Jamie Pope, Steven Nizielski, and Alison McCook NUTRITION for a Changing World FIRST EDITION Chapter 2 Healthy Diets From Desert to Oasis © 2016 by W. H. Freeman and Company & Scientific American

Chapter 2 Objectives Identify the primary characteristics of a healthy diet Define nutrient and energy density and describe why it is necessary to consider these factors when making food selections Identify the key excesses and inadequacies of the current average American diet List the core recommendations of the Dietary Guidelines for Americans and discuss the significant changes that have occurred in the dietary recommendations to Americans over time Describe how the USDA’s MyPlate and the associated My Daily Food Plan can be used to design a healthy diet Explain what characteristics of a healthy diet are common throughout the world Identify the information that is required on food labels, and describe how this information can be used to select healthier foods Identify the types of claims that can be made on food labels and discuss how their use is regulated by the FDA

Healthy Diets What is a food desert? Mari Gallagher, food researcher, found children who had never heard of strawberries or grapes Can you have a healthy diet in a food desert? In the photo, Mari Gallagher is taking a picture of a food desert in an urban neighborhood with a corner store that only carries chips, fast food, and processed foods. This is a community with little access to a variety of affordable, healthy foods, such as fruits and vegetables. Here boys have never heard of strawberries or grapes, as a grocery store with a wide variety of foods is a long bus ride away and some families don’t have the time or money for that. Healthy diets require choosing healthy foods, and availability is part of the equation. Other factors include convenience, taste, price, emotions, and cultural and social influences.

Healthy Diets Common Qualities Variety of foods Balanced across food groups and macronutrients Adequate amounts to promote health Moderation and not overindulging

Nutrient-Dense Versus Energy-Dense Foods

Food Composition and Energy Density

Food Composition and Energy Density

The American Diet Excessive amounts of energy-dense foods Minimal amounts of nutrient-dense foods

Dietary Guidelines for Americans (DGA) Updated every 5 years by the US Department of Agriculture (USDA) and US Department of Health and Human Services (HHS) Based on the latest science-based information about nutrition and health Core of federal food and nutrition education programs The guidelines provide advice on how to eat healthfully and reduce the risk of chronic disease. The most recent guidelines stress the importance of the consumption of nutrient-dense foods and balancing calorie intake with the amount expended throughout the day in physical activity. They suggest consuming more fruits, vegetables, whole grains, fish, seafood, beans, nuts and seeds, and fat-free and low-fat dairy products. The guidelines recommend getting no more than 15 percent of one’s daily calories from solid fats and added sugars (SoFAS) and eating fewer foods with refined grains and less sodium.

ADD NEW GUIDELINES INFO

Increase fruit intake, especially whole fruits Eat a variety of vegetables – especially dark-green, red, and orange – and beans and peas. Consume half of all grains as whole grains. Replace solid fats with oils where possible. Avoid foods and beverages with added sugars.

Food Advice in Action The USDA updates tools to implement dietary advice To put the food advice from the Dietary Guidelines into action, the USDA—the agency that regulates farming and food production—updates tools to make it easier for people to consolidate dietary advice when choosing meals. These tools began in the 1940s with the Basic 7, which became the Basic 4.

Food Advice in Action The USDA updates tools to implement dietary advice The basic 4 followed by the Food Pyramid in the 1990s. Finally, in 2011 the USDA released MyPlate to help consumers make better food choices.

Choose MyPlate The web site has tips and tools for tracking and moderating the intake of calories, SoFAs, fruits, vegetables, and more. You can create a personalized diet plan with My Daily Food Plan, with more detailed recommendations, and track your intake on SuperTracker.

Food Desert Research People choose foods based on many factors All of this advice about healthy diets isn’t helpful to families who have little or no access to nutritious food. Mari Gallagher found that more than 600,000 residents in Chicago live in food deserts with no access to grocery stores that sell healthy foods. These people were more likely to be obese and die prematurely from diabetes. In Alabama she found 90,000 people living in food deserts, including more than 20,000 children, with increases in cancer and other diseases linked to dietary causes. Further research by Helen Lee, PhD, at MDRC shows mixed evidence on whether access is the problem as to what kids actually eat and the types of foods available to them. Food desert research may correlate food deserts to income and obesity, but it does not show that lack of access to foods is the cause of residents’ unhealthy eating habits. People choose foods based on many factors. Access doesn’t mean people will eat healthy, but it does give them the power to choose.

Food Guides Around the World International food guides share common recommendations of consuming more plant-based foods, choosing lean protein sources, limiting intake of sugar and sodium, minimizing intake of unhealthy fats, controlling portion sizes, and increasing physical activity.

Understanding the Food Label Food and Drug Administration (FDA) Nutrition Labeling and Education Act (NLEA) Requires standardized food labeling Nutrition Facts Panel Specific information about fats, proteins, carbohydrates, and some vitamins and minerals Percent Daily Value (or %DV) Ingredient list To help make purchasing nutritious items at the grocery store easier, food policy experts have developed tools, like the food label. The Food and Drug Administration (FDA) introduced a law called the Nutrition Labeling and Education Act (NLEA) that requires food labels of most foods to use a standardized format.

Food Labels

FDA Developed the %DV Food Component %DV based on 2000 kcal Fat <65 g Saturated fat <20 g Protein 50 g Cholesterol <300 mg Carbohydrate 300 g Fiber 25 g Sodium <2400 mg Potassium 3500 mg The Percent Daily Value (%DV) on a food is based on a standard diet and allows comparison of products. On the Nutrition Facts Panel, the %DV is the percentage of a nutrient provided by a standard serving of a food in relation to the approximate requirement for that nutrient (those approximate requirements are listed in the table above). Percent daily values are based on a 2000-calorie diet. So the %DV of fat on a food label is the percent of the standard daily amount (65 grams) that is contained in one serving of the product

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 Nutrient components Percent Daily Value

Calculate the Percentage of Calories from Fat Using the Food Label Calculate the Percentage of Calories from Fat 12 g of fat 12 g fat * 9 kcal/g = 108 kcal 108 kcal / 360 total kcal = 0.30 0.30 x 100 = 30% calories from fat Percentage of calories from carbohydrates = 54% Percentage of calories from proteins = 14%

Claims Made on Foods and Supplements The NLEA also regulates claims that can appear on food and dietary supplement labels to inform consumers of the health-related attributes of these products.

Future Food Labels Making labels more useful Address ongoing concerns Propose food label changes

Healthy Diets Large chain restaurants Increase food access In 2010 the government began requiring that menu items list the total calorie content Increase food access Decreasing food deserts Encourage shoppers to make healthier choices If policymakers don’t address food deserts, giving people access to healthy foods, then they can’t expect people to follow their advice, says Gallagher. Yet even those who have access aren’t always making healthy choices, so we still need to find ways to encourage people to eat healthier.

Summary A healthy diet is a pattern of eating, characterized by variety, balance, adequacy, and moderation, that promotes health and reduces the risk of chronic disease A healthy diet emphasizes nutrient-dense foods that provide a higher proportion of nutrients relative to calories A healthy diet minimizes energy-dense or “empty calorie” foods. Energy density is a measure of the calorie content of a food relative to a given weight The Dietary Guidelines for Americans provide evidence-based advice about balancing calorie intake with expenditure and making informed food choices to attain and maintain a healthy weight, reduce risk of chronic disease, and promote overall health

Summary (Cont’d) The DGAs are revised every 5 years and are the basis of federal nutrition policy and nutrition education initiatives and programs The DGAs recommend reducing intake of solid fats and added sugars (SoFAs), which are energy dense and nutrient poor, and consuming less sodium MyPlate is based on the DGAs and provides a presentation of the five food groups on a virtual place setting to represent the ideal balance and variety of nutrients International food guides share common recommendations

Summary (Cont’d) The Nutrition Labeling and Education Act (NLEA) of 1990 established guidelines under the authority of the Food and Drug Administration (FDA) for the labeling of food products and for a standardized presentation of food labels The Nutrition Facts Panel provides specific information about the serving size and calorie content and any other mandatory nutrition information The NLEA established guidelines for the regulation of three types of claims that can be used on food and dietary supplement labels: nutrient content claims, health claims, and structure/function claims