Transcript Chapter_16R

FOOD FACTORS AFFECTING
HEALTH
CHAPTER 16
Copyright © 2015, 2010, 2005, 1998 by Saunders, an imprint of Elsevier Inc.
Food Patterns
 Food patterns are generally developed during
childhood and reflect the following influences:
 Cultural
 Socioeconomic status
 Symbolic (e.g., religious)
 Geographical
 Psychological
 All of these influence one’s attitudes, feelings,
and beliefs about food
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Food Patterns:
Cultural Influences
 Cultural food patterns establish foundation for
child’s lifelong eating patterns regarding:
 Time and number of meals per day
 Foods acceptable for specific meals
 Preparation methods
 Likes and dislikes
 Foods suitable for specific members of a group
 Table manners
 Social role of foods and eating
 Attitudes toward eating and health
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Food Patterns:
Status and Symbolic Influences
 Because of symbolic meanings of food, eating
becomes associated with sentiments and
assumptions about oneself and the world
 Choice of different foods influenced by:
 Religious beliefs
 Availability
 Cost
 Cultural values and traditions
 Even endorsement or condemnation by a highly
respected person
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Working with Patients: Respect for
Others’ Eating Patterns
 Be sensitive to preferences, avoid
being judgmental, treat each patient
with respect
 Intervention must be adapted to
address cultural, personal, and ethnic
preferences in order to be effective
 Use open-ended questions to elicit
information
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Working with Patients:
Effecting Change
 Basic facts that may assist in approaching
patients from various ethnic groups to promote
sound nutritional practices:
 People have a remarkable ability to obtain a nutritious
diet out of available foodstuffs
 Food patterns of other countries are in some instances
nutritionally superior or at least comparable to
“ordinary” American traditions
 Culturally preferred foods may be costly or unavailable
in some communities
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Working with Patients:
Effecting Change
 Basic facts that may assist in approaching
patients from various ethnic groups to promote
sound nutritional practices (cont’d):
 Each food/food-related behavior and tradition is
categorized as beneficial, neutral, or potentially harmful

Efforts at change should be focused on potentially harmful food
behaviors/choices
 Food patterns are generally deeply ingrained; suggest
minimal alterations in the patient’s normal patterns
 Cultural patterns tend to be used more consistently by
older family members (first-generation immigrants)
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Working with Patients:
Religious Food Restrictions
 Religious beliefs affect eating patterns, attaching
symbolic meanings to food and drink, such as:
 Bread and wine served during the Christian
communion service
 Hindu reverence for the cow
 The month-long fast of Ramadan of the Muslim faith
 Many Seventh-Day Adventists are vegetarians or
vegans
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Food Budgets
 Evidence of poor or fair health status and
malnutrition increases as income level decreases
 Low-income households score below higher income
households on healthy eating indices
 Average American family spends approx 15% of
income on food; those at poverty level spend as
much as 33%
 Foods supplying the most nutrients relative to cost
include beef, fresh potatoes, brown rice, wheat germ,
milk, eggs, and peanut butter
 Lack of transportation may limit options for shopping
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Referrals for Nutritional Resources
 Area Information Center (211) has
comprehensive databases of resources: federal,
state, and local agencies, community-based and
private nonprofit organizations
 Supplemental Nutrition Assistance Program
(formerly Food Stamp Program) is cornerstone of
US nutrition safety net
 Special Supplemental Food Program for Women,
Infants and Children (WIC) designed to prevent
nutritional problems in high-risk, low-income
groups
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Referrals for Nutritional
Resources
 USDA breakfast and lunch programs provide
nutritious free and reduced-price meals for
children at school
 Nutrition Program for the Elderly (Title III) provides
group and home-delivered meals (Meals on
Wheels)
 Expanded Food and Nutrition Education Program
(EFNEP) assists with meal planning, budgeting,
cooking, and other food- and nutrition-related
problems
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Referrals for Nutritional Resources
 Head Start is a preschool educational program
for low-income families; meals are furnished for
the children, and nutrition education is available
for parents
 Locally funded food agencies provide assistance
through food banks and food pantries
 83% of the food banks report they are unable to
adequately meet the needs of their community
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Maintaining Optimal Nutrition During
Food Preparation
 Methods of preparation
 Discourage addition of large amount of fat for cooking
 Do not discard water that vegetables are cooked in
 Food sanitation and safety
 Five major control factors for food safety
 Personal hygiene
 Adequate cooking
 Avoiding cross-contamination
 Keeping food at safe temperatures
 Avoiding foods from unsafe sources
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Maintaining Optimal Nutrition During
Food Preparation
 Effects of processing on nutrients
 Nutrients considered stable if at least 85% of original
level is retained during processing and storage
 Food processing attempts to maintain optimal qualities
of color, flavor, texture, and nutritive value
 Convenience foods
 Popular because save time in meal preparation,
planning, purchasing, and cleanup
 Require more preservatives; contain more fat, sodium
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Maintaining Optimal Nutrition During
Food Preparation
 Irradiated foods
 Process of treating food with controlled amounts of
ionized radiation for prescribed period to kill
spoilage- and disease-causing bacteria and molds
 Can lengthen the period of ripeness of fruits and
vegetables, prolong the freshness of many foods
along with preventing certain foodborne illnesses
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Maintaining Optimal Nutrition During
Food Preparation
 Organic foods
 Grown without synthetic pesticides, growth
hormones, antibiotics, or genetic engineering
 USDA does not support claims organic food is
safer or more nutritious than conventionally
produced foods

But several studies demonstrate they contain more
polyphenols or antioxidants that have potential human
health benefits
 Cost is higher than conventional products
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Maintaining Optimal Nutrition During
Food Preparation
 Fast foods
 Average meal between 900 and 1800 kcal (33%–66%




of RDA for young men or 45% 90% for young women)
Sodium content high: ranges from 1000 to 2515 mg
Fat content of some meals can be as high as 51% of
kcal consumed
Mega-size portions may contain a day’s
worth of kcal in one meal
Wise choices possible with new menu
items and reduced portion sizes
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Maintaining Optimal Nutrition During
Food Preparation
 Food additives
 Additives deemed to be
harmless are labeled
“generally recognized as
safe” (GRAS)
 99% of additives derived
from natural sources or
synthetically produced to
be identical to the natural
chemical substance
 Food additives have
several benefits:





Improve nutritional value
(enrichment)
Maintain wholesomeness and
palatability (preservatives)
Maintain product consistency
Provide leavening or control
pH
Enhance flavor, appearance
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Food Fads and Misinformation
 Purveyors of misinformation capitalize on fears
and hopes
 Food fad is a catch-all term covering all aspects of
nutritional nonsense, characterized by exaggerated
beliefs about the value of nutrition in health and
disease

Fad diets capitalize on those looking for a magic weight loss
formula
 Food quackery is promotion of nutrition-related
products or services having questionable
safety and/or effectiveness for the claims
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Food Fads and Misinformation
 Identifying sources of nutrition
misinformation
 Evaluate findings in light of well-established
nutrition principles
 Check the credentials of person making a
questionable claim
 A single study is never perfect, providing
conclusive information, but provokes more
questions for further studies

Single study is not very meaningful by itself but
serves as another piece of the puzzle if it can be
replicated
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Food Fads and Misinformation
 Role of the dental hygienist
 Assess patients’ use of food fads, economic level,
educational level, and nutrient adequacy of any fad
diet undertaken
 Provide positive advice based on a broad knowledge
base and understanding of nutritional concepts and
current research findings
 Do not offer remedies unless they have been
demonstrated to be safe and effective
 Referral to a registered dietitian may be needed
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HEALTH APPLICATION
Food Insecurity
 Discuss the impacts of food insecurity in the US
 Consider the various populations impacted by
food insecurities
Discuss factors accounting for increased food
insecurity in the US
Discuss why food insecurity is a major public
health concern
Discuss food insecurity in relation to the goals of
Healthy People 2020
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