Agenda

• Lecture– Nutritional States– Diet planning– Food labels

• Group activity– Design a menu

Lecture 14: Nutritional Status and Diet Planning

Will Brown2/23/2012

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

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

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

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

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

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

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.

• Folate involved in DNA sysnthesis

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

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.

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

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.

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

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-heme iron 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.

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

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

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

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

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

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

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