Standards for Nutrient Intake

1. Standards for Nutrient Intake Nutritional Analysis & Assessment NS-210 Unit 2 Jennifer Neily, MS, RD, CSSD, LD Kaplan University

2. Review Unit 1 • What are the 4 nutrition assessment methods?

3. Review Unit 1 • What are 4 of the top 10 nutrition related deaths?

4. Review Unit 1 • What is PEM?

5. Review Unit 1 • What kind of dogs do I rescue and foster? :-)

6. Tonight we will review dietary standards • History of RDA and DRIs (set of 4) • Nutrient density • Indices of dietary quality • Dietary Guidelines for Americans • Food labels • Diet Planning Guides

7. History of Dietary Standards • Advances in metabolism, vitamin and mineral research during the early twentieth century led to the establishment of human nutrient requirements. • One of the first Standards were the Recommended Dietary Allowance (RDA’s) • RDA does have limitations

8. Dietary Reference Intakes • Standards defined for: • Energy nutrients • Other dietary components • Physical activity • Collaborative effort of U.S. and Canada • Recommendations apply to healthy people • May be different for specific groups

9. Dietary Reference Intakes (DRI) • Recommended Dietary Allowances (RDA) • The average daily amount of a nutrient considered adequate to meet the needs of practically ALL healthy people. • Based on scientific knowledge & are prepared by a Committee of the Food & Nutrition Board. • RDA set for energy, protein, many vitamins and minerals.

10. Dietary Reference Intakes -DRIs • DRIs include 4 Reference Values • A set of 4 values for the dietary nutrient intake of healthy people in the US and Canada. • Estimated Average Requirement (EAR) • Adequate Intake (AI) • Tolerable Upper Level (UL) • Recommended Dietary Allowance (RDA)

12. Estimated Average Requirement (EAR) • An amount that appears sufficient to maintain a specific body function in half of the population.

13. Recommended Dietary Allowance (RDA) • Based on scientific knowledge & are prepared by a Committee of the Food & Nutrition Board. • The average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97% to 98%) healthy individuals in a particular life state gender group.

14. Recommended Dietary Allowances (RDAs) • Set according to gender • Set according to age • Recommendations for pregnancy and lactation • Set high enough to meet 98% of the healthy population

15. Fig. 1-5, p. 18

16. Adequate Intake (AI) • The average amount of a nutrient that appears sufficient to maintain a specified criterion. • A value used when an RDA cannot yet be determined. • RDA based upon enough scientific research; AI set when not enough scientific research yet available.

17. Tolerable Upper Intake Level (UL) • “The highest level of daily nutrient intake that is likely to pose no risk of adverse health effects in almost all individuals in the specified life stage group.”

18. Fig. 1-6, p. 19

19. Fig. 1-7, p. 22

20. Example Nutrient DRI Vitamin C (Adult age 19-70) UL = 2000 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/day

21. Using Nutrient Recommendations • Serve as estimates for HEALTHY people. • RECOMMENDATIONS that include a generous margin of safety. • Intended to be met through diets composed of a VARIETY of foods. • Apply to AVERAGE DAILY INTAKES (to meet the RDA daily is difficult and unnecessary.) • Most appropriately used to develop nutrition programs for groups (EAR); for individuals (RDA or AI).

22. Energy & Macronutrient Recommendations • Estimated Energy Requirement (EER) • Acceptable macronutrient distribution ranges: • Carbohydrate 45 – 65% of total calories • Fiber requirement: 20 – 35g/day (14g/1000cal) • Fat 20 – 35% • Protein 10 – 35%

23. Nutrient Density Nutrient Density: a measure of nutrients relative to energy (cal) • Refers to a foods vitamin and mineral content relative to its energy content • Examples of high nutrient dense foods • Examples of low nutrient dense foods

24. Which is more nutrient dense?

25. Energy Density of Breakfast Options Compared 450 g breakfast provides 500cal for an energy density of 1.1 (500cal / 450g = 1.1 cal/g) 144 g breakfast provides 500cal for an energy density of 3.5 (500cal / 144g = 3.5 cal/g)

26. Indices of Diet Quality • Diet Quality Index (DQI) • Used to assess the overall diet quality of groups and to evaluate risk for chronic disease related to dietary patterns • The DQI scores diet on the basis of 10 indicators of diet quality • Health Eating Index (HEI) • Developed by the United States Department of Agriculture (USDA) • Single summary measure of overall diet quality defined in terms of adequacy, moderation and variety

27. Dietary Guidelines • Goals or standards primarily intended to address the more common and pressing nutrition-related health problems of chronic disease • Maintenance of healthy body weight, decrease consumption of fat, increased consumption of complex carbohydrates and use of alcoholic beverage in moderation, if at all.

28. Principles and Guidelines • Dietary Guidelines for Americans • Science-based advice • Promote health and reduce chronic diseases • Nine areas of recommendation, covering: • Diet • Physical activity

29. Dietary Guidelines for Americans US Dept of Health and Human Services & the USDA – updated every 5 years; current version introduced January 11, 2005. New version….early 2011 • Make smart choices from each food group. • Find your balance between food and physical activity. • Get the most nutrition out of your calories.

30. 2005 Dietary Guidelines for Americans

31. Nutrition Labeling • Nutrition Labeling and Education Act • Passed in 1990 by the FDA • Mandates nutrition labeling for almost all processed foods regulated by the FDA • Calls for activities to educate consumers about nutrition information

32. Food Labels

33. Nutrition Labeling & Education Act of 1990 • FDA & USDA designed the requirements. • Descriptive terms. According to law each • label must have: • Common name of product. • Name & address of mftr or distributor. • Net contents; wt, measure, or count. • Ingredients (descending order by weight). • Serving size and # of servings. • Quantities of specified nutrients.

35. Health Claims Any statement that characterizes the relationship between any nutrient or other substance in a food and a disease or health related condition.

36. Health Claims • Food Label Health Claim • Statements based on specific nutrition-disease • relationships • FDA approved • Structure Function Claim • Broad statements that characterize the relationship • between a nutrient in a food and its role in the body • Not FDA approved

37. Table 2-11, p. 58

38. Authorized Health Claims • Sodium & ? • Calcium & ? • Dietary saturated fat, cholesterol & ? • Fiber & ? • Folate & ?

39. Examples of Allowable Nutrient Content Claims • High, rich in = 20% or more Daily Value to describe protein, vitamins, minerals, dietary fiber or potassium per serving • Good source of = 10% to 19% or more of Daily Value per serving • Low Calorie= 40kcal or less per serving

40. Food Guides • A nutrition education tool translating scientific knowledge and dietary standards and recommendations • Problem oriented and address specific nutritional problems identified within the targeted population • USDA at the forefront of food guide development

41. Diet Planning Guides

42. Diet Planning Guides • These guides are important in selecting foods for a nutritious diet providing balance, variety, adequacy and moderation. • A combination of whole grains, vegetables, legumes, fruits, meats or meat alternates and milk products is essential to a healthy diet.

43. Diet Planning Guides Food Group Plans • Diet planning tools that sort foods of similar origin and nutrient content into groups and then specify that people should eat certain numbers of servings from each group. • The Food Guidance System • Exchange Lists

44. Food Guidance System • Developed by the USDA & US Dept HHS • Classifies groups by their common nutrients. • Emphasizes grains, fruits, & vegetables. • Recommends the majority of servings • from these groups.

45. Food Guidance SystemIntroduced April 2005 www.MyPyramid.gov

47. The multiple colors of the pyramid illustrate variety: each color represents one of the five food groups, plus one for oils. Different widths of colors suggest the proportional contribution of each food group to a healthy diet. The name, slogan, and website present a personalized approach. A person climbing steps reminds consumers to be physically active each day. The narrow slivers of color at the top imply moderation in foods rich in solid fats and added sugars. The wide bottom represents nutrient-dense foods that should make up the bulk of the diet. Greater intakes of grains, vegetables, fruits, and milk are encouraged by the width of orange, green, red, and blue, respectively. GRAINS VEGETABLES FRUITS OILS MILK MEAT & BEANS

48. Diet Planning Guides – USDA Food Guidance System • www.mypyramid.gov • The width of the bands represent the • amount that should be consumed. • The pyramid can be individualized for • each person. • Website provides consumer education • about making food choices.

49. Example based upon 2000 calories Grains - Total grains: 6.0 • Whole grains 3.0 • Refined grains 3.0 Vegetables – 2.5 cups Fruits – 2.0 cups Milk – 3.0 cups Meat and Beans – 5.5 oz Oils – 6.0 tsp

50. Exchange Lists • Originally developed by the American Diabetes • Association to help people with diabetes in meal • planning. • Names the food on each list and specifies portion • sizes. • States the amount of CHO, protein, fat, and calories • each portion contributes.