Lecture 2b- 21 September 2017Planning a healthy diet/Applying dietary guidelines

Lecture Outline

1) Planning a healthy diet

Canada’s food guideFood labelsExchange lists-originally for diabetics

2) Buying Groceries i.e. applying dietary guidelines

Canada’s food guideFood labels

3) Exercise

4) Next lecture –digestion/absorption/transport/excretion

Planning a healthy diet

Do this :

Adequacy (A) Balance (B)

NRG control (C)Nutrient density (D)Moderation (M)Variety (V)

A, B, C, D, M, V = 6 dietary principles

These are the six dietary principles.

By following:

food guides – Canada and others

- note that Canada’s food guide changed last in 2007

-relation between food guide and 6 dietary principles

food labels-relation between food labels and 6 dietary principles

exchange lists-attempt at keeping blood glucose controlled while meeting the six dietary principles

-exchange lists-originally developed for diabetics

Eating Well with Canada’s Food Guide

• Rainbow

• Background image

Canada’s Food Guide Defines and Promotes Healthy Eating for Canadians

• It translates the science of nutrition and health into a a healthy eating pattern

• It emphasizes the importance of combining healthy eating and physical activity

This Presentation will Give You Information on:

• What amount of food you need:– Servings per day– What is a serving

• What type of food to choose, and• The importance of physical activity

Having the Amount and Type of Food Recommended and Following the Tips in Canada’s Food Guide will

help:

• Meet your needs for vitamins, minerals and other nutrients

• Reduce your risk of obesity, type 2 diabetes, heart disease, certain types of cancer and osteoporosis

• Contribute to your overall health and vitality

The Information Inside the Food Guide

What Amount of Food do You Need?

What is one Food Guide Serving?

• A reference amount

• Not necessarily what you would eat in one sitting

• A number of ways are used to illustrate a “Food Guide Serving”

One Food Guide Serving of Vegetables and Fruit is:

• 125 mL (½ cup) fresh, frozen or canned vegetable or fruit or 100% juice

• 250 mL (1 cup) leafy raw • vegetables or salad

• 1 fruit

One Food Guide Serving of Grain Products is:

• 1 slice (35 g) bread or ½ bagel (45 g)

• ½ pita (35 g) or ½ tortilla (35 g)

• 125 mL (½ cup) cooked rice, pasta, or couscous

• 30 g cold cereal

• 175 mL (¾ cup) hot cereal

One Food Guide Serving of Milk and Alternatives is:

• 250 mL (1 cup) milk or fortified soy beverage

• 175 g (¾ cup) yogurt

• 50 g (1 ½ oz.) cheese

One Food Guide Serving of Meat and Alternatives is:

• 75 g (2 ½ oz.) or 125 mL (½ cup) cooked fish, shellfish, poultry or lean meat

• 175 mL (¾ cup) cooked beans

• 2 eggs

• 30 mL (2 Tbsp) peanut butter

Oils and Fats

• Include a small amount - 30 to 45 ml (2 to 3 Tbsp) - of unsaturated fat each day – This includes oil used for cooking, salad dressings,

margarine and mayonnaise

• Use vegetable oils such as canola, olive and soybean

The type of food that you eat is as important as the amount that

you eat!

Vegetables and Fruit

• Eat at least one dark green and • one orange vegetable each day

• Choose vegetables and fruit prepared with little or no added fat, sugar or salt

• Have vegetables and fruit more often than juice

Grain Products

• Make at least half of your grain products whole grain each day

• Choose grain products that are lower in fat, sugar or salt

Milk and Alternatives

• Drink skim, 1% or 2% milk each dayDrink fortified soy beverages if you do not

drink milk

• Select lower fat milk alternatives

Meat and Alternatives

• Have meat alternatives such as beans, lentils and tofu often

• Eat at least two Food Guide • Servings of fish each week

• Select lean meat and alternatives prepared with little or no added fat or salt

Counting Food Guide Servings in a Meal

Count the Food Guide Servings in this Meal

• 125 mL (½ cup) fresh spinach

•  (1 cup) carrot, cauliflower, mushrooms, green beans, onion

• about 90 mL (6 Tbsp) chickpeas

• 15 mL (1 Tbsp) peanut oil

Vegetable Curry

Canada’s Food Guide also Recommends:

– Satisfying your thirst with water

– Enjoying a variety of foods from the four food groups

Canada’s Food Guide also Recommends:

– Limiting foods and beverages high in calories, fat, sugar or salt

– Examples include cakes and pastries, doughnuts and muffins, french fries and potato chips, nachos and other salty snacks, alcohol, fruit flavoured drinks, soft drinks, sports and energy drinks

Read the Label

• Compare the Nutrition Facts table on food labels to choose products that contain less fat, saturated fat, trans fat, sugar and sodium

• Keep in mind that the calories and • nutrients listed are for the amount • of food found at the top of the • Nutrition Facts table

Advice for Different Ages and Stages

• People of different ages and at different stages of life have specific needs. These groups include:

• Children• Women of childbearing age, and• Men and women over the age of 50

Advice for Children

• Serve small nutritious meals and snacks each day

• Do not restrict nutritious foods because of their fat content

• Be a good role model

Advice for Women of Childbearing Age

• All women who could become pregnant and those who are pregnant or breastfeeding

need a multivitamin containing folic acid everyday

• Pregnant women also need extra iron from a multivitamin

• Pregnant and breastfeeding women need extra calories – Include an extra 2-3 Food Guide Servings from

any of the food groups

Advice for Pregnant and Breastfeeding Women

Advice for Men and Women over 50

• The need for vitamin D increases after the age of 50

• In addition to following the Food Guide, take a daily vitamin D supplement of 10 µg (400 IU)

Eating Well and Being Active Work Together for a Healthier You!

• The benefits of eating well and being active include:

• Better overall health• Lower risk of disease• A healthy body weight• Feeling and looking better• More energy• Stronger muscles and bones

Be Active

• Physical Activity Guidelines recommend accumulating:

2 1/2 hours of moderate to vigorous physical activity each week for adults

• At least 60 minutes a day for children and youth

• Start slowly and build up!

Take a Step Today…

• Have breakfast every day• Walk whenever you can• Spend less time being inactive• Eat vegetables and fruit at all meals and snacks• Enjoy eating with family and friends• Take time to eat and savour every bite

For More Information Visit Canada’s Food Guide Online:

www.healthcanada.gc.ca/foodguide

EXCHANGE LISTS

1) carbohydrates carbohydrate starch

vegetablesfruitsother carbohydrates

milks-non-fat and low fat milks-reduced fat

milks-whole

Other exchange groups2) protein-meat and meat substitutes

leanvery leanmedium fathigh fat

3) fat group

Canadian exchanges-www.diabetes.ca/clinical-practice-education/professional-resources/diet-nutrition-beyond-the-basics

Buying Groceries Canada’s food guide i.e. applying dietary guidelines

- go through Canada’s food guide handout

Food labels-apply to good nutrition and exchange groups

-advertising and packaging issues and terms

Understanding Nutrition Labelling to Make Informed Food Choices

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Nutrition information provided on food labels

INGREDIENTS: Whole wheat, wheat bran, sugar/glucose-fructose, salt, malt (corn flour, malted barley), vitamins (thiamine hydrochloride, pyridoxine hydrochloride, folic acid, d-calcium pantothenate), minerals (iron, zinc oxide).

• Nutrition Facts

• Ingredient List

• Nutrition Claims

• Health Claims “A healthy diet…”

“Good source of fibre”

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Since 2005

Nutrition Facts: • Easy to find

• Easy to read

• On most prepackaged foods

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What food products have Nutrition Facts?Almost all prepackaged foods have Nutrition Facts.

Some exceptions are:

• fresh fruit and vegetables;

• raw meat, poultry, fish and seafood;

• foods prepared or processed at the store:

bakery items, sausage, salads;

• foods that contain very few nutrients:

coffee beans, tea leaves, spices;

• alcoholic beverages.

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Use Nutrition Facts…• to easily compare similar foods

• to look for foods with a little or a lot of a specific nutrient

• to select foods for special diets

…to make informed food choices

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Nutrition Facts are based on a specific amount of food

Compare this to the amount you eat.

The specific amount is:• listed under the Nutrition Facts title.• listed in common measures you use

at home and a metric unit.• not necessarily a suggested quantity

of food to consume.

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Examples of Specific Amount of FoodFood type Suggested Serving Size

Bread 50 g (1slice), if unsliced

OR

25 - 70 g (1-2 slices), if sliced

Crackers and

melba toast

15 - 30 g (4 crackers)

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Nutrition Facts

Bran cereal with raisins

1 cup (59 g)

Amount you eat

Bran cereal with raisins

1 ½ cups

Specific amount of food Compare it to the amount you eat.

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The % Daily Value (% DV) is:

• used to determine whether there is a little or a lot of a nutrient in the amount of food.

• a benchmark to evaluate the nutrient content of foods.

• based on recommendations for a healthy diet.

Yogurt

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How to use the % Daily ValueFollow these three steps:Step 1: LOOK at the amount of foodNutrition Facts are based on a specific amount of food. Compare this to the amount you eat.

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How to use the % Daily ValueStep 2: READ the % DVThe % DV helps you see if a specific amount of food has a little or a lot

of a nutrient.

5% DV or less is a LITTLE15% DV or more is a LOT

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How to use the % Daily Value

Step 3: CHOOSE Make a better choice for you. Here are some nutrients you may

want…

more of…• Fibre• Vitamin A• Calcium• Iron

less of…• Fat•Saturated and trans fats•Sodium

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For example, if you would like to eat more fibre…

Cereal A Cereal B

… cereal A would be a better choice for you as part of a healthy lifestyle.Remember: 5% DV or less is a little and 15% DV or more is a lot.

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• Lists all of the ingredients for a food by weight, from the most to the least.

• Is a source of information for certain nutrients.

• Is a source of information for people with food allergies.

INGREDIENTS: WHOLE GRAIN ROLLED OATS, SUGAR, HIGH MONOUNSATURATED CANOLA OIL, ALMOND PIECES, RAISINS, GOLDEN SYRUP, SALT, CRISP RICE (RICE FLOUR, SOY PROTEIN, SUGAR, MALT, SALT), SOY LECITHIN, NATURAL FLAVOUR

Example:

The Ingredient List

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• Are regulated statements made when a food meets certain criteria.

• They are optional, and may be found only on some food products.

Nutrition Claims

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Nutrition ClaimsWhen you want to decrease the amount of certain nutrients, look for:

Free • none or hardly any of this nutrient• an example is “sodium free”

Low • a small amount• an example is “low fat”

Reduced• at least 25% less of the nutrient compared with a

similar product• an example is “reduced in Calories”

Light • can be used on foods that are reduced in fat or reduced in Calories

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Nutrition ClaimsWhen you want to increase the amount of certain nutrients, look for:

Source • contains a significant amount of the nutrient • an example is “source of fibre”

High or good

source• contains a high amount of the nutrient• an example is “high in vitamin C”

Very high or

excellent source

• contains a very high amount of the nutrient• an example is “excellent source of calcium”

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Disease risk reduction claims

Example: “A healthy diet low in saturated and trans fats may reduce the risk of heart disease. (Naming the food)

is free of saturated and trans fats.”

Health Claims

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General Health Claims• General health claims are generally developed:

• Consumers should not solely rely on general health claims to make informed choices

by third party organizations by corporations

Buying Groceries Nutrient content claims-some examples•a food that has a % DV of 5% or less for fat, sodium or cholesterol would be low in these three nutrients

•a food that has a % DV of 10% or less for saturated and trans fats would be low in these two nutrients

•a food that has a % DV of 15% or •more for calcium, vitamin A or fibre would be high in these three nutrients

Buying Groceries

Nutrient content claims-some further examples

EXERCISE-RELATION TO NUTRIENTS

-nutrients needed for all tissues supporting exercise

-helps keep energy consumption in balance

-helps reduce disease – pre- and post-onsetunderweight (less than 18.5)normal weight (between 18.5 and 24.9)overweight (between 25 and 29.9)obese (30 and over)WC- < 94 cm males/ <80 cm females

-go through exercise tear off sheet

Next up today…

ingestion/digestion/absorption/transport/metabolism/excretion common digestive problems

chapter 3

   

Next up today…

1) ingestion 2) digestion3) absorption4) transport5) metabolism6) excretion7) regulation of IDATME8) common digestive tract disorders

-dysregulation of IDATME

INGESTION

a) Mouth-open, chew and swallow

b) Tube feeding c) IV and catheter

DIGESTIONa) Sequencing of eventsb) Digestion -process by which food is broken down into absorbable units -anatomy

-function of each of anatomical parts-figure 3-1 Rolfes et al-mechanics

-muscular action of digestion-peristalsis-stomach action-segmentation

http://nutrition.jbpub.com/resources/animations.cfm?id=1&debug=0

-sphincters-secretions of digestion

Fig. 3-1, p. 74

digestive glands/secretions (enzymes)-saliva-gastric – water, HCl and pepsin-proteins-pancreatic juice/intestinal enzymes

carbohydraseslipasesproteases

summary of digestive secretions-pg 78

Summary of Digestive Secretions and Their Major Actions

TABLE 3-1 Summary of Digestive Secretions and Their Major ActionsOrgan or Gland Target Organ Secretion Action

Salivary glands Mouth Saliva Fluid eases swallowing; salivaryenzyme breaks down some carbohydrate.*

Gastric glands Stomach Gastric juice Fluid mixes with bolus;hydrochloric acid uncoilsproteins; enzymes break down proteins; mucus protects stomach cells.*

Pancreas Small intestine Pancreatic juice

Bicarbonate neutralizes acidicgastric juices; pancreatic enzymes break down carbohydrates, fats, and proteins.

Liver Gallbladder Bile Bile is stored until needed.

Gallbladder Small intestine Bile Bile emulsifies fat so thatenzymes can have access to break it down.

Intestinal glands Small intestine Intestinal juice

Intestinal enzymes break downcarbohydrate, fat, and protein fragments; mucus protects the intestinal wall.

Saliva and gastric juice also contain lipases, but most fat breakdown occurs in the small intestine.

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Absorption

1) define-passage of nutrients from gi tract into blood or lymph

A) simple diffusion-water small lipids/fat solublevitamins

B) facilitated diffusion-fructose/water soluble vitamins

C) active transport-glucose/amino acidsdo not confuse active transport with the transport

discussed below

2) anatomy-goblet cells/crypts/villi and microvilli

Fig. 3-10, p. 79

Transport

defined

getting nutrients, via blood or lymphatic systems,

to where needed (W)when needed (W)in the form needed (F)and in the correct quantities needed (Q)

WWFQ

anatomy of transport

two routes

-blood and lymph

Anatomy BLOOD ROUTE

Heart to artery to capillaries (intestine) to vein to capillaries (liver)–in liver get detoxification and preparation of nutrients for body use-vein to heart from liver for distribution to the rest of the body .

water soluble nutrients and smaller products of fat digestion go this route

Lymph route

Lymph (tissue spaces to blood) intestine to heart directly for distribution to rest of body

-larger fat digestion products and fat soluble vitamins (ADEK)

use this route

E:\Media\Animations\chapter3\Vascular_System\311.html

file:///E:/Media/Animations/chapter3/Vascular_System/311.html

Metabolism

Building up - requires energy

Tearing down- gives energy

Tearing down-provides building blocks to build up

-also leads to excretion

Excretion-in whole or as a metabolite

-urine-protein (urea), minerals, water, carbohydrate, vitamins

-feces-carbohydrates, lipid, vitamins, protein, water, minerals

-sweat-minerals,water-saliva?-minerals?, carbohydrates?,

lipids?, protein?, water?, vitamins?

-breathing-O2 and CO2

 

Regulation of IDATME

-all hinges on homeostasishomeostasis-maintenance of constant internal conditionshomeostasis can be disrupted by physical immaturity,

aging, illness, nutrition

-stomach pH homeostasis – pH 1.5-hormonalregulation-important for digestion

Regulation of IDATME

Digestion regulation

Pyloric sphincter

hold food ready for duodenum duodenum has pH sensors -too acid-close pyloric sphincter

and bicarbonate added to chymemaking chyme neutral and thenpyloric sphincter opens again

why? -pH important for enzyme function

Regulation of IDATME

Digestion regulation continued

hormonal regulation of 3 types of enzymes- type and amount of enzymesfrom pancreas

bile-fat emulsion-amount under hormonal regulation

fat slows peristalsis-hormonal

digestion regulation leads to absorption regulation

leads totransport regulation

Regulation of IDATME

•Ingestion regulates digestion •Digestion regulates absorption•Absorption regulates transport•Transport regulates metabolism (WWFQ)•Metabolism regulates excretion

Common digestive problemschoking- epiglottis-tough meats, hot dogs, nuts, grapes

carrots, hard candies, popcorn and peanut butter

vomiting-cause-gastric irritation -effects are : dehydration

: nutrient loss (salts) : teeth damage if excessive

(bulimia) : aspiration

-solution-replace salts/fluids by oral or IV

diarrhea-cause-infection, drugs, sorbitol, olestra, colitis -effects-if not reversed get dehydration and nutrient loss -solutions-oral or IV replacement of fluid and

nutrients with low fat small mealsand a gradual increase in fibre

Common digestive problemsconstipation-cause-failure to respond to defecation

signal -lack of activity (intestinal muscle tone) -medications -tumours

-solution-eat fibre(eg prunes)- attracts water -drink more water -eat fat- bile produced-attracts water

belching -cause-swallowing air, gallbladder disease or peptic ulcer

-solution-medical treatment of cause

gas-cause-carbohydrate rich diet with partial digestion of fibre ingut and rest goes to bacteria that make gas

-solution-change diet

Common digestive problems

heartburn and acid indigestion-cause-acid reflux-anatomical defect

-eat or drink too much -chew too little -smoking

-solution- if not an anatomical defect- eliminate other causes

ulcers-gastric or peptic (duodenal)-cell erosion -cause-not stress or spicy foods -H. pylori story

-AIDS drugs

-solution-avoid pertinent infections

disorders causing excessive gastric acid secretion

treat via- antibiotics

- withdrawal of offending foods

-withdrawal of caffeine or

alcohol on acase by case basis

Next lecture

Carbohydrates-structure and classification

-IDATME of carbohydrate