CHAPTER 16 FOOD FACTORS AFFECTING HEALTH Copyright © 2015, 2010, 2005, 1998 by Saunders, an imprint of Elsevier Inc

CHAPTER 16CHAPTER 16

FOOD FACTORS AFFECTING FOOD FACTORS AFFECTING HEALTHHEALTH

Copyright © 2015, 2010, 2005, 1998 by Saunders, an imprint of Elsevier Inc.

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Food PatternsFood patterns are generally developed during

childhood and reflect the following influences:CulturalSocioeconomic statusSymbolic (e.g., religious)GeographicalPsychological

All of these influence one’s attitudes, feelings, and beliefs about food


Food Patterns: Cultural Influences

Cultural food patterns establish foundation for child’s lifelong eating patterns regarding:Time and number of meals per dayFoods acceptable for specific mealsPreparation methodsLikes and dislikesFoods suitable for specific members of a groupTable mannersSocial role of foods and eatingAttitudes toward eating and health


Food Patterns: Status and Symbolic Influences

Because of symbolic meanings of food, eating becomes associated with sentiments and assumptions about oneself and the world

Choice of different foods influenced by:Religious beliefsAvailabilityCostCultural values and traditionsEven endorsement or condemnation by a highly

respected person


Working with Patients: Respect for Others’ Eating Patterns

Be sensitive to preferences, avoid being judgmental, treat each patient with respect

Intervention must be adapted to address cultural, personal, and ethnic preferences in order to be effective

Use open-ended questions to elicit information


Working with Patients: Effecting Change

Basic facts that may assist in approaching patients from various ethnic groups to promote sound nutritional practices:People have a remarkable ability to obtain a nutritious

diet out of available foodstuffsFood patterns of other countries are in some instances

nutritionally superior or at least comparable to “ordinary” American traditions

Culturally preferred foods may be costly or unavailable in some communities


Working with Patients: Effecting Change

Basic facts that may assist in approaching patients from various ethnic groups to promote sound nutritional practices (cont’d):Each food/food-related behavior and tradition is

categorized as beneficial, neutral, or potentially harmful Efforts at change should be focused on potentially harmful food

behaviors/choices

Food patterns are generally deeply ingrained; suggest minimal alterations in the patient’s normal patterns

Cultural patterns tend to be used more consistently by older family members (first-generation immigrants)


Working with Patients: Religious Food Restrictions

Religious beliefs affect eating patterns, attaching symbolic meanings to food and drink, such as:Bread and wine served during the Christian

communion serviceHindu reverence for the cowThe month-long fast of Ramadan of the Muslim faithMany Seventh-Day Adventists are vegetarians or

vegans


Food BudgetsEvidence of poor or fair health status and

malnutrition increases as income level decreasesLow-income households score below higher income

households on healthy eating indices

Average American family spends approx 15% of income on food; those at poverty level spend as much as 33%Foods supplying the most nutrients relative to cost

include beef, fresh potatoes, brown rice, wheat germ, milk, eggs, and peanut butter

Lack of transportation may limit options for shopping


Referrals for Nutritional ResourcesArea Information Center (211) has comprehensive

databases of resources: federal, state, and local agencies, community-based and private nonprofit organizations

Supplemental Nutrition Assistance Program (formerly Food Stamp Program) is cornerstone of US nutrition safety net

Special Supplemental Food Program for Women, Infants and Children (WIC) designed to prevent nutritional problems in high-risk, low-income groups


Referrals for Nutritional Resources

USDA breakfast and lunch programs provide nutritious free and reduced-price meals for children at school

Nutrition Program for the Elderly (Title III) provides group and home-delivered meals (Meals on Wheels)

Expanded Food and Nutrition Education Program (EFNEP) assists with meal planning, budgeting, cooking, and other food- and nutrition-related problems


Referrals for Nutritional ResourcesHead Start is a preschool educational program

for low-income families; meals are furnished for the children, and nutrition education is available for parents

Locally funded food agencies provide assistance through food banks and food pantries83% of the food banks report they are unable to

adequately meet the needs of their community


Maintaining Optimal Nutrition During Food Preparation

Methods of preparationDiscourage addition of large amount of fat for cookingDo not discard water that vegetables are cooked in

Food sanitation and safetyFive major control factors for food safety

Personal hygiene Adequate cooking Avoiding cross-contamination Keeping food at safe temperatures Avoiding foods from unsafe sources



Effects of processing on nutrientsNutrients considered stable if at least 85% of original

level is retained during processing and storageFood processing attempts to maintain optimal qualities

of color, flavor, texture, and nutritive value

Convenience foodsPopular because save time in meal preparation,

planning, purchasing, and cleanupRequire more preservatives; contain more fat, sodium



Irradiated foodsProcess of treating food with controlled amounts of

ionized radiation for prescribed period to kill spoilage- and disease-causing bacteria and molds

Can lengthen the period of ripeness of fruits and vegetables, prolong the freshness of many foods along with preventing certain foodborne illnesses



Organic foodsGrown without synthetic pesticides, growth

hormones, antibiotics, or genetic engineeringUSDA does not support claims organic food is

safer or more nutritious than conventionally produced foods But several studies demonstrate they contain more

polyphenols or antioxidants that have potential human health benefits

Cost is higher than conventional products



Fast foodsAverage meal between 900 and 1800 kcal (33%–66%

of RDA for young men or 45% 90% for young women)Sodium content high: ranges from 1000 to 2515 mgFat content of some meals can be as high as 51% of

kcal consumedMega-size portions may contain a day’s

worth of kcal in one meal Wise choices possible with new menu

items and reduced portion sizes



Food additivesAdditives deemed to be

harmless are labeled “generally recognized as safe” (GRAS)

99% of additives derived from natural sources or synthetically produced to be identical to the natural chemical substance

Food additives have several benefits: Improve nutritional value

(enrichment) Maintain wholesomeness and

palatability (preservatives) Maintain product consistency Provide leavening or control

pH Enhance flavor, appearance


Food Fads and Misinformation

Purveyors of misinformation capitalize on fears and hopesFood fad is a catch-all term covering all aspects of

nutritional nonsense, characterized by exaggerated beliefs about the value of nutrition in health and disease Fad diets capitalize on those looking for a magic weight loss

formula

Food quackery is promotion of nutrition-related products or services having questionable

safety and/or effectiveness for the claims



Identifying sources of nutrition misinformationEvaluate findings in light of well-established

nutrition principlesCheck the credentials of person making a

questionable claimA single study is never perfect, providing

conclusive information, but provokes more questions for further studies Single study is not very meaningful by itself but

serves as another piece of the puzzle if it can be replicated



Role of the dental hygienistAssess patients’ use of food fads, economic level,

educational level, and nutrient adequacy of any fad diet undertaken

Provide positive advice based on a broad knowledge base and understanding of nutritional concepts and current research findings

Do not offer remedies unless they have been demonstrated to be safe and effective

Referral to a registered dietitian may be needed

HEALTH APPLICATIONFood Insecurity

Discuss the impacts of food insecurity in the USConsider the various populations impacted by

food insecurities

Discuss factors accounting for increased food insecurity in the US

Discuss why food insecurity is a major public health concern

Discuss food insecurity in relation to the goals of Healthy People 2020


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CHAPTER 16 FOOD FACTORS AFFECTING HEALTH Copyright © 2015, 2010, 2005, 1998 by Saunders, an imprint of Elsevier Inc