Transcript Week 2-3 - UniMAP Portal

ERT 426 Food Engineering
Semester 1 Academic Session 2014/15
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Subtopics
1. Nutritional Status
2. How is Nutritional Status Assessed?
3. Food Composition Tables and Dietary
4.
5.
6.
7.
Analysis
How much of a nutrient is adequate?
Assessment of Energy Intake.
How to easily assess and plan a person’s diet?
How to use food labels to plan a healthy diet?
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1. Nutritional status
 Most people know that not getting enough of the
essential nutrients can lead to suboptimal
physiological function and undesirable long term
health outcomes.
 Consuming too little of a nutrient, a situation called
undernutrition can cause nutritional deficiency ,
which can be serious and sometimes fatal.
 Consuming too many fatty foods can lead to obesity
– it is related to health consequences.
 overconsumption of some vitamins and minerals can
be fatal - nutritional toxicity.
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Nutritional status
 Undernutrition and overnutrition make up the
extreme ends of what is called the nutritional status
continuum.
 both are examples of malnutrition.
 Malnutrition is defined as a state of poor nutrition due
to an imbalance between the body’s nutrient
requirements and nutrient consumption.
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Nutritional status
Nutrient Intake Largely Determine Nutritional Status and Contributes to Health
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Nutritional status
 Primary malnutrition is due to inadequate or
excess food intake.
 Secondary malnutrition is caused by other
factors.
 For example, a person may be deficient in one of
the B-vitamins
1. because his or her diet is lacking vitamin-rich
fruits and vegetables (this is primary
malnutrition) or
2. because an illness interferes with vitamin B
absorption (this is secondary malnutrition).
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2. How is nutritional status assessed?
 Because adequate nutrition is required for
optimal health, it is important for health care
providers to be able to assess a person’s
nutritional status.
 In general, there are FOUR (4) ways in which
nutritional status can be assessed:
1. Anthropometric measurements
2. Biochemical measurements
3. Clinical assessment
4.Dietary assessment
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How is nutritional status assessed?
 Although each of these types can provide some
information about a person’s nutritional
status, it is essential to know that each one (by
itself) cannot tell everything.
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How is nutritional status assessed?
1. Anthropometric measurements:
 Anthropometry literally means ‘to
measure the human body’.
 It is a assessment of a person’s body’s
physical dimensions (height, weight,
circumferences) and composition (fat
mass).
 It is easy & inexpensive to obtain.
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How is nutritional status assessed?
1.1 Physical Dimensions:
 Height & weight are often used to assess the
risk for certain chronic degenerative diseases,
such as heart disease and type 2 diabetes.
 Changes in body weight and height can provide
information regarding the progression of
certain diseases.
 For examples, loss of height in an elderly
person might indicate a decline in bone
density.
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How is nutritional status assessed?
 Height & weight are commonly used to assess
nutritional status in infancy, childhood &
pregnancy.
 Other physical dimensions: various
circumferences such as those of the waist, hips
& head.
 Increase in waist and hip circumferences
typically indicate altered body fat
distribution.
 Head circumference is frequently measured to
monitor brain growth during infancy.
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How is nutritional status assessed?
1.2 Body composition:
 Estimation of body composition – the
proportions of fat, water, lean tissue and
mineral (bone) mass that make up your tissues.
 How these components of your body are
distributed can provide an important
indicator of your nutritional status and overall
health.
 E.g. too much body fat can lead to
cardiovascular disease and loss of bone mass is
a major risk factor for osteoporosis.
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How is nutritional status assessed?
 Body composition measurements, are often
used along with other anthropometric
measurement to provide more detailed
information concerning nutritional status.
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How is nutritional status assessed?
2. Biochemical measurements:
 These involve laboratory analysis of a
biological sample, such as blood or
urine.
 the sample is analyzed for a specific
nutrient – blood calcium levels can be
measured to determine calcium status.
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How is nutritional status assessed?
 In other laboratory tests, the sample is analyzed for an
indicator (biological marker / biomaker) that reflects the
nutrient’s function.
 the hemoglobin content of blood is often measured as a
biological marker of iron status.
 This is because hemoglobin levels decrease during iron
deficiency.
 Biochemical measurements are powerful because they can
help diagnose a specific nutrient deficiency or excess.
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How is nutritional status assessed?
 Biochemical measurements are powerful
because they can help diagnose a specific
nutrient deficiency or excess.
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How is nutritional status assessed?
3. Clinical Evaluation:
 By conducting a face-to-face clinical
assessment & it is usually involve a series of
activities (taking medical history).
 information about previous diseases,
unusual weight loss &/or weight gain,
surgeries, medication & family health
history.
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How is nutritional status assessed?
 Clinical assessments are valuable in
nutritional assessment because they can
uncover signs and symptoms of
malnutrition.
 It is important for clinicians (e.g. clinical
dietitians, nurses, doctors) to know the
various signs & symptoms associated with
nutrient deficiencies so that they can be sure
to make the appropriate observations & ask
the right question.
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How is nutritional status assessed?
4. Dietary assessment:
 Two (2) methods:
i. Retrospective methods – require a person
to remember foods consumed in the past.
ii. Prospective methods – require a person to
keep track of which and how much food
he/she consume during a specified period
of time.
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How is nutritional status assessed?
4.1 Retrospective methods: Recalls &
Questionnaires.
 In 24 hours recall method, a person must
record everything that has been eaten or
drunk in the previous 24hours & then
analyze the information to estimate
nutrient intake.
 Food frequency questionnaire – typically
asks for information on food intake patterns
over an extended period of time.
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How is nutritional status assessed?
4.2 Prospective methods: Diet records.
 it is more accurate & it is better to
record foods & beverages as they are
consumed.
The portion sizes is estimate using
standard household measurements (e.g.
tablespoon or cup) or weigh the food
before eat.
This information is analyzed to estimate
the nutrient intake.
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3. Food composition tables and Dietary
analysis
 After completing a dietary record, subsequently
the micronutrient, macronutrient and energy
(calories) contents in a diet is to be determined.
 There are basically two (2) ways to find
information concerning the nutrient composition
of foods:
1. Food composition tables
2. Computerized nutrient database.
(US Department of Agricultural websitehttp://www.ars.usda.gov/nutrientdata)
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4. How much of a nutrient is adequate?
 Different people require different amounts of nutrients
depending on their sex, age, genetics, medications,
lifestyle choices and environmental
influences(climate).
 A set of nutritional standards has been developed to
help both medical professionals and interested
individuals assess dietary adequacy.
 Dietary Reference Intakes (DRIs):
1. Estimated Average Requirement (EAR)
2. Recommended Dietary Allowance (RDA)
3. Adequate Intake Level (AI)
4. Tolerable Upper Intake Level (UL)
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How much of a nutrient is adequate?
Dietary Reference Intake (DRI) standards.
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How much of a nutrient is adequate?
 Nutrient requirement:
 the amount of a nutrient that a person must consume
to promote optimal health.
 In general, nutrient requirements of all the individuals
in a population are distributed in a bell-shaped
manner.
 the vast majority of people have requirements at some
mid level amount with some requiring much less and
others requiring much more.
 Note: DRI reference values only consider age, lifestage and sex.
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How much of a nutrient is adequate?
1. Estimated average requirements (EARs):
 It reflects a population’s average need.
 The energy is not a nutrient, EARs for it
were not established but Estimated Energy
Requirement (EER) are provided (see later ).
 EAR values represent the intakes thought to
meet the requirements of half the healthy
individuals in each particular age, life-stage
& sex group.
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How much of a nutrient is adequate?
Estimated
Average
Requirements
(EARs)
compared with
Recommended
Dietary
Allowance
(RDSs)
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How much of a nutrient is adequate?
2. Recommended Dietary Allowances (RDAs):
 RDAs are used as nutrient-intake goals for individuals,
in contrast to the EARs, which are geared toward
assessing nutritional status of populations.
 RDA values were derived directly from the EARs using
mathematical equations.
3. Adequate Intake (AI) levels:
 It were set when data were lacking for EARs (or RDAs).
 AIs are meant to be used as nutrient intake goals for
individuals.
 AIs were based on intake levels that seem to maintain
adequate nutritional status in healthy people.
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How much of a nutrient is adequate?
 Note that, since rigorous studies cannot ethically be done
on young infants (0 to 6 months of age), there are no
RDAs for this life-stage group, but only AIs.
4. Tolerable Upper Intake Levels (UL):
 Have been established as the highest level of usual daily
nutrient intake likely to be safe.
 The ULs are not to be used as goals for dietary intake.
_______________________________SUMMARY________________________________
 EAR, RDA, AI – to help us consume nutrients in
sufficient quantities to support health.
 UL – helps us avoid consuming nutrients in such large
quantities that they actually do harm.
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How much of a
nutrient is adequate?
 Table 1 : Availability
Dietary Reference Intake
(DRI) Standards and
Acceptable Macronutrient
Distribution Ranges
(AMDR) values for adults.
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How much of a nutrient is adequate?
 Using EARs, RDSs, AIs & ULs to assess your nutrient
intake:
Using EARs, RDAs and ULs to assess dietary adequacy
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How much of a nutrient is adequate?
 When EARs, RDAs and ULs have been established:
 If you intake of a nutrient (X) is:
1. X << EAR, it is likely to be inadequate – increasing
the risk of nutrient deficiency.
2. EAR > X > RDA, you should probably increase your
intake.
3. RDA > X > UL, it is probably adequate.
4. X > UL, it is probably too high.
 When only AIs are available:
 If you intake of a nutrient (X) is:
1. AI > X > UL, it is probably adequate.
2. X < AI, no conclusion.
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How much of a nutrient is adequate?
 Example 1:
Consider a 20 years old female who, upon completing a
food record and dietary assessment, learns that her
vitamin A intake is 1,500 µg/day, 600 µg/day and 3,500
µg/day for January 2010, February 2010 and March 2010,
respectively.
For her case, RDA = 700 µg/day
EAR = 500 µg/day
UL = 3,000 µg/day
What should be her conclusion?
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5. Assessment of Energy Intake.
 Energy Intake Assessment:
 There are two (2) types of standards to assess the
energy intake:
1. Estimated Energy Requirements (EERs)
2. Acceptable Macronutrients Distribution Ranges
(AMDRs)
 Estimated Energy Requirements (EERs) represent the
average energy intakes needed to maintain weight in a
healthy person of a particular age, sex, weight, height
and physical activity level.
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Assessment of Energy Intake.
 EERs are calculated using mathematical equations:
1. Adult men:
EER = 662 – [9.53 x Age (year)]+ PA x [15.91 x Weight
(kg) + 539.6 x Height (m)]
2. Adult women:
EER = 354 – [6.91 x Age (year)]+ PA x [9.36 x Weight
(kg) + 726 x Height (m)]
 where PA – physical activity level.
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Assessment of Energy Intake.
 Table 2: Physical Activity (PA) Categories and Values
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Assessment of Energy Intake.
Effects of Age and Activity level on Estimated Energy
Requirements (EERs)
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Assessment of Energy Intake.
 Aside from knowing the right amount of total calories,
it is important to know whether the distribution of
energy sources (carbohydrates, proteins, fats) is
healthy.
 The Acceptable Macronutrient Distribution Ranges
(AMDRs) reflects the ranges of intakes for each class of
energy-yielding nutrient associated with reduced risk for
chronic disease while providing adequate intakes of
essential micronutrients.
 AMDRs were published along with the EERs.
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Assessment of Energy Intake.
 Acceptable Macronutrient Distribution Ranges
(AMDRs)
1. Carbohydrates : 45 – 65 % of total energy
2. Protein
: 10 – 35% of total energy
3. Fat
: 20 – 35% of total energy
Note: Total energy = EER
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Assessment of Energy Intake.
 Student volunteer is a xx years old woman who weighs xx
pounds.
 She is x feet x inches (x m) tall and has a low activity
level.
i. Calculate the EER for Student volunteer.
ii. Propose the AMDRs for Student volunteer.
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6. How to easily assess and plan a person’s
diet?
 Completing a dietary assessment along with DRI, EER
& AMDR values can help a person to determine
whether his/her nutrient and energy intakes are likely
adequate.
 However, this process can be rather cumbersome.
 Luckily there are many additional tools available for
simplifying this process.
1. Dietary guidelines (Food Guides)
2. The Food Guide Pyramid
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How to easily assess and plan a person’s diet?
 Dietary Guidelines (Adopted from USDA):
 Consume a variety of foods within and among the







basic food groups while staying within energy needs.
Control calorie intake to manage body weight.
Be physical active every day.
Increase daily intake of fruits and vegetables, whole
grains and nonfat or low-fat milk and milk products.
Choose fats wisely for good health.
Choose carbohydrates wisely for good health.
Choose and prepare foods with little salt.
Keep food safe to eat
Key concepts: Variety, Balance, Moderation, Nutrient
Density.
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How to easily assess and plan a person’s diet?
 Based on a person’s calorie requirement, the recommended number of
servings from each food group in the Food Guide:
Food Category
Grains
Vegetables
Fruits
Amounts
Recommended
(per day)*
3-10 oz
1-4 cups
1-2.5 cups
Dairy products
2-4 cups
Meats, poultry,
eggs, fish, nuts
and seeds.
2-7 oz
Oils
3-11 tsp
Dietary Significance
Major sources of B vitamins, iron,
magnesium, selenium, energy and dietary
fiber.
Rich sources of potassium; vitamins A, E & C;
folate & dietary fiber.
Rich sources of folate, vitamins A and C,
potassium and fiber
Major sources of calcium, potassium, vitamin
D and protein.
Rich sources of protein, magnesium, iron,
zinc B, vitamins, vitamin D, energy and
potassium.
Sources of essential fatty acids and vitamin E.
* Based on age, sex & physical activity level
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How to easily assess and plan a person’s diet?
 Food Guide Pyramid:
 It is more consumer-friendly.
 The pyramid shape helped to emphasize the
relative contribution of each food group.
 The large base of the pyramid was made up of
foods of plant origin (grains, vegetables & fruits)
 The smaller, upper sections of the pyramid
contained food that come primarily from animals
(milk, yoghurt, cheese, meat, poultry, fish &
eggs).
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How to easily assess and plan a person’s diet?
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An example
of a
personalized
Food Pyramid.
To create a
personal
pyramid plan –
http://www.
mypyramid.
gov
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7. How to use food labels to plan a healthy diet?
Understanding Food Labels
and Nutrition Facts Panel.
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How to use food labels to plan a healthy diet?
1. Understand what is included on nutrition facts panels.
 The information on a food label:
 Product name & place of business
 Product net weight
 Product ingredient content (from most to least abundant
ingredient).
 Company name & address
 Country of origin
 Product code (UPC bar code)
 Product dating or Religious symbols (if any)
 Safe-handling instructions / Special warning instruction (if
any)
 Nutrition facts panel outlining specified nutrient information.
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How to use food labels to plan a healthy diet?
2. The Nutrition Facts Panel.
 The manufacturer must include the serving size of the
food.
 Serving sizes have been standardized for ease of
comparison.
 Nutrition fact panels must provide information
concerning specific nutrients that the Dietary
Guidelines suggest limiting.
 These include total fat, saturated fat, trans fat,
cholesterol and sodium.
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How to use food labels to plan a healthy diet?
3. Daily values (DVs) and Percent Daily Values (%DVs):
 Although Nutrition facts panels provide an impressive
amount of nutrition information – but how does a
consumer know if that amount is a little or a lot?
 Daily Values (DVs) and percent Daily Value (%DV) were
created to give consumers a benchmark for knowing
whether a food is a good source of a nutrient and
allowing them to easily compare one food with another.
 For example, the DV for vitamin C is 60mg/day
 thus, a cereal providing 30mg of vitamin C per
serving would contain half of the DV.
 in other words, the food would have a %DV of 50%.
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How to use food labels to plan a healthy diet?
4. Look for nutrient content claims & health claims:
 Nutrient content claims described in a very consumerfriendly way how much of a nutrient (or its content) is
in a food.
 These include phrases: ‘sugar free’, ‘low sodium’,
‘good sources of fiber’…….
 Some manufacturers include information about
potential health benefits a person might get by
consuming their products.
 Manufacturers can make two (2) kinds of health
claims:
1. Regular health claims 2. Qualified health claims.
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How to use food labels to plan a healthy diet?
 In US, Food’s package, health claims must be
approved by the FDA (Food and Drug
Administration).
 Both claims concerning the relationship
between a specific food component or whole
food and a health-related condition.
 regular health claims are supported by
considerable research, while qualified health
claims have less scientific backing and must
be accompanied by a disclaimer (or qualifier)
statement.
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How to use food labels to plan a healthy diet?
 Table 3: FDA-approved nutrient content claims
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Answer (Example 1):
 In January 2010:
The vitamin A intake falls between the RDA (700µg/day) and
the UL (3000µg/day), she should conclude that her vitamin A
intake is probably adequate.
 In February 2010:
The vitamin A intake falls between the EAR(500µg/day)and the
RDA (700µg/day), she should conclude that her vitamin A
intake is probably inadequate and she should probably
consume more.
 In March 2010:
The vitamin A intake far above the UL (3000µg/day), she should
conclude that her vitamin A intake is too high.
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Answer (Example 2):
 Convert the weight from pounds to kilogram (kg)
so, 115 pounds = 52.3 kg.
 Since she has a low physical activity level ,
so, PA = 1.12.
 The EER for Siti Nurhaliza is
EER = 354 – [6.91 x Age (year)]+ PA x [9.36 x Weight (kg) +
726 x Height (m)]
= 354 – (6.91 x 31 years) + 1.12 x [9.36 x 52.3kg + 726 x
1.6m]
=1 989 kcal /day.
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Answer (Example 2):
 Since EER =1 989 kcal /day,
 Acceptable Macronutrient Distribution Ranges (AMDRs)
1. Carbohydrates : 45 – 65 % of EER
45% = (45/100) x 1989 kcal/day = 895 kcal/day
65% = (65/100) x 1989 kcal/day = 1293 kcal/day
2. Protein
: 10 – 35% of EER
10% = (10/100) x 1989 kcal/day =199 kcal /day
35% = (35/100) x 1989 kcal/day = 696 kcal/day
3. Fat
: 20 – 35% of EER
20% = (20/100) x 1989 kcal/day =398 kcal /day
35% = (35/100) x 1989 kcal/day = 696 kcal/day
So, she should be getting 895 – 1293 kcal/day of carbohydrates, 199 –
696 kcal/day of protein and 398 – 696 kcal/day of fat in her diet.
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Life stages
 A life stage
typically refers
to an age group
&/or physiologic
state such as
pregnancy.
 Female:
 16 life stages
groups.
 Male:
 10 life stages
groups.
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What is a Kilocalorie?
 Kilocalorie
 A kilocalorie (kcal) is the amount of heat required
to raise the temperature of 1 kg of water by 1oC.
It is a unit of measurement we use to quantify the
amount of energy in food that can be supplied to the
body.
 Calorie
 A calorie is also a unit of measurement;
technically 1 kcal = 1000 calories.
For the sake of simplicity, nutrition labels
use the term calories to indicate kilocalories.
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