1. Guidelines for Healthy Eating Chapter 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.)
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 2020
The overall objectives under nutrition and weight status are listed in Box 8.1 Healthy People 2020.

5. Dietary Guidelines for Americans

7. 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

8. Dietary Reference Intakes
Series of eight 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 four 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)

9. Dietary Reference Intakes—(cont.)
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).

10. Dietary Reference Intakes—(cont.)
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

11. Question
The Recommended Dietary 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

12. 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.

13. 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.

14. 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.

15. 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

16. 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

17. 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

18. 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.

19. 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 MyPlate.
Dietary recommendations also made by
American Heart Association
American Cancer Society
American Institute of Cancer Research

20. 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 nine major messages
Twenty-three key recommendations
Eighteen additional recommendations are made for specific population groups.

21. Dietary Guidelines for Americans—(cont.)
Intended to represent a pattern of eating for Americans older than 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.

22. Question Is the following statement true or false?
The Tolerable Upper Intake Level is not intended to be a recommended level of intake.

23. 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.

24. MyPlate In early 2011, MyPlate replaced MyPyramid.
New graphic by which the Dietary Guidelines for Americans are translated into food and activity choices for healthy individuals older than the age of 2 years.
Philosophy is that nutrient needs should be met through food, not supplements.

25. MyPlate—(cont.) 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.

26. MyPlate—(cont.) Designed to convey the concepts of Variety Moderation
Proportionality
Gradual improvement
Personalization
Physical activity

29. 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.

30. Clearing Up Controversy—(cont.)
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.

31. Clearing Up Controversy—(cont.)
Discretionary calories—(cont.)
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.

32. Clearing Up Controversy—(cont.)
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.

33. Clearing Up Controversy—(cont.)
Variety
Eating a varied diet helps ensure essential nutrients are consumed in adequate amounts.

34. 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.