NDFS 1020: Basis of a Healthy Diet - Chapter 03 Unit 01 Notes

Basis of a Healthy Diet

Recommendations Versus Rules: Principles of Intuitive Eating

• Intuitive Eating: A concept based on $10$ principles that requires time to learn and implement.

  • Goal: In this class, the objective is exposure, not mastery. Students are encouraged to explore and experiment with Intuitive Eating at their own pace.

  • Flexibility: There is no requirement to eat a certain way or embrace a specific paradigm if it does not resonate personally.

  • Value: Understanding the basics of Intuitive Eating is helpful, both for oneself in the future and for others.

Textbook Sections & Core Principles of a Healthy Diet

• Textbook Sections:

  1. Dietary Reference Intakes (DRIs)

  2. Major Food Groups

  3. Dietary Guidelines for Americans

  4. AMDRs for Macronutrients (Acceptable Macronutrient Distribution Ranges)

  5. Food Guides (MyPlate)

  6. Food and Supplement Labels

• Core Principles of a Healthy Diet:

  • Adequacy:

    • Dietary Guidelines for Americans

    • EER (Estimated Energy Requirement) + AMDRs for Macronutrients

  • Balance:

    • Dietary Reference Intakes (DRIs)

    • MyPlate Food Guide

  • Variety:

    • Major Food Groups

  • Moderation:

    • Food and Supplement Labels

Adequacy: Dietary Guidelines for Americans & EER/AMDRs

Dietary Guidelines for Americans (DGA)

• Revision Cycle: Revised and updated every $5$ years.

• Current Edition: $2020 - 2025$ Guidelines.

• Issuing Bodies: Developed jointly by the Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA).

• Scope: Current guidelines provide recommendations for all life stages, from infancy to senior adulthood, including pregnancy.

• Resource: Accessible at https://www.dietaryguidelines.gov/.

• Development Process: Involves hundreds of experts and scientists who systematically review the best research and scientific evidence related to diet and health.

• $2020-2025$ Key Guides: "Make Every Bite Count" (DGA Scientific Report):

  • Follow a healthy dietary pattern at every life stage: Covers recommendations for the first $6$ months, starting at $6$ months, and from $12$ months through adulthood.

  • Customize and enjoy nutrient-dense food and beverage choices: Based on culture, budget, and personal preference.

  • Focus on meeting food group needs with nutrient-dense foods and beverages: Within allotted calorie limits.

  • Limit foods and beverages higher in added sugars, saturated fat, and sodium: Also limit alcoholic beverages.

• **$2025-2030$ Projected Changes (Based on Scientific Report of the $2025$ Dietary Guidelines Advisory Committee):

  • Increased Emphasis on Plant-Based Foods: Promotion of plant-based protein sources like beans, peas, lentils, nuts, and seeds.

  • Reorganized Protein Group: Plant-based proteins will be highlighted earlier in the protein group recommendations to acknowledge their nutritional importance.

  • Reduced Ultra-Processed Foods: New guidelines will advise against ultra-processed foods, often linked to health issues.

  • Health Equity Lens: The development process incorporates a health equity perspective, considering how socioeconomic status, race, ethnicity, and culture influence health outcomes, to ensure guidelines are accessible and relevant to all.

  • Comprehensive Life Stages: Continued emphasis on healthy dietary patterns across all life stages, from infancy to older adulthood.

Hunger & Fullness Scale (Intuitive Eating Context)

• A $1-10$ scale assisting in recognizing hunger and satiety signals:

  • $\mathbf{1 \rightarrow Starving,\ Dizzy,\ Irritable}$

  • $\mathbf{2 \rightarrow Very\ Hungry,\ Unable\ to\ Concentrate}$

  • $\mathbf{3 \rightarrow Hungry,\ Ready\ to\ Eat}$

  • $\mathbf{4 \rightarrow Beginning\ Signals\ of\ Hunger}$

  • $\mathbf{5 \rightarrow Comfortable,\ Neither\ Hungry\ or\ Full}$

  • $\mathbf{6 \rightarrow Satisfied}$

  • $\mathbf{7 \rightarrow Comfortably\ Full,\ Satisfied}$

  • $\mathbf{8 \rightarrow Very\ Full,\ Feel\ as\ if\ You've\ Overeaten}$

  • $\mathbf{9 \rightarrow Uncomfortably\ Full,\ Feel\ Stuffed}$

  • $\mathbf{10 \rightarrow Stuffed\ to\ the\ Point\ of\ Feeling\ Sick}$

Estimated Energy Requirement (EER)

• Definition: The average daily energy intake (kcal/day) predicted to maintain energy balance in healthy adults, representing Total Energy Expenditure.

• Age Group: For adults $19$ years and older.

• Formulas (from Institute of Medicine. Dietary reference intakes for energy… $2002$):

  • Men: $\text{EER} = 662 - (9.53 \times \text{age [y]}) + \text{PA} \times [(15.91 \times \text{weight [kg]}) + (539.6 \times \text{height [m]})]$

  • Women: $\text{EER} = 354 - (6.91 \times \text{age [y]}) + \text{PA} \times [(9.36 \times \text{weight [kg]}) + (726 \times \text{height [m]})]$

  • Note: PA = Physical Activity factor.

• Example EER Values (kcal/day) by Age:

• Ranges of Daily Calorie Requirements by Gender, Age, and Physical Activity Level:

Acceptable Macronutrient Distribution Ranges (AMDRs)

• Definition: Provide adequate energy and nutrients while reducing the risk of chronic disease.

• Ranges:

  • Carbohydrates: $45-65\%$

  • Protein: $10-35\%$

  • Fat: $20-35\%$

• Example Calculation for a $2000$ kcal diet:

  • Carbohydrates: $55\% \text{ of } 2000 \text{ kcals} = 1100 \text{ kcals} \rightarrow 1100 \text{ kcals} / 4 \text{ kcal/g} = 275 \text{ g}$ (assuming $4$ kcal/g for CHO)

  • Fat: $25\% \text{ of } 2000 \text{ kcals} = 500 \text{ kcals} \rightarrow 500 \text{ kcals} / 9 \text{ kcal/g} = 56 \text{ g}$ (assuming $9$ kcal/g for Fat)

  • Protein: $20\% \text{ of } 2000 \text{ kcals} = 400 \text{ kcals} \rightarrow 400 \text{ kcals} / 4 \text{ kcal/g} = 100 \text{ g}$ (assuming $4$ kcal/g for Protein)

• Sample Calorie Needs and Macronutrient Distribution:

Balance: Dietary Reference Intakes (DRIs) & MyPlate Food Guide

Dietary Reference Intakes (DRIs)

• Definition: Reference values or recommendations for vitamins, minerals, and other nutrients.

• Purpose:

  1. Indicate daily intake amounts that meet the needs of most healthy people and reduce the risk of chronic disease (RDA and AI).

  2. Set a 'low' intake level (EAR) to guard against deficiency.

  3. Set a 'high' intake level (UL) to guard against toxicity.

• Components of DRIs:

  1. EAR (Estimated Average Requirement): Intake level estimated to meet the need of $50\%$ of healthy individuals in a life-stage or gender group.

  2. RDA (Recommended Dietary Allowance): Average daily dietary nutrient intake level sufficient to meet the nutrient requirements of nearly all ($97-98\%$) healthy individuals in a particular life-stage and gender group.

  3. AI (Adequate Intake): Established when an RDA cannot be determined; recommended average daily nutrient intake level based on observed or experimentally determined approximations of nutrient intake by a group of healthy people.

  4. UL (Tolerable Upper Intake Level): The highest daily nutrient intake level likely to pose no risk of adverse health effects to almost all individuals in the general population.

  5. EER (Estimated Energy Requirement): (As described above).

  6. AMDR (Acceptable Macronutrient Distribution Range): (As described above).

• Visualizing DRI Levels (Intake Level of Nutrient X):

  • Too Little (Low Intake): High risk of deficiency (below EAR).

  • RDA/AI Range: Low risk of deficiency or toxicity (ideal intake).

  • UL (Upper Limit): Above this, there is a high risk of toxicity.

• Example: Vitamin C for a $24$-year-old Male

  • Too Much (Toxicity): Symptoms like Nausea, Vomiting, Diarrhea, etc.

  • Upper Limit (UL): $2000$ mg/day

  • Recommended (RDA): $90$ mg/day

  • Lower Limit (EAR): $45$ mg/day

  • Too Little (Deficiency): Scurvy, etc.

• Example: Calcium for an Infant (0-6 Months)

  • Too Much (Toxicity): Not specified, but a UL exists.

  • Upper Limit (UL): $1000$ mg/day

  • Adequate (AI): $210$ mg/day (RDA is Not Established)

  • Lower Limit (EAR): Not Established

  • Too Little (Deficiency): Not specified.

• Comparison: EER vs. RDA

  • EER (Estimated Energy Requirement): Represents the average (RDA) daily kcals needed for energy balance. The distribution is typically bell-shaped around the average.

  • Nutrient RDA: Represents the daily units of a nutrient aimed to cover nearly all individuals, with a curve showing low risk of deficiency around the RDA/AI and low risk of toxicity below the UL.

• Applying Recommendations:

  • Healthy People: Recommendations generally apply to healthy people.

  • Not Minimum Requirements: DRIs are recommendations, not minimums. They represent average daily intake.

  • Food vs. Supplements: Prioritize obtaining nutrients from food over supplements where possible.

MyPlate Food Guide

• Purpose: A visual food guide developed by the USDA to help Americans make healthy food choices based on the Dietary Guidelines for Americans.

• Focus: It explains 'How' to implement nutrition recommendations, offering simple ideas for daily life.

• Food Groups: MyPlate consists of $5$ main food groups, visually represented on a plate:

  1. Fruits

  2. Vegetables

  3. Grains (Carbs, Whole Grain, Fiber, or Starch)

  4. Protein (Meat, Dairy)

  5. Dairy (Often represented as a drink alongside the plate)

• Practical Application:

  • Method 01 (Count Food Groups): Identify which food groups are present in a meal (e.g., Toast = Grain, Yogurt = Dairy, Avocado + Orange Juice = Fruit).

  • Method 02 (Grain + Protein + Produce): Simplify by identifying a grain, a protein, and a produce item (vegetable or fruit) in a meal.

• MyPlate Tools (myplate.gov):

  • MyPlate Quiz: Provides a snapshot of performance on MyPlate food groups and personalized resources (Apprentice, Pro, All Star, Rookie, Beginner, Hall of Famer).

  • MyPlate on Alexa: Offers healthy eating tips for feeding babies and toddlers.

  • MyPlate App ("Start Simple with MyPlate"): Allows users to set daily food group goals, track progress, and earn badges. Syncs with quiz results.

  • Shop Simple with MyPlate Tool: Helps find savings and discover budget-friendly food preparation methods.

Variety: Major Food Groups

Major Food Groups

• The $5$ main food groups emphasized by MyPlate are essential for variety:

  1. Grains: Provide carbohydrates, fiber, and some B vitamins.

  2. Dairy: Source of calcium, Vitamin D, and protein.

  3. Fruits: Rich in vitamins, minerals, fiber, and antioxidants.

  4. Vegetables: High in vitamins, minerals, fiber, and diverse phytonutrients.

  5. Protein: Essential for muscle building and repair, includes meats, poultry, fish, eggs, nuts, seeds, and legumes.

Enriched vs. Fortified Foods

• Enriched: Nutrients that were lost during processing are added back to the food (e.g., iron, niacin, thiamin, riboflavin, folate in grains, breads, cereals, pastas).

• Fortified: Nutrients are added to a food item beyond the amounts originally present, or added where none were present before (e.g., calcium in orange juice, vitamins and minerals in cereals, Vitamin D in milk).

Moderation: Food and Supplement Labels

Disordered Eating vs. Intuitive Eating

• Disordered Eating: Often characterized by rigid structure.

• Intuitive Eating: A balanced approach combining structure with flexibility, and valuing both nourishment and satisfaction.

Food Labels

• Regulation: Regulated by the FDA (Food & Drug Administration).

• Information Found on a Food Label:

  • Name of the product.

  • Name and address of the manufacturer.

  • Amount of product in the package.

  • List of ingredients in descending order by weight.

  • Nutrition Facts Panel:

    • Start Here: Serving Size and Servings Per Container.

    • Check Calories: Total calories per serving.

    • Quick Guide to % Daily Value (DV):

      • $\mathbf{5\%\ or\ less}$ is considered Low for a nutrient.

      • $\mathbf{20\%\ or\ more}$ is considered High for a nutrient.

    • Limit These Nutrients: Saturated Fat, Trans Fat, Cholesterol, Sodium, and Added Sugars.

    • Get Enough of These Nutrients: Dietary Fiber, Vitamin D, Calcium, Iron, Potassium.

    • Footnote: Explains that the % Daily Value is based on a $2000$ calorie diet and can vary based on individual calorie needs.

• **Example (New vs. Old Label):

  • Old label might list "Total Sugars" and not distinguish "Added Sugars."

  • New label explicitly lists "Total Sugars" and "Includes [X]g Added Sugars" with a %DV for Added Sugars.

Supplement Labels

• Resource: NIH National Institutes of Health, Office of Dietary Supplements (https://ods.od.nih.gov/factsheets/list-all/).

• Purpose: Strengthens knowledge and understanding of dietary supplements.

• Available Information: Fact sheets and other resources on dietary supplements and their ingredients, including vitamins, minerals, herbs, botanicals, and probiotics.

• Audience: Resources are often available for both health professionals and consumers, in multiple languages.