Tools for Designing a Healthy Diet

The Typical American Diet

16% of kcals as proteins~66% from animal sources

50% of kcals as CHO~50% from simple sugars

33% of kcals as fat~60 % from animal fats

Assessing Our Diets

Continuing Survey of Food Intakes by Individuals (CSFII) [USDA]

National Health and Nutrition Examination Survey (NHANES) [US Dept. of Health & Human Services]

Improving Our Diets

Energy intake

Salt (sodium)

Alcohol

Fat

Adequate fluids

Eat 5-A-Day

Use supplements wisely

Healthy People 2010

A systematic approach to health improvement

To promote healthy lifestyle and reduce preventable deaths and diseases

Examples of Healthy People 2010 Nutrition Goals

19-2.Reduce the proportion of adults who are obese.

19-4.Reduce growth retardation among low-income children under age 5 years.

19-5. Increase the proportion of persons aged 2 years and older who consume at least two daily servings of fruit.

For more information, access http://www.healthypeople.gov/document/

Healthy People 2010

Reduce obesity in adults and children

Increase intake of fruits, vegetables, and whole grain products

Lower the intake of fat, saturated fats, and sodium

Increase the intake of calcium and iron

Health Promotion and Disease Prevention: Diet

Essential nutrients

Dietary fiber

Moderate calories

Moderate saturated fats

Moderate cholesterol

Moderate alcohol

Health benefits

Recommendations Continue: Physical Activities

Regular

30 minutes minimum on most days

Benefits

Recommendations Continue: Lifestyle

Minimize alcohol

1-2 drinks a day

Benefits

Not smoking

Benefits

What Is A Healthy Diet?

To “consume a variety of foods balanced by a moderate intake of each food”Variety - choose different foodsBalanced - select foods from the major food groupsModeration - plan your intake; control portion size

Variety

Choose different foods (within a food group)

Ensures intake of sufficient nutrients

Inclusion of phytochemicals

Balance

Select foods from the five food groups

Milk and other dairy

Meat and meat substitutes

Vegetables

Fruits

Bread, cereal, rice, pasta

Moderation

Refers mostly to portion size

Are there really “no good or bad foods”?

Nutrient Density

Comparison of vitamin and mineral content to number of kcals

Empty caloriesProvides kcals and few to none

other nutrients

Comparison of Nutrient Density

Energy Density

Comparison of the kcal content with the weight of food

Food rich in calories but weighs little is energy dense

Low-energy-density foods in a meal contributes to satietyFoods with more water and dietary fiber

Energy Density

Desirable State of Nutritional Health

Intake meets body’s needs

Body has a small surplus

Undernutrition

Intake is below body’s needs

Stores used

Health declines

Biochemical evidence

Subclinical deficiency

Clinical symptoms

Overnutrition

Intake exceeds body’s needs

Short term, few symptoms

Long term, serious conditions

Obesity

Intake of supplements

Measuring Nutritional State

Anthropometric

Biochemical

Clinical

Dietary

Economic status

Limitation in Assessment

Long delay between development of poor nutritional health and the first clinical evidence of a problem

Often the evidence linking nutrition status to symptoms is vague

2005 U.S. Dietary Guidelines

The Dietary Guidelines

General goals for nutrient intakes and diet compositionApproved by the Secretaries of Health and Human Services and AgriculturePromote adequate vitamin and mineral intakePromote health and reduce the risk of chronic diseasesIntended for healthy children (>2 yrs) and adults

Dietary Guidelines 2005

Increased emphasis on physical activity

More focus on weight management through food choices

Recommendations to eat less highly processed foods with unhealthful fat, added sugar, and salt

Dietary Guidelines: ActivityTo reduce the risk of chronic disease in adulthood: engage in at least 30 minutes of moderate-intensity physical activity…on most days of the week

To help manage body weight, engage in…60 minutes of moderate to vigorous intensity activity on most days of the week

To sustain weight loss in adulthood: participate in at least 60-90 minutes of daily moderate-intensity physical activity while not exceeding calorie requirements

2005 Dietary GuidelinesKey Recommendations

Consume a variety of nutrient-dense foods and beverages within and among the basic food groups…choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol

Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the USDA Food Guide or the DASH eating plan

Dietary Guidelines: Weight Management

To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended

To prevent gradual weight gain over time, make small descreases in food and beverage calories and increase physical activity

2005 Dietary GuidelinesFoods to Encourage

Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and 21/2 cups of vegetables per day…for a 2000-calorie intakeChoose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables and other vegetables)

2005 Dietary GuidelinesFoods to Encourage

Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products…at least half the grains should come from whole grains

2005 Dietary GuidelinesFoods to Encourage

Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products

2005 Dietary Guidelines: Fats

Consume less than 10% of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possibleKeep total fat intake between 20-35% of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils

2005 Dietary Guidelines: Carbohydrate

Choose fiber-rich fruits, vegetables, and whole grains often.

Choose and prepare foods and beverages with little added sugars or caloric sweeteners, such as amounts suggested by the USDA Food Guide and the DASH eating plan

Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar and starch-containing foods and beverages less frequently

2005 Dietary Guidelines: Sodium and Potassium

Consume less than 2300 mg of sodium (approximately 1 tsp of salt) per day

Choose and prepare foods with little salt. At the same time, consume potassium-rich foods, such as fruits and vegetables

2005 Dietary Guidelines: Alcoholic Beverages

Those who choose to drink alcoholic beverages should do so sensibly and in moderation—defined as the consumption of up to one drink per day for women and up to two drinks per day for men.

Changes in Current Consumption to Meet Recommended Intakes

Changes in Current Consumption to Meet Recommended Intakes

The Food Guide Pyramid

Purpose of the USDA Food Guides

Intended to help consumers interpret and apply the U.S. Dietary Guidelines

The Pyramid was developed as an educational tool to help Americans select healthful diets.

Translates nutrition recommendations–the Dietary Guidelines for Americans and the Dietary Reference Intakes (DRI)—into the kinds and amounts of food to eat each day.

USDA Food Guide

The old Food Guide Pyramid provided generalized messages for the total population

With the growth of overweight and obesity, a “one-size-fit-all” approach no longer works

The new Guide provides core messages, along with individualized guidance

The Food Guide Pyramidr.i.p. 1992-2005

Was developed to

translate science into practical terms

help people meet the nutritional needs for carbohydrate, protein, fat, vitamins, & minerals

provide a foundation to eating

USDA Food Guide

Provides individualized meal patterns for kcal levels from 1000 kcals to 3200 kcals in 200-kcal incrementsIncludes discretionary calories in addition to servings from basic groupsAccess the Guide within the U.S. Dietary Recommendations at http://www.healthierus.gov/dietaryguidelines/

USDA Food GuideFood 1000 kcal 1600 kcal 2400 kcal

Fruits 2 3 4

Vegetables 2 4 6

Grains 3 5 6

Lean meat and beans

2 5 6 ½

Milk 2 3 3

Oils 15 g 22 g 31 g

Discretionary kcals

165 132 362

Daily Reference Intake (DRI)

New nutrient recommendations

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 healthy people of similar age and gender”---- the

Food and Nutrition Board of the National Academy of Sciences

RDA

Meets the needs of ~97% of all individuals

Set ~20% above what an average person needs

Accommodates for people with higher needs

RDAs, by definition, are generous allowances

Set for only 19 nutrients

RDA

Improvement in health are not expected if consume more than the RDA amounts

Goal is to eat close to the RDA amounts

Short term deficiencies appear harmless

Adequate Intakes

Not enough research information available

Based on observed or experimentally determined estimates

Set for some vitamins, choline, some minerals

Tolerable Upper Intake Levels

Maximum level of daily intake without causing adverse health effects

Chronic daily use

Not a goal, but a ceiling

Uses for the DRIs

Diet planning

Using RDA or AI

Do not exceed the UI

For the healthy population

Standards For Food Labeling (DVs)

DRIs not used on food label since they are gender and age specific

FDA developed the Daily Values (DV)

DV exist for vitamins, minerals, and protein, mostly set at or close to the highest RDA value or related nutrient standard seen in the age/gender categories for a given nutrient

Standards For Food Labeling (DVs)

DVs also set for dietary components not currently part of the DRIs

Includes cholesterol, carbohydrate, fiber, and others

Values based on dietary advice from U.S. federal agencies

Standards for Food Labels (DVs)

Only used on food labels

Allow for comparison shopping

DRV for 2000 kcal

Food Component DRV 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

Portion Size Equivalents

What’s on the Food Label?

Product name

Manufacturer’s name and address

Uniform serving size

Amount in the package

Ingredients in descending order by weight

For more information, go to http://vm.cfsan.fda.gov/~dms/foodlab.html

Food Label Nutrition Facts

Food Label Side Panel

Sample Calculation of a Nutrition Label

Per serving CHO: 15g x 4 kcal/g = 60 kcal PRO: 3g x 4 kcal/g = 12 kcal FAT: 1g x 9 kcal/g = 9 kcal TOTAL: 81 kcal, rounded down to 80

What Food Requires a Label?

Nearly all packaged foods and processed meat products

Any food labeled with health claims

Fresh fruit, vegetable, raw single ingredient meal, poultry, fish are voluntary

What is not required on a label?

% Daily Value for protein (for foods intended for 4 yrs. or older)

Protein deficiency is rare

Procedure to determine protein quality is expensive

Health Claims Allowed on Food Labels

osteoporosis

cancer

cardiovascular disease

hypertension

neural tube defects

tooth decay

stroke

use of “may” or “might”

Comparative and Absolute Nutrient Claims

Sugar (free, no added)

Calories (free, low)

Fiber (high, food source, added)

Fat (free, low, reduced)

Cholesterol (free, low, reduced)

Sodium (free, low, light)

Nutrient Claims Must Meet Specific Standards

Cholesterol free: less than 2 mg cholesterol and 2 g or less of saturated fat per servingLow cholesterol: 20 mg or less of cholesterol and 2 g or less of sfaReduced or less cholesterol: at least 25% less cholesterol and 2 g or less of sfa per serving than reference food

Sodium Label Claims

Sodium free: less than 5 mg per servingVery low sodium: 35 mg or less per servingLow sodium: 140 mg or less per servingLight in sodium: at least 50% less per serving than reference foodReduced or less sodium: at least 25% less per serving than reference food

Claims

Fortified/enriched

Healthy

Light, lite

Diet

Good source

Organic

Natural