1. The Role of Nutrition in Our Health
Chapter 1

2. Test Yourself A calorie is a measure of the amount of fat in a food.
Proteins are not a primary source of energy for our bodies.
All vitamins must be consumed daily to support optimal health.
The Recommended Dietary Allowance is the maximum amount of a nutrient that people should consume to support normal body functions. T F T F T F T F

3. What is Nutrition?
Nutrition is a relatively new discipline of science.
Nutrition: the study of food, including
How food nourishes our bodies
How food influences our health
Digestion Absorption Utilization Excretion

4. How Does Nutrition Contribute to Health?
Nutrition contributes to wellness.
Wellness: more than absence of disease
Many factors contribute to an individual’s wellness. Primary among these are:
Nutrition
Physical activity

5. How Does Nutrition Contribute to Health?
Healthful diet is part of disease prevention

6. How Does Nutrition Contribute to Health?

7. How Does Nutrition Contribute to Health?
Nutrition is so important it has become a national goal to promote optimal health and disease prevention.
Goals of Healthy People 2020 – this is a health promotion and disease prevention plan for the United States.
Increase quality and years of healthy life
Eliminate health disparities

8. How Does Nutrition Contribute to Health?
Obesity is a growing problem in the U.S.
Note the states in dark “red” which indicates a prevalence of obesity >30%

9. What Are Nutrients?
Nutrients: chemicals in foods that our bodies use for energy and to support the growth, maintenance, and repair of our tissues. Six groups of nutrients:
Carbohydrates
Lipids
Proteins
Vitamins
Minerals
Water

10. What Are Nutrients?
Essential nutrients: nutrients for which specific biological functions have been identified, and which our bodies cannot make enough of to meet our biological needs
Essential nutrients must be obtained from our diet
Examples: Vitamin C, Calcium, Thiamin

11. What Are Nutrients? Carbohydrates, lipids, proteins
Macronutrients: nutrients required in relatively large amounts.
Carbohydrates, lipids, proteins
Provide energy to our bodies
Micronutrients: nutrients required in smaller amounts.
Vitamins and minerals

12. What Are Nutrients?
Organic nutrients: nutrients contain an element of carbon that is an essential component of all living organisms
Carbohydrates, lipids, proteins, vitamins
Inorganic nutrients: nutrients that do not contain carbon
Minerals and water

13. Energy From Nutrients
We measure energy in kilocalories (kcal). Kilocalorie: amount of energy required to raise the temperature of 1 kg of water by 1oC. On food labels, “calorie” actually refers to kilocalories.

14. Carbohydrates
Primary source of fuel for the body, especially for the brain and physical activity.
Provide 4 kcal per gram.
Carbohydrates are found in grains (wheat, rice), vegetables, fruits, and legumes (lentils, beans, peas), milk products.

15. Lipids - triglycerides, phospholipids, sterols
Insoluble in water.
Provide 9 kcal per gram.
An important energy source during rest or low intensity exercise.
Stored as adipose tissue (body fat) – major form of stored energy.
Foods containing lipids also provide fat-soluble vitamins and essential fatty acids.

16. Proteins Proteins are chains of amino acids.
Support tissue growth, repair, and maintenance.
Proteins can supply 4 kcal of energy per gram, but are not a primary energy source.
Proteins are an important source of nitrogen.

17. Vitamins
Vitamins are organic molecules that assist in regulating body processes:
critical in building and maintaining healthy bones and tissues
support immune system
ensure healthy vision
Many can be destroyed by heat and oxidation
Vitamins do not supply energy to our bodies; however, many vitamins act as coenzymes for energy producing reactions

18. Vitamins Type Names Distinguishing Features Fat Soluble A,D,E, and K
Soluble in fat
Stored in the human body
Toxicity can occur from consuming excess amounts, which accumulate in the body
Water Soluble
C, B-vitamins (thiamin, riboflavin, niacin, vitamin B6, vitamin B12, pantothenic acid, and folate)
Soluble in water
Not stored to any extent in the human body
Excess excreted in urine
Toxicity generally occurs as a result of vitamin supplmentation

19. Minerals
Minerals are inorganic substances required for body processes. Minerals have physiological functions, such as fluid regulation, energy production, bone structure, muscle movement, and nerve functioning.

20. Minerals
Our bodies require at least 100 mg per day of the major minerals such as:
Calcium
Phosphorus
Magnesium
Sodium
Potassium
Chloride.
We require less than 100 mg per day of the trace minerals such as:
Iron
Zinc
Copper
Selenium
Iodine
Fluoride

21. Water Inorganic nutrient, essential for survival
Involved in many body processes:
fluid balance and nutrient transport
nerve impulses
body temperature
removal of wastes
muscle contractions
chemical reactions

22. Determining Nutrient Needs
Dietary Reference Intakes (DRIs): updated nutritional standards
Expand on the traditional RDA values
Set standards for nutrients that do not have RDA values
Dietary standards for healthy people only
For preventing deficiency diseases and reducing chronic diseases

23. Determining Nutrient Needs

24. Determining Nutrient Needs
Estimated Average Requirement (EAR)
The average daily intake level of a nutrient that will meet the needs of half of the healthy people in a particular category
Used to determine the Recommended Dietary Allowance (RDA) of a nutrient

25. Determining Nutrient Needs
Recommended Dietary Allowances (RDA)
The average daily intake level required to meet the needs of 97 – 98% of healthy people in a particular category

26. Determining Nutrient Needs
Adequate Intake (AI)
Recommended average daily intake level for a nutrient
Based on observations and experimentally determined estimates of nutrient intakes by healthy people
Used when the RDA is not yet established: calcium, vitamin D, vitamin K, fluoride

27. Determining Nutrient Needs
Tolerable Upper Intake Level (UL)
Highest average daily intake level likely to pose no risk of adverse health effects to most people
Consumption of a nutrient at levels above the UL, the potential for toxic effects and health risks increases

28. Determining Nutrient Needs
Vitamin C (adult age 19-70) UL = 2,000 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/d
Example Nutrient DRI

29. Determining Nutrient Needs
Estimated Energy Requirement (EER)
Average dietary energy intake (kcal) to maintain energy balance in a healthy adult
Based on age, gender, weight, height, level of physical activity

30. Determining Nutrient Needs
Acceptable Macronutrient Distribution Ranges (AMDR)
Describes the portion of the energy intake that should come from each macronutrient
Carbohydrates: 45-65%
Fats: %
Proteins: %
Potential for inadequate nutrient levels if nutrient intake falls below this range
Potential for increased chronic disease risk if nutrient intake falls above this range
AMDR

31. Malnutrition
Nutritional status is out of balance: Individual is getting too much or too little of a particular nutrient or energy over a significant period of time Undernutrition: too little energy or too few nutrients, causing weight loss or a nutrient deficiency disease Overnutrition: too much energy or too much of a given nutrient over time, causing obesity, heart disease, or nutrient toxicity

32. Assessing Nutritional Status – A,B,C,D’s
A – Anthropometric Data
Weight, Height, Muscle Mass, Fat Mass
B – Biochemical Data
Cholesterol, Glucose, Albumin, Sodium, Liver Enzymes, Kidney Enzymes
C- Clinical Data
Disease history, Socioeconomic Status, Physical Exam
D – Dietary Data
Nutrient intake, supplement use

33. Dietary Intake Tools

34. Twenty-four Hour Recall
Recalls all food and beverages consumed in the previous 24-hour period
Accurate recall includes serving sizes, food preparation methods, and brand names of convenience foods or fast foods
Limitations:
may not be typical intake
rely on memory
ability to estimate portion sizes

35. Diet History Information from interview or questionnaire:
Weight (current and usual weight, goals)
Factors affecting appetite and food intake
Typical eating pattern (time, place, dietary restrictions, frequency of eating out, etc.)
Disordered eating behaviors (if any)
Education and economic status
Living, cooking/food purchasing arrangements
Medication and dietary supplements
Physical activity

36. Food Frequency Questionnaires
Determine typical dietary pattern over a predefined period of time Include lists of foods with the number of times these foods are eaten Some assess only qualitative information (typical foods without amounts) Semiquantitative questionnaires assess specific foods and quantity consumed

37. Diet Records
List of all foods and beverages consumed over a specific time period (3-7 days)
Kept by person seeking nutritional advice
More accurate with:
foods are weighted or measured
labels of convenience foods and supplements
People may change food intake to simplify record keeping
Analyses are time consuming and costly

38. Nutrition Deficiencies
Primary deficiency occurs when a person does not consume enough of a nutrient, a direct consequence of inadequate intake
Secondary deficiency occurs when…
a person cannot absorb enough of a nutrient in his or her body
too much nutrient is excreted from the body
a nutrient is not utilized efficiently by the body

39. Primary or Secondary Deficiency?
Jane and John were both told by their primary care physicians that they had a type of anemia called “pernicious anemia” which is caused by a deficiency of vitamin B12 in the body. What type of deficiency do Jane and John have based on the evidence below?
Jane is a strict vegetarian and does not consume any animal-based foods and does not consume a vitamin/mineral supplements.
John consumes a regular diet consisting of all major food groups but has a condition called “gastritis” preventing his production of intrinsic factor, which is needed to help absorb vitamin B12

40. Deficiency Symptoms
Subclinical deficiency occurs in the early stages, few or no symptoms are observed
Covert symptoms are hidden and require laboratory tests or other invasive procedures to detect
Symptoms of nutrition deficiency that become obvious are referred to as overt

41. Nutrition Deficiencies
What happens in the body:
Physical deficiency caused by inadequate diet OR secondary deficiency caused by problem inside the body
Declining nutrient stores
Abnormal functions inside the body
Physical (outward) signs and symptoms
Which assessment method reveals changes:
Diet history
Health history
Laboratory tests
Laboratory test
Physical examination and anthropometric measures

42. Registered Dietitians (RD)
Requirements:
Bachelor’s degree in nutrition
Completion of supervised clinical experience
Passing a national registration examination
Work in a variety of settings:
Hospitals, clinics, nursing homes
Sports nutrition
Food-service management
Community and public health nutrition
Nutrition research

43. Nutrition Advice: Who Can You Trust?
Nutrition is a new science
Increased interest in nutrition
Overwhelming amount of health claims
Reliability of nutrition information
Misinformation
Potential harmful quackery

44. Trustworthy Nutrition Experts
Registered Dietitian (RD)
Licensed Dietitian meets the credentialing requirements of a given state
Nutritionist has no legal definition
Professional with advanced nutrition degree (masters-MS, MA; doctoral-PhD)
Physician

45. Government Information Sources
Centers for Disease Control and Prevention (CDC)
National Health and Nutrition Examination Survey (NHANES)
Behavioral Risk Factor-Surveillance System (BRFSS)
National Institutes of Health (NIH)

46. Reliable Nutrition Information
American Dietetic Association
American Society for Nutrition Sciences
American Society for Clinical Nutrition
Society for Nutrition Education
American College of Sports Medicine
North American Association for the Study of Obesity

47. Evaluating Research Case Control Studies Clinical Trials Randomized
Single Blind
Double Blind
Placebo

48. Evaluating Media Reports
Questions to ask?
Who conducted/paid for the research?
Who is reporting the information?
Is it based on reputable research studies?
Is the report based on testimonials?
Are the claims too good to be true?
Is someone profiting?

49. Activity

50. Calculate the Nutrition
Fat = 18 grams Carbs = 6 grams Protein = 7 grams Total Calories: _________ ____% Fat _____ % Carbs ______% Protein

51. Calculate the Nutrition
Fat = 18 grams Carbs = 6 grams Protein = 7 grams Total Calories: % Fat 11% Carbs 13% Protein

52. Calculate the Nutrition
Fat = 8.4 grams Carbs = 23.4 grams Protein = 4.2 grams
Fat = 2 grams Carbs = 0 grams Protein = 28 grams
Calculate the combined calories, protein, fat, carbs and the percentage.

53. Calculate the Nutrition
Fat = 10.4 grams (93.6 calories) Carbs = 23.4 grams (93.6 calories) Protein = 32.2 grams (128.8 calories) Total Calories: 316 ~30% Fat ~30% Carbs ~40% Protein

54. Calculate the Nutrition
Total Calories: 680 Fat: ______ Carbs: 71 grams Protein: 44 grams

55. Calculate the Nutrition
Total Calories: 680 Fat: 24 grams Carbs: 71 grams Protein: 44 grams

56. Calculate the Nutrition
The doctor has recommended his patient eat a 1600 calorie diet that is 50% carbs, 25% protein and 25% fat. How many grams and calories will the patient be eating from each of the three macronutrients?

57. Calculate the Nutrition
Answer: Calories: 1600 Carbs: 200 grams (800 calories) Protein: 100 grams (400 calories) Fat: 44 grams (400 calories)

58. Evaluating Research
Health Benefits of Chocolate A Look at Goji Juice – Scam or Super Fruit High Fructose Corn Syrup