Transcript Fundamentals of Nutrition

Chapter 2
Planning a Healthy Diet
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Objectives
• Define balanced diet
• List U.S. government’s Dietary Guidelines for
Americans and explain reasons for each
guideline
• Identify food groups and their placement on
MyPyramid
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Objectives
• Describe information commonly found on
food labels
• List some food customs from various cultural
groups
• Describe development of food customs
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Balanced Diet
• Includes all essential nutrients in appropriate
amounts
• Preserves and promotes good health
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Stop and Share
• Divide into groups of two
• Consider the following question:
– How do you know you eat a balanced diet?
• Share your answer with your partner
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Stop and Share
• Meal planning
– Cumbersome and timeconsuming if tables
must be followed for
each meal
– Tables provide Dietary
Reference Intakes
(DRIs)
• Simple system
– Dietary Guidelines for
Americans developed by
United States Department
of Agriculture (USDA) and
Department of Health and
Human Services (DHHS)
– MyPyramid developed by
USDA
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Dietary Guidelines for Americans
• Key recommendations:
– Adequate nutrients within caloric needs
• Consume nutrient-dense foods
– Weight management
• Balance calories consumed with calories expended
– Physical activity
• To prevent chronic diseases, manage body weight, prevent weight
gain, and sustain weight loss
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Dietary Guidelines for Americans
• Key recommendations:
– Food groups to encourage
• Consume variety of fruits and vegetables
• Consume half of grains from whole grains
• Consume fish, nuts, and vegetable oils as sources of fats
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Dietary Guidelines for Americans
• Key recommendations:
– Fats
• Have total fat intake between 20 and 35 percent calories
• Limit saturated fat and trans-fatty acids
• Consume less than 300 milligram (mg) cholesterol per day
– Carbohydrates
• Consume fiber-rich fruits, vegetables, and whole grains
• Limit foods with added sugars
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Dietary Guidelines for Americans
• Key recommendations:
– Sodium and potassium
• Consume less than 2,300 mg sodium per day
– People with high blood pressure should have less than 1,500 mg per
day
» E.g., African-Americans, middle-aged adults, older adults
• Consume 4,700 mg per day of potassium
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Dietary Guidelines for Americans
• Key recommendations:
– Alcoholic beverages
• Limit to one drink per day for women and two drinks per day for
men
– Food safety
• Wash hands when handling foods
• Wash, store, cook, and chill foods properly
• Avoid foods more likely to be contaminated
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
MyPyramid
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
MyPyramid
• Grains
– Bread, cereal, rice, and pasta
• Vegetable group
• Fruit group
• Milk, yogurt, and cheese group
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
MyPyramid
• Meat, poultry, fish, dry beans, eggs, and nuts
group
• Fats, oils, and sweets group
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
MyPyramid
• Takes guidance from Dietary Guidelines for
Americans 2005
• Calorie level individually determined
• 12 different pyramids according to caloric
needs
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
MyPyramid
• Recommendations for each food group depend
on caloric needs
• Encourages physical activity
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Mediterranean Diet Pyramid
• Developed by World Health Organization
(WHO) and Harvard’s School of Public Health
• Encourages monounsaturated fats
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Labeling
• Mandatory labeling for nearly all processed
foods started in May 1994
– Result of Nutrition Labeling and Education Act (NLEA)
• Primary objective:
– Ensure labels on most foods provide consistent nutrition
information
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Labeling
• Food and Drug Administration (FDA)
– Sets health claims allowed
– Determines serving sizes
– Standardizes descriptive terms
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Labeling: Nutrition Facts
Required
•
•
•
•
•
•
Total calories
Calories from fat
Total fat
Saturated fat
Trans fat
Cholesterol
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Labeling: Nutrition Facts
Required
•
•
•
•
•
Sodium
Total carbohydrates
Dietary fiber
Sugars
Protein
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Labeling: Nutrition Facts
Required
•
•
•
•
Vitamin A
Vitamin C
Calcium
Iron
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Customs
• Food habits may be based on nationality,
culture, and religion
• Foods available in certain area may be favored
for economic reasons
• Economic status and social status contribute to
food habits
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Stop and Share
• Consider the following questions:
– How can a health care professional gain knowledge
regarding a client’s dietary preferences?
– Why is it important for a health care professional to
understand food patterns unique to different cultures?
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Stop and Share
• Talking with clients and learning about their
background helps health care professionals
gain knowledge regarding food preferences
• Plan nourishing meals consisting of foods that
appeal to clients
• Adjustments in diet can be made gradually and
effectively
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Native American Influence
• Influenced half of edible plants commonly
eaten in U.S. today
– E.g., corn, potatoes, squash, cranberries, pumpkins,
peppers, beans, wild rice, sunflower seeds, sweet potatoes,
avocadoes, papayas, cocoa beans
• Influenced wild fruits, game, and fish
– Prepared as soups and stews or dried
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
U.S. Southern Influence
• Diversity of foods congruent with diversity of
its people
– African-American influence
• Popular foods:
– Down-home breads, biscuits, greens, black-eye peas, okra, etc.
• Soul foods
• High in fat, sodium, and carbohydrates
• May be deficient in iron, calcium, fiber, potassium, and vitamin C
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
U.S. Southern Influence
• Diversity of foods congruent with diversity of
its people
– French-American influence
• Cajun and Creole cuisine are fusion of French and Spanish cooking
• Popular foods:
– Wild game, seafood, vegetables, herbs, rice, tomatoes, sausage, hot
peppers, and crawfish
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
U.S. Southern Influence
• Diversity of foods congruent with diversity of
its people
– French-American influence
• Lacking in fruits
• Creole cooking adds rich sauces and calories
• May be deficient in calcium, vitamin D, vitamin E and vitamin C
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Spanish Influence
• Mexican influence
– Combination of Spanish and Native Americans foods
• Popular foods:
– Beans, rice, tomatoes, onions, jalapenos, masa harina, corn tortilla
stuffed with cheese, beef, and pork
• Flan
– Favorite dessert
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Spanish Influence
• Mexican influence
– Combination of Spanish and Native Americans foods
• Often lacking in vitamin C and green and yellow vegetables and
fruits
• Lactose intolerance common
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Spanish Influence
• Puerto Rican influence
– Influenced by Spanish, Africans, and Taino Indians
• Popular foods:
– Corn, wheat, seafood, beef, pork, rice, olive oil, chicken, pinto beans,
and okra
• Often use starchy vegetables and tropical fruits
• Lacking in milk and non-starchy vegetables
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Mediterranean Influence
• Healthiest in the world
– Italian influence
• Popular foods:
– Pastas, rice, beans, olives, fruits, vegetables, seafood, and cheese
•
•
•
•
•
Use olive oil
Eat small portions
Seldom eat beef
Eat main meal at lunch
Could benefit from increase in low-fat milk and meat
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Mediterranean Influence
• Healthiest in the world
– Greek influence
• Popular foods:
– Broccoli, cauliflower, wild greens, artichokes, fava beans, green
beans, eggplants, legumes, olives, yogurt, and feta cheese
•
•
•
•
Includes fish, seafood, lamb, goat, and pork
Use bread as basis of meal
Use fruity olive oil as primary fat
Eat fruit for dessert
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Northern and Western European
Influences
• Have given U.S. “meat and potato” mentality
• Lots of meat, poultry, or fish with small
amounts of vegetable and starch
• Essential to have sausages, blood sausage,
head cheese, dark breads, and dairy
• Could benefit from more fresh fruits and
vegetables
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Central European Influences
• Popular foods:
– Pork, chicken, beef, sausages, fish and game, cabbage,
carrots, turnips, potatoes, beans, lentils, and onions
• Use eggs and dairy products abundantly
• Consume spatzle, dark breads, and muesli
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Central European Influences
• Could benefit from limiting number of eggs,
using fat-free or low-fat dairy products, and
adding fresh fruits and vegetables
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Middle Eastern Influences
• Popular foods:
– Lamb, pita and flatbread, sourdough, legumes, and dairy
• Use dates, figs, pistachios, and fresh fruits for
snacks and desserts
• Adding fresh fruits and vegetables would
increase vitamins, minerals, and fiber
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Asian Influences
• Each Asian country has traditional foods
– Chinese influence
• Five essential grains of life:
– Rice, soybeans, barley, wheat, and millet
• Many vegetables:
– Bean sprouts, shitake mushrooms, broccoli, peppers, snow peas, etc.
• Protein from seafood, eggs, pork, chicken, beef, and tofu
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Asian Influences
• Each Asian country has traditional foods
– Chinese influence
• Often use water chestnuts, sesame seeds, and other nuts
• Season with soy sauce, garlic, ginger, and many spices
• Soy sauce and monosodium glutamate (MSG) may contribute to
high blood pressure
• Lactose intolerance may cause lack in calcium sources
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Asian Influences
• Each Asian country has traditional foods
– Japanese influence
• Essentials foods:
– Bamboo shoots, tofu, cucumbers, eggplants, Enoki mushrooms,
spinach, and ginger
• Protein from seafood, eggs, and chicken
• Season with mirin, soy sauce, miso, and wasabi
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Asian Influences
• Each Asian country has traditional foods
– Japanese influence
• Drink green tea as preferred beverage
• Lactose intolerance problems
• Could benefit from more fresh fruits
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Asian Influences
• Each Asian country has traditional foods
– Southeast Asian influence
•
•
•
•
Influenced by India and China
Many vegetables, rice, noodles, soybean paste, and soy sauce
Protein from fish, pork, chicken, and beef
Prefer coconut and soybean milk to dairy because of lactose
intolerance
• High sodium may cause high blood pressure
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Indian Influences
• Vegetarianism prevalent due to religion
• Protein from lentils, beans, and dairy products
for vegetarians
• Protein from meat and fish for non-vegetarians
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Indian Influences
• Popular foods:
– Wheat, rice, vegetables, garlic, eggplants, and curry
• Acceptable to eat with one’s fingers
• Lack of calcium may be problematic
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
New Immigrant Influences
• Somali influence
– No pork due to religion
– Popular foods:
• Millet, cornmeal, rice, noodles, bananas, mango, papaya,
vegetables, liver, seafood, beans, etc.
– Frankincense often chewed after meals
– Lack of dairy may cause calcium deficiency
– High liver consumption may cause high cholesterol
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
New Immigrant Influences
• Haitian influence
–
–
–
–
–
Influenced by African, French, and Spanish cooking
Based on rice, corn, millet, yams, and beans
Wealthy can afford meat, lobster, shrimp, duck, and desserts
Use pig fat for flavoring
Avocadoes, mangoes, pineapples, coconuts, and guava
available
– Malnutrition and lack of dairy concerning
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
New Immigrant Influences
• Korean influence
– Grains:
• Rice, millet, soybeans, and red beans
– Eat chicken and seafood
• Little red meat
– National dish kimchi served with each meal
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
New Immigrant Influences
• Korean influence
– Season with red pepper paste, green onion, ginger, garlic,
and bean paste
• Use soy sauce extensively
– Eat fresh fruits for snacks and desserts
– Diet usually adequate
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
New Immigrant Influences
• Dominican Republic influence
– Mix of Spanish and Taino Indian cuisine
– Meats:
• Goat and chicken
– Eat fresh seafood in seaside towns
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
New Immigrant Influences
• Dominican Republic influence
– Starches:
• Plantains, chayote, and rice
– Fruit smoothies common
– Wide variety of food can provide adequate diet
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
New Immigrant Influences
• Burmese influence
– Many varieties of fruits, vegetables, and tropical fruits
– Carbohydrates:
• Rice, noodles, red lentils, and mung peas
– Protein from pork, beef, lamb, chicken, duck, fish or
prawns, tofu, and eggs
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
New Immigrant Influences
• Burmese influence
– Eat fresh fruits for desserts
– Eat sweets for snacks
– Wide variety of food can ensure good nutrition
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Patterns Based on Religion or
Philosophy
• Jewish
– Orthodox Jews always follow dietary laws
– Kosher foods
• Prepared according to dietary laws
– Dietary laws forbid several foods
• E.g., birds of prey, flesh of animals without cloven hooves,
leavened bread during Passover
– Food served generally rich
• May be deficient in fresh vegetables and milk
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Patterns Based on Religion or
Philosophy
• Roman Catholic
– Meat not allowed on Ash Wednesday, Good Friday, and
Fridays during Lent
• Eastern Orthodox
– Includes Christians from Middle East, Russia, and Greece
– Meat, poultry, fish, and dairy products restricted
Wednesdays, Fridays, and during Lent and Advent
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Patterns Based on Religion or
Philosophy
• Seventh Day Adventist
– Many lacto-ovo vegetarians
– May consume nuts, legumes, and meat substitutes (tofu)
– Coffee, tea, and alcohol considered harmful
• Mormon
– Coffee, tea, and alcohol prohibited
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Patterns Based on Religion or
Philosophy
• Islamic
– Muslims
• Adherents of Islam
– Pork and alcohol prohibited
• Other meat slaughtered by specific laws
– During month of Ramadan, do not eat or drink during
daylight hours
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Food Patterns Based on Religion or
Philosophy
• Hindu
– All life sacred
• Do not eat animals or eggs
– Most vegetarians
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Other Food Patterns
• Vegetarians
– Lacto-ovo vegetarians
• Use dairy products and eggs, but not meat, poultry, or fish
– Lacto-vegetarians
• Use dairy products, but not meat, poultry, or eggs
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Other Food Patterns
• Vegetarians
– Vegans
• Avoid all animal foods
• Can lack calcium, protein, vitamin A, vitamin D, and vitamin B12
– Diets should be carefully planned to include essential
amino acids
• Can be very nutritious
(continues)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Other Food Patterns
• Zen-Macrobiotic diets
– Developed from Zen Buddhism
– System of 10 diet plans
– Gradually give up the following foods:
• Desserts, salads, fruits, animal foods, soups, and ultimately
vegetables until only cereals are consumed
– Usually brown rice
– Usually nutritionally inadequate
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Conclusion
• Tools can be used to help clients plan healthy
diets
• Individual food customs must be respected
• Registered dietitians can help plan diets
• Gradual corrections in dietary habits easier and
more effective when reasons for food habits
understood
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.