Chapter 2: Tools for designing a healthy diet

Objectives
Upon completion of this chapter, the student will be able to:
develop an eating plan based on the concepts of variety,
balance, moderation, nutrient density, and energy density.
outline the ABCDEs of nutrition assessment.
describe what the Recommended Dietary Allowances (RDA)
represent and how these relate to the other standards
included in the new Dietary Reference Intakes.
learn the food groupings used in the Food Guide Pyramid and
list potentially inadequate nutrients in that diet plan.
list the Dietary Guidelines and the diseases these guidelines
are designed to prevent or minimize.
describe what a nutrition label currently consists of, and when
and which health claims are allowed on a food package.
describe various ethnic influences on the North American diet.

A food philosophy that works

To consume a variety of
foods balanced by a
moderate intake of each food
Variety - choose different
foods.
Complementarity
Phytochemicals found in
plants are protective

Balanced - select foods from

the 5 major food groups
Moderation - plan your intake;
control portion size

Recommended by health
professionals for many years.
Not just giving up what you
like!

MODERATION NOT ELIMINATION

Lets fine tune this advice

Variety
Choose from different food
groups and even within a
group.
Remember
phytochemicals.

Balance
Dont over consume from 1
group.

Moderation
Portion size

Nutrient density
Energy density

All foods are not created equal

Nutrient density
Nutritional quality of an
individual food.
Comparison of vitamin and
mineral content to number of
kcals (energy).
High ND when food provides
lots of nutrients for few
calories.
Assess ND for individual
nutrients.

Energy density
Comparison of the kcal
content to the weight of the
food nuts/cookies high ED

Empty calories
Provides kcals and few to
none other nutrients

Table 2.3

States of nutritional health

Desirable nutrition
When body tissues have enough of a particular nutrient

Undernutrition
When intake does not meet needs.
May be subclinical for some time

Overnutrition
Consumption of more nutrients than the
body needs.
In the short term minimal problems
In the long term serious disease
Small gap between desirable nutrition
and overnutrition for vitamin A, calcium, iron.

Malnutrition

How can your nutritional state be measured?

Are you nutritionally fit? Nutritional assessment.
Analyzing background factors
Family history.
Medical history.
Economic history.

Evaluating the ABCDEs

Anthropometric
Biochemical assessment
Clinical examination
Diet history
Economic status

Limitations of nutritional assessment

Delay of evidence.
Early detection is crucial.
Cholesterol CVD.
Calcium Osteoporosis.

Clinical evidence is non specific.

The food guide pyramid

A menu planning tool
To translate science into practical terms.
A four food group plan.
Milk, meat, fruit/veg, bread/cereal
To help people meet the nutritional needs for
carbohydrate, protein, fat, vitamins, & minerals.
Provides a foundation to eating.
Pay attention to serving size.

Recommendations for food choice

A menu planning tool with variety the key to success

The food guide pyramid

Not for children under the age of 2
Each food is deficient in at least one
essential nutrient No one food is
essential.
Variety is key
Calorie and nutrient content may vary
within a food group

Recommendations with using the

Food Guide Pyramid
Choose low-fat options from milk group.
Include vegetable protein several times a week.
Include dark green/yellow/orange vegetable
every day.
Dont focus on potatoes as vegetable source.

Include a vitamin C rich food every day

Choose whole grains.
Include some plant oils.

Number of servings for different energy intakes

Energy
Bread
Veg
Fruit
Milk
Meat
Total fat
Total
sugar

1600
kcal
6
3
2
2-3
5
53
6 tsp

2200
kcal
9
4
3
2-3
6
73
12 tsp

2800
kcal
11
5
4
2-3
7
93
18 tsp

1600kcal diet
sedentary
adult/older
person.
If this is too
much food
increase
exercise level.

Evaluation of Our Diet Using the

Food Guide Pyramid
Do not meet all the serving recommendations for all food
groups
Consume only 1-2 servings of fruit a day (versus
recommended 2-4)
Consume only 2-3 servings of vegetables (mainly from
potatoes not nutrient dense) a day (versus
recommended 3-5)
Excessive intake in the fats, oils, and sweets group
(versus use sparingly)

Criticisms of the Food Guide

Pyramid
Difficulty digestion lactose
Lumping together refine and whole
grains
Fat on the topemphasis on plant oils

Dietary guidelines
Aid diet planning.
Published by USDA and
DHHS to aid dietary
planning.
Since it is over
consumption of energy,
sat. fat, cholesterol,
alcohol or Na that is
problem.
Three principles:
Aim for fitness.
Build a healthy base.
Choose sensibly.

The Dietary Guidelines: Aim for

Fitness
Aim for a healthy weight
Be physically active each day

The Dietary Guidelines: Build a

Healthy Base
Let the pyramid guide your food choices
Choose a variety of grains daily, especially
whole grains
Choose a variety of fruits and vegetables
daily
Keep foods safe to eat

The Dietary Guidelines: Choose

Sensibly
Choose a diet that is low in saturated fat
and cholesterol and moderate in total fat
Choose beverages and foods to moderate
your intake of sugars
Choose and prepare foods with less salt
If you drink alcoholic beverages, do so in
moderation

Practical use of Dietary Guidelines

Designed to promote adequate intake of vitamins and
minerals.
Made to decrease the risk for obesity, hypertension,
cardiovascular disease, type 2 diabetes, alcoholism
and food-borne illness.
Not expensive/difficult to implement
Many disease are genetic in nature
Dietary changes may only help some
Provides general information for a population (not
individual)

Nutrient needs Alphabet soup

Before designing a diet plan using the
food guide pyramid we need to
determine what amount of each essential
nutrient is needed to maintain health.
Nutrient standards include
DRI
RDA
AI
UL

What do these abbreviations mean?

Dietary Reference Intakes (DRI)

Blanket term
Nutrient
recommendations to
prevent chronic diseases
DRI set for all vitamins
and minerals
In the plans
macronutrients,
electrolytes, water and
other components

Standards Under the DRI

Recommended Dietary Allowances
(RDAs)
Adequate Intake (AI)
Tolerable Upper Intake Levels (ULs)

The Recommended Dietary

Allowances
Recommended intakes of nutrients that
meet the needs of almost all (~97%)
healthy people of similar age and
gender---- the Food and Nutrition Board of the National
Academy of Sciences

Recommended dietary allowances

RDA for only 19 of the important nutrients.
Allows comparison of own intake to RDA for specific nutrients if
data exists.
NO data available for Ca, vitamin D, Fl, biotin (use AI).

Set at about 20% above what is needed by an average

person.
RDAs, by definition, are generous allowances.
Intake slightly above or below of no concern.

Amount to prevent deficiency and chronic diseases

RDA for healthy males and females of various age
groups
RDA for pregnant and lactating women

Recommended dietary allowances

Improvement in health are not expected if
consume more than the RDA amounts
Goal is to eat close to the RDA amounts
Eating less does not necessarily mean
you are not getting enough
Short term deficiencies appear harmless
Consuming ~ or above 3x in the long
term may cause problems.

Uses for RDAs

Planning food supplies for groups
Establishing standards for food
assistance programs
Evaluating dietary survey data
Develop food & nutrition information
Help establish food label standards
Regulate food fortification
Developing new food products

RDA for Energy

Rough estimate
Dependant on energy use
Maintain healthy weight

Adequate intakes (AI)

Not enough information available to
generate RDAs.
Based on observed or experimentally
determined estimates of people
maintaining good health.
Set for some vitamins, choline, some
minerals
Planned for children under the age of 1

Tolerable upper intake levels

Maximum level of daily intake without
causing adverse health effects
Chronic daily use.
Not a goal, but a ceiling.
Available for some vitamins and minerals.

Uses for the DRIs

Diet planning
Using RDA or AI
Do not exceed the UI
For the healthy population

Standards for food labeling

DRIs not used on food label since gender and
age specific.
FDA developed the Daily Values (DV)
used on food labels, no gender differences and wide
age range (4 yr old adult).
rough guide for comparing nutrient content with
needs.
set at or close to the highest RDA value.
Many exceed current nutrient requirements

More relevant to everyday life.

Useful tool for consumers though not RDAs

Available for vitamins, minerals, proteins,

cholesterol, CHO, fiber

DV for 2000 kcal diet

Food Component D V 2000 kcal
Fat
<65 g
Sat. Fat
< 20 g
Protein
50 g
Cholesterol
< 300 mg
CHO
300 g
Fiber
25 g
Sodium
<2400 mg
Potassium
3500 mg

Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Nutrition facts

Whats on the food label?

Product name
Manufacturers name
and address
Uniform serving size
Amount in the
package
Ingredients in
descending order by
weight.

What food requires a label?

Nearly all packaged foods and processed
meat products.
Health claims
Requires additional info on polyunsat fat,
monounsat fat, dietary fiber, K.

Fresh fruit, vegetable, raw single

ingredient meal, poultry, fish are
voluntary

What food do not require a label?

Food for immediate consumption.
Fresh fruit and vegetables

Ready-to-eat foods not for immediate

consumption but prepared on site.
Bulk food sold to consumer.
Medical foods.
Foods that contain very little nutrient.
Food produced by small businesses.
Food packaged in small containers.

Health claims allowed on food labels

Began in 1984.
Limited by the FDA
Osteoporosis/Ca
Cancer/fat
Heart disease/sat. fat
and cholesterol.
Hypertension/Na
Neural tube
defects/folic acid
Tooth decay/sugar
Stroke/K

Ethnic influences on the American diet

25% of all restaurant in the U.S. have an
ethnic theme
Selection of healthy options
Advantages and disadvantages

Ethnic Diets

Native Americans
Hispanic-Americans
Northern European-Americans
African-Americans
Asian Americans
Italian-Americans

Review