1. Chapter 2 NUTRITION GUIDELINES: Applying the Science of Nutrition

2. Nutrition Recommendations for the Canadian Diet In the 1860s, the Industrial Revolution induced the British government to make the first nutritional recommendations. Today, the World Health Organization makes international health recommendations. Canada makes nutritional and health recommendations for its citizens in Eating Well with Canada’s Food Guide (2007). Copyright 2012, John Wiley & Sons Canada, Ltd.

3. Dietary Reference Intakes Used for planning and assessing diets of healthy people Vary according to life-stage and gender Have replaced Recommended Nutrient Intakes (RNIs) Promote good health and reduce chronic disease Copyright 2012, John Wiley & Sons Canada, Ltd.

4. Dietary Reference Intakes DRIs have been developed for:  Energy (carbohydrate, protein and fat)  Water-soluble vitamins (B’s and C)  Fat-soluble vitamins (A, D, E and K)  Minerals (iron, calcium, phosphorus, magnesium, fluoride, selenium, zinc, copper, sodium and potassium)  Water Copyright 2012, John Wiley & Sons Canada, Ltd.

5. Dietary Reference Intakes: 4 Sets The DRIs for macro- and micronutrients are listed in four different sets of values: 1.Estimated Average Requirement (EAR) – the estimated amount of a nutrient required to meet the needs of 50% of people within a particular sex and life-stage group 2.Recommended Dietary Allowance (RDA) – the recommended target intake of a nutrient for an individual Copyright 2012, John Wiley & Sons Canada, Ltd.

6. Dietary Reference Intakes: 4 Sets 3.Adequate Intake (AI) – the recommended specific amount of a nutrient for an individual 4.Tolerable Upper Intake Level (UL) – the maximum daily intake of a nutrient unlikely to cause adverse health effects Copyright 2012, John Wiley & Sons Canada, Ltd.

7. Dietary Reference Intakes: Energy Recommendations The DRIs make two types of energy intake recommendations:  Estimated Energy Requirement (EER) – used to calculate kcalorie intake needed to maintain body weight  Acceptable Macronutrient Distribution Range (AMDR) – range for healthy intake  carbohydrate (45 to 60%)  protein (10 to 35%)  fat (20 to 35%) Copyright 2012, John Wiley & Sons Canada, Ltd.

8. Dietary Reference Intakes Copyright 2012, John Wiley & Sons Canada, Ltd.

9. Dietary Guidelines for Canadians The dietary guidelines for Canadians are Eating Well with Canada’s Food Guide – a food-based dietary pattern that shows people how to obtain necessary nutrients and ensure good health. Copyright 2012, John Wiley & Sons Canada, Ltd.

10. Eating Well with Canada’s Food Guide Copyright 2012, John Wiley & Sons Canada, Ltd.

11. Eating Well with Canada’s Food Guide Individuals should consume foods from all four food groups to meet their needs for vitamins, minerals and other nutrients. There are recommended serving sizes for each food. The recommended number of servings varies depending on sex and life-stage. The recommendations are for age 2 and above. Eating the recommended types and amounts of foods reduces risk for chronic diseases (diabetes, heart disease, certain cancers and osteoporosis). Copyright 2012, John Wiley & Sons Canada, Ltd.

12. Eating Well with Canada’s Food Guide (cont’d) Food choices should be low in fat, low in sugar, low in sodium and high in fibre. Water is the recommended beverage to quench thirst. Recommendations are made for physical activity. Read food labels to assist in making better food choices. Eating Well with Canada’s Food Guide: First Nations, Inuit, and Métis recognizes the cultural values and traditional foods of these groups. Copyright 2012, John Wiley & Sons Canada, Ltd.

13. Eating Well with Canada’s Food Guide Groups are determined by nutrient content Copyright 2012, John Wiley & Sons Canada, Ltd.

16. Estimating Serving Sizes Copyright 2012, John Wiley & Sons Canada, Ltd.

17. Estimating Serving Sizes Copyright 2012, John Wiley & Sons Canada, Ltd.

21. Eating Well with Canada’s Food Guide Websites to assist in the implementation of Canada’s nutritional recommendations: www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php www.healthcanada.gc.ca/foodguide www.eatracker.ca www.hc-sc.gc.ca/fn-an/akt_formats/pdf/label- etiquet/nutrition/cons/fact-fiche-eng-pdf Copyright 2012, John Wiley & Sons Canada, Ltd.

22. Food Labels Copyright 2012, John Wiley & Sons Canada, Ltd.

23. Food Labels Food label requirements in Canada:  name of product  weight of product  date by which the product should be sold (if perishable)  name of manufacturer, packager or distributor  list of ingredients  nutrition facts table Copyright 2012, John Wiley & Sons Canada, Ltd.

24. Food Labels Ingredient List  all items must be listed  highest weighted items listed first  additives, food colours and flavourings must be listed Copyright 2012, John Wiley & Sons Canada, Ltd.

25. Food Labels The Nutrition Facts Table includes:  serving size  number of kcalories (calories) per serving  total amount of fat and amounts of saturated fat, trans fat and cholesterol per serving  total amount of carbohydrates and amount of fibre per serving  amount of protein per serving  amounts of nutrients per serving Copyright 2012, John Wiley & Sons Canada, Ltd.

26. Food Labels (cont’d) The Nutrition Facts Table includes:  amount of vitamin A per serving  amount of vitamin C per serving  amount of calcium per serving  amount of iron per serving  measurement of each nutrient and the % daily value are listed Copyright 2012, John Wiley & Sons Canada, Ltd.

27. Food Labels % Daily Value  a percentage (%) of a standard called Daily Value (DV)  developed for food labels  based on recommendations for a healthy diet  based on nutritional needs of a person consuming 2000 kcalories per day  goal: allows consumers to compare products  a 5% daily value is low  a 15% daily value is high Copyright 2012, John Wiley & Sons Canada, Ltd.

28. Evaluating Daily Values Copyright 2012, John Wiley & Sons Canada, Ltd.

29. Food Labels – Daily Values Copyright 2012, John Wiley & Sons Canada, Ltd.

30. Food Labels- Recommended Daily Intake Copyright 2012, John Wiley & Sons Canada, Ltd.

31. Food Labels Three additional claims may appear on labels:  Nutrient-content  Disease-risk reduction  Nutrient-function Food labelling is regulated by the Canadian Food Inspection Agency Copyright 2012, John Wiley & Sons Canada, Ltd.

32. Descriptors Commonly Used on Food Labels Copyright 2012, John Wiley & Sons Canada, Ltd.

33. Descriptors Commonly Used on Food Labels Copyright 2012, John Wiley & Sons Canada, Ltd.

34. Food Labels- Health Claims Copyright 2012, John Wiley & Sons Canada, Ltd.

35. Food Labels: Nutrient-Function Claims Copyright 2012, John Wiley & Sons Canada, Ltd.

36. Health Products Labelling The Natural Health Products Directorate of Health Canada regulates:  vitamin and mineral supplements  natural health products  herbal remedies  traditional medicines  homeopathic products Copyright 2012, John Wiley & Sons Canada, Ltd.

37. Health Products Labelling Labels on health products must include:  product name  product licence holder  Natural Product Number (NPN) and Homeopathic Number (DIN-HM)  medicinal and non-medicinal ingredients  dosage form  recommended use or purpose  risk information Copyright 2012, John Wiley & Sons Canada, Ltd.

38. Assessing Nutritional Health Nutritional assessments can help individuals determine if their intake is healthy and if they are at risk for chronic disease. Dietary Intake can be assessed through:  24-hour recall  food diary or food intake record  food frequency questionnaire  diet history Copyright 2012, John Wiley & Sons Canada, Ltd.

39. Assessing Nutritional Health Challenges in determining dietary intake:  unable to recall exactly what was eaten  under- and overestimation of portion consumed  weekend intake differ from that during the week  lack of commitment to recording intake  intake not a typical day For greater accuracy, more than one method should be used to obtain intake information. Copyright 2012, John Wiley & Sons Canada, Ltd.

40. Assessing Nutritional Health Copyright 2012, John Wiley & Sons Canada, Ltd.

41. Analyzing Nutrient Intake Nutrient Analysis tools are used to determine if dietary intake is adequate:  Eating Well with Canada’s Food Guide  food labels  nutrient content tables  computer programs Copyright 2012, John Wiley & Sons Canada, Ltd.

42. Additional Information Needed to Assess Nutritional Health In addition to nutrient intake, information about an individual’s physical health is needed. This can include:  anthropometric measurements, such as height and weight  medical history and physical exam  laboratory measurements Copyright 2012, John Wiley & Sons Canada, Ltd.

43. Stages of Nutrient Deficiency Copyright 2012, John Wiley & Sons Canada, Ltd.

44. Monitoring Food Supply Food Disappearance Surveys  a means of estimating the food available to a population and identifying trends in diets  Example → trends in Canadian milk consumption: Copyright 2012, John Wiley & Sons Canada, Ltd.

45. Canadian Community Health Survey The Canadian Community Health Survey  began interviewing Canadians in 2001  has a goal to examine the nutritional status of Canadians  compares trends in food intake and health  is ongoing Copyright 2012, John Wiley & Sons Canada, Ltd.

46. Canadian Healthy Eating Index The Canadian Healthy Eating Index (CHEI) scores a diet by measuring the quality of the dietary pattern according to Eating Well with Canada’s Food Guide. A score of 100% means that an individual meets the recommended servings for all food groups. The average CHEI score for Canadians is 58.8%. Copyright 2012, John Wiley & Sons Canada, Ltd.

47. Healthy Living Strategy Canada has set health goals for Canadians to be achieved by 2015:  Canadians making healthy food choices 2003 – 39% 2015 – 46.8%  Canadians engaging in physical activity (30 minutes per day) 2003 – 50.4% 2015 – 60.5%  Canadians with a normal body weight (BMI 18.5 to 24.9) 2003 – 46.7% 2015 – 56% Disparities in health will be addressed by targeting low- income Canadians and First Nations people. Copyright 2012, John Wiley & Sons Canada, Ltd.

48. Copyright Copyright © 2012 John Wiley & Sons Canada, Ltd. All rights reserved. Reproduction or translation of this work beyond that permitted by Access Copyright (The Canadian Copyright Licensing Agency) is unlawful. Requests for further information should be addressed to the Permissions Department, John Wiley & Sons Canada, Ltd. The purchaser may make back-up copies for his or her own use only and not for distribution or resale. The author and the publisher assume no responsibility for errors, omissions, or damages caused by the use of these programs or from the use of the information contained herein.. Copyright 2012, John Wiley & Sons Canada, Ltd.