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Chapter 2: Planning a Healthy Diet

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1 Chapter 2: Planning a Healthy Diet
Principles and Guidelines

2 A Healthful Diet Planning a healthful diet
Principles & Guidelines key to assisting people in selecting foods to deliver nutrients without excess energy Assist in food selection while shopping, eating at restaurant, or preparing meals at home

3 A Healthful Diet Provides proper combination of energy & nutrients.
A healthful diet is... Adequate Balanced Energy controlled Moderate Nutrient dense Varied

4 Diet Planning Principles
A Healthful Diet Is Adequate An adequate diet provides enough energy, nutrients, vitamins, minerals, and fibre to support a person’s health.

5 Diet Planning Principles
A Healthful Diet Is Balanced A balanced diet contains the right combinations of foods to provide the proper balance of nutrients. Providing foods in proportion to each other and in proportion to body’s needs

6 Diet Planning Principles
A Healthful Diet has Energy Control A healthful diet contains the right amounts of foods for maintaining proper weight. Nutrient-density supports adequacy & moderation Measure of the nutrients in a food relative to energy provided ↑ nutrients ↓ energy = high nutrient density ↑ energy ↓ nutrients = high energy density Moderate – management of food energy intake Nutrient density promotes adequacy and kcal control

7 Energy Density 450 gram breakfast delivers 500 kcal
Energy density of 1.1 kcal/g 144 gram breakfast delivers 500 kcal Energy density of 3.5 kcal/g

8 Nutrient Density CFG 1 medium apple = 1 serving 1 cup = 2 servings Apple Juice (1 cup) provides 121 kcal, 25g sugar, .5g fribre, 265mg potassium, 107 mg vit C Medium apple provides 72 kcal, g sugar, 2.6g fibre, 148mg potassium, 6.4mg vit C

9 Diet Planning Principles
A Healthful Diet Is Moderate A person practicing moderation chooses high nutrient dense foods most often & high energy dense foods least often Contributes to adequacy, balance, & energy control Variety helps to ensure you get foods that are high in different nutrients and avoid any contaminants that may be high in one food over other

10 Diet Planning Principles
A Healthful Diet Is Varied Variety refers to eating many different types of foods each day within and among the major food groups. A healthful diet is not based on only one or a few types of foods. Variety helps to ensure you get foods that are high in different nutrients and avoid any contaminants that may be high in one food over other

11 Designing a Healthful Diet
The tools for designing a healthful diet may include: Dietary Guidelines Food Guides Diet Plans Food Labels

12 Tools for Dietary Guidance - Dietary Guidelines

13 Tools for Dietary Guidance - Food Guides
Basic tools designed to help people make wise food choices. Translate science into practical pattern of food choices.

14 Evolution of Food Guides in Canada

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23 Eating Well with Canada’s Food Guide - 2007

24 Eating Well with Canada’s Food Guide
Is based on current evidence Communicates amounts and types of food needed to help: Meet nutrient needs and promote health Minimize the risk of obesity, type 2 diabetes, heart disease, certain types of cancer and osteoporosis Provides the cornerstone for nutrition policies and programs Canada’s Food Guide translates the science of nutrition and health into a healthy eating pattern, by specifying amounts and types of food to eat. By following Canada’s Food Guide, Canadians will be able to meet their nutrient needs and reduce their risk of obesity and nutrition-related chronic diseases. People with special dietary requirements (such as those with diabetes or high blood cholesterol) may need additional guidance from a health care professional. Canada’s Food Guide provides the cornerstone for nutrition policies and programs developed at the federal, provincial, regional and local levels.

25 Eating Well with Canada’s Food Guide
Rainbow design emphasizes vegetables and fruit Background image depicts connection between food and their origin Graphics reflect diversity of foods available in Canada The rainbow design on the cover of the Food Guide highlights the relative importance of each food group within the eating pattern. The green band is the most prominent arc in the rainbow, emphasizing the important role of vegetables and fruit in healthy eating. The background image helps to connect foods with their origin. Foods pictured on the cover and within the Food Guide are popular foods that align with the guidance. These foods were found to be popular based on Canadian data and/or they represent choices made by the largest multicultural groups in Canada.

26 A healthy eating pattern for Canadians
The interior pages provide guidance on quantity of food to eat and quality of food choices

27 Guidance on the quantity of food
Guidance is given for males and females, 2 years and older: Children, teens and adults A small amount of unsaturated fats is recommended For intake of essential fatty acids

28 What is one Food Guide Serving?
A “Food Guide Serving” is: A reference amount Not necessarily intended to represent what would be eaten in one sitting Illustrations and different measures are used to help communicate what is one Food Guide Serving A Food Guide Serving (FGS) is a reference amount. It is not intended to necessarily represent what someone would eat at one time but it can be used as a consistent measure to compare how much people eat to what is recommended in Canada’s Food Guide.

29 Counting Food Guide Servings
An example is provided illustrating how to estimate the number of Food Guide Servings in a meal

30 Guidance on the quality of food choices
Oils and fats The types of oils and fats to include and the types to limit Choices within each food group Guidance on lower fat / sugar / salt choices (ex: “Choose vegetables and fruit prepared with little or no added fat, sugar or salt.”) The Food Guide includes more guidance on quality of choices

31 Guidance on the quality of food choices: Vegetables & Fruit
Eat at least one dark green and one orange vegetable each day For folate and vitamin A intake Have vegetables & fruit more often than juice For fibre intake For Vegetables and Fruit, the following advice is included: ‘Eat at least one dark green and one orange vegetable each day.’ Dark green vegetables are rich sources of folate and orange vegetables are rich sources of vitamin A in the diet. Eating at least 1 dark green and 1 orange vegetable each day will ensure that people consume adequate amounts of these nutrients. ‘Have vegetables and fruit more often than juice.’ Following this guidance will help people get more dietary fibre.

32 Guidance on the quality of food choices: Grain Products
Make at least half your grain products whole grain each day For fibre and magnesium intake To reduce risk of cardiovascular disease For the Grain Products group, the Food Guide recommends to: ‘Make at least half your grain products whole grain each day.’ The consumption of whole grains is encouraged to help consumers achieve adequate amounts of fibre and magnesium. It also has been shown that a diet rich in whole grains may help reduce the risk of cardiovascular disease.

33 Guidance on the quality of food choices: Milk and Alternatives
Drink skim, 1%, or 2% milk each day For calcium and vitamin D intake Have 500 mL (2 cups) of milk every day for adequate vitamin D Drink fortified soy beverages if you do not drink milk For the Milk and Alternatives group, the Food Guide recommends to: ‘Drink skim, 1%, or 2% milk each day’. Selecting lower fat fluid milk each day is an effective way of obtaining calcium and vitamin D while remaining consistent with an appropriate macronutrient profile and energy content of the diet. The first statement found under this key message directs consumers to drinking 500 mL (2 cups) of milk every day for adequate vitamin D. A second statement “Drink fortified soy beverages if you do not drink milk” is also included as part of the advice. This statement acknowledges the fact that fortified soy beverages contain added nutrients that make them adequate milk alternatives. NOTE: Although milk is used in the production of other dairy products such as yogourt and cheese, these foods may or may not be sources of vitamin D.

34 Guidance on the quality of food choices: Meat and Alternatives
Have meat alternatives such as beans, lentils and tofu often For a lower saturated fat intake For fibre intake Eat at least two Food Guide Servings of fish each week To reduce risk of cardiovascular disease For the Meat and Alternatives group, the Food Guide recommends that people: ‘Have meat alternatives such as beans, lentils and tofu often.’ Consumption of beans and other alternatives can lower saturated fat intake if these foods are consumed instead of meat. Legumes such as beans and lentils are sources of dietary fibre. It also recommends eating at least two Food Guide Servings of fish each week. As noted earlier, fish consumption is recommended for its association with a reduced risk of cardiovascular disease. The Food Guide lists examples of fatty fish: char, herring, mackerel, salmon, sardines, trout.

35 Make each Food Guide Serving count….
Advice on the quality of food choices is an essential part of the pattern Bolded statements provide advice on quality of choices Statements in regular font provide actionable tips Messages on variety and water As presented in the last few slides, the advice on the quality of food choices under the section ‘Make each Food Guide Serving count’ provide direction on the types of foods to choose within each food group. Following this advice is an essential part of following the healthy eating pattern. Along with the bolded statements, this section also includes consumer-friendly actionable tips to help with applying the guidance. Messages found on this page of the Food Guide also encourages people to enjoy a variety of foods from the four food groups and drink water to satisfy thirst without adding extra calories to the diet.

36 Advice for children Young children need to eat small amounts of food throughout the day. Nutritious foods that contain fat do not need to be restricted. These foods are a concentrated source of calories that are needed for growth. Parents and caregivers are role models. The section titled ‘Advice for different ages and stages’ provides additional messages and guidance for children, women of childbearing age and adults over 50. During early childhood, children need enough calories for growth. Because they have small stomachs that tend to fill up quickly, children need to eat small amounts of food throughout the day. For example: one Food Guide Serving from a food group such as Meat and Alternatives can be divided up into smaller amounts of food served throughout the day. The Food Guide recommends serving small meals and snacks as a way to help children meet the recommended number of Food Guide Servings for their age and gender. For examples of how a young child can meet his/her daily Food Guide Servings, see Appendix A of the Resource for Educators and Communicators, or visit the Food Guide website, under the section ‘Choosing foods’. The Food Guide recommends that nutritious foods not be restricted for young children because of their fat content since young children have relatively high needs for energy and may need to include higher fat choices from the four food groups to help satisfy these needs. The Food Guide highlights adults as important role models since children look to parents & caregivers to learn eating behaviours.

37 Advice for women of childbearing age
All women who could become pregnant and those who are pregnant or breastfeeding need a multivitamin containing 400 micrograms folic acid every day Pregnant women - multivitamin should contain iron. For women of childbearing age, it is recommended that all women who could become pregnant should take a multivitamin containing 400 micrograms (0.4 mg) of folic acid every day, starting at least three months before becoming pregnant. This amount, together with the amount of folate found in the eating pattern, should reduce the risk of neural tube defects (NTDs) in women who have no history of the condition. During pregnancy and lactation, the requirement for folate and other nutrients (such as iron during pregnancy and vitamin A in lactation) are higher than can be obtained from following the Food Guide. It is therefore recommended that women continue taking a daily multivitamin throughout pregnancy and during lactation to help meet these increased needs. Each woman is encouraged to speak with their health care professional to help with finding a multivitamin that is right for her.

38 Advice for women of childbearing age
Extra calories are needed during: The 2nd and 3rd trimesters of pregnancy Breastfeeding Including an extra 2 or 3 Food Guide Servings is expected to meet these additional needs Extra calories are needed during pregnancy and lactation: Women need about 350 additional calories in the second trimester, and about 450 in the third trimester. Additional calories are not recommended for the first trimester since women typically do not require additional energy during the first three months of pregnancy. Generally, women need about 350 to 400 extra calories per day for the first year of breastfeeding. Therefore, the Food Guide recommends that women add an extra 2 to 3 Food Guide Servings each day from any of the food groups to the eating pattern, to meet these additional needs. Examples are provided on the Food Guide.

39 Advice for men and women over 50
Health benefits are associated with adequate vitamin D intake Vitamin D requirements increase at age 50 and again at age 70: 400 IU (10 micrograms) at age 51 600 IU (15 micrograms) at age 71 In older adults, adequate vitamin D intake is associated with health benefits including: highest bone mineral density; improved muscle strength; reduced fracture rates; reduced rates of falling; and improved mobility. Vitamin D needs increase after the age of 50. These additional needs are higher than can be obtained by following the Food Guide. For those under 50, the AI is 200 IU per day. This increases to 400 IU per day at 51 and to 600 IU per day at age 71.

40 Advice for men and women over 50
It is difficult to meet these vitamin D levels without recommending unrealistic amounts of some foods A supplement containing 400 IU vitamin D, in addition to following the Food Guide will achieve recommended dietary intake levels It is difficult to meet these levels without recommending unrealistic amounts of some foods. For example: people would need to drink 4 cups of milk per day in order to get enough vitamin D, and people over 70 would need to drink 6 cups per day to get enough vitamin D. Consuming 500 mL (2 cups) of milk each day as recommended in the Food Guide will provide approximately 200 IU of vitamin D. Adding a supplement containing 400 IU of vitamin D will ensure that individuals over the age of 50 meet their recommended intakes. NOTE: A background paper on the recommendation for people over 50 to take a vitamin D supplement is available on the website (www.healthcanada.gc.ca/foodguide) under “Background on the Food Guide”.

41 Eat well and be active every day
Highlights benefits of eating well & being active Encourages regular physical activity 30 to 60 minutes per day for adults At least 90 minutes per day for children and teens Includes messaging about adding up short periods throughout the day The back page of the Food Guide provides guidance on being active, eating well and label reading. Both healthy eating and physical activity are essential to promoting and maintaining health. To highlight this important role, some of the benefits of eating well and being active are highlighted on the Food Guide. The Food Guide includes Canada’s Physical Activity Guide recommendations for physical activity: a total of 30 to 60 minutes per day for adults a total of at least 90 minutes per day for children and teens The section ‘Be active’ also includes a message on adding up short periods of time to reach the recommended level of physical activity, making the recommendation more manageable for Canadians who are the least active. The Resource for educators and communicators provides examples of how an adult and a child can reach these recommendations by being active throughout the day.

42 Eat well and be active every day
Encourages eating the recommended amount & type of food Encourages limiting foods high in calories, fat, sugar, salt Eating Well with Canada’s Food Guide contains basic foods with little room for extras. The back page of the Food Guide provides important information on the foods that do not fit within a healthy eating pattern, on a regular basis. The ‘Eat Well’ section is designed to provide examples of the types of foods and beverages that are high in calories, fat, sugar or salt that should be limited. This means that for many Canadians, eating well requires making different choices.

43 Eat well and be active every day
Encourages the use of the Nutrition Facts table To choose foods with less fat, saturated and trans fat, sugar and sodium To become aware of the calorie content of foods Encourages asking for nutrition information to make informed choices One step towards making better food choices is becoming aware of the quality of foods consumed on a regular basis. Under the section ‘Read the label’, the Food Guide encourages consumers to use the Nutrition Facts table in order to: Compare and choose products which contain less fat, saturated and trans fats, sugar and sodium. Using the Nutrition Facts table also provides the opportunity for consumers to become aware of the calorie content of food. This builds on the approach taken in the Food Guide development to focus on ‘calorie awareness’ rather than ‘calorie-counting’ since there is no evidence that calorie counting is an appropriate approach for the population as a whole. Consumers are encouraged to ask for nutrition information when eating out. Nutrition information for food purchased in coffee shops or restaurants is often available in pamphlets on display or upon request. The Food Guide website provides even more information on nutrition labelling, including links to the interactive label and quiz.

44 Eat well and be active every day
Provides actionable tips towards… Eating well: ‘Take time to eat and savour every bite!’ And being active: ‘Walk wherever you can – get off the bus early, use the stairs.’ This last section titled ‘Take a step today’ provides consumers with actionable tips on ways of being active and eating well. For example: Taking the time to eat and savour every bite can help consumers to slow down and become aware of feelings of fullness; and Walking whenever possible will help consumers meet the recommended level of physical activity. Many more consumer-friendly tips can be found on the Food Guide website.

45 Food Guide On-line Includes interactive tools:
Guided tour My Food Guide Links to Dietitians of Canada “EATracker” The website provides interactive tools to help consumers learn, retain and implement the Food Guide’s messages: The Guided Tour highlights some of the key features of the Food Guide. My Food Guide is an interactive tool that helps consumers personalize the information found in the Food Guide. The user enters their age and gender and selects their own food choices from the four food groups, and a number of physical activities they like, in order to create a printable one-page ‘My Food Guide’. In addition to English or French the user can choose to print this tool in the following languages: Arabic, Chinese (traditional or simplified), Farsi, Korean, Russian, Punjabi, Spanish, Tagalog, Tamil or Urdu. Consumers can also link to the Dietitians of Canada EATracker. This interactive tool can help consumers evaluate their food intake. It provides personalized feedback on the total intake of energy (calories) and on a range of nutrients and compares this to what is recommended in the Food Guide and to the DRI nutrient standards, according to a person’s age and gender.

46 United States http://www.choosemyplate.gov/
Food Guides Around the World United States

47 Food Guides Around the World
Greece

48 Food Labeling in Canada

49 Consumer Use of Food Labels
¾ of Canadians say food labels play an important role in purchase decisions Important tool to making healthy food choices National Institute of Nutrition

50 Nutrition Label Regulation January 1, 2003
make nutrition labelling mandatory by 2007 update requirements for nutrient content claims allow nutrition claims

51 Food Labels in Canada Appear on virtually all processed foods
Posters or brochures for fresh products Foods not requiring nutrition labels Food products contributing few nutrients Food products made by small businesses Foods prepared & sold in same establishment Individual packages not for resale Unless a health claim is made or fortification done Many voluntarily provide labels Restaurants exempt from providing complete nutrition info except if health claim made

52 Food Labels in Canada Canadian food labels provide Name of the product
Net content Company name & address Ingredient list Nutrition facts panel May include approved nutrition claims

53 List of Ingredients Lists all ingredients in descending order by weight Identify certain nutrients and their importance in foods. Identify specific ingredients.

54 List of Ingredients - How do products compare?
Orange Drink water, sugar, citric acid, orange flavour, colour Orange Juice water, orange juice concentrate Second choice higher nutrient density

55 Serving Sizes Nutrition information presented per serving
Serving size must be presented as reference Similar products use similar serving size Allows for easy comparison Expressed in both common household & metric measures Compare serving size on label to what you are consuming Not always equivalent to food guide serving Be cautious with individually packaged foods

56 How do the amount of food on a label compare with what you eat and Canada’s Food Guide?
Food Label bran cereal with raisins 1 cup (59 g) Food Guide 30 g At home 1 ½ cups bran cereal with raisins Health Canada - Nutrition Labelling Toolkit for Educators

57 Nutrition Facts Table “Core” nutrients included
Kilocalories, kcals from fat, total amount of fat, saturated & trans fats, cholesterol, sodium, CHO, starch, sugar & fiber, protein, calcium, iron & vitamins A & C in a specified amount of food. Expressed in weight and/or percent daily value

58 * Information on Nutrition Facts table is based on a specific amount of food.
** Use % Daily Value to see if a food has a little or lot of a nutrient

59 How are % Daily Values determined?
Based on 2000 kcal diet Provides ballpark estimate of how individual foods contribute to total diet % DV = nutrient content (mg) X 100 Daily Value

60 How to use % DV? Quick product evaluation Compare products
> 20% high or excellent source 10-19% good source < 5% low 20% or less desirable for nutrients such as fat & sodium 20% or higher desirable for nutrients such as calcium & fibre Compare products Select foods for special dietary needs

61 Nutrition Claims Nutrient content claims Diet-related health claims
describe the amount of a nutrient in a food Diet-related health claims describe relationship between consumption of a food/nutrient & the reduction in risk of developing a disease or condition Structure-function claims Describe relationship between a food/nutrient or other substance & its role in the body

62 Nutrient Content Claims
Over 40 approved nutrient content claims Free - None or hardly any of this nutrient. Low - Small amount. Reduced - At least 25% less of the nutrient than a similar product. Light - Can be used in foods that are reduced in calories or fat. Page 58 in text – glossary of terms on food labels

63 Nutrient Content Claims
Source - Contains a useful amount of the nutrient High or good source - Contains a high amount of the nutrient Very high or excellent source - Contains a very high amount of the nutrient

64 Diet-related Health Claims
A diet low in saturated and trans fat reduces risk of heart disease. A diet with adequate calcium and vitamin D, and regular physical activity, reduces risk of osteoporosis. A diet rich in vegetables and fruit reduces risk of some types of cancer. A diet low in sodium and high in potassium reduces risk of high blood pressure. Specific phrases

65 Structure-function claims
Made without approval Only criteria is not to mention a disease or symptom i.e. Promotes a healthy heart

66 Nutrition Labels Consumer education
Health Canada website on nutrition labelling Canadian Diabetes Association & Dietitians of Canada: Healthy Eating is in Store for You

67 Information about Nutrient Content of Food
Canadian Nutrient File Computerized food composition database containing average values of nutrients in foods available in Canada. Used to support food surveillance and risk assessments.

68 Chapter 3 – Digestion, Absorption & Transport
Next Chapter 3 – Digestion, Absorption & Transport


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