Nutrition Concepts !!!!Class Notes : October 4, 2013!!Dietary Reference Intakes Standards defined for: energy nutrients other dietary components (fiber) physical activity !collaborative effort of U.S. and Canada Recommendations apply to healthy people ! may be different for specific 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 !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) !*Can not have an RDA without an EAR !Adequate Intakes (AI) ! Insufficient scientific evidence ! AI value set instead of RDA ! Expected to exceed average requirements -not based on a number that we actually know we need, based on a # that healthy people actually get/intake !Tolerable Upper Intake Levels (UL) ! Point where nutrient is likely to be toxic!! Helps protect against overconsumption 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) !Common misbelief: -anything below is danger, anything above is safe no because you have to still be away of the UL !!!!Nutrition Concepts !!!!Class Notes : October 4, 2013!Estimated Energy Requirement (EER) ! Average dietary energy intake to maintain energy balance !!based on... ! ! ! healthy body weight ! ! ! physical activity ! ! no upper level, anything above puts at risk for storing fat. No upper level because every body is different. Some people would be getting too much, others not enough. !Acceptable Macronutrient Distribution Ranges (AMDR) ! assures that we get adequate energy and nutrients ! reduce risk of chronic diseases !!Range... ! ! ! 45-65% kcalories from carbohydrate ! ! ! 20-35% kcalories from fat ! Remember- keeping fat calorie intake at a healthy level allows for a lower risk in heart disease !Estimates apply to HEALTHY people ! need adjustments for other groups 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 ! (packages: fruits and veggies, etc. - if try to mimic these in pills, lose phytochemicals, etc.) -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 !Nutritional Assessment- Individual level ! Deficiency 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 !!!!Class Notes : October 4, 2013!Anthropometric measurements ! Height and weight- track to identify trends (BMI, waist measurement, skin fold 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) !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 Deficiency What happens in the body: ! -primary deficiency- deficiency in zinc ! -secondary deficiency- measure of iron source through blood, and diet history (drinking a lot of milk, calcium blocks the iron so this milk is a secondary deficiency because the calcium is blocking it) not directly related to you, it’s something else that you are doing that causes this. !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 ! persist over time ! cluster prominence of risk factors: tobacco, diet and activity patterns, alcohol, microbial agents, toxic agents, motor vehicles, firearms, sexual behavior, illicit drugs. !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 factorsNutrition Concepts !!!!Class Notes : October 4, 2013!Nutrition Information and Misinformation ! Validity of information ! ! Who is providing info? Qualifications- what is that person’s degree and history of study on the topic? !Concerns in the Internet ! Anyone can publish anything- so who did it? !No guarantees of accuracy ! Hasn’t all gone through peer review (blogs, etc. not reliable because you can’t guarantee on it) !Evaluate websites !Who, when, where, [WHY] and what? ! .org, .edu, coop extensions (from universities) - not necessarily in it for money (.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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