Week 7: Nutrition and Integrative Health

What is nutrition?

The science that studies food and how food nourishes our bodies and influences our health

How does nutiriton affect all aspects of health?

• Physical Health

  • Nutrition has a role in

    promoting health and

    preventing or treating

    many diseases

• Spiritual Health

  • Food is central to

    many religious and

    spiritual

    ceremonies

• Emotional Health

  • Food can provide comfort and can

    chemically affect emotional state

• Social Health

  • Food brings

    people together

• Occupational Health

  • Good nutrition

    enables us to

    “do our best

Nutrition’s role in integrative health

The mind-body connection is fundamental for positioning nutrition within

integrative health.

• Our emotional and mental states significantly influence our eating patterns

and how our bodies process nutrients.

• When we’re stressed, anxious, or depressed, we may make poor food

choices or experience digestive and metabolic issues that impact nutrient

absorption and use.

• Alternately, specific food choices can benefit our mood, energy levels,

cognitive function, and overall sense of wellbeing

Mindful Eeating

Mindfulness is an intentional focus on one’s emotions, thoughts, and physical

sensations in the present moment.

• Mindful eating is an extension of the broader practice of mindfulness.

• Eating mindfully involves all one’s physical and emotional senses to

experience and enjoy the food choices one has made.

• Can involve deep breathing or meditation before or after the meal, along with

expressing gratitude for the meal

It encourages one to make choices that will be satisfying and nourishing to

one’s body.

• It also discourages judging one’s eating behaviours as there are different types

of eating experiences.

• These help to increase gratitude for one’s food and can improve one’s overall

eating experience, while reducing overeating and improving glycemic control

Blue Zones of Longevity

• Loma, Linda california

• Okinawa, Japan

• Sardinia, Italy

• Ikaria, Greece

• Nicoya peninsula, Costa Rica

Blue Zones of Longevity: Loma, Linda california

• Seventh day adventists

• Consume a vegan diet of leafy greens, nuts, and legumes based on

  their religious beliefs

  • Recognize the sabbath and downshift for 24 hours every wee

Blue Zones of Longevity: Okinawa, Japan

Home to the world’s longest-lived women

• Stop eating when 80% full (hara hachi bu)

• Tradition of forming social networks (~ 5 friends) that provide emotional

and financial support

Blue Zones of Longevity : Sardinia, Italy

Home to the world’s longest-lived men

• This community of shepherds walk 5 mountainous miles a day or more

• Diet is mostly plant-based consisting of whole-grain bread, beans, garden

vegetables, and fruit

• Meat is largely reserved for Sundays and special occasions

• Moderate wine intake

Blue Zones of Longevity: Ikaria, Greece

Consume lots of fruit and vegetables, whole grains, beans, potatoes, and

olive oil

• Downshift with a midafternoon break/nap

Blue Zones of Longevity: f Nicoya Peninsula, Costa Rica

Eat little to no processed foods but plenty of antioxidant-rich tropical

fruit

• Water is rich in calcium and magnesium

• Faith, family, and plan de vida (reason to live) help in maintenance of a

positive outlook and an active lifestyl

What are the characteristics of Long lived groups

Healthier lifestyles: non-obese, non-smokers, adapt to stress, quality social interactions, positive attitude, cognitive stimulation, healthy diet, natural movement, none to moderate alcohol intake

Biological factors: “Good” genes, female, having children after 40,

long-lived parents

What are macro nutrients?

-Nutrients needed by the body in large amounts

• These give us energy

• The amount of energy they provide is measured in kilo-calories (kcal

-Carbohydrates, fat, and protein

What is a calorie

A unit of energy

• 1 calorie is the amount of energy it takes to warm 1 kilogram of

water up by 1° Celsius

• Food energy is measured in kilo-calories (kcal) but it’s often just

called Calories.

Micronutrients

- Vitamins and minerals

• Vitamins are organic molecules the body needs in order to function

• Organic molecules = contain carbon

• Minerals are inorganic molecules the body needs in order to function

Don’t provide us with energy, but we need so that our bodies can

function well

• Antioxidants

• Control nerve and muscle action

• Make and maintain tissues like bones and blood

• Regulate energy metabolis

water is considered a ______ but doesnt provide energy

Macronutrient

Water in the body enables…

-Chemical reactions

• Our cells to grow

• Our muscles and nerves to function

• Hormone signaling

• Nutrient transport

• Regulation of body temperature

• And much more

What is a nutrious diet `

-Adequate – having sufficient amounts of nutrients to maintain health

• Moderate – watching portion sizes and frequency of consumption of

foods

• Balanced – mix and match food choices to ensure adequate nutrient

intake

• Varied – there are no super foods; need to eat a variety of foods ensure

adequate nutrient intake

Why do we choose the foods we do?

It’s complex and based on:

• Availability & Accessibility

• Cost, location, health status

• Cultural and family background

• Social acceptability

• Personal preference

• Psychological and emotional factors

• Health concerns

• Media

Who can we trust regarding nutrition info?

• trained persons with credentials

  • ex registered dieticians

• Government

  • ex health canadam stats can etc

• Professional organizations

  • EX Dietiitations of Canada, Canadian nutrition Society

• Well Known non- profit organizations

  • ex heart and stroke foundation

• Peer reviewed journals articles

Who can we NOT trust regarding nutirtion training?

• Doctor

  • can be trusted BUT doctors have very little nutrition training. If you have a

    dietary problem, most doctors will refer you to a dietitian

• Nutritionist

  • Not a protected title in Ontario

• The media/interent/news/tv/magazines

What do health professionals in canada/USA and the USA use to know much of something is enough?

• Dietary Reference Intakes (DRIs)

  • Developed by the insitute of Medicine

  • Developed by Canadian and American nutrition experts

What are Estimated Energy Requirements

(EERs)

For calculating how many kcalories needed to keep weight stable in an otherwise healthy individua

What are acceptable macronutrient distribution ranges ( AMDR)

Used to see if we’re getting the right proportion of macronutrient

• Percent values

What are reccomended dietary allowances ( RDA)

The RDA will meet the requirements of 98 % of the population

• A goal for individuals

• E.g., RDA for iron:

Women 19-50 = 18mg

Men 19-50 = 8mg

Tolerable upper intake level ( UL)

UL = the highest average daily nutrient intake level that poses a risk of

adverse health effects

• As intake increases above the UL, the risk of potential adverse effect

may increase

• Refers to over-consumption

• Used to ASSESS risk of adverse effects in individuals and population

Nutrition experts created Canadas food guide based on ?

-Information from the Dietary Reference Intakes

• Foods that comprise a healthy diet

• Behaviours that complement a healthy diet

What does canadas food guide say?

• eat plenty of vegetables and fruits

• eat protein foods

• make water your drink of choice

• choose whole grain foods

• Limit highly processed foods

• use food labels

• be aware that food marketing can ifnluence yoru choices

• be mindful fio your eating habits

• cook more often

• enjoy your food

• eat meals with others

Additional condsderations about food and healthy eating

-Nutritious foods to consume regularly can be fresh, frozen, canned, or dried.

▪ Nutritious foods can reflect cultural preferences and food traditions.

▪ Eating with others can bring enjoyment to healthy eating and can foster connections

between generations and cultures.

▪ Traditional foods improve diet quality among Indigenous Peoples

▪ E.g., Bannock, berries, wild rice, wild game

▪ Energy needs are individual and depend on a number of factors, including levels of physical

activity.

▪ Some fad diets can be restrictive and pose nutritional risk

What is the NOVA classfication of foods

• Developed in 2009 by a team of researchers at the University of Sao, Paulo Brazil

• Leading method to classify foods according to processing

  • Classifies foods by the nature, purpose, and extent of food

  processing, versus nutrients alone

  • Defines food processing as physical, biological, and chemical

  processes applied to foods after their separation from nature and

  before they are prepared for cooking and consumption

NOVA classifies all foods and drinks into 4 distinct groups:

1. Unprocessed or minimally processed foods

2. processed culinary ingredients

3. processed foods

4. ultra processed foods

NOVA Classification: 1. Unprocessed and minimally processed foods

include fresh, dried or frozen vegetables, grains, legumes, fruits, meats, fish, eggs , and milk

minimal processing involves removal of unwanted and inedible parts

Nova Classification: 2. Processed culinary ingredients

• include sugars, fats, oils, and salt

• used to prepare foods and to make diverse, nourishing and enjoyable dishes and meals

• obtained directly from food in group 1 by processes such as pressing, refining, grinding, milling and spray drying

• ex salt from sea water, suagr from beeet, oil from olives

Nova Classification : 3. Processed foods

• processed foods include simple breads and cheeses, and canned platn or animal foods . in moderation these can be part of healthy diets

• Relatively simple products made by adding Group 2 substances

  to Group 1 foods to increase their durability or to modify/enhance

  their sensory qualities

  • E.g., canned vegetables, salted/cured/smoked meats, canned

  fish, cheeses, freshly made bread, fruit in syrup, fermented drinks

  (beer, wine, cider)

NOVA Classifcation; 3.B Freshly prepared meals

Freshly prepared dishes combining inrpocessed or minimally processed foods with processd culianry ingreidents and modest amounts of procssed foods are the basis of healthy meals

NOVA Classification: 4.Ultra processed foods

• foods include fast food, sugary drinks, snacks, chips, candies, cookies, sweetened milk products, sweetened cereals, and sauce and dressings. They are nutritiously poor

• Industrial formulations typically with five or more ingredients

  • Often contain ingredients such as lactose, whey, hydrolyzed protein, soy

  protein isolate, maltodextrin, & high-fructose corn syrup

Ultra processed foods definition

“…industrial formulations manufactured from substances

derived from foods or synthesized from other organic sources.

They typically contain little or no whole foods, are ready-to-

consume or heat up, and are fatty, salty or sugary and depleted in

dietary fibre, protein, various micronutrients and other bioactive

compounds.

Attributes of ultra processed foods

Ultra – extreme, beyond

• Contain additives such as: dyes, colours, colour stabilizers, flavours,

flavour enhancers, non-sugar sweeteners

• Ready to eat, drink, or heat

• Hyper-palatability

• Sophisticated and attractive packaging, health claims

• Aggressive marketing to kids and teens

• Branding and ownership by transnational corporations

• Readily displace unprocessed and minimally processed foods from

the diet – e.g. fruit, nuts, seeds, milk, water

Recommendations

-Make fresh or minimally processed foods the basis of diets, preferring plant-

based foods

• Use processed culinary ingredients like sugars, oils and butter and salt in small

amounts for cooking and seasoning foods and for creating freshly made dishes and

meals

• Eat processed foods like simple breads and cheese in moderate amounts,

preferably as part of dishes and meals based on fresh or minimally processed foods

• Avoid ultra-processed foods

Eat regularly and carefully, wherever possible in pleasant environments and in

company

• Maintain, develop, learn and share skills in food acquisition, preparation, cooking

and presentation

• Plan your time to make food and eating important in your life

• Shop in places that offer plenty of variety of fresh or minimally processed foods

• Out of home, eat at places that serve freshly prepared meals

• Be wary of all forms of food product advertising and marketing

• Protect children from unhealthy food and drink advertisin

Nutrition labeling on Foods includes:

• The nutrition facts table

• the list of ingredients in the food

• front of package labels

• sometimes nutrition claims

What should youu look for on a nutrition facts table?

• serving size

• % daily value

• List of ingredients

on the nutrition facts table 5% or less daily value is considerd ____ and 15% or more is considered____

a little, a lot

What nutrient on a nutrition facts table should be limited?

Fat ( Saturated & Trans), cholesterol, Sodium

What nutrients should you try to get enough of ont he nutrition facts table?

• Vitamin A,C

• Calcium

• Iron

What is the % Daily Value

-Based on a 2,000 kcalorie per day diet

• Not quite useful as a goal

• Not quite useful for tracking one’s intake

• BUT it can give us a general idea about how much of a nutrient there

is in the food or beverage

List of ingredients

• All of the ingredients for a food are listed by weight, in descending order

• the ingredient that is in the greatest amount is listed first

Front-of- Package Labeling

• According to Health Canada, a front-of-package nutrition symbol is required on

  foods that are high in one or more of saturated fat, sugars, or sodium.

• The front-of-package nutrition symbol is meant to:

  • Help one make quick and informed choices when shopping for groceries

  • Support health professionals in educating people about foods high in sodium,

  sugars and saturated fa

What are the nutrients of concern and why

• Sodium

  • Increased sodium levels cause an increase in water retention,

    resulting in an increase in blood volume and blood pressure, increasing

    risk for cardiovascular disease

• Added Sugars

  • Lead to quick rises in postprandial blood glucose and

    insulin levels, contributing to decreased insulin sensitivity over time.

• Saturated fat

  • Increased intake contributes to increased circulating

    levels of LDL-C, often termed “bad cholesterol”.

What are the nutrition claims

optional statements on food labels that highlight

specific nutrients, foods, or ingredients.

What are the two types of nutrition claims

• nutrrient content claims

• health claims

Nutrient Content Claims

These describe the amount of a nutrient in a food and can help us choose foods that contain a nutrient we may want more of.

• Indicated by words and phrases such as:

• Source – e.g., a source of fibre

• High or good source – e.g., high in Vitamin A or a good source of iron

• Very high or excellent source – e.g., excellent source of calcium

Can also describe the amount of a nutrient in a food and can also help us choose foods that contain a nutrient we may want less of

• Indicated by words and phrases such as:

  • Low – e.g., low in sugars

  • Reduced – e.g., reduced in sodium

  • Free – e.g., trans-fat free

Health Claims

• describe the potential health effects of a food product when consumed as part of a nutritious diet.

• found on some food products

• often on the front of food packaging

• a quick and easy way to get information about a food (but we can check the Nutrition Facts table for complete information)

What are the two types of health claims foods

• function claims

• disease risk reduction claims

Function claims

• these are statements about the specific benefits a food has a normal body functions

• ex Vitamin D helps build strong bones and teeth

Disease risk reduction claims

These are statements that link a food to a lower risk of developing

a disease or a condition

E.g., Oat fibre helps lower cholesterol.

• E.g., A healthy diet rich in a variety of vegetables and fruit may help

reduce the risk of some types of cance

Regulation of Health Claims

• Health Canada has a list of accepted health claims, along with the criteria a food

product must meet in order to use them.

• Manufacturers must submit some of the claims to Health Canada for approval

before they can be used; while other claims can be submitted voluntarily.

• When companies use health claims that aren’t in the list of accepted claims, these

companies must provide scientific evidence to support their claims upon request

by the Canadian Food Inspection Agency

What does the DASH diet stand for?

• Dietary approaches to stop hypertension

What is the DASH diet?

The DASH dietary pattern emphasizes fruit, vegetables, and low-fat dairy products, and

incorporates whole grains, fish, nuts, and poultry.

• It involves reduced intake of red meat, sweets, and sugar-sweetened beverages.

• This dietary pattern has been found to reduce both systolic and diastolic blood

pressure when compared to a typical Western diet.

• Effect is due to reduced Na+ intake and increased K+ intake

• The blood pressure lowering effect has been found to be greater among those with

Stage 1 hypertension compared to those who are normotensiv

What is the mediterranean diet ?

-This represents the unique dietary pattern of many countries

surrounding the Mediterranean Sea.

• Some common attributes include:

• Increased intake of fruit, vegetables (specifically root vegetables), whole grains,

legumes, nuts, seeds, and olive oil.

• Low to moderate intake of fish, poultry, dairy products, and wine (for non-

Islamic countries).

• Decreased intake of red meat.

Diets from the Mediterranean area tend to be higher in _____ fats and lower in ____ fat

Monosaturated , saturated

Prospective cohort studies of a Greek population has shown that greater adherence to a Mediterranean diet was associated with decreased

total mortality, death from coronary heart disease, and death from cancer

In the Nurses’ Health Study, women who followed a Mediterranean diet most closely had lower relative risk for … compared to women with the lowest adherence

stroke and coronary heart disease

Clinical trials to investigate the effect of a mediterranean diet have shown significant reductions in… and increases in … compared to a low fat diet

reductions in fasting blood glucose levels, TG, Systolic and diastolic blood pressure

increases HDL- C

Vegetarian Diets

• Emphasize intake of fruit, vegetables, whole grains, legumes, nuts, seeds, and

  soy-based foods, with little to no animal products.

  • These diets are characterized by:

  • Increased intake of fibre, carbohydrates, K+, Mg2+, folic acid, n-6 PUFAs, vitamin C, and

  non-heme iron (the less biologically absorbable form of iron found mostly in plants).

  • Decreased total calories, total fat, SFA, cholesterol, and Na+

Vegetarian diets tend to be lacking in….

n heme iron, zinc, vitamin B12, Vitamin A, Vitamin D and n-3PUFAs and may need supplementation n heme iron, zinc, vitamin B12, Vitamin A, Vitamin D and n-3PUFAs and may need supplementation