1. Jamie Pope, Steven Nizielski, and Alison McCook
NUTRITION
for a Changing World
FIRST EDITION
Chapter 2
Healthy Diets
From Desert to Oasis
© 2016 by W. H. Freeman and Company & Scientific American

2. What do you think constitutes a healthy diet? What first comes to mind?
Low in fat
Low in sugar
Sufficient protein
Lots of vegetables and fruit
Moderate red meat consumption
Eat from all the food groups
Limit processed foods
Limit fast-food
Appropriate calorie intake for a healthy weight
There is no “correct” answer. This slide is just to get students thinking and to say that all the choices are part of a healthy diet. Alternately, you can skip the polling slide, ask students what factors constitute a healthy diet, and write on your board for discussion and introduction.

3. How would you rate the healthfulness of your overall diet?
Extremely healthy
Very healthy
Somewhat healthy
Not too healthy
Not at all healthy
Not sure
Most students say “somewhat” healthy. You could discuss how people determine whether or not their diet is considered healthy. I often reference an International Food Information Council survey (2012) that states more than half of the people responded it was easier to do their taxes than figure out what a healthy diet really is.

4. International Food and Information Council – 2015 Survey
The annual surveys from International Food and Information Council generally apply to the topic of healthy diets and can serve as good introduction to the topic.

5. Chapter 2
Objectives
Identify the primary characteristics of a healthy diet
Define nutrient and energy density and describe why it is necessary to consider these factors when making food selections
Identify the key excesses and inadequacies of the current average American diet
List the core recommendations of the Dietary Guidelines for Americans and discuss the significant changes that have occurred in the dietary recommendations to Americans over time
Describe how the USDA’s MyPlate can be used to design a healthy diet
Explain what characteristics of a healthy diet are common throughout the world
Identify the information that is required on food labels, and describe how this information can be used to select healthier foods
Identify the types of claims that can be made on food labels and discuss how their use is regulated by the FDA

6. Is it possible to have healthy diet in a food desert?
What is a food desert?
A community with little access to affordable healthy foods
In the photo, Mari Gallagher is taking a picture of a food desert in an urban neighborhood with a corner store that only carries chips, fast food, and processed foods. This is a community with little access to a variety of affordable, healthy foods, such as fruits and vegetables. Her boys have never heard of strawberries or grapes, as a grocery store with a wide variety of foods is a long bus ride away and some families don’t have the time or money for that. Healthy diets require choosing healthy foods and availability is part of the equation. Other factors include convenience, taste, price, emotions, and cultural and social influences.
Mari Gallagher, food researcher, found children who had never heard of strawberries or grapes.

7. Adequacy, balance, variety, and moderation are the core characteristics of healthy diets.
Adequate amounts of essential nutrients
Balanced across food groups and macronutrients
Variety of foods
Moderation and not overindulging
All types of healthy diets have a few qualities in common: a variety of foods, balanced across food groups and macronutrients (carbohydrates, protein, and fats), and adequate amounts that provide the calories and essential nutrients necessary to maintain and promote optimal health. Considering the high rates of obesity in the United States, another key component to remember is moderation—not overindulging in any one type of food or in potentially harmful foods, such as those that contain unhealthy levels of fat, sugar, and salt.
Another important component of a healthy diet is balance: the right proportion of foods from each of the food groups, and the appropriate amounts of calories, macronutrients, vitamins, and minerals. When we eat a variety of foods from each food group, it is easiest to achieve a balanced diet.

8. Energy-dense (or empty calorie) foods
Healthy diets include foods that are good sources of a number of nutrients relative to the amount of calories.
Nutrient-dense foods
Provide healthy nutrients in appreciable amounts relative to calories
Energy-dense (or empty calorie) foods
Provide calories and low amounts of nutrients
It is easier to build an adequate and healthy diet around nutrient-dense foods than around empty calorie foods.
Healthy diets are full of foods with high nutrient density; these foods contain many beneficial nutrients relative to calorie content. Nutrient-dense foods are a “good deal” nutritionally in that they provide many nutrients at a low calorie “cost.” Healthy diets also take into consideration the energy density of foods. Foods that are rich in calories relative to weight are considered energy dense.

9. The typical American diet does not align with recommended limits or goals.
Excessive amounts of energy-dense foods
Insufficient amounts of nutrient-dense foods
American diets fall well below the recommended goal for beneficial foods and nutrients. Meanwhile, these same diets exceed limits for foods and nutrients for which a reduction in intake is recommended.

10. Energy density is the number of calories in a given volume of food.
Energy density (calorie-density)
Number of calories in a portion of food divided by the food’s weight in grams
Example: 107 calories in 20 grams of potato chips
Energy density: 107/20 = 5.4
Fat, sugar, and alcohol tend to increase energy density.
Fluid (water) and fiber tend to decrease energy density.
Next slide provides graphic representation and more explanation.

11. The water, fiber, and fat content of foods is the primary factor that determines energy density.
The water, fiber, and fat content of foods is the primary factor that determines energy density. As the water and fiber content of food increases, they generally decrease the energy density of food by adding weight and volume but no (or very few) calories. Fat content has the opposite effect—the more fat is added to food, the more energy dense it becomes, since fat has more than twice as many calories per gram as either protein or carbohydrates. In general, as the energy density of foods increases, the nutrient density decreases. Most vegetables are nutrient dense as they provide lots of essential nutrients relative to their calorie content.

12. For an equal number of calories, portion size decreases as energy-density increases.
These food examples show how water and fat content affect energy density and portion size.

13. Eating a low energy-dense diet allows you to eat a larger volume of food, all while maintaining energy balance.

14. Comparison of content of soup meal vs. chicken sandwich and fries meal

15. Dietary Guidelines for Americans (DGAs) are updated every 5 years.
Issued by the U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (HHS)
Evidence-based guidelines to promote health and reduce risk for major chronic disease
Intended for health professionals to help people age 2 and over consume a healthy diet and prevent chronic disease
Intended for policy makers as basis for Federal food and
nutrition policies, programs, and education
To help people make nutritious choices, experts created tools such as the Dietary Guidelines for Americans (DGAs), which provide essential advice for how to eat healthfully and reduce the risk of chronic diseases. Since their creation in 1980, the DGAs have been updated every five years by the United States Department of Agriculture (USDA) and the Department of Health and Human Services (HHS), according to the newest science-based information about nutrition and health, and they provide the core of federal food and nutrition education programs.
The main purpose of the Dietary Guidelines is to inform the development of federal food, nutrition, and health policies and programs. The primary audiences are policymakers, as well as nutrition and health professionals, not the general public.

16. Dietary Guidelines for Americans Over the Years
2000
2010
All the Guidelines that have been published since 1980 are shown here. They evolved over time to make better use of nutrition science and to better communicate the science. The first four versions of the DGs were small brochures that aimed at consumers. The information came mainly from the experts appointed to the Dietary Guidelines Advisory Committees. The Committee members drew from their collective knowledge of nutrition research. Note that many of the fundamental principles remain the same but wording changed (from “avoid” in early editions to “choose” in later editions – attempt to make messages more positive), as well as specific limits or levels that might be established or altered.
The 2000 version was a 39-page document that was both consumer-oriented and a policy document combined. This reflected a move by the government toward helping nutrition educators and dietitians, who apply dietary guidance in their work, to better understand the science behind the consumer material.
In 2005, a 70-page booklet served solely as a policy document and represented a departure by acknowledging that nutrition educators, nutritionists, and policymakers all needed the science—in plain language—that would serve as the foundation for their work. A search and review of the scientific literature served as the basis for these guidelines.
The 2010 document again was a policy document intended for policymakers to design and carry out nutrition-related programs and for nutrition educators and health professionals, who develop nutrition curricula, teaching tools, and advice for consumers. However, for 2010, a robust, systematic approach was used to organize and evaluate the science on which the Guidelines are based. The quality of the research was assessed using evidence-based reviews, conducted by the staff of USDA’s new Nutrition Evidence Library. The Advisory Committee’s scientific conclusions, on which the policy rests, were derived from an objective analysis of the preponderance and quality of published research.
1980
1985
1995
2005

17. 2015 Dietary Guidelines for Americans Overview
Five overarching guidelines to steer population toward a healthy eating pattern
2015 edition focuses more on eating patterns than individual food groups or dietary components.
Followed by key recommendations which:
Specify foods that a healthy eating pattern includes
Nutrients that a healthy eating pattern limits

18. 2015 Dietary Guidelines for Americans
Follow a healthy eating pattern across the lifespan
Focus on variety, nutrient density, and amount
Limit calories from added sugars and saturated fats and reduce sodium intake
Shift to healthier food and beverage choices
Support healthy eating patterns for all
The DGAs recommend that Americans consume a variety of fruits, vegetables, and protein foods (including fish, poultry, legumes, nuts, and lean meats). They also recommend that we replace refined grains with whole grains, and solid fats with oils; and limit the consumption of saturated fat (to 10% of total calories) and sodium. The limit for sodium is set at 2,300 milligrams per day for adults and children 14 years and older because excess sodium intake can increase the risk of high blood pressure (hypertension) and heart disease. For adults with prehypertension or hypertension it is recommended that they further reduce sodium intake to 1,500 mg per day to allow for greater reductions in blood pressure.
For the first time, the 2015 DGAs also specifically recommend that added sugars be limited to 10% of total calories. Because added sugars contribute calories to the diet but no essential nutrients, their consumption above recommended levels can make it difficult to meet nutrient requirements without consuming excess calories. Lastly, because the environments we live, learn, and work in dramatically influence our behaviors, the Dietary Guidelines remind us that everyone has a role in supporting individuals as they shift their food and activity choices to improve their health.

19. 2015 Dietary Guidelines for Americans Healthy Eating Patterns
Adaptable framework in which individuals can enjoy foods that meet their personal, cultural, and traditional preferences and fit within their budget
Healthy U.S. Style Eating Pattern
Based on the types and proportions of foods Americans typically consume, but in nutrient-dense forms and appropriate amounts
Provided at 12 different calorie levels
Other examples of healthy eating patterns that translate and integrate the recommendations
Healthy Mediterranean-Style Eating Pattern
Healthy Vegetarian Eating Pattern
The 2015 Dietary Guidelines for Americans (DGAs) focus on healthy eating patterns—the combinations of all the foods and drinks that we consume over time, and not on specific foods or nutrients. Three healthy eating patterns are provided as examples, U.S.-style, Mediterranean-style, and Vegetarian, which can be adapted to meet personal preferences. It is emphasized that all foods consumed as part of a healthy eating pattern fit together like the pieces of a puzzle to meet our nutrient needs without exceeding limits for sodium, saturated fat, added sugars, and total calories. All the pieces of this food puzzle are necessary to promote good health and prevent disease.

20. The 2015 DGAs focus on shifts to emphasize the need to make substitutions.
Health benefits from shifting food choices in and across food groups
Choosing nutrient-dense foods and beverages in place of less healthy choices
Rather than increasing intake overall
The current Dietary Guidelines also focus on improving the diet of Americans by encouraging small shifts in eating habits to align our diet with these healthy eating patterns. Emphasis is placed on the need to substitute nutrient-dense foods and beverages for less healthy choices (those that are high in saturated fat, added sugars and/or sodium, and calories).

21. 2015 Dietary Guidelines for Americans

22. A healthy eating pattern includes:
These three slides allow focus on each of the food groups listed under “A Healthy Eating Pattern.” You can delete it/these if you don’t go through each food group.

23. A healthy eating pattern includes:

24. A healthy eating pattern includes:

25. A healthy eating pattern limits:
Can use this slide to discuss the changes in the added sugar and sodium recommendations from 2010 to 2015 or use slides that follow.

26. What’s new? 2015 DGAs Cholesterol
“…the Key Recommendation from the 2010 DGAs to limit consumption of dietary cholesterol to 300 mg per day is not included in the 2015 edition, but this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns.”
Average U.S. intake of cholesterol at 270 mg per day
Recommendation included to “consume as little as possible….”
These next few slides focus on changes in the 2015 DGAs from Can include or delete.

27. What’s new? 2015 DGAs Sodium 2010: 2015:
General population reduce daily sodium intake to < 2,300 mg
Persons who are aged 51 and older, African American, or have hypertension, diabetes, or chronic kidney disease were encouraged to further limit sodium to 1,500 mg per day.
2015:
Recommendation to reduce daily sodium intake to < 2,300 mg was maintained
The 1,500-mg recommendation limited to adults with hypertension or prehypertension
Average U.S. intake of sodium is 3,400 mg per day
Tolerable Upper Intake Limit (UL) from the IOM Dietary Reference Intakes is 2,300 mg
Age specific DGA sodium recommendations align with the UL for age

28. What’s new? 2015 DGAs Added Sugars
General messaging to reduce intake of added sugars was maintained from 2010 to 2015 with the addition of a specified energy limit
2015: Americans encouraged to “consume < 10% of calories per day from added sugars”

29. What’s new? 2015 DGAs Protein
2010: “replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils”
2015: changed to recommend a healthy eating pattern including “a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products.”
The overconsumption of protein by teen boys and adult men in particular prompted the 2015 DGAs to recommend that they specifically reduce consumption of protein foods by decreasing intake of meats, poultry and eggs.

30. What’s new? 2015 DGAs Fats Saturated fats Trans-fatty acids Solid fats
Key recommendation to consume < 10% of calories from saturated fatty acids was maintained from the 2010 to 2015 DGAs.
Trans-fatty acids
Advice to keep trans fat intake as low as possible is consistent from 2010 to 2015
June 2015: FDA bans trans-fatty acids from U.S. food supply
No longer “generally recognized as safe” (GRAS)
Food manufacturers have 3 years to remove PHOs (partially hydrogenated oils)
Solid fats
2010: Use of term “solid fat” and acronym “SoFAS” (Solid Fats and Added Sugars)
2015: Term and acronym no longer used. The overall messaging was similar, with Americans encouraged to limit solid fat intake and to replace solid fats with oils.

31. What’s new? 2015 DGAs Dietary Fiber
2015 DGAs maintain recommendation to consume at least half of grains as whole grains (limit refined grains).
Although no longer mentioned in the key recommendations, the language to choose foods rich in dietary fiber was consistent between 2010 and 2015.

32. What’s new? 2015 DGAs Alcohol
While alcohol was no longer mentioned in the key recommendations, the language remained the same in the 2015 Dietary Guidelines:
“If alcohol is consumed, it should be in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.“
“Drink” defined as: 12 oz. beer, 5 oz. wine, or 1.5 oz. 80 proof liquor

33. What’s new? 2015 DGAs Caffeine
Caffeine was not mentioned in the 2010 DGAs but was thoroughly discussed in the 2015 guidelines. While caffeine is not a nutrient and does not have a daily requirement, guidance on coffee consumption was provided:
“Moderate coffee consumption (three to five 8-oz cups/day or providing up to 400 mg/day of caffeine) can be incorporated into healthy eating patterns.”
This included cautions concerning drinks with added sugars, mixing alcohol and caffeine, individuals who do not already consume caffeinated beverages and women who are pregnant, trying to become pregnant, or who are breastfeeding.

34. 2015 Dietary Guidelines for Americans References and Resources

35. The USDA updates tools to implement dietary advice.
To put all of this food advice into action, the USDA, the agency that regulates farming and food production, updates tools to make it easier for people to consolidate dietary advice when choosing meals. During the 1940s, for instance, the government promoted the Basic 7, in which people were encouraged to eat something from each of seven categories of foods (meat, milk, green/yellow vegetables, etc.). This system was designed to provide a foundation to help Americans meet nutrient needs when food was scarce. The Basic 7 eventually became the Basic 4 in the 1960s and 1970s, which painted a simpler picture of a nutritious diet but lacked specific guidance about fats, sugar, and calories. In the 1990s, a new Food Pyramid ranked the five food groups by how much of each to consume per day.
The iconic pyramid illustrated graphically the key concepts of variety, moderation, and proportion. After 20 years of promoting variations on the Food Pyramid, in 2011 the USDA released MyPlate—a new tool to help consumers make better food choices.

36. MyPlate consumer messages help communicate the 2015 DGAs.
All food and beverage choices matter—focus on variety, amount, and nutrition.
The right mix can help you be healthier now and in the future.
Start with small changes to make healthier choices you can enjoy.
Find your healthy eating style and maintain it for a lifetime.
MyPlate translates the Dietary Guidelines into easily implemented recommendations for the general public.
MyPlate is an illustration of a healthy meal on a “plate” divided into vegetables and fruits (slightly more vegetables than fruits), just under one-quarter lean protein sources, and just over one-quarter from grains (at least half of which should be whole grains). One serving of dairy is indicated in a serving off to the side—as a cup of milk or carton of yogurt.

37. The website www. ChooseMyPlate
The website provides tips and tools for tracking and moderating the intake of calories, solid fats and added sugars, and more. This website is where you can access a personalized diet plan (My Daily Food Plan), with more detailed recommendations about specific foods to eat each day and each week that essentially mirror those recommendations found in the DGA.

41. Food Guides from around the world have common recommendations.
International food guides share common recommendations of consuming more plant-based foods, choosing lean protein sources, limiting intake of sugar and sodium, minimizing intake of unhealthy fats, controlling portion sizes, and increasing physical activity. Countries don’t just rely on pyramids or plates to provide advice—in France, dietary guidelines are illustrated as stairs. Foods you can eat frequently are found at the top of the stairs, those that should only be consumed in small quantities are found at the bottom, and those to avoid are hidden in a magnifying glass.
Suggest to students to locate a few other examples of food guides from other countries to share.

42. International Dietary Guidelines have similar characteristics.
Most healthy diet plans emphasize the following:
Eat more plant foods, including fruits, vegetables and whole grains
Choose lean protein from a variety of sources
Limit sweets and salt
Control portion sizes
Be physically active
Most healthy diet plans focus on eating more plant foods, including vegetables, fruits, whole grains, and beans. Meals should include lean proteins from a variety of sources, and healthy fats, which are present in foods such as avocados, olive oil, nuts, and some types of fish. Healthy eaters should minimize their intake of unhealthy fats (lard, butter, fatty meats), sugar, and salt; eat appropriate portion sizes; and stay physically active.

43. World Health Organization (WHO)
“Improving dietary habits is a societal, not just an individual, problem. Therefore it demands a population-based, multisectorial, multi-disciplinary, and culturally relevant approach. These recommendations need to be considered when preparing national policies and dietary guidelines, taking into account the local situation.”
Achieve energy balance and a healthy weight
Limit energy intake from total fats and shift fat consumption away from saturated fats to unsaturated fats and toward the elimination of trans-fatty acids
Increase consumption of fruits and vegetables, and legumes, whole grains and nuts
Limit the intake of free sugars
Limit salt (sodium) consumption from all sources and ensure that salt is iodized
Obesity has become such a global problem that even the World Health Organization (WHO), the agency of the United Nations concerned with global health, has issued recommendations to countries about preparing national policies and dietary guidelines. Along with the features common to all dietary guidelines, the WHO suggests that food policies should encourage people to achieve and maintain a healthy weight, and reduce the intake of saturated fats and trans-fatty acids.

44. Food and nutrition labeling guide consumers toward more healthful diets.
Helps consumers see how individual foods contribute to daily nutritional needs
Incentive for food companies to improve the nutritional qualities of their products
To assist people in making nutritious purchases at the grocery store, consumer, public health, and medical organizations led a campaign in the 1980s for legislation that required food labeling using a standardized format.

45. How often do you read food labels?
Nearly every day
When I go shopping
Rarely
Never – What food label?

46. 1990 Nutrition Labeling and Education Act (NLEA)
FDA oversees nutrition labeling
Established standardized “Nutrition Facts” panel
Established standard portion sizes
Provides details of nutrient content and ingredients
Simplifies comparison of similar foods
Incentive for manufacturers to produce or modify food products to improve nutritional profile
Before 1990, manufacturers had not been required to provide details of any nutritional content, and any labeling that occurred was not consistent. In 1990, after several years of effort, the U.S. Congress passed the Nutrition Labeling and Education Act (NLEA) giving the Food and Drug Administration (FDA) the authority to require products sold in the United States to provide detailed nutrition information, as well as requiring nutrition and health claims for foods to comply with government standards.
The requirement for nutrition labeling also serves as an incentive for food manufacturers to produce or modify their food products to improve the nutritional profile.

47. What information do you look for first?
Serving size
Calories
Total fat
Saturated or trans fat
Carbohydrate
Fiber
Protein
Sodium
Other
Most students will respond with calories. You can talk about how this might change with public focus, for example, carbohydrates were “hot” in the early 2000s and fat in the 1990s.

48. Which of the following is a standard portion size for luncheon meat?
1 ounce
2 ounces
2 slices
3 ounces

49. The Nutrition Facts Panel provides key nutrition information and is consistently presented on food products.
Food labels must include a Nutrition Facts Panel that provides specific information about the calorie content and nutritional values for specific components. On every food label, you will see serving size, number of servings, and number of calories per serving, as well as information on the amount of dietary fat, cholesterol, dietary fiber, dietary sodium, carbohydrates, proteins, and at least two vitamins and minerals in each serving.

50. What’s mandatory on a food label?
Product name
Manufacturer’s name and address
Uniform serving size
Amount in the package
Ingredients in descending order by weight
Potential allergens
Nutrient components
Percent Daily Value
Food labels must include a Nutrition Facts Panel that provides specific information about the calorie content and nutritional values for specific components. On every food label, you will see serving size, number of servings, and number of calories per serving, as well as information on the amount of dietary fat, cholesterol, dietary fiber, dietary sodium, carbohydrates, proteins, and at least two vitamins and minerals in each serving. Other label requirements are that all juices must indicate the percentage of fruit juice content, and all foods must list any ingredient that could cause an allergic reaction, such as milk, peanuts, sulfites, and eggs.

51. Daily Values are levels for nutrients developed specifically for nutrition labels.
Food Component
%DV based on
2000 kcal
Fat
<65 g
Saturated fat
<20 g
Protein
50 g
Cholesterol
<300 mg
Carbohydrate
300 g
Fiber
25 g
Sodium
<2400 mg
Potassium
3500 mg
The Percent Daily Value (%DV) on a food is based on a standard diet and allows comparison of products. Daily Values were established by the FDA and are based on the RDAs. On the Nutrition Facts Panel, the %DV is the percentage of a nutrient provided by a standard serving of a food in relation to the approximate requirement for that nutrient (those approximate requirements are listed in the table above). Percent daily values are based on a 2000-calorie diet. So, the %DV of fat on a food label is the percent of the standard daily amount (65 grams) that is contained in one serving of the product.

52. Ingredients on a food label are listed in descending order of amount.
The NLEA also requires an ingredients list, which is another useful tool when making purchases, as it provides more specific information about what the food product contains. The ingredients must be listed in descending order of amount, measured by weight. Many foods include added colors; without them, colas wouldn’t be brown, and mint-flavored ice cream wouldn’t be green. Any pigment or coloring derived from natural materials can be listed simply as “artificial colors,” but any coloring derived from synthetic chemicals must be listed by name. Other label requirements are that all juices must indicate the percentage of fruit juice content, and all foods must list any ingredient that could cause an allergic reaction, such as milk, peanuts, sulfites, and eggs.

53. The Food and Drug Administration (FDA) regulates the claims that can be made on food and dietary supplement labels.
The NLEA also regulates the claims that can appear on food and dietary supplement labels that inform consumers of the health-related attributes of these products. For instance, manufacturers will make nutrient claims that describe the level of a nutrient in a food using terms such as “low,” “high,” “excellent source,” “light,” or “reduced.” The FDA regulates the use of these terms to ensure that they are used consistently across all types of food products.

54. FDA-regulated claims on food labels can inform consumers of potential health-related attributes of a food product.
In addition to nutrient-content claims described above, health claims describe the link between a food, food component, or dietary supplement substance, and a reduction in the risk of a disease. All health claims that appear on food products and dietary supplement labels must be approved by the FDA, which ensures they are supported by a significant amount of science before appearing on a label. Recently, the agency began allowing claims based on new research, but these must include a statement indicating that the evidence supporting the claim is limited, or even weak. Structure/function claims describe the role of a nutrient or dietary substance in maintaining normal structures, function, and health, but may not have any relationship to disease.

56. FDA Approved Food Label Health Claims
High in calcium, vitamin D Osteoporosis
High in fiber-containing grain Cancer
products, fruits, & vegetables
High in fruits & vegetables Cancer
High in fiber Heart disease
Low in fat Cancer
Low in saturated fat & cholesterol Heart disease
Low in sodium High blood pressure
High in folate (folic acid) Neural tube defects
High in soluble fiber Heart disease
Soy protein Heart disease
Carbohydrate sweeteners Dental caries
Plant sterols/stanols Heart disease

57. Which of the following is an approved nutrition claim for disease prevention?
Magnesium and hypertension
Sodium and cancer
Calcium and osteoporosis
Fat and tooth decay
Folate and heart disease
Review - C

58. In 2014, the FDA issued proposed changes to the Nutrition Facts Panel.
To address ongoing concerns about food labels, experts are debating ways to revamp labels and make them more useful to the average American. Serving sizes sometimes seem unrealistically small, and people who eat 2 to 3 servings in one sitting may not realize the nutrient values should be multiplied. Some experts have proposed putting calorie and serving size information in larger type at the top of the label, so that it’s immediately clear.
In 2014, the FDA issued proposed changes to the Nutrition Facts Panel.

59. Summary
A healthy diet is a pattern of eating, characterized by variety, balance, adequacy, and moderation, that promotes health and reduces the risk of chronic disease.
A healthy diet emphasizes nutrient-dense foods that provide a higher proportion of nutrients relative to calories.
A healthy diet minimizes energy-dense or “empty calorie” foods. Energy density is a measure of the calorie content of a food relative to a given weight.
The Dietary Guidelines for Americans provide evidence-based advice about balancing calorie intake with expenditure and making informed food choices to attain and maintain a healthy weight, reduce risk of chronic disease, and promote overall health.

60. Summary (Cont’d)
The DGAs are revised every 5 years and are the basis of federal nutrition policy and nutrition education initiatives and programs.
The DGAs recommend reducing intake of solid fats and added sugars (SoFAs), which are energy dense and nutrient poor, and consuming less sodium.
MyPlate is based on the DGAs and provides a presentation of the five food groups on a virtual place setting to represent the ideal balance and variety of nutrients.
International food guides share common recommendations.

61. Summary (Cont’d)
The Nutrition Labeling and Education Act (NLEA) of 1990 established guidelines under the authority of the Food and Drug Administration (FDA) for the labeling of food products and for a standardized presentation of food labels.
The Nutrition Facts Panel provides specific information about the serving size and calorie content and any other mandatory nutrition information.
The NLEA established guidelines for the regulation of three types of claims that can be used on food and dietary supplement labels: nutrient content claims, health claims, and structure/function claims.