Nutrition Concepts Class N o t e s Oct obe r 4 2 013 Dietary Reference Intakes Standards de ned for energy nutrients other dietary components ber physical activity collaborative effort of U S and Canada Recommendations apply to healthy people may be different for speci c groups i e elderly newborns toddlers EAR and RDA Compared EAR Estimated Average Requirement for a nutrient is the amount that meets the needs of about half of the population Can not have an RDA without an EAR RDA Recommended Dietary Allowance for a nutrient is set well above the EAR meeting the needs of about 98 of the population calculation from our mean requirement Adequate Intakes AI not based on a number that we actually know we need based on a that healthy people actually get intake Insuf cient scienti c evidence AI value set instead of RDA Expected to exceed average requirements Tolerable Upper Intake Levels UL i e woman needs Vitamin A to be healthy but if consumes too much there can be birth defects not typical for people to get to the upper level with food supplement use is how people usually reach this very rare to reach on own Point where nutrient is likely to be toxic Helps protect against overconsumption Common misbelief anything below is danger anything above is safe no because you have to still be away of the UL Nutrition Concepts Class N o t e s Oct obe r 4 2 013 Estimated Energy Requirement EER every body is different Some people would be getting too much others not enough Average dietary energy intake to maintain energy balance based on no upper level anything above puts at risk for storing fat No upper level because healthy body weight physical activity Acceptable Macronutrient Distribution Ranges AMDR assures that we get adequate energy and nutrients reduce risk of chronic diseases Range Remember keeping fat calorie intake at a healthy level allows for a lower risk in heart disease 45 65 kcalories from carbohydrate 20 35 kcalories from fat need adjustments for other groups Estimates apply to HEALTHY people Recommendations not minimum levels nor optimal levels Goals intended to be met through diet Apply to average daily intakes Each DRI category serves a unique purpose Hopefully one day through gene sequencing through nutritional genomics we will be able to have a minimum and optimal level but as of now no packages fruits and veggies etc if try to mimic these in pills lose phytochemicals etc Nutritional Assessment Individual level De ciency or excess over time leads to malnutrition undernutrition and over nutrition Symptoms of malnutrition Diarrhea Skin rashes Fatigue Others Seen in obesity increased in over nourishment of fat calories etc but undernourishment of minerals and vitamins from fruits and vegetables etc Creating a total picture of the individual Historical information Health status SES drug use family history Diet history intake over several days portion sizes computer analysis Nutrition Concepts Anthropometric measurements to track progress and identify trends Physical examinations tongue tells a lot about nutrition skin Dry eczema Laboratory tests urine stool blood hair zinc Class N o t e s Oct obe r 4 2 013 Height and weight track to identify trends BMI waist measurement skin fold measurements Socioeconomic status previous health scares and problems breast cancer survivor etc examples Could be at risk for things did not know about Stages in the Development of a Nutrient De ciency What happens in the body milk calcium blocks the iron so this milk is a secondary de ciency because the calcium is blocking it not directly related to you it s something else that you are doing that causes this primary de ciency de ciency in zinc secondary de ciency measure of iron source through blood and diet history drinking a lot of covert signs abnormal functions inside the body through lab tests physical signs and symptoms overt see through physical exam Nutrition Assessment Population Level Nutritional nutrition monitoring programs coordinates two major national surveys oversample high risk groups National health goals Healthy people Lowered cholesterol but only by prescription drugs and because of that yes cholesterol did go down but nothing else did National Trends Diet and Health Food plays vital role in supporting health Chronic disease increasing at epidemic levels Multiple factors over multiple years not just eating lack of exercise smoking etc Leading causes of death Risk Factors prominence of risk factors tobacco diet and activity patterns alcohol microbial agents toxic agents motor vehicles rearms sexual behavior illicit drugs persist over time cluster No exact one that causes heart disease because caused by many health factors so want to make sure we are addressing this because that can reduce the risk factors Who is providing info Quali cations what is that person s degree and history of study Nutrition Concepts Class N o t e s Oct obe r 4 2 013 Nutrition Information and Misinformation on the topic Validity of information Concerns in the Internet No guarantees of accuracy it Anyone can publish anything so who did it Hasn t all gone through peer review blogs etc not reliable because you can t guarantee on org edu coop extensions from universities not necessarily in it for money Evaluate websites Who when where WHY and what coms are usually for businesses if selling a supplement or something like that is that reliable because they just want oyur money Who wrote what references Identify fake credentials Accreditation Diploma Mills Fraudulent businesses
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