six groups of nutrients:

1. Carbohydrates2. Lipids3. Proteins4. Vitamins5. Minerals6. Water

What Are Nutrients?

Essential nutrients: nutrients for which specific biological functions have been identified, and which our bodies cannot make enough of to meet our biological needs

♦ Essential nutrients must be obtained from our diet

♦ Examples: Vitamin C, Calcium, Thiamin

What Are Nutrients?

Macronutrients: nutrients required in relatively large amounts.

Carbohydrates, lipids, proteinsProvide energy to our bodies

Micronutrients: nutrients required in smaller amounts.

Vitamins and minerals

What Are Nutrients?

Organic nutrients: nutrients contain an element of carbon that is an essential component of all living organisms

Carbohydrates, lipids, proteins, vitamins

Inorganic nutrients: nutrients that do not contain carbon

Minerals and water

Energy From Nutrients

We measure energy in kilocalories (kcal).

Kilocalorie: amount of energy required to raise the temperature of 1 kg of water by 1oC.

On food labels, “calorie” actually refers to kilocalories.

Carbohydrates

•Primary source of fuel for the body, especially for the brain and physical activity.

•Provide 4 kcal per gram.

Carbohydrates are found in grains (wheat, rice), vegetables, fruits, and legumes (lentils, beans, peas), milk products.

Lipids - triglycerides, phospholipids, sterols

•Insoluble in water.

•Provide 9 kcal per gram.

•An important energy source during rest or low intensity exercise.

•Stored as adipose tissue (body fat) – major form of stored energy.

•Foods containing lipids also provide fat-soluble vitamins and essential fatty acids.

Proteins

•Proteins are chains of amino acids.

•Support tissue growth, repair, and maintenance.

•Proteins can supply 4 kcal of energy per gram, but are not a primary energy source.

•Proteins are an important source of nitrogen.

Vitamins

Vitamins are organic molecules that assist in regulating body processes: critical in building and maintaining healthy

bones and tissues support immune system ensure healthy vision Many can be destroyed by heat and oxidation

Vitamins do not supply energy to our bodies; however, many vitamins act as coenzymes for energy producing reactions

Vitamins

Type Names Distinguishing Features

Fat Soluble A,D,E, and K •Soluble in fat•Stored in the human body•Toxicity can occur from consuming excess amounts, which accumulate in the body

Water Soluble C, B-vitamins (thiamin, riboflavin, niacin, vitamin B6, vitamin B12, pantothenic acid, and folate)

•Soluble in water•Not stored to any extent in the human body•Excess excreted in urine•Toxicity generally occurs as a result of vitamin supplmentation

Minerals

Minerals are inorganic substances required for body processes.

Minerals have physiological functions, such as fluid regulation, energy production, bone structure, muscle movement, and nerve functioning.

Minerals

Our bodies require at least 100 mg per day of the major minerals such as:

•Calcium

•Phosphorus

•Magnesium

•Sodium

•Potassium

•Chloride.

We require less than 100 mg per day of the trace minerals such as:

•Iron

•Zinc

•Copper

•Selenium

•Iodine

•Fluoride

Water

Inorganic nutrient, essential for survivalInvolved in many body processes:

fluid balance and nutrient transportnerve impulsesbody temperatureremoval of wastesmuscle contractionschemical reactions

Determining Nutrient Needs

Dietary Reference Intakes (DRIs): updated nutritional standards

Expand on the traditional RDA valuesSet standards for nutrients that do not have

RDA valuesDietary standards for healthy people onlyFor preventing deficiency diseases and

reducing chronic diseases



Estimated Average Requirement (EAR)

The average daily intake level of a nutrient that will meet the needs of half of the healthy people in a particular category

Used to determine the Recommended Dietary Allowance (RDA) of a nutrient


Recommended Dietary Allowances (RDA)

The average daily intake level required to meet the needs of 97 – 98% of healthy people in a particular category


Adequate Intake (AI)Recommended average daily intake level for a

nutrientBased on observations and experimentally

determined estimates of nutrient intakes by healthy people

Used when the RDA is not yet established: calcium, vitamin D, vitamin K, fluoride


Tolerable Upper Intake Level (UL)Highest average daily intake level likely to pose

no risk of adverse health effects to most peopleConsumption of a nutrient at levels above the

UL, the potential for toxic effects and health risks increases


Example Nutrient DRI

Vitamin C (adult age 19-70)

UL = 2,000 mg/d

RDA = 75 mg/d (female)

90 mg/d (male)

EAR = 60 mg/d (female)

75 mg/d (male)

Amount needed to prevent

Deficiency = ~10 mg/d


Estimated Energy Requirement (EER)Average dietary energy intake (kcal) to

maintain energy balance in a healthy adultBased on age, gender, weight, height, level of

physical activity


Acceptable Macronutrient Distribution Ranges (AMDR)

Describes the portion of the energy intake that should come from each macronutrientCarbohydrates: 45-65%Fats: 20-35%Proteins: 10-35%

Potential for inadequate nutrient levels if nutrient intake falls below this range

Potential for increased chronic disease risk if nutrient intake falls above this range

AMDR

Malnutrition

Nutritional status is out of balance: Individual is getting too much or too little of a particular nutrient or energy over a significant period of time

Undernutrition: too little energy or too few nutrients, causing weight loss or a nutrient deficiency disease

Overnutrition: too much energy or too much of a given nutrient over time, causing obesity, heart disease, or nutrient toxicity

Assessing Nutritional Status – A,B,C,D’s

A – Anthropometric Data♦ Weight, Height, Muscle Mass, Fat Mass

B – Biochemical Data♦ Cholesterol, Glucose, Albumin, Sodium, Liver

Enzymes, Kidney Enzymes

C- Clinical Data♦ Disease history, Socioeconomic Status, Physical Exam

D – Dietary Data♦ Nutrient intake, supplement use

Dietary Intake Tools

Dietary Intake Tools

24-Hour Recall Diet HistoryFood Frequency Questionnaire

Diet Records

Twenty-four Hour Recall

Recalls all food and beverages consumed in the previous 24-hour period

Accurate recall includes serving sizes, food preparation methods, and brand names of convenience foods or fast foods

Limitations: may not be typical intake rely on memory ability to estimate portion sizes

Diet History

Information from interview or questionnaire: Weight (current and usual weight, goals) Factors affecting appetite and food intake Typical eating pattern (time, place, dietary restrictions,

frequency of eating out, etc.) Disordered eating behaviors (if any) Education and economic status Living, cooking/food purchasing arrangements Medication and dietary supplements Physical activity

Food Frequency Questionnaires

Determine typical dietary pattern over a predefined period of time

Include lists of foods with the number of times these foods are eaten

Some assess only qualitative information (typical foods without amounts)

Semiquantitative questionnaires assess specific foods and quantity consumed

Diet Records

List of all foods and beverages consumed over a specific time period (3-7 days)

Kept by person seeking nutritional advice

More accurate with: foods are weighted or measured labels of convenience foods and supplements

People may change food intake to simplify record keeping

Analyses are time consuming and costly

Nutrition Deficiencies

Primary deficiency occurs when a person does not consume enough of a nutrient, a direct consequence of inadequate intake

Secondary deficiency occurs when…a person cannot absorb enough of a nutrient in

his or her bodytoo much nutrient is excreted from the bodya nutrient is not utilized efficiently by the body

Primary or Secondary Deficiency?

Jane is a strict vegetarian and does not consume any animal-based foods and does not consume a vitamin/mineral supplements.

John consumes a regular diet consisting of all major food groups but has a condition called “gastritis” preventing his production of intrinsic factor, which is needed to help absorb vitamin B12

Jane and John were both told by their primary care physicians that they had a type of anemia called “pernicious anemia” which is caused by a deficiency of vitamin B12 in the body. What type of deficiency do Jane and John have based on the evidence below?

Deficiency Symptoms

Subclinical deficiency occurs in the early stages, few or no symptoms are observed

Covert symptoms are hidden and require laboratory tests or other invasive procedures to detect

Symptoms of nutrition deficiency that become obvious are referred to as overt

Nutrition DeficienciesWhat happens in the body:

Physical deficiency caused by inadequate diet OR secondary deficiency caused by problem inside the body

Declining nutrient stores

Abnormal functions inside the body

Physical (outward) signs and symptoms

Which assessment method reveals changes:

Diet historyHealth history

Laboratory tests

Laboratory test

Physical examination and anthropometric measures

Registered Dietitians (RD)

Requirements: Bachelor’s degree in nutrition Completion of supervised clinical experience Passing a national registration examination

Work in a variety of settings: Hospitals, clinics, nursing homes Sports nutrition Food-service management Community and public health nutrition Nutrition research

Nutrition Advice: Who Can You Trust?

Nutrition is a new science

Increased interest in nutrition

Overwhelming amount of health claims

Reliability of nutrition information

Misinformation

Potential harmful quackery

Trustworthy Nutrition Experts

Registered Dietitian (RD)

Licensed Dietitian meets the credentialing requirements of a given state

Nutritionist has no legal definition

Professional with advanced nutrition degree (masters-MS, MA; doctoral-PhD)

Physician

Government Information Sources

Centers for Disease Control and Prevention (CDC)

National Health and Nutrition Examination Survey (NHANES)

Behavioral Risk Factor-Surveillance System (BRFSS)

National Institutes of Health (NIH)

Reliable Nutrition Information

American Dietetic Association

American Society for Nutrition Sciences

American Society for Clinical Nutrition

Society for Nutrition Education

American College of Sports Medicine

North American Association for the Study of Obesity

Evaluating Research

• Case Control Studies

• Clinical Trials• Randomized• Single Blind• Double Blind• Placebo

Evaluating Media Reports

• Questions to ask?• Who conducted/paid for the research?• Who is reporting the information?• Is it based on reputable research studies?• Is the report based on testimonials?• Are the claims too good to be true?• Is someone profiting?

Activity

Calculate the Nutrition

Fat = 18 grams

Carbs = 6 grams

Protein = 7 grams

Total Calories: _________

____% Fat _____ % Carbs ______% Protein


Fat = 18 grams

Carbs = 6 grams

Protein = 7 grams

Total Calories: 214

76% Fat

11% Carbs

13% Protein


Fat = 8.4 grams

Carbs = 23.4 grams

Protein = 4.2 grams

Fat = 2 grams

Carbs = 0 grams

Protein = 28 grams

Calculate the combined calories, protein, fat, carbs and the percentage.


Fat = 10.4 grams (93.6 calories)

Carbs = 23.4 grams (93.6 calories)

Protein = 32.2 grams (128.8 calories)

Total Calories: 316

~30% Fat

~30% Carbs

~40% Protein


Total Calories: 680

Fat: ______

Carbs: 71 grams

Protein: 44 grams


Total Calories: 680

Fat: 24 grams

Carbs: 71 grams

Protein: 44 grams


The doctor has recommended his patient eat a 1600 calorie diet that is 50% carbs, 25% protein and 25% fat.

How many grams and calories will the patient be eating from each of the three macronutrients?


Answer:

Calories: 1600

Carbs: 200 grams (800 calories)

Protein: 100 grams (400 calories)

Fat: 44 grams (400 calories)

Evaluating Research

Health Benefits of Chocolate

A Look at Goji Juice – Scam or Super Fruit

High Fructose Corn Syrup

http://www.youtube.com/watch?v=bU_gjNuaWFw&p=66952D307D77D81E&playnext=1&index=28

http://www.youtube.com/watch?v=oqgtSi4fLzI&feature=fvst

Documents

The Role of Nutrition in Our Health Chapter 1. Test Yourself 1. A calorie is a measure of the amount of fat in a food. 2. Proteins are not a primary source