Guidelines for Healthy Eating Chapter 8

1. Guidelines for Healthy EatingChapter 8

2. How to Choose a Healthy Diet • A healthy diet provides enough of all essential nutrients to avoid deficiencies but not excessive amounts that may increase the risk of nutrient toxicities or chronic diseases • Four of the 10 leading causes of death in the United States are associated with dietary excesses: • Heart disease • Cancer • Stroke • Diabetes

3. How to Choose a Healthy Diet (cont’d) • Many other health problems are related, at least in part, to dietary excesses • Obesity • Hypertension • Hypercholesterolemia • A healthy diet has the potential to alleviate the high economic and personal costs of morbidity and mortality associated with these diseases

4. Healthy People 2010 • Overall goals are to increase quality and years of healthy life and eliminate health disparities among Americans • Specific, measurable objectives serve as the basis for monitoring and measuring improvements in the nation’s health over the 10-year period from 2000 to 2010

5. Primarily Professional • Historically, recommended dietary allowances (RDAs) advocated a level of nutrients set to protect people from nutrient deficiency diseases • Old RDAs have been replaced with a new set of standards, the dietary reference intakes (DRIs), that incorporate an expanded focus of reducing the risk of chronic diseases associated with dietary excesses • Primarily for professional use because they deal with quantities of nutrients as opposed to amounts of food

6. Dietary Reference Intakes • Series of 8 in-depth reports featuring a new set of references called dietary reference intakes (DRIs) • Cover vitamins, minerals, the energy nutrients, cholesterol, fiber, electrolytes, and water • DRI is a group name that includes 4 separate reference values that are based on the concepts of probability and risk: • Updated RDAs, estimated average requirement (EAR), adequate intake (AI), and the tolerable upper intake level (UL)

7. Dietary Reference Intakes (cont’d) • Each of these reference values has a specific purpose and represents a different level of intake • Each reference value is viewed as an average daily intake over time, at least 1 week for most nutrients • Additional reference values include acceptable macronutrient distribution ranges (AMDRs) and an estimated energy requirement (EER)

8. Dietary Reference Intakes (cont’d) • Recommended dietary allowances • Represent the average daily recommended intake to meet the nutrient requirements of 97% to 98% of healthy individuals by life stage and gender • Based on specific criteria indicators • Set high enough to account for daily variations in intake

9. Question • The recommended daily allowances (RDAs) are said to be primarily for professional use. Why is this? a. Because they are based on a variety of recommendations by professional people b. Because it takes a professional to truly understand them c. Because only professional people are concerned about what we eat d. Because they deal with quantities of nutrients rather than amounts of food

10. Answer d. Because they deal with quantities of nutrients rather than amounts of food Rationale: Historically, the recommended dietary allowances (RDAs) in the United States and the recommended nutrient intakes in Canada established levels of nutrients to protect people from nutrient deficiency diseases. Therefore, professionals had to interpret them in the diet.

11. Estimated Average Requirement • Amount of a nutrient that is estimated to meet the requirement of half of healthy people in a lifestyle or gender group • Not based solely on the prevention of nutrient deficiencies • Consideration for reducing the risk of chronic disease • Takes into account the bioavailability of the nutrient • EAR values are used to determine RDA values

12. Adequate Intake • Adequate intake (AI) is set when an RDA cannot be determined due to lack of sufficient data on requirements • A recommended average daily intake level thought to meet or exceed the needs of virtually all members of a life stage/gender group based on observed or experimentally determined estimates of nutrient intake by groups of healthy people • Primary purpose of the AI is as a goal for the nutrient intake of individuals

13. Tolerable Upper Intake Level • Highest level of average daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population • Not intended to be a recommended level of intake

14. Acceptable Macronutrient Distribution Ranges • Broad ranges for each energy nutrient • Expressed as a percentage of total calories consumed • Associated with reduced risk of chronic disease while providing adequate intakes of essential nutrients

15. Estimated Energy Requirements • Similar to the EAR • Defined as the dietary energy intake predicted to maintain energy balance in healthy, normal- weight individuals of a defined age, gender, weight, height, and level of physical activity consistent with good health

16. How Are the DRIs Used? • DRIs are used by: • Scientists and nutritionists who work in research or academic settings • Dietitians who plan menus for specific populations • Used to assess the adequacy of an individual’s intake by comparing estimated intake with estimated requirements • DRIs are not suited to teaching people how to make healthy choices

17. Conveying the Concept of a Healthy Diet to Consumers • Dietary Guidelines for Americans is most prominent tool to assist Americans in making wise food choices • Companion tool is MyPyramid • Dietary recommendations also made by: • American Heart Association • American Cancer Society • American Institute of Cancer Research

18. Dietary Guidelines for Americans • Serves as the federal policy on nutrition • Evidence-based recommendations on diet and physical activity to promote health and decrease the risk of chronic diet-related diseases • Covers 9 major messages • 23 key recommendations • 18 additional recommendations are made for specific population groups

19. Dietary Guidelines for Americans (cont’d) • Intended to represent a pattern of eating for Americans over the age of 2 years • Should ideally be implemented as a whole • Major themes: • Eat fewer calories • Be more physically active • Make wiser food choices

20. Question • Is the following statement true or false? The tolerable upper intake level is not intended to be a recommended level of intake.

21. Answer True. Rationale: The tolerable upper intake level (UL) is the highest level of average daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. It is not intended to be a recommended level of intake.

22. MyPyramid • Newest generation of the food guide • Vehicle by which the Dietary Guidelines for Americans are translated into food and activity choices for healthy individuals over the age of 2 • Philosophy is that nutrient needs should be met through food, not supplements

23. MyPyramid (cont’d) • Basic messages • Eat more fruit, vegetables, and whole grains • Eat less saturated fat, trans fat, and cholesterol • Limit sweets and salt • Use alcohol in moderation, if at all • Balance calorie intake with calorie expenditure • Be physically active most days of the week

24. MyPyramid (cont’d) • Designed to convey the concepts of: • Variety • Moderation • Proportionality • Gradual improvement • Personalization • Physical activity

25. Clearing Up Controversy • Putting knowledge into practice is difficult • Misunderstandings about servings and food group placement are common • Appropriate calorie level • Actually an estimate of how many calories a person of similar age and average height and weight needs to maintain an appropriate weight

26. Clearing Up Controversy (cont’d) • Discretionary calories • Allow consumers to incorporate small amounts of calorie-dense or “empty calorie” foods into their eating plan and still meet nutrient needs without exceeding total calorie constraints • Discretionary calories may be “eaten up” by choosing foods within the existing plan that are high in fat or added sugar

27. Clearing Up Controversy (cont’d) • Discretionary calories (cont’d) • Recommendations for the amount of food to consume are based on the “healthiest” choices within each group • Selecting the “healthiest” choices from each food group is vital for achieving appropriate calorie and nutrient recommendations

28. Clearing Up Controversy (cont’d) • Serving sizes • Quality of foods chosen influences total calorie intake, so does the quantity of foods eaten • Large serving sizes contribute to overeating • Most effective way to downsize portion sizes may be to change a person’s environment

29. Clearing Up Controversy (cont’d) • Variety • Eating a varied diet helps ensure essential nutrients are consumed in adequate amounts

30. Guidelines and Graphics in Other Countries • Pyramid shape is not necessarily superior or even appropriate for food guides in other countries • Core recommendations are consistently similar

31. Recommendations From Health Agencies • Recommendations are similar to each other and to the Dietary Guidelines for Americans • American Plate, a campaign by the American Institute of Cancer Research to teach Americans how to implement their diet guidelines, uses a dinner plate as a visual aid • Landmark report entitled Food Nutrition and the Prevention of Cancer: A global perspective • Additional recommendations regarding physical activity and weight management are offered