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Chapter 1

An Overview of Nutrition
Food Choices
• Personal preferences for flavors of food are
  the main reason people make food choices
  and choices can be influenced by genetics.
• Habits are comforting and food choices are
  often just a habit.
• Ethnic heritage or traditions are strong
  influences on eating.
• Social interactions such as special events,
  customs, and holidays are shared by
  groups of people. Food is often involved.
Food Choices
• Food availability, convenience, and the economy
  are affecting many food choices in today’s world.
• There are many positive and negative associations
  with food that affect what food is chosen to eat.
• Eating for emotional comfort can be the result of
  changes in brain chemistry that occur when foods
  are consumed. While this may be appropriate at
  times, it can lead to overeating.
• Values such as religious beliefs, political views, or
  environmental concerns may affect food choices.
• Body weight and image can affect food choices
  both positively and negatively.
• The nutrition and health benefits of functional
  foods, such as whole, modified, or fortified foods,
  are becoming more popular.
The Nutrients
• Nutrients in Foods and in the Body
   Composition of foods includes the six nutrient
    classes of water, carbohydrates, lipids, proteins,
    vitamins and minerals. Foods can also contain
    nonnutrients and other compounds, such as fibers,
    phytochemicals, pigments, additives, alcohols and
    others.
   Composition of the human body is made of
    chemicals similar to food.
   Chemical composition of nutrients includes both
    organic (those that contain carbon) and inorganic
    (those that do not contain carbon) compounds.
   Essential nutrients are those the body cannot make
    or cannot make in sufficient quantities to meet
    needs. These are also called indispensable nutrients.
The Nutrients
• Energy-Yielding Nutrients: Carbohydrate,
  Fat and Protein
   Macro- vs. micronutrients
     • Carbohydrate, fat, and protein are macronutrients
       because the body needs them in large quantities.
     • Water, vitamins, and minerals do not provide
       energy and are known as micronutrients because
       the body needs them in smaller quantities.
   Energy is measured in Calories (calories,
    kilocalories, kcalories, kcal).
     • Internationally, food energy is measured in
       joules.
The Nutrients
• Energy-Yielding Nutrients: Carbohydrate, Fat and
  Protein
    Energy from food differs in energy density.
     Carbohydrate yields 4 kcalories per gram, protein 4
     kcalories per gram, and fat 9 kcalories per gram.
    Activity in the body is fueled by food as energy is
     released from bonds within carbohydrate, fat, and
     protein as they are broken down. The processes by
     which food is broken down to yield energy are called
     metabolism.
    Excess energy is stored in the body as compounds
     such as body fat.
    Other roles of energy-yielding nutrients include
     building body tissues and regulating body processes.
Lower energy density               Higher energy density
This 450-gram breakfast            This 144-gram breakfast
delivers 500 kcal, for an energy   delivers 500 kcal, for an energy
density of 1.1                     density of 3.5
(500 kcal/450 g = 1.1 kcal/g)      (500 kcal/144 g = 3.5 kcal/g)
The Nutrients
• Vitamins are organic, essential
  nutrients that allow the body to
  obtain energy from carbohydrate,
  fat, and protein.
• Minerals are inorganic, essential
  nutrients that are found in the bones,
  teeth, and body fluids.
• Water is an indispensable and
  abundant essential nutrient that
  participates in many life processes.
The Science of Nutrition
• Conducting Research
   Nutrition Research tests hypotheses and
    develops theories.
   Information based on personal experience is
    known as an anecdote.
   Types of studies
     • Epidemiological studies include cross-sectional,
       case-control, and cohort designs.
     • Laboratory-based studies include animal studies
       and laboratory-based in vitro studies.
     • Human intervention or clinical trials
The Science of Nutrition
• Conducting Research
   Controls
     • Subjects are divided into two groups. The experimental
       group receives the treatment being studied and the
       control group does not receive the treatment.
     • Randomization is used to randomly assign subjects to
       the experimental or control group.
   Sample sizes must be large to accurately detect
    differences.
   Placebos are used to control the placebo effect with
    subjects in experiments. Subjects in blind
    experiments do not know if they are in the
    experimental or control group.
   In double-blind experiments, the researchers and
    the subjects do not know their groups to prevent
    researcher bias.
The Science of Nutrition
• Analyzing Research Findings
   Correlations and causes in experiments
    involve studying variables and correlations,
    or relationships, between variables.
     • A positive correlation is when the same thing
       happens to two variables: as one increases the
       other increases.
     • A negative correlation if when the opposite things
       happen to two variables: as one increases the
       other decreases.
   Cautious conclusions must be drawn when
    examining or generalizing the results of a
    study.
The Science of Nutrition

• Publishing Research
  A peer review process is used to
   evaluate the procedures used and the
   conclusions drawn from a study.
  When a study has validity it means
   that the conclusions were supported
   by the findings.
  Replication is used to confirm or
   disprove findings.
The Dietary Reference
       Intakes (DRI)
• Establishing Nutrient Recommendations
   Estimated Average Requirement (EAR) defines the
    requirement of a nutrient that supports a specific function
    in the body for half of the healthy population.
   Recommended Dietary Allowances (RDA) use the EAR as a
    base and include sufficient daily amounts of nutrients to
    meet the known nutrient needs of practically all healthy
    populations. This recommendation considers deficiencies.
   Adequate Intakes (AI) reflect the average daily amount of
    a nutrient without an established RDA that appears to be
    sufficient.
   Tolerable Upper Intake Level (UL) is a maximum daily
    amount of a nutrient that appears safe for most healthy
    people and beyond which there is an increased risk of
    adverse health effects.
The Dietary Reference
       Intakes (DRI)
• Establishing Energy Recommendations
   Estimated Energy Requirement (EER)
    represents the average daily energy intake
    to maintain energy balance and good health
    for population groups.
   Acceptable Macronutrient Distribution Range
    (AMDR) represents the range of intakes for
    energy nutrients that provide adequate
    energy and nutrients and reduce risk of
    chronic disease.
The Dietary Reference
       Intakes (DRI)
• Using Nutrient Recommendations
  Apply to healthy people
  Recommendations are not minimum
   requirements and can be adjusted for
   individuals by registered dietitians.
  Achieved by consuming a variety of
   foods
  Apply to average daily intakes
  Each DRI category serves a unique
   purpose.
The Dietary Reference
       Intakes (DRI)
• Comparing Nutrient
  Recommendations
  Food and Agricultural Organization
   (FAO)
  World Health Organization (WHO)
Nutrition Assessment
• Nutrition Assessment of Individuals -
  evaluates the many factors that influence
  or reflect nutritional health.
   Historical information regarding diet, health
    status, drug use, and socioeconomic status
    is gathered.
   Anthropometric data measure physical
    characteristics including height and weight.
   Physical examinations require skill and
    reveal possible nutrition imbalances.
   Laboratory tests detect early signs of
    malnutrition.
Nutrition Assessment
• Nutrition Assessment of Individuals
   Stages in Nutrient Deficiency (example is
    given for iron)
     • Overt is easy to observe
     • Primary deficiency is inadequate dietary intake
     • Secondary deficiency is caused by disease or
       drugs
     • Subclinical deficiency is the early stages of
       deficiency without outward signs
     • Covert is hidden
Nutrition Assessment

• Nutritional Assessment of Populations
  National Nutrition Surveys
    • National Nutrition Monitoring Program
      uses survey research to collect data on
      foods people eat and people’s health
      status.
    • Data collected is used for nutrition policy,
      food assistance programs and food
      supply regulation.
Nutrition Assessment
• Nutrition Assessment of Populations
   National Health Goals
     • Healthy People is a national public health
       initiative under the U.S. Department of Health
       and Human Services that is published every 10
       years.
     • Identifies the most significant threats to health
     • Focuses efforts on eliminating these threats
   National Trends show an increased intake of
    fast food, increased portion sizes, and an
    increased consumption of energy-dense
    foods and drinks. This intake is associated
    with an increased risk for overweight and
    obesity.
Diet and Health

• Chronic Diseases
  Research indicates that behavior and
   certain conditions are related to
   disease.
  Five of six leading causes of death
   have a relationship with diet or
   alcohol.
  Many leading causes of death have a
   relationship with obesity.
Diet and Health

• Risk Factors for Chronic Diseases
  Risk factors persist over time.
  Risk factors cluster and focusing on
   one factor may improve another.
  Risk factors in perspective: The most
   prominent are tobacco use, diet and
   activity patterns and alcohol use.
Nutrition Information and
      Misinformation
   On the Net and in the News
Nutrition Information &
       Misinformation
• Nutrition on the Net (Internet, World Wide
  Web, www, cyberspace, websites)
   Internet information can be published by
    ANYONE.
   May be high-quality information: National
    Library of Medicine’s PubMed
   May be misleading, incomplete, and
    inaccurate
• Nutrition in the News
   Can be misleading and contradictory
   May report scientific findings prematurely
Nutrition Information &
       Misinformation
• Identifying Nutrition Experts
   Consumers listen to many people except
    dietitians.
   Qualifications of the speaker must be
    evaluated.
   Dietitians have been educated and trained
    in nutrition.
   Physicians and Other Health Care
    Professionals
     • American Dietetic Association (ADA) recommends
       nutrition education be a part of all health care
       professionals’ curricula.
     • A qualified nutrition expert is a registered
       dietitian (RD).
Nutrition Information &
       Misinformation
• Identifying Nutrition Experts
   Registered Dietitians (RD)
     • Maintain up-to-date registration
     • May use the title nutritionist
     • Many states require a license to practice. These
       are licensed dietitians (LD).
     • Certified nutritionists, certified nutritional
       consultants, and certified nutritional therapists do
       not have the same credentials as an RD.
     • Public health dietitians work for government-
       funded agencies.
   Other Dietary Employees
     • Dietetic Technicians assist RDs
     • Dietetic Technicians Registered (DTR) are dietetic
       technicians that have passed a national exam.
Nutrition Information &
      Misinformation
• Identifying Fake Credentials
  Look for a degree from an accredited
   college or university.
  Be careful of correspondence schools.
  Fraudulent businesses may provide
   false credentials.
Nutrition Information &
       Misinformation
• Red Flags of Nutritional Quackery
   Nutritional misinformation can be identified
    by using the following eight red flags:
     •   Satisfaction guaranteed
     •   Quick and easy fixes
     •   Natural
     •   One product does all
     •   Time tested
     •   Paranoid accusations
     •   Personal testimonials
     •   Meaningless medical jargon
Chapter 1

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Chapter 1

  • 1. Chapter 1 An Overview of Nutrition
  • 2. Food Choices • Personal preferences for flavors of food are the main reason people make food choices and choices can be influenced by genetics. • Habits are comforting and food choices are often just a habit. • Ethnic heritage or traditions are strong influences on eating. • Social interactions such as special events, customs, and holidays are shared by groups of people. Food is often involved.
  • 3. Food Choices • Food availability, convenience, and the economy are affecting many food choices in today’s world. • There are many positive and negative associations with food that affect what food is chosen to eat. • Eating for emotional comfort can be the result of changes in brain chemistry that occur when foods are consumed. While this may be appropriate at times, it can lead to overeating. • Values such as religious beliefs, political views, or environmental concerns may affect food choices. • Body weight and image can affect food choices both positively and negatively. • The nutrition and health benefits of functional foods, such as whole, modified, or fortified foods, are becoming more popular.
  • 4. The Nutrients • Nutrients in Foods and in the Body  Composition of foods includes the six nutrient classes of water, carbohydrates, lipids, proteins, vitamins and minerals. Foods can also contain nonnutrients and other compounds, such as fibers, phytochemicals, pigments, additives, alcohols and others.  Composition of the human body is made of chemicals similar to food.  Chemical composition of nutrients includes both organic (those that contain carbon) and inorganic (those that do not contain carbon) compounds.  Essential nutrients are those the body cannot make or cannot make in sufficient quantities to meet needs. These are also called indispensable nutrients.
  • 5.
  • 6. The Nutrients • Energy-Yielding Nutrients: Carbohydrate, Fat and Protein  Macro- vs. micronutrients • Carbohydrate, fat, and protein are macronutrients because the body needs them in large quantities. • Water, vitamins, and minerals do not provide energy and are known as micronutrients because the body needs them in smaller quantities.  Energy is measured in Calories (calories, kilocalories, kcalories, kcal). • Internationally, food energy is measured in joules.
  • 7. The Nutrients • Energy-Yielding Nutrients: Carbohydrate, Fat and Protein  Energy from food differs in energy density. Carbohydrate yields 4 kcalories per gram, protein 4 kcalories per gram, and fat 9 kcalories per gram.  Activity in the body is fueled by food as energy is released from bonds within carbohydrate, fat, and protein as they are broken down. The processes by which food is broken down to yield energy are called metabolism.  Excess energy is stored in the body as compounds such as body fat.  Other roles of energy-yielding nutrients include building body tissues and regulating body processes.
  • 8. Lower energy density Higher energy density This 450-gram breakfast This 144-gram breakfast delivers 500 kcal, for an energy delivers 500 kcal, for an energy density of 1.1 density of 3.5 (500 kcal/450 g = 1.1 kcal/g) (500 kcal/144 g = 3.5 kcal/g)
  • 9. The Nutrients • Vitamins are organic, essential nutrients that allow the body to obtain energy from carbohydrate, fat, and protein. • Minerals are inorganic, essential nutrients that are found in the bones, teeth, and body fluids. • Water is an indispensable and abundant essential nutrient that participates in many life processes.
  • 10.
  • 11. The Science of Nutrition • Conducting Research  Nutrition Research tests hypotheses and develops theories.  Information based on personal experience is known as an anecdote.  Types of studies • Epidemiological studies include cross-sectional, case-control, and cohort designs. • Laboratory-based studies include animal studies and laboratory-based in vitro studies. • Human intervention or clinical trials
  • 12.
  • 13. The Science of Nutrition • Conducting Research  Controls • Subjects are divided into two groups. The experimental group receives the treatment being studied and the control group does not receive the treatment. • Randomization is used to randomly assign subjects to the experimental or control group.  Sample sizes must be large to accurately detect differences.  Placebos are used to control the placebo effect with subjects in experiments. Subjects in blind experiments do not know if they are in the experimental or control group.  In double-blind experiments, the researchers and the subjects do not know their groups to prevent researcher bias.
  • 14. The Science of Nutrition • Analyzing Research Findings  Correlations and causes in experiments involve studying variables and correlations, or relationships, between variables. • A positive correlation is when the same thing happens to two variables: as one increases the other increases. • A negative correlation if when the opposite things happen to two variables: as one increases the other decreases.  Cautious conclusions must be drawn when examining or generalizing the results of a study.
  • 15. The Science of Nutrition • Publishing Research A peer review process is used to evaluate the procedures used and the conclusions drawn from a study. When a study has validity it means that the conclusions were supported by the findings. Replication is used to confirm or disprove findings.
  • 16. The Dietary Reference Intakes (DRI) • Establishing Nutrient Recommendations  Estimated Average Requirement (EAR) defines the requirement of a nutrient that supports a specific function in the body for half of the healthy population.  Recommended Dietary Allowances (RDA) use the EAR as a base and include sufficient daily amounts of nutrients to meet the known nutrient needs of practically all healthy populations. This recommendation considers deficiencies.  Adequate Intakes (AI) reflect the average daily amount of a nutrient without an established RDA that appears to be sufficient.  Tolerable Upper Intake Level (UL) is a maximum daily amount of a nutrient that appears safe for most healthy people and beyond which there is an increased risk of adverse health effects.
  • 17.
  • 18.
  • 19. The Dietary Reference Intakes (DRI) • Establishing Energy Recommendations  Estimated Energy Requirement (EER) represents the average daily energy intake to maintain energy balance and good health for population groups.  Acceptable Macronutrient Distribution Range (AMDR) represents the range of intakes for energy nutrients that provide adequate energy and nutrients and reduce risk of chronic disease.
  • 20. The Dietary Reference Intakes (DRI) • Using Nutrient Recommendations Apply to healthy people Recommendations are not minimum requirements and can be adjusted for individuals by registered dietitians. Achieved by consuming a variety of foods Apply to average daily intakes Each DRI category serves a unique purpose.
  • 21. The Dietary Reference Intakes (DRI) • Comparing Nutrient Recommendations Food and Agricultural Organization (FAO) World Health Organization (WHO)
  • 22. Nutrition Assessment • Nutrition Assessment of Individuals - evaluates the many factors that influence or reflect nutritional health.  Historical information regarding diet, health status, drug use, and socioeconomic status is gathered.  Anthropometric data measure physical characteristics including height and weight.  Physical examinations require skill and reveal possible nutrition imbalances.  Laboratory tests detect early signs of malnutrition.
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  • 24. Nutrition Assessment • Nutrition Assessment of Individuals  Stages in Nutrient Deficiency (example is given for iron) • Overt is easy to observe • Primary deficiency is inadequate dietary intake • Secondary deficiency is caused by disease or drugs • Subclinical deficiency is the early stages of deficiency without outward signs • Covert is hidden
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  • 26. Nutrition Assessment • Nutritional Assessment of Populations National Nutrition Surveys • National Nutrition Monitoring Program uses survey research to collect data on foods people eat and people’s health status. • Data collected is used for nutrition policy, food assistance programs and food supply regulation.
  • 27. Nutrition Assessment • Nutrition Assessment of Populations  National Health Goals • Healthy People is a national public health initiative under the U.S. Department of Health and Human Services that is published every 10 years. • Identifies the most significant threats to health • Focuses efforts on eliminating these threats  National Trends show an increased intake of fast food, increased portion sizes, and an increased consumption of energy-dense foods and drinks. This intake is associated with an increased risk for overweight and obesity.
  • 28. Diet and Health • Chronic Diseases Research indicates that behavior and certain conditions are related to disease. Five of six leading causes of death have a relationship with diet or alcohol. Many leading causes of death have a relationship with obesity.
  • 29. Diet and Health • Risk Factors for Chronic Diseases Risk factors persist over time. Risk factors cluster and focusing on one factor may improve another. Risk factors in perspective: The most prominent are tobacco use, diet and activity patterns and alcohol use.
  • 30. Nutrition Information and Misinformation On the Net and in the News
  • 31. Nutrition Information & Misinformation • Nutrition on the Net (Internet, World Wide Web, www, cyberspace, websites)  Internet information can be published by ANYONE.  May be high-quality information: National Library of Medicine’s PubMed  May be misleading, incomplete, and inaccurate • Nutrition in the News  Can be misleading and contradictory  May report scientific findings prematurely
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  • 33. Nutrition Information & Misinformation • Identifying Nutrition Experts  Consumers listen to many people except dietitians.  Qualifications of the speaker must be evaluated.  Dietitians have been educated and trained in nutrition.  Physicians and Other Health Care Professionals • American Dietetic Association (ADA) recommends nutrition education be a part of all health care professionals’ curricula. • A qualified nutrition expert is a registered dietitian (RD).
  • 34. Nutrition Information & Misinformation • Identifying Nutrition Experts  Registered Dietitians (RD) • Maintain up-to-date registration • May use the title nutritionist • Many states require a license to practice. These are licensed dietitians (LD). • Certified nutritionists, certified nutritional consultants, and certified nutritional therapists do not have the same credentials as an RD. • Public health dietitians work for government- funded agencies.  Other Dietary Employees • Dietetic Technicians assist RDs • Dietetic Technicians Registered (DTR) are dietetic technicians that have passed a national exam.
  • 35. Nutrition Information & Misinformation • Identifying Fake Credentials Look for a degree from an accredited college or university. Be careful of correspondence schools. Fraudulent businesses may provide false credentials.
  • 36. Nutrition Information & Misinformation • Red Flags of Nutritional Quackery  Nutritional misinformation can be identified by using the following eight red flags: • Satisfaction guaranteed • Quick and easy fixes • Natural • One product does all • Time tested • Paranoid accusations • Personal testimonials • Meaningless medical jargon