1. Nutritional Guidelines Content created and narrated by: Jiyan Ma PhD Molecular and Cellular Biochemistry The Ohio State University For more information contact: Charles E. Bell PhD Associate Professor, Dept. of Molecular and Cellular Biochemistry

2. Primary Learning Objective Secondary Learning Objective Describe the relationship between nutritional status and nutrient intake. Differentiate primary from secondary malnutrition. Compare and contrast the following terms: Recommended Dietary Allowances (RDA), Dietary Reference Intake (DRI), estimated average requirement (EAR), Adequate Intake (AI), Tolerable Upper Intake Level (UL). Describe USDA’s MyPlate, its key messages, SuperTracker, and the recommended foods to increase and decrease. Assess the various components that go into meeting the nutritional needs of a patient

3. Malnutrition is a disorder of nutrition resulting from an imbalanced or insufficient diet or defective assimilation or utilization of nutrients. Nutritional Status and Nutrient Intake

4. Recommended Dietary Allowances (RDA) The Recommended Dietary Allowances (RDA) are the amounts of various nutrients that will provide satisfactory levels of the nutrients for most (97.5%) of the people in designated groups identified by age and sex. Average requirement and this level of nutrient is sufficient for 50% of the population level of a nutrient RDA (2SD above average) Meets the need for 97.5% of the population

5. RDA table

6. Dietary Reference Intakes (DRI) DRI include revised RDA values, but also extend to other values: Estimated Average Requirement (EAR) --- a nutrient intake value that is estimated to meet the needs of 50% of the person in a specific age and gender group. Basically, the average upon which RDAs are determined. Adequate Intake (AI) --- the amount that appears to sustain good health in a group of people. AI is for nutrients that have not yet received enough scientific study to merit setting of an official RDA. Tolerable Upper Intake level (UL) --- the highest level of a nutrient that is likely to pose no risk of adverse health effects to 98% of a population.

7. The relationship among these values Adequate Intake ULEARRDA Intake goal Risk of inadequacy Risk of excess Increasing nutrient intake

8. In 2010, USDA developed healthy eating guideline, MyPlate. Please read the next articulate engage tab page and the attached pdf file “MyPlateCommunitytoolkit”. The objectives for reading these materials are listed below: Objective: Be able to describe: 1) What is MyPlate? 2) What are the key messages? 3) What is SuperTracker? 4) What are the foods to increase? 5) What are the foods to reduce? Additional resources are available at http://www.choosemyplate.gov/http://www.choosemyplate.gov/ MyPlate

10. The scientists at Harvard School of Public Health and Harvard Medical School created the Healthy Eating Plate. Please read the comparison between two dietary guidelines at: http://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/healthy- eating-plate-vs-usda-myplate/index.html Objective: Describe the differences between two guidelines and the biggest controversial points. Healthy Eating Plate

11. Summary for Nutritional Guidelines Malnutrition can be resulted from both under- and over-nutrition. The Recommended Dietary Allowances (RDA) is set to prevent nutrient deficiency and it will provide satisfactory levels of nutrients for 97.5% of the people in a designated age and sex group. The Dietary Reference Intake (DRI) is set to prevent nutrient deficiency and to reduce the risk of chronic diseases, which consists of RDA, EAR, AI, UL. MyPlate is the newest healthy eating guideline developed by USDA, and the Healthy Eating Plate is the dietary guideline developed by scientist at Harvard School of Public Health and Harvard Medical School.

13. Thank you When you have questions: Charles Bell PhD bell.489@osu.edu

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