1. Nutrition for wellness
Chapter 3
Nutrition for wellness

2. Objectives
Define nutrition and describe its relationship to health and well-being.
Learn to use the USDA MyPlate guidelines for healthier eating.
Describe the functions of the nutrients – carbohydrates, fiber, fats, proteins, vitamins, minerals, and water – in the human body.
Define the various energy production mechanisms of the human body.
Be able to conduct a comprehensive nutrient analysis and implement changes to meet the Dietary Reference Intakes (DRIs).
Identify myths and fallacies regarding nutrition.
Become aware of guidelines for nutrient supplementation.
Learn the 2010 Dietary Guidelines for Americans.

3. Eat this or that?

4. Introduction Proper nutrition is essential to overall health
Having good nutrition:
Means that a person's diet supplies the essential nutrients needed to carry out normal tissue growth and repair.
Supplies enough substrates to fuel all body processes.
The USDA provides nutrition guidelines and recommended daily food amounts according to various caloric requirements.

5. Introduction
Nutrients should be obtained from a wide variety of sources.
U.S. diet
Too high in calories, sugar, saturated fat, trans fat, sodium
Too low in grains, fruits, vegetables
Diet and nutrition play a role in the development and progression of heart disease, cancer, obesity, diabetes, and osteoporosis

6. Nutrients Six essential nutrients By function: By Amount:
Fuel Nutrients needed for energy: carbohydrates, fats, and proteins.
Regulatory nutrients necessary to function normally with no caloric value: vitamins, minerals, water, and fiber.
By Amount:
Macronutrients needed in proportionally large amounts daily: carbohydrates, fats, proteins, and water.
Micronutrients required in small amounts daily: vitamins and minerals.

7. Nutrients Nutrient Density Calorie:
Foods packed with nutrients but with low or moderate calories are classified as having high nutrient density.
Calorie:
The simplified term for a kilocalorie (kcal), the amount of heat necessary to raise the temperature of 1 kilogram of water 1 degree Centigrade.

8. MyPlate food plan

9. MyPlate food groups Vegetables are divided into 5 subgroups Protein
Dark green vegetables
Red and orange vegetables
Beans and peas
Starchy vegetables
Other vegetables
Fruits
Grains are divided into 2 subgroups
Whole grains
Refined grains
Protein
Includes meat, poultry, seafood, beans and peas, eggs, soy products, nuts and seeds
Dairy
Choose low-fat or fat-free options
Cream cheese, cream and butter are not part of the dairy group

10. Recommended daily amounts of nutrients

11. Carbohydrates Major source of energy (4 calories/gram)
Regulate fat and metabolize protein
Major sources are breads, cereals, fruits, vegetables, milk/dairy products
Two types:
Simple
Complex

12. Major Types of Carbohydrates

13. Simple Carbohydrates
Often called “sugars,” which have little nutritive value
Examples are candy, soda, and cakes
Divided into monosaccharides and disaccharides
Monosaccharides: glucose, fructose, galactose
Disaccharides: sucrose, lactose, maltose

14. Complex Carbohydrates
Also referred to as “polysaccharides”
Carbohydrates formed by ten or more monosaccharide molecules linked together
Starches
Storage form of glucose in plants
Dextrins
Formed from the breakdown of starches exposed to dry heat
Glycogen
Storage form of glucose

15. Fiber Form of complex carbohydrates
Present mainly in plant leaves, skins, roots, and seeds
Processing and refining foods removes most of their natural fiber
Dietary sources include
Whole-grain cereals and breads
Fruits and vegetables
Legumes

16. Fiber Soluble fiber Insoluble fiber Most common types of fiber are:
Dissolves in water to form gel-like substance that encloses food particles
Helps decrease blood cholesterol and blood sugar levels
Oats, fruits, barley, legumes, psyllium
Insoluble fiber
Not easily dissolved in water but binds with water
Causes a softer and bulkier stool
Speeds passage of food residues through intestines
Wheat, cereals, vegetables, skins of fruits
Most common types of fiber are:
Cellulose – found in plant cell walls
Hemicellulose – found in cereal fibers
Pectins – found in vegetables and fruits
Gums and mucilages – found in small amount of food of plant origin

17. High-fiber foods are essential in a healthy diet
Age 50 and under
Women = 25 g/day
Men = 38 g/day
Over age 50
Women = 21 g/day
Men = 30 g/day
Current average daily U.S. intake
About 15 g/day

19. Fat Also called lipids Most concentrated source of energy (9 cal/gram)
Need fat for:
Part of cell structure
Stored energy
Insulator for body heat preservation
Shock absorption
Supplies essential fatty acids
Carries fat-soluble vitamins (A, D, E, K)

20. Major types of fats (lipids)
Simple Fats
Over 90% of the weight of fat in foods and over 95% of the fat stored in the body are in the form of triglycerides
Saturated fats are mainly of animal origin
Unsaturated are found mostly in plant products
Further classified into monounsaturated and polyunsaturated fatty acids

21. Chemical structure of saturated and unsaturated fats
Meats, animal fat, lard, whole milk, cream, butter, cheese, ice cream, hydrogenated oils, coconut oil, and palm oils
Usually do not melt at room temperature
Coconut oil and palm oils are exceptions
Raise blood cholesterol level

22. Unsaturated Fats Usually liquid at room temperature
Help lower blood cholesterol
Monounsaturated fats (MUFAS)
found in olive, canola, peanut, sesame oils, avocados, cashews, and peanuts
Polyunsaturated fats (PUFAS)
found in corn, cottonseed, safflower, walnut, sunflower, soybean oils, and fish, almonds, pecans

23. Fats (Lipids) Trans fatty acids
The result of partial hydrogenation to increase shelf life.
Provide no known health benefit.
The words "partially hydrogenated" and "trans fatty acids" indicate that the product carries a health risk just as high as or higher than that of saturated fat.
Found in
Margarine and spreads, shortening, some nut butters, crackers, cookies, dairy products, meats, processed foods, and fast foods

24. Fats (Lipids) Polyunsaturated omega fatty acids
Essential to human health and have to be consumed in the diet.
Omega-3 fatty acids
Polyunsaturated fatty acids found primarily in cold-water seafood and flaxseeds thought to lower blood cholesterol and triglycerides
Three major types of omega-3 fatty acids:
EPA, DHA, and ALA
protect against irregular heartbeats and blood clots, reduce triglycerides and blood pressure, and defend against inflammation.
Omega-6 fatty acids
LA, GLA, and AA
Excessive intake tends to contribute to inflammation – 4 to 1 ratio recommended

25. Fats (Lipids)
The canning process for fish destroys most of the omega-3 fatty acids
Good sources of omega-3 ALA include flaxseeds, canola oil, walnuts, wheat germ, and green leafy vegetables

26. Fats (Lipids) Compound fats
Lipoproteins transport fats in the blood and play a large role in heart disease
Major forms are HDL, LDL, VLDL
Derived fats
Sterols
Found in food and manufactured in the body primarily from saturated and trans fats

27. Proteins
Needed for:
Build and repair tissue
Part of hormones, antibodies, and enzymes
Necessary for normal functioning
Help maintain normal body fluid balance
Source of energy (4 calories/gram) if carbohydrate is insufficient
Sources are meats and alternatives, milk, and other dairy products
Excess proteins can be converted to glucose or fat, or excreted in urine
Daily consumption of beef, poultry, or fish should be limited to 3 ounces to 6 ounces.

28. Amino Acids
The body uses 20 amino acids to form different types of protein
9 amino acids are termed “essential” because the body cannot produce them
11 amino acids are termed “nonessential” because the body can produce them if food proteins in the diet provide adequate nitrogen
All amino acids must be present in the diet for the body to function normally

29. Vitamins
Organic nutrients essential for normal metabolism, growth, and development
Classified according to solubility
Fat soluble (A, D, E, and K)
Water soluble (B complex and C)
Most vitamins must be obtained through diet
A, D, and K are formed in the body
C, E, and beta-carotene are “antioxidants”

32. Minerals Inorganic nutrients essential for normal body functions
Part of all cells
Help maintain water balance and acid-base balance
Essential components of enzymes
Regulate muscular and nervous tissue impulses, blood clotting, normal heart rhythms

34. Water Most important nutrient
Studies show people are getting enough water from the liquids and the moisture content of solid foods.
To avoid dehydration, use the thirst signal
Exception is exercise

35. Balancing the American Diet
National Academy of Sciences created guidelines for a well-balanced diet
The ranges allow for flexibility in planning diets for individual health and physical activity needs
The source of fat calories is critical

36. Dietary Reference Intakes describe nutrition standards
Estimated Age Requirement (EAR)
Amount of nutrient meeting the dietary need for half the people in a specific age and gender group
Recommended Dietary Allowance (RDA)
Daily amount of a nutrient considered adequate to meet known nutrient needs of almost 98% of all healthy people in the United States
Adequate Intake (AI)
Recommended amount of intake when EAR and RDA aren’t available
Tolerable Upper Intake Level (UL)
Highest level of nutrient intake that seems safe for most healthy people, beyond which exists an increased risk of adverse effects

37. Nutrition Standards

38. Daily Values
Reference values for nutrients and food components listed on food-packaging labels
Based on a 2,000 calorie/day diet
Need to be adjusted based on an individual’s Estimated Energy Requirement
Average dietary energy intake predicted to maintain energy balance in a healthy adult of a defined age, gender, weight, height and level of physical activity, consistent with good health

39. Food Label with U.S. Recommended Daily Values

40. Nutrient Analysis Use the food tracker on choosemyplate.gov
Keep a 3-day record of all foods and beverages consumed
Includes measurements of calories, carbohydrates, fats, protein, cholesterol, sodium, vitamins, and minerals.
Use the food tracker on choosemyplate.gov

41. Nutrient Analysis
Most revealing information learned in a nutrient analysis is the source of fat intake
Average daily fat consumption in the U.S. diet
About 34% of the total caloric intake
Much of it from saturated fat and trans fatty acids, which increase the risk for chronic diseases

42. Achieving a balanced diet
Vegetables, fruits whole grains and dairy provide base for healthy diet
Vegetables and fruits are the sole source of Phytonutrients which prevent and fight cancer
When increasing nutrients from above food groups, reduce the intake of low-nutrient foods

43. Choosing Healthy Foods
Learn the nutritive value of typical foods you eat by reading food labels
Be aware that there is label misinformation as the FDA does not have the manpower to regularly check food labels
Healthy eating requires proper meal planning and adequate coping strategies

44. Choosing Healthy Foods

45. Vegetarianism Diet consisting of foods with vegetable or plant origin
Five types of vegetarians
Vegans – eat no animal products
Ovovegetarians – allow eggs in their diet
Lactovegetarians – consume foods from the milk group
Ovolactovegetarians – include egg and milk products in their diet
Semivegetarians – do not eat red meat, but eat fish and poultry, milk products and eggs

46. Vegetarianism Nutrient concerns Strict vegans need B12 supplements
Eat foods that possess complementary proteins
Vegetarian diets may also lack vitamin D, riboflavin, calcium, iron, zinc
But can be found in certain foods…

47. Approaches to avoid nutrient deficiency in a vegetarian diet
Vitamin D – moderate exposure to the sun or supplementation
Riboflavin – consume green, leafy vegetables, whole grains and legumes
Calcium – consume fortified soybean milk or orange juice, calcium-rich tofu and some cereals
Iron – consume whole grains, dried fruits, nuts and legumes
Zinc – consume whole grains, wheat germ, beans, nuts and seeds

48. Soy products contain antioxidants
Soy consumption is recommended as a replacement to meat consumption, but further research is needed to understand impact of soy on women
Current recommendations in the University of California at Berkeley Wellness Letter:
Do not exceed 3 servings per day
Limit intake to a few servings per week if you have or have had breast cancer
Avoid soy supplements because they may contain more isoflavones than soy foods

49. Probiotics
Healthy microbes (bacteria) that help break down foods and prevent disease-causing organisms from settling in the intestines
Example:
Yogurts with Lactobacillus bifidus, Lactobacillus acidophilus and inulin
Avoid yogurt with added fruit jam, sugar, and candy

50. Advanced Glycation End Products (AGEs)
Derivatives of glucose-protein and glucose-lipid interactions that are linked to aging and chronic diseases
Decrease consumption of AGEs
Limit cooking meats at high temperature
Avoid high-fat foods
Increase intake of fruits, vegetables, grains, fish and low-fat milk products
Cook at home using fresh, unprocessed foods
Avoid browning (frying, broiling and grilling)
French fries have 8 time the amount of baked potatoes

51. Diets from other cultures
Mediterranean diet
Focuses on olive oil, red wine, grains, legumes, vegetables and fruits, with limited amounts of meat, fish, milk and cheese
Reduces rates of heart disease and cancer
Other ethnic diets also provide health benefits by emphasizing intake of complex carbohydrates and limited fat-intake

52. Diets from Other Cultures

53. Nutrient supplementation
A healthy diet of 1,500 calories contains the necessary nutrients
Many people take supplements even though their diet contains sufficient nutrients
Groups who may need nutrient supplementation
Adults over 60
Individuals on low-calorie diets
Individuals with nutrition deficiencies
Avoid megadosing vitamins – consuming 10 times more than the RDA

54. Anitoxidants
Compounds such as vitamins C and E, beta-carotene and selenium that prevent oxygen from combining with other substances in the body to form harmful compounds
Work best as prevention and progression of disease, but cannot repair damage that has already occurred
More research is required to understand the impact of antioxidants

55. Antioxidants
Free radicals attack and damage proteins, lipids, cell membranes, and DNA
Free radical formation is enhanced by solar radiation, cigarette smoke, air pollution, radiation, some drugs, injury or infection, chemicals (such as pesticides), and other environmental factors

56. Vitamin supplementation
Vitamin E
Found in oil-rich seeds and vegetable oils
Little to no research demonstrates benefit
Vitamin C
May offer benefits against heart disease, cancer, and cataracts
Body absorbs the first 200 milligrams per serving or dose and the rest is excreted
Beta-Carotene
Can be obtained from sweet potatoes, pumpkin, cantaloupe, squash, kale, broccoli, tomatoes, peaches, apricots
Preferable to receive through food rather than supplementation
Selenium
Take mcg daily
One Brazil nut (unshelled) provides 100 mcg

57. Top antioxidant foods
Fruits and vegetables are the richest sources of antioxidants and phytonutrients

58. Vitamin supplementation
Multivitamins
No solid scientific evidence that they decrease risk of cardiovascular disease or cancer
May be able to fill deficiencies, but don’t provide energy, fiber, phytonutrients
Vitamin D
Best source is 15 minutes of sunshine daily
Vitamin D levels in the blood should be between 50 and 80 ng/mL throughout the year
Folate
B vitamin that is recommended for all pre-menopausal women

59. Benefits of Foods
Choosing a wide variety of food is the best strategy to gain nutritional benefits.
Supplements do not supply all of the nutrients and other beneficial substances present in food and needed for good health.
Wholesome foods contain vitamins, minerals, carbohydrates, fiber, proteins, fats, phytochemicals, and other substances not yet discovered.
Many nutrients work in synergy, enhancing chemical processes in the body.

60. Functional Foods
Foods or food ingredients containing physiologically active substances that provide specific health benefits beyond those supplied by basic nutrition
Different than fortified foods which have been modified by the addition or increase of nutrients that either were not present or were present in insignificant amounts, with the intent of preventing nutrient deficiencies

61. Organic Foods
Is not more nutritious than non-organic food, but contains fewer pesticides
Created under strict governmental regulations
Cannot use genetically-modified organisms during the growth process

62. Genetically modified crops
Genetically modified food (GM)
Basic genetic material is manipulated by inserting genes with desirable traits from one plant, animal or microorganism into another one to either introduce new traits or enhance existing ones
No evidence indicates that GM foods are harmful, but no compelling evidence guarantees that they are safe

63. Energy substrates for physical activity
Two main fuels
Glucose derived from foods is stored as glycogen in muscles and the liver.
Fatty acids, the product of the breakdown of fats, stored as fat in the body
Amino acids from proteins are used as an energy substrate when glucose is low.

64. Energy substrates for physical activity
The body uses Adenosine triphosphate (ATP) for immediate energy. It is resynthesized in 3 ways:
ATP-CP System
Used in the first few seconds of all-out exercise
Anaerobic or lactic acid system
Used during maximal intensity exercise from seconds
Produces lactic acid which leads to muscle fatigue
Aerobic system
Used during slow, sustained exercise and requires glucose, fatty acids and oxygen

65. Nutrition for athletes
Supplementation is not required for most athletes, but increased food intake may be needed
Increased protein:

66. Nutrition for athletes
Carbohydrate loading replenishes glycogen storage, used for sustained exercise, greater than 90 minutes
For exercise 60 minutes or less, 60 percent of carbohydrate intake should be maintained for the rest of the day
For exhaustive exercise of several hours a day, 70 percent of carbohydrate intake should be maintained
Within 30 minutes after exercise, a snack of protein and carbohydrate enhances re-storage of glycogen

67. Nutrition for athletes
Protect against hyponatremia by ingesting extra sodium prior to the event and replace with 1 gram of sodium per hour during an event
Creatine supplementation
Creatine is a higher-energy compound that the cells use to resynthesize ATP during all-out activities of very short duration
Loading: grams/day for 5-6 days split into four or five doses
Maintenance: 2 grams/day

68. Bone Health and Osteoporosis
A condition that leads to softening, deterioration, or loss of bone mineral density
Causes disability, fractures, and even death from medical complications
About 22 million women in the U.S. suffer from this condition (16 million do not know they have it)
Women are especially susceptible after menopause when estrogen is no longer produced
One in 2 women and one in 8 men will suffer from osteoporosis

69. Bone health and osteoporosis
Promote bone health through adequate calcium intake and sufficient physical activity
Calcium supplementation
Calcium carbonate – not well absorbed without food
Calcium citrate – absorbed without food
Avoid eating an iron-rich meal with calcium supplement
Excessive protein discourages rebuilding of bones

71. Hormone replacement therapy (HRT)
Originally provided to decrease bone loss after menopause
HRT relieves acute symptoms of menopause and decreases risk of hip fractures and colorectal cancer
HRT was found to increase risk for developing breast cancer, blood clots, strokes and heart disease
Alternative therapies:
Synthetic calcitonin
Nonhormonal medications
Selective estrogen receptor modulators

72. Iron deficiency Iron is carried by hemoglobin:
The protein-iron compound in red blood cells that transports oxygen in the blood
Deficiency more common in women, endurance athletes, children and teenagers
Iron levels are assessed through measurement of blood ferritin:
The form of iron stored in the body
RDA for adult women is mg per day
RDA for adult men is 8-11 mg per day

73. Iron Deficiency

74. 2010 Dietary Guidelines for Americans
Two key concepts
Balance calories with physical activity to sustain a healthy weight
Focus on consuming nutrient-dense foods and beverages
Fruits and vegetables
Whole grains
Fat-free and low-fat dairy products
Seafood
Visit:

75. 2010 Dietary Guidelines for Americans