Tools for Designing a Healthy Diet

1. Tools for Designing a Healthy Diet

2. The Typical American Diet 16% of kcals as proteins ~66% from animal sources 50% of kcals as CHO ~50% from simple sugars 33% of kcals as fat ~60 % from animal fats

3. Assessing Our Diets Continuing Survey of Food Intakes by Individuals (CSFII) [USDA] National Health and Nutrition Examination Survey (NHANES) [US Dept. of Health & Human Services]

4. Improving Our Diets Energy intake Salt (sodium) Alcohol Fat Adequate fluids Eat 5-A-Day Use supplements wisely

5. Healthy People 2010 A systematic approach to health improvement To promote healthy lifestyle and reduce preventable deaths and diseases

6. Examples of Healthy People 2010 Nutrition Goals 19-2.Reduce the proportion of adults who are obese. 19-4.Reduce growth retardation among low-income children under age 5 years. 19-5. Increase the proportion of persons aged 2 years and older who consume at least two daily servings of fruit.

7. Healthy People 2010 Reduce obesity in adults and children Increase intake of fruits, vegetables, and whole grain products Lower the intake of fat, saturated fats, and sodium Increase the intake of calcium and iron

8. Health Promotion and Disease Prevention: Diet Essential nutrients Dietary fiber Moderate calories Moderate saturated fats Moderate cholesterol Moderate alcohol Health benefits

9. Recommendations Continue: Physical Activities Regular 30 minutes minimum on most days Benefits

10. Recommendations Continue: Lifestyle Minimize alcohol 1-2 drinks a day Benefits Not smoking Benefits

11. What Is A Healthy Diet? To “consume a variety of foods balanced by a moderate intake of each food” Variety - choose different foods Balanced - select foods from the major food groups Moderation - plan your intake; control portion size

12. Variety Choose different foods (within a food group) Ensures intake of sufficient nutrients Inclusion of phytochemicals

13. Balance Select foods from the five food groups Milk and other dairy Meat and meat substitutes Vegetables Fruits Bread, cereal, rice, pasta

14. Moderation Refers mostly to portion size

15. Are there really “no good or bad foods”?

16. Nutrient Density Comparison of vitamin and mineral content to number of kcals Empty calories Provides kcals and few to none other nutrients

17. Comparison of Nutrient Density

18. Energy Density Comparison of the kcal content with the weight of food Food rich in calories but weighs little is energy dense Low-energy-density foods in a meal contributes to satiety Foods with more water and dietary fiber

19. Energy Density

20. Desirable State of Nutritional Health Intake meets body’s needs Body has a small surplus

21. Undernutrition Intake is below body’s needs Stores used Health declines Biochemical evidence Subclinical deficiency Clinical symptoms

22. Overnutrition Intake exceeds body’s needs Short term, few symptoms Long term, serious conditions Obesity Intake of supplements

23. Measuring Nutritional State Anthropometric Biochemical Clinical Dietary Economic status

24. Limitation in Assessment Long delay between development of poor nutritional health and the first clinical evidence of a problem Often the evidence linking nutrition status to symptoms is vague

25. 2005 U.S. Dietary Guidelines

26. The Dietary Guidelines General goals for nutrient intakes and diet composition Approved by the Secretaries of Health and Human Services and Agriculture Promote adequate vitamin and mineral intake Promote health and reduce the risk of chronic diseases Intended for healthy children (>2 yrs) and adults

27. Dietary Guidelines 2005 Increased emphasis on physical activity More focus on weight management through food choices Recommendations to eat less highly processed foods with unhealthful fat, added sugar, and salt

28. Dietary Guidelines: Activity To reduce the risk of chronic disease in adulthood: engage in at least 30 minutes of moderate-intensity physical activity…on most days of the week To help manage body weight, engage in…60 minutes of moderate to vigorous intensity activity on most days of the week To sustain weight loss in adulthood: participate in at least 60-90 minutes of daily moderate-intensity physical activity while not exceeding calorie requirements

29. 2005 Dietary GuidelinesKey Recommendations Consume a variety of nutrient-dense foods and beverages within and among the basic food groups…choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the USDA Food Guide or the DASH eating plan

30. Dietary Guidelines: Weight Management To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended To prevent gradual weight gain over time, make small descreases in food and beverage calories and increase physical activity

31. 2005 Dietary GuidelinesFoods to Encourage Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and 21/2 cups of vegetables per day…for a 2000-calorie intake Choose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables and other vegetables)

32. 2005 Dietary GuidelinesFoods to Encourage Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products…at least half the grains should come from whole grains

33. 2005 Dietary GuidelinesFoods to Encourage Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products

34. 2005 Dietary Guidelines: Fats Consume less than 10% of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possible Keep total fat intake between 20-35% of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils

35. 2005 Dietary Guidelines: Carbohydrate Choose fiber-rich fruits, vegetables, and whole grains often. Choose and prepare foods and beverages with little added sugars or caloric sweeteners, such as amounts suggested by the USDA Food Guide and the DASH eating plan Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar and starch-containing foods and beverages less frequently

36. 2005 Dietary Guidelines: Sodium and Potassium Consume less than 2300 mg of sodium (approximately 1 tsp of salt) per day Choose and prepare foods with little salt. At the same time, consume potassium-rich foods, such as fruits and vegetables

38. 2005 Dietary Guidelines: Alcoholic Beverages Those who choose to drink alcoholic beverages should do so sensibly and in moderation—defined as the consumption of up to one drink per day for women and up to two drinks per day for men.

39. Changes in Current Consumption to Meet Recommended Intakes

40. Changes in Current Consumption to Meet Recommended Intakes

41. The Food Guide Pyramid

42. Purpose of the USDA Food Guides Intended to help consumers interpret and apply the U.S. Dietary Guidelines The Pyramid was developed as an educational tool to help Americans select healthful diets. Translates nutrition recommendations–the Dietary Guidelines for Americans and the Dietary Reference Intakes (DRI)—into the kinds and amounts of food to eat each day.

43. USDA Food Guide The old Food Guide Pyramid provided generalized messages for the total population With the growth of overweight and obesity, a “one-size-fit-all” approach no longer works The new Guide provides core messages, along with individualized guidance

44. The Food Guide Pyramidr.i.p. 1992-2005 Was developed to translate science into practical terms help people meet the nutritional needs for carbohydrate, protein, fat, vitamins, & minerals provide a foundation to eating

45. USDA Food Guide Provides individualized meal patterns for kcal levels from 1000 kcals to 3200 kcals in 200-kcal increments Includes discretionary calories in addition to servings from basic groups Access the Guide within the U.S. Dietary Recommendations at http://www.healthierus.gov/dietaryguidelines/

46. USDA Food Guide

47. Daily Reference Intake (DRI) New nutrient recommendations Nutrient recommendations to prevent chronic diseases DRI set for all vitamins and minerals In the plans: macronutrients, electrolytes, water and other components

48. Standards Under the DRI Recommended Dietary Allowances (RDAs) Adequate Intake (AI) Tolerable Upper Intake Levels (ULs)

49. The Recommended Dietary Allowances “Recommended intakes of nutrients that meet the needs of almost all healthy people of similar age and gender”---- the Food and Nutrition Board of the National Academy of Sciences

50. RDA Meets the needs of ~97% of all individuals Set ~20% above what an average person needs Accommodates for people with higher needs RDAs, by definition, are generous allowances Set for only 19 nutrients

51. RDA Improvement in health are not expected if consume more than the RDA amounts Goal is to eat close to the RDA amounts Short term deficiencies appear harmless

52. Adequate Intakes Not enough research information available Based on observed or experimentally determined estimates Set for some vitamins, choline, some minerals

53. Tolerable Upper Intake Levels Maximum level of daily intake without causing adverse health effects Chronic daily use Not a goal, but a ceiling

54. Uses for the DRIs Diet planning Using RDA or AI Do not exceed the UI For the healthy population

55. Standards For Food Labeling (DVs) DRIs not used on food label since they are gender and age specific FDA developed the Daily Values (DV) DV exist for vitamins, minerals, and protein, mostly set at or close to the highest RDA value or related nutrient standard seen in the age/gender categories for a given nutrient

56. Standards For Food Labeling (DVs) DVs also set for dietary components not currently part of the DRIs Includes cholesterol, carbohydrate, fiber, and others Values based on dietary advice from U.S. federal agencies

57. Standards for Food Labels (DVs) Only used on food labels Allow for comparison shopping

58. DRV for 2000 kcal

59. Portion Size Equivalents

60. What’s on the Food Label? Product name Manufacturer’s name and address Uniform serving size Amount in the package Ingredients in descending order by weight

61. Food Label Nutrition Facts

62. Food Label Side Panel

63. Sample Calculation of a Nutrition Label Per serving CHO: 15g x 4 kcal/g = 60 kcal PRO: 3g x 4 kcal/g = 12 kcal FAT: 1g x 9 kcal/g = 9 kcal TOTAL: 81 kcal, rounded down to 80

64. What Food Requires a Label? Nearly all packaged foods and processed meat products Any food labeled with health claims Fresh fruit, vegetable, raw single ingredient meal, poultry, fish are voluntary

65. What is not required on a label? % Daily Value for protein (for foods intended for 4 yrs. or older) Protein deficiency is rare Procedure to determine protein quality is expensive

66. Health Claims Allowed on Food Labels osteoporosis cancer cardiovascular disease hypertension neural tube defects tooth decay stroke use of “may” or “might”

67. Comparative and Absolute Nutrient Claims Sugar (free, no added) Calories (free, low) Fiber (high, food source, added) Fat (free, low, reduced) Cholesterol (free, low, reduced) Sodium (free, low, light)

68. Nutrient Claims Must Meet Specific Standards Cholesterol free: less than 2 mg cholesterol and 2 g or less of saturated fat per serving Low cholesterol: 20 mg or less of cholesterol and 2 g or less of sfa Reduced or less cholesterol: at least 25% less cholesterol and 2 g or less of sfa per serving than reference food

69. Sodium Label Claims Sodium free: less than 5 mg per serving Very low sodium: 35 mg or less per serving Low sodium: 140 mg or less per serving Light in sodium: at least 50% less per serving than reference food Reduced or less sodium: at least 25% less per serving than reference food

70. Claims Fortified/enriched Healthy Light, lite Diet Good source Organic Natural