Lecture 2b 18 September 2017 Overview of Nutrition

1. Lecture 2b 18 September 2017 Overview of Nutrition

2. Overview of lecture • sources of nutrition information-reliable versus unreliable sources of information and how to tell the difference • planning a healthy diet (including the 6 dietary principles), importance of the combination of good nutrition and physical activity • eating well on a low income

3. Sources of nutrition information-usually reliable University publications (.edu) Web sites ending in .gov or .org Peer reviewed journal publications (American Journal of Clinical Nutrition, Nutrition Research, British Journal of Nutrition, Nutrition Reviews, New England Journal of Medicine, Lipids, Journal of Lipid Research, Proceedings of the National Academy of Sciences, Journal of Biological Chemistry and Journal of Clinical Investigation)

4. Sources of nutrition information-usually reliable Government Health Canada http://www.hc-sc.gc.ca Nova Scotia Department of Health www.gov.ns.ca/health/ Cape Breton Regional Health Unit www.cbdha.nshealth.ca Pharmaceutical and nutraceutical firms (.com) – caution- they have something to sell but good science required by Health Canada before approval is given. FDA

5. Sources of nutrition information-usually reliable Volunteer Agencies Canadian Cancer Society http://www.cancer.ca/ Canadian Diabetes Association www.diabetes.ca Heart and Stroke Foundation of Canada http://ww1.heartandstroke.ca/

6. Sources of nutrition information-usually reliable Consumer groups American Council on Science and Health www.acsh.org Federal Consumer Information Centre http://www.pueblo.gsa.gov/ International Food Information Council http://www.ific.org/

7. Sources of nutrition information-usually reliable Professional Associations American Dietetic Association http://www.eatright.org/ Dietitians of Canada www.dietitians.ca American Medical Association http://www.ama-assn.org/ Canadian Medical Association www.cma.ca

8. Sources of nutrition information-unreliable • Firms and other organisations that are here one day and gone the next • Firms that claim to have qualifications in the field but can produce no evidence of qualifications

9. Sources of nutrition information-reliable or unreliable • Be cautious with .com 

10. Reliable versus unreliable sources of nutrition information based on: • Credentials • Real results • Evidence of misinformation

11. Credentials for reliability for sources of nutrition information -nutrition and/or dietetics training from an accredited university (who is doing the accreditation?) -at least 3-4 years of training from a properly accredited university to be reliable

12. Credentials for reliability for sources of nutrition information Watch out for: • people using nonsense terminology like “nutrimedicine” • fee for degree schools • liberal use of the word doctor • members of “professional societies” • dietitian or nutritionist-this term may be unregulated in some placesjurisdictions

13. Reliable nutrition information Real credentials yield real results usually: -however, watch out for dry labing or fixing results -real results are only gained by the scientific method

14. Reliable nutrition information gained by the scientific method. The scientific method involves a(an): -hypothesis -objective -method-validity and numbers of subjects -results-data and statistics are accurate -discussion and interpretation

15. Reliable nutrition information gained by the scientific method. The scientific method also involves: Conclusions -not generalised to all people – use of word may References Publication in reputable peer-reviewed journals Repetition- within group and by multiple groups

16. Reliability of nutrition information Identifying misinformation via: • personal testimonials (paid or otherwise) and hearsay and gossip-none of these use the scientific method • time-testing Is it really true?- true findings would be widely published over time • nonsense medical jargon e.g. Hunger stimulation point

17. Identifying misinformation about nutrition via involvement/use of: Paranoia people are just out to get me- especially my competitors Quick and easy fixes who knows of the overnight cancer treatment? Natural products natural is not necessarily safer or better

18. Identifying misinformation about nutrition via involvement/use of: Satisfaction guaranteed How, over what time, what recourse does one have? One product does it all Is there only one chemical reaction or disease in the body? Glossy adverts – in all media Watch out for the slick willy approach: Have I got a deal for you

19. Identifying misinformation about nutrition -people telling you not to listen to physicians or other qualified persons

20. Reliability of nutrition information Remember: if it is too good to be true then it likely is not true and that the internet is hard to regulate- the internet is worldwide and not every country has regulations at the point of source

21. Planning a healthy diet -plan out your week ahead keeping Canada’s food guide and physical activity in mind -emphasis on: -fruits, vegetables, whole grains and low fat milk products and milk product alternatives -lean meats, poultry, seafoods, eggs, seeds and nuts -low saturated (?), trans, sodium intake -matching your calories (input) with your physical activity (output) -six dietary principles

22. Principles of Good Nutrition = The six dietary principles • Adequacy (A) • Balance (B) • Energy Control (C) • Nutrient Density (D) • Moderation (M) • Variety (V) • Remember ABCDMV

23. Adequacy Diet provides sufficient energy and enough of the nutrients to meet (but not exceed) the needs of healthy people.

24. Balance Getting enough but not too much of each type of food Meats fish and poultry rich in iron but poor in calcium Milk-rich in calcium but poor in iron Helps to ensure adequacy

25. Energy control Adequate balanced diet without overeating Calories in should = calories out in a person of normal waist circumference Calories out = basal metabolism plus physical activity Basal metabolism = energy expenditure lying still

26. Nutrient density Eating well without overeating accomplished by: • having lots of nutrients relative to energy content of food ( nutrient density) • avoiding/seriously limiting empty kcal foods like soft drinks, candies, chips (few nutrients relative to energy content of food) • remember that nutrient density contributes to adequacy and energy control

27. Moderation • avoiding or seriously limiting empty kcal foods • contributes to adequacy, balance and energy control

28. Variety • Eating a wide selection of foods within and among the four food groups in Canada’s food guide • Contributes to adequacy, balance, energy control, nutrient density and moderation

29. Importance of combining a good diet with physical activity • A good diet allows one to be physically active • Physical activity burns calories and is an appetite suppressant-this controls waist circumference and hence certain diseases-physical activity ties in with energy control • Get a minimum of 150 minutes a week of moderate (e.g. brisk walking (> 5 km/hour but not race walking) to vigourous exercise (e.g. jogging or race walking) - walking is cheap-all that is required is two feet, two legs and a safe place to walk-no expensive gym membership required!!

30. EXERCISE GUIDELINES http://www.csep.ca/CMFiles/Guidelines/CSEP-InfoSheets-adults-ENG.pdf

31. Eating well on a low income

32. Remember in terms of cost /kg meats > dairy >fruits and vegetables> grains • these principles maintained by following Canada’s Food Guides (food groups and numbers of servings) Chicken and pork are cheaper/kg than beef and lamb

33. DO: Buy in bulk, freeze what you can Buy unprocessed foods Buy unpackaged foods wherever possible Buy only what you can eat to maintain components of food selection without waste (reliable fridge and freezer)

34. DO: Read flyers and watch for coupons Shop at bulk food stores or join a food coop Avoid high-end chain stores Live with people who share your enthusiasm for a healthy diet and like similar foods

35. DO: Repeat menu every 3 weeks (chicken, pork, beef, specific type of fish) Perhaps substitute soybeans for beef Remember that carrots, peas, chickpeas, various beans, rice and potatoes are relatively inexpensive and very nutritious when consumed in accordance with the dietary principles listed above and Canada’s food guide Not substitute supplements for food

36. Menu for the week  Sunday Breakfast eggs bread 1-2 % milk Lunch bread fruit fruit juice Dinner vegetables fish fruit juice

37. Monday Breakfast cereal bread 1-2 % milk Lunch salad fruit fruit juice Dinner vegetables rice 1-2 % milk

38. Tuesday Breakfast cereal bread 1-2 % milk Lunch cheese fruit fruit juice Dinner pancakes fruit juice

39. Wednesday Breakfast cereal bread 1-2 % milk Lunch bread fruit fruit juice Dinner vegetables fish

40. Thursday Breakfast cereal bread 1-2 % milk Lunch salad fruit fruit juice Dinner chicken rice and vegetables fruit juice

41. Friday Breakfast cereal bread 1-2 % milk Lunch bread fruit fruit juice Dinner pasta with vegetables 1-2 % milk

42. Saturday Breakfast cereal bread 1-2 % milk Lunch salad fruit fruit juice Dinner vegetables Fish, fruit juice

43. GROUP ACTIVITY assess the above menu and write in specific foods

44. Summary of lecture • sources of nutrition information-reliable versus unreliable sources of information and how to tell the difference • planning a healthy diet (including the 6 dietary principles), importance of the combination of good nutrition and physical activity • eating well on a low income