MODULE 2: NUTRITION
Transcription
MODULE 2: NUTRITION
King Abdul-Aziz University Faculty of Science Department of Biochemistry NUTRITIONAL BIOCHEMISTRY BIOC 314 MODULE 2: NUTRITION Prepared by: Demonstrator/ Hadeel Muhanna Alsufiani Nutrition Timeline 1734 • scurvey recognized 1910 • pasturized milk introduced 1937 • pellagra found to be due to a deficiency of niacin 1997 • RDAs expanded to DRIs 1744 1816 • first record of ice-cream in america 1913 • protein and amino acids identified 1929 • first vitamin discovered (vitamin A) 1947 • essential fatty acids identified 1956 • vitamin B12 identified 1998 • basic 4 food groups released by USDA 2006 • folic acid fortification begins • obesity and diabetes reccognized as global epidemics Reference: Brown, J.(2008): Nutrition Now. Fifth edition. THOMSON WADSWORTH 2 Energy Balance and Body Weight Control Objectives: to evaluate the healthy of current body weight by calculating BMI, measuring body fat content and fat disribution pattern to calculate the total kcal of a meal after knowning it's nutrient content how to use calipers to measure body fat content how to calculate the energy requirements for basal metabolism, physical activity and dietary thermogenesis and total needs 3 Healthful Body Wieght There are different methods that can help you evaluate the health of your current body weight. Methods BMI Body composition Fat distribution pattern 1) Body Mass Index (BMI): Body Mass Index (BMI) is a number calculated from a person’s weight and height. BMI is used as a screening tool to identify possible weight problems for adults. However, BMI is not a diagnostic tool. For example, a person may have a high BMI. However, to determine if excess weight is a health risk, a healthcare provider would need to perform further assessments. These assessments might include skinfold thickness measurements and others. BMI is calculated as: BMI= 𝑏𝑜𝑑𝑦 𝑤𝑒𝑖𝑔 ℎ𝑡 (𝑖𝑛 𝐾𝑔) ℎ𝑒𝑖𝑔 ℎ𝑡 2 (𝑖𝑛 𝑚 ) 4 BMI for adults are interpreted as follows: BMI WEIGHT STATUS Associated with increased risk of health problems and death < 18.5 Under weight 18.5 to 24.9 Normal 25 to 29.9 Overweight 30 to 39.9 COMMENTS Healthy weight-for-height Increased health risk Obese ≥40 Major health risk Morbid obesity Exercise (1): Calculate your BMI? What your value shows? Adult BMIs should not be applied to children, still growing adolescents, frail older people, pregnant and lactating women and high muscular individuals. these different age groups have their unique BMI standards (will be discussed in later) 5 2) Body Composition: Body composition is the proportions of muscle, bone, fat and other tissue that make up a person’s total body weight. Direct measures of body composition are impossible in living human beings. Instead, researchers assess body composition indirectly based on the following assumption: body weight= fat + lean tissue (including water). Measuring body fat content is very important because sometimes people who are classified as normal weight or underweight by BMI standards have too much body fat because they are physically inactive. On the other hand some people classified as overweight, but their body fat content may actually be very low (this is because of usage of certain medications which makes people retain fluids) There are many methods available to assess the amount of body fat (or adipose tissue). One of these methods is the skin fold thickness. It is used to estimate total body fat content by using calipers to measure the fat layer under the skin. For body fat measurement instructions and charts see appendix (B) Exercise (2): What is your body fat measurement in millimeters? What is your body fat percentage? What your percentage means? 6 3) Fat distribution patterns: To evaluate the health of your body weight, it is also helpful to consider the way fat is distributed throughout your body. This is because your fat distribution is known to affect your risk for various diseases. Some people store fat in upperbody areas whereas others stores fat lower on the body. The picture below shows two types of fat patterning. apple-shaped fat paternning (uper-body obesity) (the typical male pattern) • a person's risk for many chronic diseases. • also it causes problems with the metabolism of fat and carbohydrate, leading to unhealthful changes in blood cholesterol, insulin and glucose. pear-shaped fat patterning (lower-body fat) (the typical female pattern) • doesn't seem to significantly a person's risk for chronic disease 7 To determine the type of fat patterning, flow these steps: 1- Measure your circumference of natural waist in inches (i.e. the narrowest part of your torso from the front) 2- Measure your hip circumference at the maximal width of the buttocks from the side (in inches) 3- Divide the waist value by the hip value. This measurement is called “waist-tohip ratio” A ratio higher than .90 (in men) and higher than .80 (in women) An apple shaped fat distribution pattern. 8 In addition, waist circumference alone can indicate the risk for chronic disease: Female waist Male circumference > 35 inches (88 cm) waist circumference > 40 inches (102 cm) Indicates increased risk for chronic disease. 45 years old man, his waist circumference is 50 inches and his hips are 40 inches: calculate his hip-to-waist ratio? Waist-to-hip ratio= 50 40 = 1.2 What type of fat patterning does he have? Apple-shaped fat distribution patterning Is he in risk for chronic disease? Why? Yes, because he has an apple-shaped fat pattern and also his waist circumference is above 40 inches. EXERCISE ( 3): - Calculate your waist-to-hip ratio? - What type of fat patterning do you have? - Are you at risk for chronic disease? 9 Energy Balance To achieve or maintain a healthy body weight you must pay more attention to the important concept of ENERGY BALANCE. When the energy intake (in the form of food and beverages) equals the energy expended (through basal metabolism and physical activity) this means energy is balanced. 𝑒𝑛𝑒𝑟𝑔𝑦 𝑖𝑛𝑡𝑎𝑘𝑒 = 𝑒𝑛𝑒𝑟𝑔𝑦 𝑒𝑥𝑝𝑒𝑛𝑑𝑖𝑡𝑢𝑟𝑒 The figure below shows how your weight changes when you change either side of the equation. 10 The figure below shows the component of energy intake and expenditure in details Energy intake: Energy intake is equal to the amount of energy in the food we eat each day. This value includes all foods and beverages and expressed as kilocalories per day (Kcal/day). The energy content of each food is comes from: Carbohydrates • provides 4 Kcal/g Protein Fat • provides 4 Kcal/g 11 • provides 9 Kcal/g Alcohol • provides 7 Kcal/g One cup of oatmeal contains 6 gm of protein, 25 gm of carbohydrates and 2 gm of fat. Calculate the total energy content of this oatmeal? Kcal from protein= 6×4= 24 kcal Kcal from carbohydrates= 25×4= 100 kcal Kcal from fat= 2×9= 18 kcal Total kcal for 1 cup of oatmeal= 24+100+18= 142 kcal Exercise (4): Determine the caloric contribution of the fat, carbohydrate and protein content of the following snack foods? Potato chips pretzels (20 chips contains: 10 g fat, 15 carbohydrates and 2 g Protein) (17 pieces contains: 0 g fat, 24 carbohydrates and 3 g protein) Which snack is lower in total calorie? .................................. Which snack is lower in fat calories? …………………………… 12 you can know the number of grams of nutrients and energy content of a given food by using food composition tabels or computrized dietary analysis programs (will be discussed indetails later) Energy Expenditure: Energy expenditure (also known as energy output) is the energy our body expends to maintain its basic functions and to perform all levels of movement and activity. The body uses energy for three general purposes: basal metabolism, thermic effect of food, energy cost of physical activity and a fourth minor form of energy output known as thermogenesis. 1) Basal Metabolism: basal metabolic rate is expressed as BMR and it represents the energy the body expends to maintain its fundamental physiologic functions at rest. These functions include respiration, beating of the heart, maintaining body temperature, synthesis of new cells and tissues and other functions. The majority of our energy output each day (about 60-75%) is a result of our BMR. To estimate the BMR for one hour: The body weight (kg) × 1 kcal/kg of body weight/hour (in men) The body weight (kg) × 0.9 kcal/kg of body weight/hour (in women) To estimate the BMR for one day: The body weight (kg) × 1 kcal/kg of body weight/hour × 24 (in men) The body weight (kg) × 0.9 kcal/kg of body weight/hour × 24 (in women) 13 Assume a man weigh 79.5 kg; calculate his BMR for 24 hours? BMR for the total day= 79.5 kg × 1 kcal/kg of body weight/hour × 24 hour = 1909 kcal/day Exercise (5): Calculate your BMR per day? 2) The energy cost of physical activity(PA): it is the energy that is expended on body movement and muscular work above basal levels. It represents about 15-35% of our total energy output each day. (i.e. It represents calorie used for total body cell metabolism above what is needed during rest). This Table shows the energy expenditure by usual level of activity: Activity level % of basal metabolism calories Inactive: sitting most of the day; less than 2 hours of moving about slowely or standing 30% Average: sitting most of the day; walking or standing 2 to 4 hours, but no strenuous activity 50% Active: physically active 4 or more hours each day; little sitting or standing; some physically strenuous activites 75% 14 Calculate the energy cost of physical activity for preceding example if you know that he is inactive? The total energy cost of physical activity= BMR×30%= 1909×(0.3)= 572.7 kcal Exersise(6): Calulate your energy cost of physical activity? 3) The Thermic Effect of Food (TEF): (also called dietary thermogenesis) is the energy we expend as a result of processing the food we eat. A certain amount of energy is needed to digest, absorb, transport, metabolize and store the nutrients we eat. TEF is estimated as 10% of the sum of basal metabolic rate and usual physical activity calories. 4) Calculate dietary thermogenesis required for the preceding example? Dietary thermogenesis= 10% × ( BMR + PA)= 0.1×(572.7+1909)= 248.17 kcal Exercise(7): Calculate your dietary thermogenesis? 15 4) Thermogenesis: some additional energy is spent when a person adapt to dramatically changed circumstances (adaptive thermogenesis). When the body has to adapt to physical conditioning, extreme cold, starvation, trauma, or other types of stress, it has extra work to do, building tissues and producing the enzymes and hormones necessary to cope with the demand. Because this component of energy expenditure is so variable and specific to individuals, it is not included when calculating energy requirements. Estimation of Total Energy Requirements There are different equations to estimate total daily need for calories. One of these is equivalent to the sum of calories used for basal metabolism, physical activity and dietary thermogenesis. Calculate the estimated energy requirements for the preceding example? BMR PA (1909) (572.7) TEF (248.17 ) Exercise(8): Calculate your total energy requirements? 16 TOTAL CALORIE NEED (2729.87 kcal) if you are obese • substract 500 kcal from your total energy requirements if you are underweight • add 500 kcal for your total energy requirements Refrences: 1) Thompson, J. and Manore, M. (2009): Nutrition an applied approach. Second edition. Pearson Benjamin cummings. USA. 2) Wardlaw, G. and Smith, A. (2009): Contemporary Nutrition. Seventh edition. McGrowHill.USA. 3) Brown, J. (2008): Nutrition Now. Fifth edition. Thomson Wadsworth. 4) Whitney, E. and Rolfes, S.R. (2005): Understanding nutrition. Tenth edition. Thomson Wadsworth publisher. Further Reading: Wardlaw, G. and Smith, A. (2009): Contemporary Nutrition. Seventh edition. McGrowHill.USA. (chapter 7) How the number of calories in a certain food is determined with a bomb calorimeter instrument Thompson, J. and Manore, M. (2009): Nutrition an applied approach. Second edition. Pearson Benjamin cummings. USA.(chapter 11) various methods for the determination of body composition. . هكتبت العبيكاى. الطبعت األولي. تخطيط الوجباث الغذائيت:)2004 ( عصام بي حسي،عويضت .طزق أخزى لتقذيز إجوالي إحتياجاث الطاقت الكليت )(الفصل التاسع 17 Food Composition Tabels and Computerized Dietary Analysis Programms Objectives: to collect data about dietary intake by using 24- hour recall to analyze and calculate total energy and nutrients of a diet by using food composition tabels and computer programms 18 to compare nutrient intake with standards Food Composition Tabels They are tables that provide information about nutrients and energy content of foods. They are based on average values from a number of samples analyzed in the laboratory It’s used to estimate the quantity of daily intake of nutrients and energy. To achieve that; you must follow the following steps: 1 • Know the type and quantity of foods daily consumed 2 • Estimate of energy and nutrients found in food consumed 3 • Compare nutrients intake with standards (recommended dietary allowance) 19 Step one: There are different methods used to collect data about a person’s dietary intake. One of the easiest methods is the 24-hour dietary recall. This method requires individuals to remember the specific foods and drinks consumed, the methods of preparation and the amount eaten in the past 24 hours. Use food models to aid in estimating the quantity of food consumed Below is an example of filled 24-hour recall form for a 25 years old female: meal breakfast Food type and description Fried egg Brown bread (toasted) Fresh Orange juice Apple with peal (2.75 diam) Snack lunch snack dinner snack quantity 2 peaces 2 slices 1 cup 0.5 peace Cooked Rice Spinach Fried breast chicken Chocolate milk shake Big Mac (from MacDonald’s) French fries Low fat yogurt with fruits 20 .75 cup 0.5 cup 1 peace 1 cup 1 peace 20 peaces o.5 cup Exercise(1): Fill out the 24-hour recall form with your food and drinks consumed yesterday? meal Food type and description Breakfast Snack Lunch Snack Dinner snack 21 quantity Step two: After gathering information about dietary intake it can be analyzed by using food composition tables to estimate total energy and nutrient intake or computerized dietary programs. To analyze the fried eggs consumed by the female(by food composition tables): 1. Look for PAGE KEY in the food composition table (Appendix A) until you found [A-10= Eggs]. That means go to page A-10 to find where the eggs are analyzed. (Note: if you did not found fried eggs in that page go to the next page) 2. Under cooked you will find (fried in margarine). The values are for 1 egg and she consumed 2. Thus, you must multiply all the values by 2. 3. Record it in the nutrient analysis form. 22 Below is an example for all foods and beverages consumed by the female: Nutrient Analysis Form Fried breast chicken Spinach Cooked rice Apple w/peal (2.75diam) A-10 2020 A-36 15057 A-56 5147 A-26 38013 A-14 3000 A-18 3090 A-22 42029 1 peace 1 cup 1 peace 0.5 cup 0.75 cup o.5 peace 1 cup 2 peaces 2 peaces Quantity 332 590 211 322 21 153.75 36 112 138 184 Energy (kcal) 4 24 6 58 3 3 <0.5 2 6 12 Protein (gm) 40 47 34 1 3 33.75 9.5 26 26 <2 Carb. (gm) 4 3 3 0 2 5.75 1.5 <1 4 0 Fiber (gm) 18 34 6 8 <1 <0.75 <0.5 <1 2 14 Total fat (gm) 6 11 3.8 2.2 T 0.075 T t 0.6 4 Saturate d fat (gm) Name Chocolatmil k shake A-72 69010 20 peace 0.85 Page & compute r code no. A-12 19509 Big Mac A-54 5139 1.5 Brown bread toasted Orange juice (fresh) Fried eggs French fries 0 28.525 23.5 86.75 5.5 19.25 125 245.75 0.5 cup 124 A-10 2001 2224.75 Low fat yogurt w/fruit Total 23 0.075 T T 1 5.8 Monoun saturate d fat (gm) 0.075 T T 0.6 2.4 Polyunsa turated fat (gm) 0 0 0 0 420 Choleste rol (gm) 12 4 27 40 54 Calcium (mg) 1.425 0.085 0.5 1.86 1.82 Iron (mg) 1.5 0.5 2 296 188 Sodium (mg) 0.5775 0.015 0.12 1.1 1.1 Zinc (mg) 472 0 2 25 <2 182 Vitamin A (RAE) 131 69 2 74 20 46 Folate (μg) 9 0 3 124 0 0 Vitamin C (MG) 0 0.68 7 63 12 3.21 1.86 122 136 0 1.96 T 28 T 157 4 1.8 49 6 3 22 1 1 4.8 0 11 148 8 1090 0.4 12 439 34 4.5 612 0.905 750 0.68 300 1.66 71 12.2375 161 85 12 0.085 2621 0.51 0 186 17.615 188 1.4 5 973 22 11.7 T 689 0.2 0.35 6.475 1.8 23.725 24 Exercise (2): Analyze your food and drinks consumed yesterday by using food composition tables? Name total Page & compute r code no. Quantity Energy (kcal) Protein (gm) Carb. (gm) Fiber (gm) Total fat (gm) Saturate d fat (gm) Monoun saturate d fat (gm) 25 Polyunsa turated fat (gm) Choleste rol (gm) Calcium (mg) Iron (mg) Sodium (mg) Zinc (mg) Vitamin A (RAE) Folate (μg) Vitamin C (MG) Also you can analyze your foods by using computerized dietary analysis programs. 26 Step Three: Now compare nutrient intake with standards such as recommended dietary allowance (RDA) which reflects the average daily amount of nutrient considered adequate to meet the needs of most healthy people. If there is insufficient evidence to determine DRA, an adequate intake (AI) is set. AI are more tentative than RDA, but both may be used as for nutrient intake. Appendix C contains recommended Dietary Allowances (RDA) and adequate intakes tables. These tables are divided according to different age groups. • if the person intake was from(70200%) of dtandards • the person meet the needs for 1 day • if the intake was < 70% of standards • if the intake was > 200% of standards • there is deficiency of requaired nutrient • there is over consumption of required nutrient 27 Compare the nutrient intake for the preceding example? energy Pro. Carb. Fibe r Ca iron Na zinc Vit.A Fola Vit. te C Nutrie12.2 nt 2224.7 124 245.7 19.2 973 17.61 2621 750 439 148 3 intake Standa -rds 2403 46 130 25 1000 18 1500 8 700 400 75 (RDA OR AI) % 197 ( 92.58 269.5 189.0 97.3 98.06 174.7 152. 107.1 109. 77% .33 𝒊𝒏𝒕𝒂𝒌𝒆 % % % % % % 97% 4% 75% 𝒔𝒕𝒂𝒏𝒅𝒂𝒓𝒅 % ×100) More AdequEvaluat than ate Adequate intake -ion requi intake -red CommThis female should lower her protein intake ent Exercise(3): Evaluate your nutrients intake? energy Pro. Carb. Fiber Ca iron Na zinc Vit.A Folate Vit.C Nutrient intake Standards (RDA OR AI) 28 % Evaluation Comment Refrences: Brown, J. (2008): Nutrition Now. Fifth edition. Thomson Wadsworth. عويضت ،عصام بي حسي ( :)2004تخطيط الوجباث الغذائيت .الطبعت األولي .هكتبت العبيكاى. عبذالقادر ،هٌي خليل ( :)2001تقيين الحالت الغذائيت .دار الٌيل للٌشز .الطبعت األولي Mahan, L., Escott-Stump, S. (2004): Food, Nutrition and Diet Therapy. 11th edition. SAUNDERS. )1 )2 )3 )4 Further Reading: other الوذًي ،خالذ علي ( :)2004تقيين الحالت الغذائيت .الطبعت األولي .الٌاشز دار الوذًي بجذة dietary intake methods. 29 Planning a Healthy Diet Healthy diet It is a diet that provides the proper combination of energy and nutrients. It requires only some simple planning and doesn’t have to mean deprivation and misery. The BEST PLAN consists of learning the six basic diet-planning principles and the three tools (dietary guidelines, food labels and My pyramid). Principles Tools Adequacy Dietary guidlines Balance Energy Control Food labeling Nutrient Density Moderation My Pyramide Variety 30 31 32 33 Diet Planning Principles Objectives: 1 to know what does each principle mean 2 to know how to apply these principles in planning a healthy diet 3 to evaluate the nuteient density of foods 1. Adequacy: Adequate diet means that the diet provides sufficient energy and enough of all the nutrients to meet the needs of healthy people. Sufficient energy intake will maintain healthy body weight. For nutrients, sufficiency corresponds to intakes that are in line with recommended intake levels represented by the RDA or AI. A diet may be inadequate if for example people eat plenty of breads, meats, fruits and dairy products but do not eat enough vegetables. Thus, their intake of many of the important nutrients found in vegetables (such as fiber, betacarotene, and potassium) is likely to be inadequate. 2. Balance: Balance diet involves consuming enough- but not too much- of each type of food. That means not over consuming any single type of food. 34 1 way to balance your diet Each day select foods from the 5 food groups • grains • vegetabels • fruits • milk • meat and beans balance in the diet helps to ensure adequacy 3. Energy control: Means management of food energy intake the key to energy control Remember energy balance is to select foods low in energy density low energydense foods energy-dense foods Energy density: is a comparison of the calorie (Kcal) content of a food with the weight of the food. • high in calories but weighs very little 35 • has few calories but weighs alot 4. Nutrient density: The nutrient density of a food is a characteristic used to determine its nutritional quality. It is a measure of the nutrients a food provides relative to the energy it provides. The more nutrients and the less energy, the higher the nutrient density. To evaluate the nutrient density of foods: nutrinent content (mg) ÷ calorie content (Kcal) the more mg/Kcal, the more nutrient density 1.5 ounce cheddar Cheese: 303 mg calcium 169.5 kcal Nutrient density= 1.79 1 cup fat- free milk: 316 mg calcium 91 Kcal nutrient density= 3.47 *Both are excellent choices for adequacy’s sake alone. * But to achieve adequacy while controlling k cal, the fatfree milk is the better choice fat free is twice as Calcium dense as cheddar cheese nutrient density promotes adequecy and calories control 5. Moderation: Foods rich in fat and sugar provide enjoyment and energy but relatively few nutrients. In addition, they promote weight gain when eaten in excess. A person practicing moderation would eat such foods only on occasions and would regularly 36 select foods low in fat and sugar, a practice that automatically improves nutrient density. Returning to the previous example of cheddar cheese and fat-free milk, the fatfree milk not only offers the same amount of calcium for less energy, but it contains far less fat than the cheese. moderation contributes to adequecy, balance and energy control 6. Variety: Variety in your diet means choosing a number of different foods within any given food group rather than eating the “same old thing” day after day. A variety of foods is best because no one food meets all your nutrient needs. Strawberry and apricots both are from the fruit group but • rich in vitamin C • rich in vitamin A 37 A variety makes meals more interesting and help ensure that a diet contains sufficient nutrients. As the adage goes: variety is the spice of life Refrences: 1) Thompson, J. and Manore, M. (2009): Nutrition an applied approach. Second edition. Pearson Benjamin cummings. USA. 2) Wardlaw, G. and Smith, A. (2009): Contemporary Nutrition. Seventh edition. McGrowHill.USA. 3) Brown, J. (2008): Nutrition Now. Fifth edition. Thomson Wadsworth. 4) Whitney, E. and Rolfes, S.R. (2005): Understanding nutrition. Tenth edition. Thomson Wadsworth publisher. 38 Diatry Guidlines objectives: • to know the nine group topic in the guidlines • to know the how to apply it in planning a healthy diet Dietary Guidelines for Americans 2005: The USDA and U.S. department of health and human services (DHNS) have published dietary guidelines for Americans since 1980 to aid diet planning. The latest version of the dietary guidelines was published in 2005 and it identifies both food choices and physical activity habits that can help reduce our risk for chronic diseases. They are grouped into nine group topic. Adequate nutrients within energy needs Consume a variety of nutrient-dense foods and beverages within and among the basic food groups; limit intakes of saturated and trans fats, cholesterol, added sugars, salt, and alcohol Meet recommended intakes within energy needs by adopting a balanced eating pattern 39 Weight management To maintain body weight in a healthy range, balanced calories from foods and beverages with calories expended To prevent gradual weight gain over time, make small decreases in food and beverages calories and increase physical activity. Physical activity Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight Achieve physical fitness by including cardiovascular conditioning, stretch exercises for flexibility, and resistance exercise or calisthenics for muscle strength and endurance. Food groups to Encourage Consume a sufficient amount of fruits, vegetables, milk and milk products, and whole grains while staying within energy needs. Select a variety of fruits each day, include vegetables from five subgroups (dark green, orange, legumes, starchy vegetables and other vegetables) several times a week. Make at least half of the grain selections whole grains. Select fat-free or low-fat products. Fats Keep saturated fat, trans fat, and cholesterol consumption low-less than 10% of calories fromm saturated and trans fats and less than 300 mg of cholesterol per day Keep total fat intake between 20 to 35% of calories, mostly from foods that provide unsaturated fats, such as fish, nuts, olives and vegetable oils. Select and prepare foods that are lean, low fat, or fat-free carbohydrates Choose fiber-rich fruits, vegetables, and whole grains often Choose and prepare foods and beverages with little added sugars 40 Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods and beverages less frequently. Sodium and potassium Choose and prepare foods with less salt (less than 2300 mg sodium or approximately 1 tea spoon salt). At the same time, consume potassiumrich foods, such as fruits and vegetabels Alcoholic beverages Those who choose to drink alcoholic beverages should do so sensibly and in moderation. Some individual should not consume alcoholic beverages. Food safety To avoid microbial food borne illness, keep foods safe: clean hands, food contact surfaces, and fruits and vegetables; separate raw, cooked, and ready-to-eat foods; cook foods to a safe internal temperature; chill perishable food promptly; and defrost food properly… These dietary guidelines are not difficult to implement. The table below shows recommended diet changes based on the dietary guidelines. 41 Refrences: 1. www.cnpp.usda.gov/Publications/DietaryGuidelines/2005/2005DGPolicyDocument.pdf 2. Wardlaw, G. and Smith, A. (2009): Contemporary Nutrition. Seventh edition. McGrowHill.USA. 3. Sizer, F., and Whitney, E.(2006): Nutrition Concepts and controversies.10 th edition.THOMSON WADSWORTH 42 Food Label Objectives: to learn the five components induced on food labels how to read and use the nutrition facts panel to determine the nutritonal value of foods to compare products according to label information to apply the nutriton facts labels to your daily food choices An essential step in designing and following a healthful diet is to learn how to read food label. Components on food label: Five primary components of information must be included on food labels (See the figure below): 1. A statement of identify: The common name of the product or an appropriate identification of the food product must be prominently displayed on the label. This information tells us very clearly what the product is. 2. The net content of the package: The quantity of the food product in the entire package must accurately describe. Information may be listed as weight (e.g., grams), value (e.g. fluid ounces), or numerical count (e.g., 4 each) 43 3. Ingredient list: The ingredients must be listed by their common name, in descending order by weight. This means that the first product listed in the ingredient list is the predominant in that food. 44 This information can be very useful when you are looking for foods that are lower in fat or sugars, or when you are attempting to identify foods that contain whole-grain flour instead of processed wheat flour. The ingredient list must also clearly state the presence of any of eight common food allergens, including peanuts, tree nuts, milk, wheat, eggs, soy, fish and shellfish. Which of these two products are more nutritious? Ingredient: “sugar, citric ingredient:”water, tomato Acid, natural flavors……” concentrate, concentrated Juices of carrots, celery…” Ingredient: “sugar, apples, Water” ingredient: “apples, water” 4. The name and address of the food manufacturer, packager or distributor: This information can be used if you want to find out more detailed information about a food product. 5. Nutrition information: The nutrition facts panel contains the nutrition information required by the FDA. This panel is the primary tool to assist you in choosing more healthful foods. 45 Nutrition facts panel: The information in the main or top section (see #1-4 and #6 on the sample nutrition label below), can vary with each food product; it contains product-specific information (serving size, calories, and nutrient information).the bottom part (see #5 on the sample label below) contains a footnote with daily values (DVs) for 2,000 and 2,500 calories diets. This footnote provides recommended dietary information for important nutrients, including fats, sodium and fiber. The foot note is found only on larger packages and does not change from product to product. 46 1. The serving size: The first place to start when you look at the nutrition Facts Label is the serving size. Serving sizes are standardizes to make it easier to compare similar foods. They are provided in familiar units, such as cups or peaces, followed by the metric amount, e.g., the number of grams. Pay attention to the serving size, especially how many servings there are in the food package. Then, ask your self, “how many servings am I consuming”? (e.g. 0.5 serving, 1 serving or more) In the sample label, if you consume the whole package that means how many servings did you consume? 2 servings (228 g ×2= 456 g) 2. Calories ( and calories from fat): Calories provide a measure of how much energy you get from a serving of this food. It can help you manage your weight (i.e. gain, lose or maintain). In the preceding example, there are 250 calories in 1 serving of the macaroni and cheese. How many calories you will get if you consume 114 g? 114g = 0.5 serving= 125 calories ( 55 from fat). 47 3 and 4. The nutrients: It shows you some key nutrients that impact on your health and separates then into two main groups: the nutrients get enough of these limit these nutrients eating too much fat, trans fat, cholesterol, or sodium may increase your risk of certain chronic diseases eating enough of these nutrients can improve your health and reduce the risk of some diseases and conditions If you consume 0.5 serving how many grams of fat, Trans fat, and cholesterol you will be provided? 6 Gm fat, 1.5 g saturated fat, 1.5 g is Trans fat and 15 g cholesterol. 5. The percent daily value (%DV): The daily values reflect dietary recommendations for nutrients and dietary components that have important relationships with health. The “%Daily Value” column on a label provides a ballpark estimate of how individual foods contribute to the total diet. It compares key nutrients in a serving of food with the daily goals of a person consuming 2000 kcalories. Even if you do not consume 2000 calories each day, you can still use the % DV to figure out whether a food is high or low in a given nutrient. < 5% DV of a nutrient • low in that nutrient 10-19% DV of anutrient • Good source 48 > 20%DV of a nutrient • high in that nutreinet In the preceding example, 12 grams of fat constitutes 18% of an individual’s total daily recommended of fat intake. ( 18%DV means it is not high in fat but 36% means high in fat) * 470 mg of sodium constitutes…………. Of total daily recommended of sodium intake. * 60 mg of cholesterol constitutes………….. Of total daily recommended of cholesterol intake 6. Food note (or the lower part of panel): Includes a foot note that must be present on all food labels. This footnote tells you that the %DV are based on a 2000 calories diet and that your needs may be higher or lower based on your caloric needs. The reminder of the footnote includes a table with values that illustrate the deference’s in recommendation between a 2000 calorie and 2500 calorie diet. Someone eating 2000 calories diet should strive to eat less than 65 gm of fat per day, whereas a person eating 2500 calories should eat less than 80 gm of fat per day. Nutrient-Claims: Nutrient claim is a statement that characterize the quantity of a nutrient in a food Have you noticed phrases such as “good source of fiber” on a box of a cereal or “rich in calcium” on a package of cheese? These and other nutrient claims may be used on labels as long as they meet FDA definitions. See the table below for these definitions. 49 50 Health claims: On approval by FDA, foods or food components with scientifically Agreed –upon benefits to disease prevention can be labeled with a Health claims. The table below shows U.S. food and drug Administration-approved health claims on label. 51 Health claims are statements that characterize the relationship between a nutrient or other substance in a food and a disease or health-related condition Exercise(1): Rate the nutrition value of these 2 cereals by completing the table below using the information from the nutrition facts panel. Whole-grain cereal Provides…………….calories/serving Contributes……………calories from fat ( or ……..% of the %DV) Each serving also provides………mg of Na (or ……….% of the %DV), …….gm of dietary fiber ( or ……….% of the %DV), and …… gm of sugars. Health granola cereal Provides…………….calories/serving Contributes……………calories from fat ( or ……..% of the %DV) Each serving also provides………mg of Na (or ……….% of the %DV), …….gm of dietary fiber ( or ……….% of the %DV), and …… gm of sugars. *which cereal provides the better nutritional value? exercise (2): these pretzels are low in sodium o True o false 52 Exercise(3): Below are two kinds of milk. One is “reduced fat”, the other is “non-fat” milk. Which one has more calcium? Which has more calories and saturated fats? Reduced fat Non- fat Exercise(4): If you love desserts but you’re concerned about your calorie intake; which of these is lower in calories: Half the container of Low fat blueberry frozen yogurt the whole container of low fat cherry yogurt 53 Exercise(5): Assume you are trying to eat foods with more fiber and potassium. Decide which food is a more nutritious choice? References: 1) Thompson, J. and Manore, M. (2009): Nutrition an applied approach. Second edition. Pearson Benjamin cummings. USA. 2) www.cfsan.fda.gov 3) Whitney, E. and Rolfes, S.R. (2005): Understanding nutrition. Tenth edition. Thomson Wadsworth publisher. Further Reading: To read about: - Enriched or fortified food labeling - food additives on the label - Dietary supplements labeling - structure-function claims - irradiated foods labeling - organic foods labeling Brown, J. (2008): Nutrition Now. Fifth edition. Thomson Wadsworth : (unit 4) 54 My Pyramid Objectives: to learn about MyPyramid in details to apply MyPyramid in diet planning to know your recommended no. of servings from each food group according to your EER how to translate your recommendati ons into food examples how to distribute food examples into meals The U.S. department of Agriculture (USDA) food guide pyramid is another tool that can guide you in designing a healthful diet. It was created to provide a conceptual framework for the types and amounts of foods that make up a healthful diet. The USDA simplified the nutrition recommendation by the mid-1950 s to a four food group plan: milk group, meat group, fruit and vegetables group and bread and cereal group. In 1992 this plan was illustrated using a pyramid (i.e., food guide pyramid) In April 2005, USDA unveiled their latest food guide plan, My Pyramid. Replaces the food guide pyramid and provides a more individualized approach to improving diet and lifestyle than previous food guides. It goals is to provide advice that will help us live longer, better, and healthier lives. 55 The Anatomy of MyPyramid The My Pyramid symbol represents the recommended proportion of foods from each food group to create a healthy diet. Physical activity is a new element in the pyramid. My Pyramid is designed to illustrate personalization, gradual improvement, activity, variety, proportionality, and moderation. These concepts are explained in the figure below. 56 Consumer Messages The consumer messages below have been developed by the USDA to help you navigate My Pyramid and to aid you in your diet planning. 57 Putting My Pyramid into Action To put My Pyramid into action: step one: You need to estimate your calorie needs (see chapter 1). Exercise(1): Write your estimated energy requirements step two: Now use the table to discover how that calorie allowance corresponds to the recommended number of servings from each food group. 58 A 19 years old girl, her calorie needs is 1600 calorie, what are her daily amounts of food from each group? calorie fruits vegetables grains Meat & beans milk oils 1600 1.5 cups 2 cups 5 oz.eq 5 oz.eq 3 cups 5 tsp Exercise (2): Fill the table with your recommendations calorie fruits vegetables grains Meat & beans milk oils Step Three: Translate the recommendations into food examples by using the table below Food group Grains Amount that counts as 1 ounce equivalent or 1 cup 1 regular slice bread, 0.5 regular hamburger bun, 1 small biscuits, 5 whole wheat or 7 refined grains crackers, 1 small muffins, 0.5 C cooked oatmeal, 1 large pancake or 2 small, 3 C popcorn, 1 C cornflakes, 0.5 C cooked rice or pasta, 1 small flour tortilla. 59 Vegetables 1 C of row or cooked vegetables such as (broccoli, kale, carrots, spinach, pumpkin, beans, peas, lentil, soy beans, okra, tofu, corn, mashed potato, cabbage, celery, raw cucumber, green or red peppers, mushrooms, onions, tomato) 1 medium boiled or baked potato, 20 medium to long strips French fries, 2 cups of row leafy greens (such as spinach, lettuce), 1 C vegetable juice. Fruits 1 small or 0.5 large apple, 2 small banana, 1C cantaloupe, 32 Peaces grapes, 1 medium grapefruit, 1 large orange, 1 large peach, 1 medium pear, 1 C pineapple or watermelon, plum, 8 large strawberries, 1 C mixed fruit (fruit cocktail), 0.5 C dried fruit (raisins, prunes, apricots, etc.), 1 C fruit juice Milk 1 C milk or yogurt, 45 gm cheese (cheddar, mozzarella, Swiss, parmesan, etc..), 0.5 C ricotta cheese, 2C cottage cheese. 1 C pudding made with milk, 3 scopes icecream. Meats & beans 30 gm (lean beef, chicken without skin, turkey, fish), 1 egg, 15 gm of nuts (12 peace almonds, 24 pistachios, 7 walnuts halves), 1 table spoon of peanut butter, 0.25 cup cooked beans or peas. Chicken breast= 90 gm 1 C lentil soup= 60 gm 60 Beans and peas can be counted either as vegetables or in the meat group. Generally, individuals who regularly eat meat, would count beans and peas in the vegetable group. Individuals who seldom eat meat would count some of the dry beans and peas in the meat group. Oils 1 tsp vegetables oils (such as canola, corn, olive, peanut, soybean and sun flower), mayonnaise, salad dressing Below are food choices for the preceding example. Food group Amount of food Amount according to My Pyramid grains 2 slices brown toast bread 1 cup whole-bran cornflakes 0.5 cup cooked rice 1 slice of white bread 2 oz. 1 cup 1 cup 1 oz. 0.5 cup cooked spinach 0.5 cup carrot juice 0.5 cup lentil soup 1 small banana 0.5 cup fruit cocktail 0.5 large orange 1 cup low-fat milk 1 cup low-fat yogurt 1 cup pudding made with milk 45 gm lean beef 90 gm breast chicken 0.5 table spoon peanut butter 0.5 cup 0.5 cup 1 cup 0.5 cup 0.5 cup 0.5 cup 1 cup 1 cup 1 cup 1.5 3 0.5 5 tsp canola oil used during cooking 5 tsp vegetables fruits milk Meat &beans oils 61 Exercise (3): Fill the table below with your food choices Food group Amount of food grains vegetables fruits milk Meat &beans oils Step Four: Distribute food examples into meals 62 Amount according to My Pyramid Below is sample menu for the preceding example Meal Food group 1 C whole-bran corn flakes 1C low-fat milk 1 small banana Grains Milk fruits Breakfast: Snack: vegetables 0.5 C carrot juice Lunch: 0.5 C cooked spinach 0.5 c cooked rice 45 gm of lean beef 0.5 C lentil soup 1 C pudding Vegetables Grains Meat Vegetables milk 0.5 table spoon peanut butter 1 slice white bread Meat grain Snack: Lunch: Chicken sandwich (2slices brown bread and 90 gm chicken breast) 0.5 C Fruit cocktail 0.5 large orange Late-night snack: 1 C low-fat yogurt 63 Meat &grain Fruit fruit milk Exercise(4): Distribute your food examples into meals? Meal Food group Breakfast: Snack: Lunch: Snack: Lunch: Late-night snack: References: 1. www.mypyramid.gov 2. Wardlaw, G. and Smith, A. (2009): Contemporary Nutrition. Seventh edition. McGrowHill.USA. تن بحوذ اهلل 64