Transcript ch2-guideline


Chapter 2 健康的飲食指標
Concepts
There are many types of nutrition recommendations designed to
promote health

The Dietary Reference Intakes are a set of reference values for the
amounts of calories, nutrients, and food components needed in
healthy diets

The Food Pyramid is a tool to plan diets that meet nutrition
recommendations

Food labels provide information about the nutrient content of
individual foods and how they fit into an overall healthy diet

Dietary Guidelines for Americans are a set of nutrition and
lifestyle recommendations that help consumers reduce the risks
of chronic disease

The Exchange lists is a food group system for planning and
evaluating diets

Nutritional status can be assessed by evaluating your food intake,
body size, and medical history
Chapter 2: Guidelines for a Healthy Diet
Nutrition Recommendations Promote a
Healthy Population



There are many different guidelines regarding
what we should eat
Many are made by government agencies
responsible for promoting the well-being of
people in the population
Governments have been making nutrition
recommendations for 150 years

Some of the earliest nutrition recommendations
were made in England in the 1860s
Chapter 2: Guidelines for a Healthy Diet
There are many types of nutrition
recommendations in the Unites States

The original dietary standard in the U.S. was the Recommended
Dietary Allowances (RDAs) 建議攝取量

The first RDA was published in 1943 in response to the
widespread food limitations from WW II

Overt nutrient deficiencies are now rare in the U.S., while the
incidence of diet-related chronic diseases has increased

In response to these changes in our diet and health, the original
RDAs have been replaced by Dietary Reference Intakes (DRIs)
 DRIs are a set of reference values for intake of nutrients and food
components 膳食營養素參考攝取量
A set of standards called the Daily Values has been established
for use on food labels
 Daily Value is a nutrient reference value used on food labels to
help consumers see how foods fit their overall diets

Dietary Reference Intakes Are Nutrient
Intake Standards

The current standard for nutrient intake in the U.S. and Canada is the DRI

The DRIs include several types of recommendations designed for different
purposes

Values have been set for each gender and for various life-stage groups
 Life-stage groups are groupings of individuals based on stages of growth
and development, pregnancy, and lactation that have similar nutrients
needs

DRI values that recommend specific amounts of nutrients for individuals
include the RDAs and Adequate Intakes (AIs) 足夠攝取量

Estimated Average Requirements (EARs) are intakes that meet the
estimated nutrient needs of 50% of individuals in a gender group and lifestage group 平均需要量

Tolerable Upper Intake Levels (ULs) are maximum daily intakes that are
unlikely to pose risks of adverse health effects 上限攝取量
The DRIs recommend proportions of
carbohydrate, fat, and protein

Acceptable Macronutrient Distribution
Ranges (AMDRs) is a range of intake for
carbohydrate, fat, or protein, expressed as a
percentage of total energy intake

According to the AMDRs a healthy diet for an
adult can contain from 45 to 65% of calories
from carbohydrate, 20 to 35% from fat, and
10 to 35% from protein.
Chapter 2: Guidelines for a Healthy Diet
The DRIs estimate energy
requirements for weight maintenance

The recommendations for energy intake established
by the DRIs are called Estimated Energy
Requirements (EERs)

EERs provide equations that can be used to
calculate the number of calories needed to keep
weight stable in a healthy person

Factors in EERs calculations are based on the
individual’s age, gender, weight, height, and level of
physical activity

You can use the DRIs to make sure your diet is
healthy
飲食形態：三大營養素所佔熱量百分比
Abkhazia 阿布哈西亞
The Food Pyramid Is a Tool for Diet Planning

The Pyramid is built around five food groups:
1.
2.
3.
4.
5.
Bread, Cereal, Rice, and Pasta
Vegetable
Fruit
Milk, Yogurt, and Cheese
Meat Poultry, Fish, Dry Beans, Eggs and Nuts

The Pyramid’s shape indicates the relative contributions
of each food group

Serving size recommendations ensure enough and not
too much

Large serving sizes that Americans have become accustomed
to are thought to be one of the reasons for the growing rate of
obesity in the U.S.
金字塔
Following the Pyramid selection tips helps
you choose a varied, nutrient-dense diet

Just choosing a specified number of servings from
each group of the Food Guide Pyramid will not ensure
an optimal diet if wise choices are not made

If you pay attention to the selection tips provided along
with the Pyramid, you will be choosing a varied,
nutrient-dense diet

Choosing a varied diet is also important because there
are positive or negative interactions between different
foods and nutrients

The Pyramid meets individual needs and preferences

Because each food group contains a huge variety of food
choices, a diet planned using the Pyramid can suit the
preferences of people from diverse cultures and lifestyles
Chapter 2: Guidelines for a Healthy Diet
Many different choice
The Pyramid is being revised to promote better choices

The Food Guide Pyramid is not the first food
guide to be used in the U.S.

The first one was published in 1917 and was
called “How to Select Foods”

Today, incidence of nutrition-related diseases
are on the rise and nutrition surveys reveal
that Americans are not following the
recommendations of the Pyramid

A revised Pyramid is expected to be released
in 2005
Revised pyramid
飲食指南
1975
五大食物分類
1980
動物性食品份量最多
1995
奶類自成一類
強調五穀根莖類
Food Labels Can Help You Make Wise Food Choices

Standardized food labels provide information
about the nutrient composition of foods and
about how a food fits into the overall diet

These labels must appear on almost all
packaged foods

Raw fruits, vegetables, fish, meat, and poultry
are not required to carry labels

Most food labels contain a “Nutrition Facts”
panel and a list of the food’s ingredients
Food Labels

The “Nutrition Facts” list the amounts of calories
and nutrients per serving


Daily Values tell you how one foods fits into
your total diet


The serving size on the label is followed by the
number of servings per container, total calories, and
the calories from fat in each serving
The Daily Values are a set of standards developed
for food labels to compare the amount of a nutrient in
a food to recommendations for the amount of that
nutrient in a healthy diet
The ingredient list tells you what’s in your food
Chapter 2: Guidelines for a Healthy Diet
Food labels may include claims about nutrient content

Food labels often highlight specific characteristics of a
product that might be of interest to the consumer, such
as “high in fiber”

Standard definitions for these descriptors have been
established by the Food and Drug Administration (FDA)

Food labels may show health claims




Food labels are permitted to include a number of health claims if
they are relevant to the product
Health claims refer to a relationship between a nutrient or a food
and the risk of a disease or health-related condition
All health claims are reviewed by the FDA
Food labels can help you choose a healthy diet
宣稱的量化標準
宣稱的量化標準
Chapter 2: Guidelines for a Healthy Diet
The Dietary Guidelines for Americans Tie It
All Together

The Dietary Guidelines for Americans is a
set of recommendations on diet and lifestyle
designed to promote health, support active
lives, and reduce chronic disease risks

The Dietary Guidelines for Americans, 2000,
has 3 tiers:
1.
2.
3.
Aim for Fitness
Build a Healthy Base
Choose Sensibly
Chapter 2: Guidelines for a Healthy Diet
Chapter 2: Guidelines for a Healthy Diet
Dietary Guidelines for Americans Tiers

Aim For Fitness



Build a healthy base



Aim for a healthy weight
Be physically active each day
Recommends a diet based on the Food Guide Pyramid and
emphasizes variety
Keep food safe to eat
Choose sensibly


Choose a diet low in saturated fat and cholesterol and
moderate in fat
Choose beverages and foods that limit your intake of sugars
Chapter 2: Guidelines for a Healthy Diet
Chapter 2: Guidelines for a Healthy Diet
飲食指標
中華民國飲食指標1989
國民飲食指標1995
一、維持標準體重
一、維持標準體重
二、多攝食各類新鮮的食物
二、均衡攝食各類食物
三、多選用五穀根莖的食物
三、三餐以五穀為主食
四、多食取高纖維的食物
四、儘量選用高纖維食物
六、避免進食過量的食鹽或鈉
五、少油、少鹽、少糖的飲食原則
（少吃太鹹或調味過重的食物）
七、避免進食過量脂肪和膽固醇食物 六、多攝食鈣質豐富的食物
八、多與家人在家進餐
七、多喝白開水
五、
八、飲酒要節制
盡量少喝酒
Exchange Lists Focus on Energy and Macronutrients

The Exchange Lists is a food group system that is
useful in planning and evaluating diets

This system was developed in 1950

The Exchange Lists divide foods into 3 main
groups based on their macronutrient content
1.
2.
3.

Carbohydrate group
Meat and meat-substitute group
Fat group
The exchange are designed so that each serving
within a list contains approximately the same
number of calories and grams of carbohydrate,
protein, and fat
There Are Many Other Guidelines for Health Promotion

The Healthy People Initiative is a set of public health
objectives



U.S. Public Health Service, along with hundreds of private and
public organizations, has developed a set of public health
objectives called Healthy People
The purpose of Healthy People 2010 is to promote health and
prevent illness, disability and premature death
Other recommendations are designed to reduce risks for
particular diseases

The American Heart Association and the American Institute for
Cancer Research have published guideline for groups at risk for
heart disease and cancer, respectively
Are You Meeting Your Nutritional Needs?

Nutritional assessment can evaluate an
individual’s nutritional health

Assessing nutritional status can help determine
whether the dietary choices you are making are
meeting your nutrient needs and minimizing your
risks of chronic disease

Nutritional status is determined by doing an
individual nutritional assessment, which requires a
review of past and present dietary intake, body
size assessment, physical exam, medical history,
and lab tests
Compare your intake to recommendations to
see if your diet is adequate

A good place to start when evaluating your nutritional
status is to determine what you typically eat

This requires recording everything you eat and drink,
including descriptions of cooking methods and product
brand names

Once you have a record of what you ate, you can
compare your intake to recommendations

For a more complete analysis of your diet, you can
use food composition tables or a computer database
to calculate your intake of energy and nutrients
Nutritional Health

Compare your body size to standards to see where you fit
 Evaluating nutritional health also involves assessing your height
and weight

Your nutrient needs are affected by your current health and medical
history
 The optimal diet for you depends on who you are, what your
genetic background is, and how healthy you are
 Nutrient needs change throughout your life cycle

Your genetic background affects your risk for nutrition-related
diseases

Laboratory tests can measure nutrient levels and assess risk of
chronic disease
 Measures of nutrients, by their by-products, or their functions in
your blood, urine, and body cells can help detect nutrient
deficiencies and excesses
Assessment can also evaluate the
nutrition health of the population

By surveying the food
supply and the population,
we can find out what foods
are available to the
population and what foods
are consumed

This information can be
used to identify possible
nutrient deficiencies and
excesses in the population
Chapter 2: Guidelines for a Healthy Diet
飲食與疾病之間的關係
因果關係 (Cause and effect relationship)： 消除原因 =====> 改變結果
缺維生素 C ====> 壞血病
細菌感染 =====> 發炎
相關性 (Association)：
為機率性，非因果關係
高脂飲食，高血壓，抽煙 ++++++ 心血管疾病
危 險 因 子 (Risk factor)
疾 病
營 養 性 危 險 因 子
心血管疾病、動脈硬化
糖尿病
肝硬化
不孕症
生長遲緩
蛀牙
便秘
肥胖
高血壓
骨質疏鬆症
神經管缺陷
高動物性油脂、高膽固醇、肥胖
肥胖
酒精過量、營養不良
體重過輕、肥胖、鋅缺乏（男性）
熱量、蛋白質、鐵、鋅攝取不足
糖份
膳食纖維、水 不足
熱量過剩
高鈉、高鹽、酒精過量、肥胖
鈣、維生素 D 不足
葉酸缺乏