Nutrition for WellnessNutrition for Wellness

Chapter 3

ObjectivesObjectives Define nutrition and describe its relationship to health and

well-being. Learn to use the USDA MyPyramid guidelines for healthier

eating. Describe the functions of the nutrients – carbohydrates,

fiber, fats, proteins, vitamins, minerals, and water – in the human body.

Define the various energy production mechanisms of the human body.

Be able to conduct a comprehensive nutrient analysis and implement changes to meet the Dietary Reference Intakes (DRIs).

Identify myths and fallacies regarding nutrition. Become aware of guidelines for nutrient supplementation. Learn the 2005 Dietary Guidelines for Americans. Analyze your diet and plan for healthy nutrition.

IntroductionIntroduction Proper nutrition is essential to overall health

Having good nutrition: Means that a person's diet supplies the essential nutrients needed to carry out normal tissue growth and repair.

Supplies enough substrates to fuel all body processes.

ChooseMyPlate.gov provides nutrition guidelines and recommended daily food amounts according to various caloric requirements.

ChooseMyPlate: ChooseMyPlate: Steps to a Healthier YouSteps to a Healthier You

IntroductionIntroduction Nutrients should be obtained from a wide

variety of sources. U.S. diet

Too high in calories, sugar, saturated fat, trans fat, sodium

Too low in grains, fruits, vegetables Diet and nutrition play a role in the

development and progression of heart disease, cancer, obesity, diabetes, and osteoporosis

NutrientsNutrients Six essential nutrients

Fuel Nutrients needed for energy: carbohydrates, fats, and proteins.

Regulatory nutrients necessary to function normally with no caloric value: vitamins, minerals, water, and fiber.

Macronutrients needed in proportionally large amounts daily: carbohydrates, fats, proteins, and water.

Micronutrients required in small amounts daily: vitamins and minerals.

NutrientsNutrients Nutrient Density

Foods packed with nutrients but with low or moderate calories are classified as having high nutrient density.

Calorie: The simplified term for a kilocalorie

(kcal), the amount of heat necessary to raise the temperature of 1 kilogram of water 1 degree Centigrade.

CarbohydratesCarbohydrates Major source of energy (4

calories/gram) Regulate fat and metabolize protein Major sources are breads, cereals,

fruits, vegetables, milk/dairy products Two types:

Simple Complex

Major Types of Major Types of CarbohydratesCarbohydrates

Simple CarbohydratesSimple Carbohydrates Often called “sugars,” which have little

nutritive value Examples are candy, soda, and cakes

Divided into monosaccharides and disaccharides Monosaccharides: glucose, fructose,

galactose Disaccharides: sucrose, lactose, maltose

Complex CarbohydratesComplex Carbohydrates Also referred to as “polysaccharides” Carbohydrates formed by ten or more

monosaccharide molecules linked together Starches

Storage form of glucose in plants Dextrins

Formed from the breakdown of starches exposed to dry heat

Glycogen Storage form of glucose

FiberFiber Form of complex carbohydrates Present mainly in plant leaves, skins,

roots, and seeds Processing and refining foods removes

most of their natural fiber Dietary sources include

Whole-grain cereals and breads Fruits and vegetables Legumes

FiberFiber Soluble fiber

Dissolves in water to form gel-like substance that encloses food particles

Helps decrease blood cholesterol and blood sugar levels Oats, fruits, barley, legumes, psyllium

Insoluble fiber Not easily dissolved in water but binds with water Causes a softer and bulkier stool Speeds passage of food residues through intestines Wheat, cereals, vegetables, skins of fruits

Most common types of fiber are: Cellulose, Hemicellulose, Pectins, Gums and Mucilages

High-fiber foods are essential in High-fiber foods are essential in a healthy dieta healthy diet

Age 50 and under Women = 25 g/day Men = 38 g/day

Over age 50 Women = 21 g/day Men = 30 g/day

Current average daily U.S. intake

About 15 g/day

FatFat Also called lipids Most concentrated source of energy (9

cal/gram) Need fat for:

Part of cell structure Stored energy Insulator for body heat preservation Shock absorption Supplies essential fatty acids Carries fat-soluble vitamins (A, D, E, K)

Major types of fats (lipids)Major types of fats (lipids)

Simple Fats Over 90% of the weight of

fat in foods and over 95% of the fat stored in the body are in the form of triglycerides

Saturated fats are mainly of animal origin

Unsaturated are found mostly in plant products

Further classified into monounsaturated and polyunsaturated fatty acids

Chemical structure of saturated and Chemical structure of saturated and unsaturated fatsunsaturated fats

Saturated Fats Meats, animal fat, lard,

whole milk, cream, butter, cheese, ice cream, hydrogenated oils, coconut oil, and palm oils

Usually do not melt at room temperature

Coconut oil and palm oils are exceptions

Raise blood cholesterol level

Unsaturated FatsUnsaturated Fats Usually liquid at room temperature Help lower blood cholesterol Monounsaturated fats (MUFAS)

found in olive, canola, peanut, sesame oils, avocados, cashews, and peanuts

Polyunsaturated fats (PUFAS) found in corn, cottonseed, safflower,

walnut, sunflower, soybean oils, and fish, almonds, pecans

Fats (Lipids)Fats (Lipids) Trans fatty acids

The result of partial hydrogenation to increase shelf life.

Provide no known health benefit. The words "partially hydrogenated" and

"trans fatty acids" indicate that the product carries a health risk just as high as or higher than that of saturated fat.

Found in Margarine and spreads, shortening, some nut butters,

crackers, cookies, dairy products, meats, processed foods, and fast foods

Fats (Lipids)Fats (Lipids) Polyunsaturated omega fatty acids

Essential to human health and have to be consumed in the diet.

Omega-3 fatty acids Polyunsaturated fatty acids found primarily in

cold-water seafood and flaxseeds thought to lower blood cholesterol and triglycerides

Three major types of omega-3 fatty acids: EPA, DHA, and ALA protect against irregular heartbeats and blood clots, reduce

triglycerides and blood pressure, and defend against inflammation.

Omega-6 fatty acids LA, GLA, and AA Excessive intake tends to contribute to

inflammation – 4 to 1 ratio recommended

Fats (Lipids)Fats (Lipids) The canning process

for fish destroys most of the omega-3 fatty acids

Good sources of omega-3 ALA include flaxseeds, canola oil, walnuts, wheat germ, and green leafy vegetables

Fats (Lipids)Fats (Lipids) Compound fats

Lipoproteins transport fats in the blood and play a large role in heart disease

Major forms are HDL, LDL, VLDL Derived fats

Sterols Found in food and manufactured in the

body primarily from saturated and trans fats

ProteinsProteins Needed for:

Build and repair tissue Part of hormones, antibodies, and enzymes (formed by proteins) Necessary for normal functioning Help maintain normal body fluid balance

Source of energy (4 calories/gram) if carbohydrate is insufficient

Sources are meats and alternatives, milk, and other dairy products

Excess proteins can be converted to glucose or fat, or excreted in urine Daily consumption of beef, poultry, or fish should be limited to 3

ounces to 6 ounces.

Amino AcidsAmino Acids The body uses 20 amino

acids to form different types of protein

9 amino acids are termed “essential” because the body cannot produce them

11 amino acids are termed “nonessential” because the body can produce them if food proteins in the diet provide adequate nitrogen

All amino acids must be present in the diet for the body to function normally

VitaminsVitamins Organic nutrients essential for normal

metabolism, growth, and development Classified according to solubility

Fat soluble (A, D, E, and K) Water soluble (B complex and C)

Most vitamins must be obtained through diet

A, D, and K are formed in the body C, E, and beta-carotene are “antioxidants”

MineralsMinerals Inorganic nutrients essential for normal

body functions Part of all cells Help maintain water balance and acid-

base balance Essential components of enzymes Regulate muscular and nervous tissue

impulses, blood clotting, normal heart rhythms

Water Water Most important

nutrient Studies show people

are getting enough water from the liquids and the moisture content of solid foods.

To avoid dehydration, use the thirst signal

Exception is exercise

Balancing the American Balancing the American DietDiet

National Academy of Sciences created guidelines for a well-balanced diet

The ranges allow for flexibility in planning diets for individual health and physical activity needs

The source of fat calories is critical

Nutrition StandardsNutrition Standards Dietary Reference Intakes (DRIs)

A general term that describes four types of nutrient standards that establish adequate amounts and maximum safe nutrient intakes in the diet (Table 3.7)

Estimated Average Requirements (EAR) Recommended Dietary Allowances (RDA) Adequate Intakes (AI) Tolerable Upper Intake Levels (UL)

Nutrition StandardsNutrition Standards Estimated Average Requirements (EAR): The

amount of a nutrient that meets the dietary needs of half the people in the U.S.

Recommended Dietary Allowances (RDA): The daily amount of a nutrient (statistically determined from the EARs) considered adequate to meet the known nutrient needs of almost 98% of all healthy people in the U.S.

Adequate Intakes (AI): The recommended amount of a nutrient intake when sufficient evidence is not available to calculate the EAR and subsequent RDA

Tolerable Upper Intake Level (UL) establishes the highest level of nutrient intake that appears safe for most healthy people (Table 3.8)

Nutrition StandardsNutrition Standards

Nutrition StandardsNutrition Standards Daily Values (DVs)

reference values for nutrients and food components for use on food labels (Figure 3.6)

Include fat, saturated fat, and carbohydrates (as a percent of total calories); cholesterol, sodium, and potassium (in milligrams); and fiber and protein (in grams).

Expressed as percentages for a 2,000-calorie diet.

Food Label Food Label with U.S. with U.S. RecommendeRecommended Daily Values d Daily Values

Nutrient AnalysisNutrient Analysis Keep a 3-day record of all

foods and beverages consumed

Includes measurements of calories, carbohydrates, fats, protein, cholesterol, sodium, vitamins, and minerals.

Use the food tracker on choosemyplate.gov

Nutrient AnalysisNutrient Analysis Most revealing information

learned in a nutrient analysis is the source of fat intake

Average daily fat consumption in the U.S. diet

About 34% of the total caloric intake

Much of it from saturated fat and trans fatty acids, which increase the risk for chronic diseases

Achieving a Balanced DietAchieving a Balanced Diet

A well-balanced diet entails eating a variety of nutrient dense foods and monitoring total daily caloric intake. Eat from all food groups

Whole grains, vegetables, fruits, and milk provide nutritional base

Meats and beans group

Oils sparingly and avoid trans fats

PhytonutrientsPhytonutrients Fruits and vegetables are the sole source

of phytonutrients Show promising results in the fight

against cancer and heart disease They seem to have a powerful ability to

block the formation of cancerous tumors They may reduce inflammation, inhibit

blood clots, and prevent LDL cholesterol oxidation to fight heart disease

Choosing Healthy FoodsChoosing Healthy Foods Learn the nutritive value

of typical foods you eat by reading food labels

Be aware that there is label misinformation as the FDA does not have the manpower to regularly check food labels

Healthy eating requires proper meal planning and adequate coping strategies

Choosing Choosing Healthy Healthy FoodsFoods

VegetarianismVegetarianism Vegetarian diets can meet the Dietary

Guidelines for Americans and the DRIs for nutrients Vegans eat no animal products at all. Ovovegetarians allow eggs in the diet. Lactovegetarians allow foods from the

milk group. Ovolactovegetarians include egg and

milk products in the diet. Semivegetarians do not eat red meat, but

do include fish and poultry in addition to milk products and eggs in the diet

VegetarianismVegetarianism Nutrient concerns

Strict vegans need B12 supplements Eat foods that possess complementary

proteins Vegetarian diets may also lack vitamin

D, riboflavin, calcium, iron, zinc But can be found in certain foods

Nuts and Soy ProductsNuts and Soy Products Nuts

Although nuts are 70 to 90 percent fat, most of this is unsaturated fat.

Supply vitamin E and folic acid, B vitamins, calcium, copper, potassium, magnesium, fiber, and phytonutrients.

Should be avoided as a snack because they are high in calories.

Soy products Rich in plant protein, unsaturated fat, and fiber;

some soy is high in calcium. Contain plant chemicals, isoflavones, that act as

antioxidants and may protect against estrogen-related cancers

Do not exceed 3 servings of soy per day

Probiotics Probiotics Healthy bacteria (abundant in yogurt)

that help break down foods and prevent disease-causing organisms from settling in the intestines

Select yogurt with L-acidophilus, Bifidus, and inulin

Avoid yogurt with added fruit jam, sugar, and candy

Advanced Glycation End Advanced Glycation End Products (AGEs)Products (AGEs)

Compounds implicated in aging and chronic diseases via increased body structure oxidation and inflammation.

Contribute to the development of atherosclerosis, diabetes, kidney disease, osteoarthritis, rheumatoid arthritis, Alzheimer’s disease, and heart disease. Found in foods that are cooked in dry heat at high

temperatures, processed, and high in fat content. Broiling, grilling, and frying produce these AGEs.

Not as much AGEs are found from braising, steaming, stewing, roasting, boiling, and poaching forms of cooking

French fries have 8 time the amount of baked potatos

Diets from Other CulturesDiets from Other Cultures Mediterraneans have lower

rates of diet-linked diseases and a longer life expectancy

Diet features olive oil, whole grains, fruits, vegetables, legumes, fish, red wine, nuts and dairy products in moderation

Although a semivegetarian diet, up to 40% of the daily caloric intake comes from fat: mostly monounsaturated fat from olive oil

Diets from Other CulturesDiets from Other Cultures Ethnic diets

Many are healthier than the typical American diet because they emphasize complex carbohydrates and limit fat intake.

Unfortunately, the generally healthier ethnic diets quickly become Americanized when these groups adapt to the United States.

Common characteristics High in fruits, vegetables, and grains. Low in fat and saturated fat. Use low-fat or fat-free dairy products. Emphasize portion control—essential in a

healthy diet plan.

Diets Diets from from Other Other CulturesCultures

Nutrient SupplementationNutrient Supplementation Nutrient requirements can be met

using MyPyramid and as few as 1,500 calories of food.

Supplement doses should not exceed the ULs

Supplements may help a small group of individuals; most supplements do not provide benefits to healthy people who eat a balanced diet.

Nutrient SupplementsNutrient Supplements Water-soluble vitamins: The body

cannot retain these vitamins as long as fat-soluble vitamins; excessive intake is excreted Small amounts, however, can be

retained for weeks or months Fat-soluble vitamins: stored in fatty

tissue; daily intake of these vitamins is not as crucial

AntioxidantsAntioxidants Oxygen is used to change

carbohydrates and fats into energy A small amount of oxygen ends up in an

unstable form, referred to as oxygen free radicals

A free radical molecule has a normal proton nucleus with a single, unpaired electron (making it extremely reactive)

AntioxidantsAntioxidants Free radicals attack and damage proteins,

lipids, cell membranes, and DNA

Free radical formation is enhanced by solar radiation, cigarette smoke, air pollution, radiation, some drugs, injury or infection, chemicals (such as pesticides), and other environmental factors

Antioxidant ProtectionAntioxidant Protection

AntioxidantsAntioxidants Vitamin E

Found in oil-rich seeds and vegetable oils Supplements should be taken with a meal that contains

some fat as vitamin E is fat soluble RDA is 15 mg

Almonds, hazelnuts, peanuts, canola oil, safflower oil, cottonseed oil, kale, sunflower seeds, shrimp, wheat germ, sweet potato, avocado, and tomato sauce

Vitamin C May offer benefits against heart disease, cancer, and

cataracts Body eliminates it in about 12 hours Consume vitamin C-rich foods twice a day for best results Body absorbs little vitamin C beyond the first 200 mg Oranges, citrus fruit, bell peppers, kale, cauliflower,

tomatoes, strawberries

AntioxidantsAntioxidants Beta-carotene

Recommended dose is 20,000 IU from food sources Research found supplements do not offer protection

against heart disease, cancer, nor offer other benefits One medium raw carrot provides about 20,000 IU Can be obtained from sweet potatoes, pumpkin,

cantaloupe, squash, kale, broccoli, tomatoes, peaches, apricots

Selenium 200 micrograms (mcg) of selenium daily decreases risk

of Prostate cancer by 63% Colorectal cancer by 58% Lung cancer by 46% Also breast, liver, and digestive tract cancers

One Brazil nut (unshelled) provides 100 mcg Shelled nuts average only about 20 mcg

Top antioxidant foodsTop antioxidant foods Fruits and vegetables

are the richest sources of antioxidants and phytonutrients

Nutrient SupplementationNutrient Supplementation A multivitamin complex that provides

100% of the DV for most nutrients can help fill deficiencies

There is no solid scientific evidence that multivitamins decrease the risk for cardiovascular disease and cancer

Multivitamins don’t provide energy, fiber, phytonutrients

Benefits of FoodsBenefits of Foods Choosing a wide variety of food is the

best strategy to gain nutritional benefits.

Supplements do not supply all of the nutrients and other beneficial substances present in food and needed for good health.

Wholesome foods contain vitamins, minerals, carbohydrates, fiber, proteins, fats, phytochemicals, and other substances not yet discovered.

Many nutrients work in synergy, enhancing chemical processes in the body.

Functional FoodsFunctional Foods Foods or food ingredients that offer

specific health benefits beyond those supplied by the traditional nutrients they contain. A tomato is a functional food because it

contains the phytochemical lycopene thought to reduce prostate cancer risk.

Some manufacturers are creating "functional foods" by adding an ingredient to enhance market appeal. May undermine good nutrition because of

their extra calories, sugar, salt, and/or fat

Genetically Modified CropsGenetically Modified Crops Genetically modified organism (GMO) benefits:

Resist disease and extreme environmental conditions better. Require less fertilizers and pesticides. Last longer. Have better nutrient content and taste. Save billions of dollars and help feed the hungry.

Debate over GM foods Genetic modifications create new "transgenic" organisms that

have potentially unpredictable effects on the environment and on humans.

Illnesses or allergies in humans; destruction of other plants or herbicide-resistant "superweeds" may emerge.

Avoiding GM foods Buy organic foods; organic trade organizations will not certify

GM foods. Buy from local markets; small farmers are less likely to use this

technology.

Energy Substrates for Energy Substrates for Physical Activity Physical Activity

Two main fuels Glucose derived from foods is stored as

glycogen in muscles and the liver. Fatty acids, the product of the

breakdown of fats, stored as fat in the body

Amino acids from proteins are used as an energy substrate when glucose is low.

Energy Substrates for Energy Substrates for Physical ActivityPhysical Activity

ATP can be resynthesized in three ways: ATP-CP (high-energy phosphate compound)

stored in the body to use during all-out activities lasting 1-10 seconds

Anaerobic/lactic acid system breaks down glucose to create ATP without oxygen for maximal-intensity exercise sustained for 10 seconds to 3 minutes

Aerobic system produces ATP using glucose, fatty acids, and oxygen for steady-state exercise

Contributions of Energy Contributions of Energy Formation During PAFormation During PA

Nutrition for AthletesNutrition for Athletes

Generally, athletes do not require special supplementation or diet.

Athletes need more calories daily and more carbohydrate intake during prolonged physical activity.

During rest, fat supplies about 2/3 of the energy needs.

During exercise, both glucose (glycogen) and fat supply the energy.

Nutrition for AthletesNutrition for Athletes Carbohydrate loading

Normal levels of glycogen storage: 1,500–2,000 calories.

About 75 percent in muscle tissue. Can be increased greatly through

carbohydrate loading. Following an exhaustive workout:

Eat a combination of carbohydrates and protein within 30 minutes of exercise to speed up glycogen storage.

Protein intake increases insulin activity, thereby enhancing glycogen replenishment.

A 70 percent carbohydrate intake then should be maintained throughout the rest of the day.

Nutrition for AthletesNutrition for Athletes Hyponatremia

In some cases, athletes participating in long or ultra long-distance races may suffer from hyponatremia or low sodium concentration in the blood

Use sports drinks that contain sodium to replace electrolytes lost in sweat and prevent blood sodium dilution.

Nutrition for AthletesNutrition for Athletes Creatine supplementation

Creatine is an organic compound derived primarily from meat and fish

Creatine combines with inorganic phosphate and forms the high-energy compound CP that is used by cells to resynthesize ATP during all-out activities of very short duration.

Supplementation can result in an approximate 20 percent increase in the amount of creatine that is stored in muscles.

Endurance competitors benefit little because of low reliance on CP energy.

Bone Health and Bone Health and OsteoporosisOsteoporosis

A condition that leads to softening, deterioration, or loss of bone mineral density

Causes disability, fractures, and even death from medical complications

About 22 million women in the U.S. suffer from this condition (16 million do not know they have it)

One in 2 women and one in 8 men will suffer from osteoporosis

Threats to Bone Health Threats to Bone Health (Osteoporosis)(Osteoporosis)

Maximize bone density during youth

Maintain adequate calcium intake

Lifetime program of physical activity

Do not smoke Avoid excessive use of

alcohol, soft drinks, coffee Avoid corticosteroid drug

use Avoid high-protein diet

Bone Health and Bone Health and OsteoporosisOsteoporosis

Bone density can be promoted early in life by making sure the diet has sufficient calcium and participating in weight-bearing activities

If you don't get enough (most people don't), take calcium supplements.

RDA for calcium is 1,000-1,300 mg per day

RDA can be met by a diet high in calcium-rich foods

Hormone-Replacement Hormone-Replacement TherapyTherapy

The most common treatment to prevent bone loss following menopause for decades, but a large study was terminated 3 years early due to increased risk for breast cancer, blood clots, stroke, and heart attack.

HRT may still be the most effective treatment to relieve acute (short-term) symptoms of menopause.

Medications Fosamax (alendronate) and Actonel

(risedronate) prevent bone loss and, furthermore, actually help increase bone mass.

Iron DeficiencyIron Deficiency Key element of hemoglobin in blood RDA for adult women is 15-18 mg per day RDA for adult men is 8-11 mg per day Depletion of iron stores leads to anemia

(hemoglobin concentration in red blood cells is too low)

Heavy training increases iron requirement Iron-rich foods should be included in the

diet

Iron DeficiencyIron Deficiency

2005 Dietary Guidelines for 2005 Dietary Guidelines for AmericansAmericans

Recommendations for general public age 2 years and older

Description of healthy diet Fruits, vegetables, whole grains, and

milk products Lean meats, poultry, fish, beans, eggs,

and nuts Low in fats, cholesterol, salt, and sugar

2005 Dietary Guidelines for 2005 Dietary Guidelines for AmericansAmericans

1. Consume a variety of foods2. Control calorie intake3. Be physically active4. Increase intake of fruits, vegetables, whole

grains, and milk products5. Choose fats wisely6. Choose carbohydrates wisely7. Choose and prepare foods with little salt8. If you drink alcohol, do so in moderation9. Keep food safe to eat

Behaviors to prevent foodborne illness

Real Life StoriesReal Life Stories

Real Life Stories Real Life Stories Critical Thinking Critical Thinking QuestionsQuestions

1. Are there similarities/differences between Kwame’s pre-Fitness and Wellness course nutrition habits and your current eating patterns? How were his eating habits affecting his overall health and quality of life?

2. Discuss ways in which you can plan ahead to maintain healthy behaviors prior to attending a social gathering that includes food and alcohol consumption?

3. Many people like Kwame regularly consume fast foods. What wise/healthy food choices can you make when you are on the go or are unable to prepare your own meals?