womens health 10

© 2008 McGraw-Hill Higher Education. All rights reserved.

Chapter Ten

Eating Well


Dietary Guidelines for Americans

Dietary Guidelines are published every 5 years by the USDA and the Dept of Health and Human Services to provides advice on how to promote health and reduce risk of chronic diseases


Dietary Guidelines 2005

• These guidelines are science based• Designed to promote health and prevent chronic

diseases• The latest guidelines reflects the latest causes of

morbidity and mortality due to lifestyle issues, especially diet and sedentary living

• In order to reverse this trend, we need to consume fewer calories and become more active


Guidelines to Good Eating

• Dietary Guidelines for Americans provides ten recommendations, grouped into 3 areas known as the ABC’s of good health

• Aim for Fitness (be more active)• Build a Healthy Base (eat fewer calories)• Choose Sensibly (make better decisions)


“Aim for Fitness” Concepts

• Aim for a healthy weight• Be physically active every

day• Build a healthy base by

eating fewer calories• Choose a variety of

grains, fruits, and vegetables

• Keep food safe to eat

• Choose a diet low in saturated fat and cholesterol and moderate in total fat

• Choose beverages and foods to moderate your intake of sugar

• Choose and prepare food with less salt

• If you drink alcoholic beverages, do so in moderation


Recommended Dietary Allowance

• Recommended Dietary Allowances (RDAs) are standards set by the Food and Nutrition Board of the National Academy of Sciences

• Nearly a decade ago, The Board created the Dietary Reference Intakes (DRI’s) to improve clarity of dietary needs

• Specific recommendations will be incorporated with reference to each nutrient covered in this chapter


Carbohydrates

• Function – energy• Types

– monosaccharides– disaccharides– polysaccharides

• Simple breakdown – glucose is a simple form of carbohydrate• Current DRI – children and adults consume 130 grams/day.

Lack of this nutrient for women can cause fat metabolism interference (ketosis)

Beware of empty calorie foods


Glycemic Index (GI)

• This is an alternative system for classifying carbohydrate-containing foods

• The GI is based on how food affect post-prandial glycemia

• Several studies have demonstrated efficacy of a low GI diet in reducing obesity

• Fruits, nuts, whole grains tend to have low GI• Long term benefits of a low GI diet appears to

increase HDL, reduce triglycerides, and lower insulin demands


Protein

• Function - growth/maintenance of tissue• Created from 9 essential/11 nonessential

proteins = 20 amino acids• Types – Complete/Incomplete Proteins• Women need 1 gram/kg of body weight/day• Beware of over-consuming protein amounts due

to the nitrogen factor and extra fat storage


Fats

• Known as “lipids”

• Function - insulation, carrier of vitamins, storage of long-term energy, and satiety

• Value - 9 kcal/gram

• Types - saturated, monounsaturated, polyunsaturated

• Keep total intake of fats between 20-35% of calories with most sources coming from unsaturated sources


What are Trans Fats?

• This is a process where manufacturers pump hydrogen into vegetable oils to produce hydrogenated oil

• Trans fat has been associated with increasing LDL’s in the bloodstream

• Manufacturers are now required to list trans fatty acids in the Nutrition Facts Panel on food labels


Vitamins

• Organic compounds needed in small amounts for normal growth, reproduction, and maintenance of health

• There are 13 different types of vitamins

• Types -9 water (BC) and 4 fat (ADEK) soluble

• Serve as co-enzymes

• Caution when boiling vegetables since minerals can be lost due to this process


What are Anti-Oxidants?

• Vitamins C, E, and beta-carotene are known anti-oxidants

• May prevent/slow the development of cancer

• May help ward off other diseases such as “age-related changes”

• Protects cells against damage by oxygen molecules called “free radicals”.

• Women should consume fruits and vegetables rich in these antioxidants to reduce certain cancers and heart disease


Minerals

• Inorganic materials act as structural elements and regulator of numerous body processes

• Found in plant and animal sources• Types (7 minerals)

– macro nutrients (major minerals found in high amounts)

– micro nutrients (small amounts in body tissues)

• RDA for minerals:– Macronutrients-250 mg/day– Micronutrients- needed in trace amounts


Calcium

• 99% of calcium in a woman’s body is found in bone

• Osteoporosis (demineralization of bone) is a serious threat to 44 million Americans

• Of the 10 million who have the disease, 80% are women

• Calcium intake has the greatest influence during childhood and elderly years for women


Calcium (cont.)

• Family History• Excess Alcohol

Consumption• Body Size• Ethnicity• Eating Disorders and

Diet

• Medications• Cigarette Smoking• Sex Hormones• Physical Activity

Factors affecting the development of Osteoporosis


Iron

• Iron helps build certain enzymes and proteins in the body

• Humans need 10-12 mg of iron/day to manufacture hemoglobin

• Women need as much as 18 mg/day or higher due to blood loss from menstruation

• Two forms of iron found in foods• Heme iron (animal sources)• Nonheme iron (plant sources)

Be cautious of certain foods which interfere with iron absorption


Water

• Over half the body’s weight is composed of water

• Function – provides medium for nutrients, waste transport, temperature control

• RDA – Women should drink at least 6 glasses per day, even though water is extracted from other food products

• Thirst is regulated by the concentration of sodium in the blood


Phytochemicals

• These are substances in plant food that act on the body’s physiology in some positive way

• Refer to Table 10.4 to see how these chemicals act as a protector against certain diseases or ailments

• In the near future, phytochemicals could be classified as essential nutrients


Nutrition and Pregnancy

• Many factors influence a successful pregnancy since changes that occur within her reproductive system are profound

• Factors include:– Energy Needs during Pregnancy– Nutrient Requirements during Pregnancy

• Increased Protein intake • Iron deficiencies• Folacin deficiencies and birth defects• Calcium intake• Vitamin and Mineral Supplementation Caution


Nutrition and Breastfeeding

• After the delivery, a woman will have to decide if breastfeeding is an option

• Cow’s milk is not recommended until after the first year since protein and minerals are too difficult to digest for the infant

• Also, the infant’s kidneys cannot process the high mineral content from cow’s milk

• The woman’s nutrient needs are similar as during pregnancy

• Be aware that items consumed, such as alcohol will be found in the milk supply, affecting the overall health of the infant


Nutrition and Physical Activity

• Nutritional needs for women depend upon the activity level concepts:– Frequency– Intensity– Time

• Caloric intake will vary according to your activity level• It is generally believed that there is no need to increase the

amount of nutrients beyond the DRI’s as a person becomes physically active, however, women should pay special attention to the following:

• Iron deficiency• Calcium intake


Vegetarianism

• Relies on plant sources for most of the nutrients the body needs– Ovo – use of eggs to supplement protein needs– Lacto – use of milk products to supplement protein

needs– Semi vegetarian –great reduction of meat products but

still consumes meat products– Vegan – removal of milk, eggs, and animal products

from their diet which requires a high level of nutritional understanding

• complementary foods are needed to maintain protein, iron, calcium, vitamin D, and vitamin B12 intake


Benefits of Vegetarianism

• Leanness• Lower levels of serum

cholesterol• Lowers blood pressure• Less colon cancer


Concerns of Vegetarianism

• Iron deficiency

• Insufficient levels of calcium

• Vitamin D deficiency

• Vitamin B-12 deficiency

No single plant contains all essential amino acids but combininga variety of grains and vegetables will help in receiving the nutrients


Food Additives

• Many women are concerned about the amount of additives found in foods

• Additives are chemicals in food that are unnatural• They are used for 5 principle reasons:

• Maintain product consistency

• Improve/maintain nutritional value

• Reduce spoilage

• Provide leavening or control alkalinity

• Enhance flavor/provide color


Natural vs. Organic Foods

• Organic foods are grown without the use of commercial chemicals

• Natural foods contain no additives and requires only minor processing during growth and marketing procedures

• Both are higher priced than standard grown foods

• Most standard foods have equivalent nutrient values as natural or organic foods


Food LabelingUSDA, 2006


Food Allergies

• A food allergy is an abnormal response to a perceived toxin that evokes an immune system response

• If a food is perceived as harmful, an antibody called immunoglobulin E (IgE) is created

• Symptoms can affect the following:• Respiratory system• Gastrointestinal tract• Skin• Cardiovascular system

Severe reactions can result in loss of consciousness or death


Managing Weight Through Nutrition

• One pound of fat equals 3,500 kcals

• Exercise is crucial to a weight management program

• Proper weight management is a lifetime lifestyle commitment

• Fad diets and weight loss programs are not the answer to weight management

• There is no fast way to weight loss

• Weight management through medications does not work

The following points will assist women to become successful with weight management


Nutrition and the Aging Population

• Understanding about nutritional needs for women over the age of 65 is essential

• People over the age of 65 account for 13% of the U.S. population

• Of this amount, 85% have nutrition-related problems such as hypertension, osteoporosis, heart disease, and type-2 diabetes

• Most older women have a diet containing about 1,300-1,600 kcals/day

• Older women need additional amounts of• Vitamin D• Vitamin B-12• Folate• Calcium


Recommendations for Older Women and Nutrition

• Use the Food Pyramid Guide as a reference (see Figure 10.4)

• Drink 8 or more servings of water/day

• Decrease fat consumption and increase nutrient dense foods such as fruits and vegetables

• Take supplements to provide nutrients not consumed in foods

• Obtain higher levels of specific nutrients such as Vitamin D and Calcium

• Maintain a physician-approved exercise regimen to strengthen bones and muscles, promote sleep, and improve appetite


Chapter Ten

Eating Well

womens health 10

Health & Medicine