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Nutrition through life > 1. DRIs > Flashcards

1. DRIs Flashcards

1
Q

DRIs:
- before, Canada VS US? (name of things + date)
- who also publishes stuff?
- since when are they both together? name? why?

A

BEFORE:
- Canada: Recommended Nutrient Intakes (RNIs) since 1938
- US: Recommended Dietary Allowances (RDAs) since 1941
- FAO/WHO/UNU published Safe level of Intake in 1985
SINCE 1997:
- Dietary Reference Intakes (DRIs)
- because increase trade btw Canada and US + similar population

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2
Q

what are the 7 panels that the (what?) committee on (what?) reviews?
- what are the 2 subcommittees?

A

Standing Committee on Scientific Evaluation of Dietary Reference Intakes
1. Ca, Vit D, P, Mg, F
2. Folate, B12, B vitamins, Choline
3. Antioxidants and related nutrients
4. trace elements
5. electrolytes
6. Energy and macronutrients
7. other food components

  • Upper reference levels subcommittee –> monitors supplement use and fortification
  • uses of DRIs subcommittee –> how can DRIs be used to assess population + communication
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3
Q

EAR vs RDA vs AI vs UL
vs what did we have before?

A

EAR:
- estimated average requirement (from which RDA is determined) –> meets needs of 50% of pop
RDA:
- recommended dietary allowance (which replaces the formed RDA and RNI) –> RDA = EAR + 2 SD –> 97.5% of pop
AI:
- adequate intake (alternative reference when EAR and consequently RDA are not available)
- approximation of safe level of intake bc not enough info to come up with RDA –> based on population intake
- not equivalent to RDA
UL:
- tolerable upper intake level: max level before toxicity risks –> intake below UL are unlikely to pose risks of adverse effects in healthy people
- usually much higher than RDA (depends on fat or water soluble though)

  • before: all were considered RDAs even if no rigorous proof
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4
Q
  • RDAs are a ________ _______ only in evaluating diets of _________
  • when assessing diet, below which percentage of RDA shows that there might be risk of nutrient deficiency?
  • as intake decreases from RDA (from +1SD to mean to -1SD to -2SD) –> probably of deficiency increases/decreases?
A
  • reference point only in evaluating diets of individual!
  • < 66% of RDA –> need to do more testing to check if risk of deficiency
  • increases! if less than -2SD of intake –> 100% risk of deficiency
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5
Q

RDA:
- amounts of selected nutrients considered adequate to meet the known nutrient needs of nearly all _________ individuals
- determined by _____________ in a __________ population
- based upon estimation of a minimal/maximal (?) requirement to achieve some _______ outcome

A

recommended dietary allowance
- all healthy individuals –> should NOT include obese people or ppl with diseases
- determined by experimentation in a healthy population
- minimal requirement to achieve some measurable outcome –> a clear biochemical index!!!

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6
Q

what are 3 valid studies that are considered when making RDAs?

A
  • deficiency states
  • balance studies (adequate intake has to match losses/amount excreted)
  • animal research –> gives you idea of biochemical markers
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7
Q

RDA must account for (4) + explain

A
  1. INDIVIDUAL VARIABILITY IN A POPULATION
    - coefficient of variability of population –> gaussian distribution can be flattened or very thin –> both could have same mean/EAR but RDA will be different!
  2. BIOAVAILABILITY
    - key concept!
    - need to check average population diet (ie 1/3 animal and 2/3 plant protein)
    - might meet RDA through diet but if all from plants = less bioavailable
  3. SEX AND AGE DIFFERENCES
    - sex: not so much in early stages in life –> more when puberty hits
  4. PHYSIOLOGICAL STATE
    - ie for pregnancy and lactation –> consider adult values + factors to accommodate for baby growth/nutrient losses through lactation
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8
Q

EAR
- what?
- suitable for individuals or groups?
- based on what?

A
  • usual intake level that is estimated to meet the requirement of half the healthy individuals in a life stage and gender group
  • suitable method to assess prevalence of inadequate intakes for GROUPS
  • based on intake DISTRIBUTION of group and not the average intake of group
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9
Q

how to calculate RDA?
1. if SD of EAR is available
2. if SD of EAR not available

A
  1. RDA = EAR + 2SD
  2. assume of coefficient of variability of 10%
    - CV = SD/EAR –> SD = CV* EAR
    - RDA = EAR + 2SD
    - RDA = EAR + 2(CV* EAR)
    - RDA = EAR(1 + 2* 0.1)
    - RDA = 1.2* EAR
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10
Q

how to calculate RDA for energy/calories?

A

you DONT calculate by using EAR + 2SD because that will definitely lead to weight gain
- humans have inherent self-regulation where you eat depending on physical activity/hunger

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11
Q

RDAs:
- intended to be met through _____ containing variety of ______
- to be achieved via ______ _______ intakes over a period of _______ –> explain
- goal = prevent (3 ish)
- not designed to (2)

A
  • through diets containing variety of foods
  • via average daily intakes over a period of days –> you dont need to reach RDA every single day bc you have body stores! –> RDAs take into account body pools
  • goals = prevent deficiency (promote health) + prevent chronic diseases (new part of RDA development!)
    *ie carotenoids can prevent eye cataract but need more than the RDA to prevent vit A deficiency
  • not designed to overcome nutrient deficiencies (will need much more than RDA) OR to recover from illness/post-operation
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12
Q

why is comparing the mean intake of a group with the EAR not a good approach?

A
  • because the bell curve can have difference coefficient of variability (ie different flatness/narrowness)
  • 2 groups can both have a mean intake above the RDA, but if group A’s bell curve is more flat, a bigger part of that group will have an intake below the EAR
    *see schéma slide 22
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13
Q

how to estimate the target mean intakes using EAR values?

A
  • one curve for requirement distribution where mean = EAR
  • another curve for intake distribution where, depending on the coefficient of variability, you want only 2.5% of the distribution/curve to be to the left of EAR from first curve
    *The EAR is used to determine the mean intake levels for population!
    *see schéma slide 23
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14
Q

How do DRIs differ conceptually from the former RDAs and RNIs? (4)

A
  1. where possible (bc sometimes not enough proof), reduction in risk of chronic degenerative disease is included in formulation of recommendation
  2. concepts of probability and risk explicitly underpin the determination of the DRIs and applications (ie <66% RDA = high risk of deficiency)
  3. upper levels of intake are established (different for children and adults and pregnant mother though)
  4. food components that may not meet the traditional concept of a nutrient are considered (but not necessarily implemented in recs bc of lack of evidence
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15
Q

what are examples of “other food components”? 9 ish
+ define

A
  • polyphenols, carotenoids, non pro vit-A carotenoids like lutein and zeaxanthin, isoflavones, tannins, anthocyanates, catechins, probiotics, prebiotics
  • “lifestyle” vitamins where a deficiency won’t cause disfunction but having it gives improved function in lifespan + decrease diseases
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16
Q

Can both RDA and AI be used as goals for individual intake?
- when is AI calculated?

A

yes! Adequate intake calculated when EAR cannot be calculated bc some nutrients don’t have good biomarkers

17
Q

Adequate intake refers to recommended average daily nutrient intake level based on (3)

A
  • observed or experimentally determined approximations
  • estimates of nutrient intake by a group (or groups) of healthy people that are assumed to be adequate –> take the bell curve of population intake that doesn’t have deficiency for that nutrient –> that becomes the AI
  • used when RDA cannot be determined
18
Q
  • if individual’s intake is above AI = what?
  • if individual’s intake falls below AI = what? can calculate probability of risks of deficiency?
A
  • if > AI –> diet is almost certainly adequate
  • if < AI –> No quantitative (or qualitative) estimate can be made of the probability of nutrient adequacy bc point where risk increases cannot be determined (unlike if < 66% of RDA = high risk of deficiency)
19
Q

as intake increases above UL, potential risk of adverse effects increases/decreases/plateaus?
- what 3 things can lead to having a nutrient intake higher than UL?

A

increases!
- fortified foods
- low diversity diet
- supplements

20
Q

is adequate intake a range? above or below RDA?

A
  • not a range! a specific number!
  • we don’t know if it’s above or below the RDA. the whole point is that when there’s an AI, it’s bc the RDA could not be calculated
21
Q

describe characteristic of each age group when setting RDA and AI:
- infants below 1 yo
- children from 1 to 18 + pregnancy/lactating mother
- adults 19 to 70
- elders above 70 yo

A
  • INFANTS –> difficult to evaluate adequacy –> usually use mother’s milk nutrient content as AI
  • CHILDREN + pregnant/lactating MOTHERS–> period of rapid growth –> RDA/AI will change year by year
  • ADULTS: not much change, recs will stay relatively the same from 19 yo to 70 bc no more growth
  • ELDERS: RDAs and AIs become more and more individual
22
Q

what are the 3 fundamental premises of dietary guidelines?

A
  1. diet-related chronic diseases are very prevalent (CVD, cancer, diabetes)
  2. nutrients and food are not consumed in isolation –> holistic concept
  3. healthy dietary patterns are encouraged at every life stage
23
Q

DIETARY GUIDELINES:
- optimal __________ of energy-yielding macronutrients
- do not usually describe nutrients but food __________/food ________ (ie?)
- do not usually express _______ of nutrients to be consumed as per the RDA –> _____-_________ advice on consumption of a food component
- can target to improve _________ towards a future goal for the ________ (not necessarily using ____)
- target the intake of every (3)
- primarily examine ________ –> rely more on __________ and food ________ data than do RDA

A
  • optimal proportion of macros
  • food components/food groups (ie cereals and grains)
  • weight of nutrients –> semi-qualitative advice
  • improve behavior towards future goal for population (not necessarily using RDA (?))
  • every man, woman and child
  • macronutrients –> more on epidemiological and food consumption data
24
Q

current fat intake –> mean of bell curve at around 38 % of energy
- guidelines want to reduce to no more than 30% of energy from fats
SO should most of the bell curve be under 30% (mean of around 20%) or the mean of the bell curve should be at 30% (so half of population would still be over 30%)?

A

prof didn’t give a clear answer but i think it should be that the mean is 30% because:
1. if you lower too much, you’ll probs increase carb/refined carb intake = risk
2. pediatric population (up to 18 yo) –> have higher needs of fats for growth –> eventually health can changed guidelines so that the <30% energy from fat only applicable after growth
3. RDA recommendations based on bioavailability of nutrients and considers a human diet of 2/3 plants and 1/3 animal. To reduce fat intake, people would eat more plants and less animal, but animal protein has higher bioavailability –> so a vegan individual might eat RDA amount but be deficient bc of low bioavailability of plant products

25
Q

what are the key recommendations of dietary guidelines? (6 “things” to eat)

A
  1. variety of vegs from all subgroups
  2. fruits, especially whole fruits
  3. grains, at least half is whole grains
  4. fat-free/low-fat dairy like milk, yogurt, cheese and fortified soy bevs
  5. variety of protein foods (seafood, lean meats, poultry, eggs, legumes, nuts, seeds, soy)
  6. oils
26
Q

what are the 4 guidelines in dietary guidelines?

A
  1. follow healthy eating pattern across lifespan
  2. focus on variety, nutrient density and amount
  3. limit cals from added sugars and sat. fats and reduce sodium intake
  4. shift to healthier food and bev choices
27
Q

what is a dietary pattern?
- what is a healthy dietary pattern?

A
  • combinations of consumption of nutrients and foods over time –> represents totality of what individuals habitually eat and drink over time
  • healthy = consists of eating nutrient-dense foods (low cal and high nutrients) and bevs from all food groups in recommended serving sizes and within calorie limits
28
Q

key components of healthy eating include:
- adequacy
- balance and moderation
- variety

A

ADEQUACY:
- food eaten provides all essential nutrients, fiber and energy in amounts sufficient to support growth and maintain helath
BALANCE AND MODERATION:
- to consume enough but not too much from all different food groups
VARIETY:
- including a lot of different foods in diet

29
Q

what are the 4 key recs that are quantitative?

A
  • less than 10% cals per day from added sugars
  • less than 10% cals per day from saturated fats
  • less than 2300 mg/d of sodium
  • 1 drink (women) or 2 drinks (men) per day of alcohol
30
Q

is dairy fat good? is it right for guidelines to preach for low-fat dairy products?

A

recent studies have shown that dairy fat (even if saturated) is beneficial for CVD and obesity and glucose tolerance
- so the <10% cals per day of saturated fat should not include the sat fats from dairy products

31
Q

Canada’s dietary guidelines 2019
- guideline 1: what type of food should be eaten + bev of choice?
- guideline 2: what should not be consumed regularly
- guideline 3: what are needed to navigate complex food environment?

A
  1. fruits, vegs, whole grains, proteins (protein should often be plant based), unsat. fat. + water = bev of choice
  2. processed or prepared foods and bevs that contribute to excess sodium, free sugars or sat. fat undermine healthy eating and should not be consumed regularly
  3. food skills! cooking and food preparation + food labels
32
Q

why are processed foods bad?

A
  • because contain excess sodium, free sugars and/or sat. fat
  • because even with same caloric content than normal food, it’s less heavy and will make you want to eat more = caloric excess
33
Q

difference btw added and free sugars? total sugars?

A
  • ADDED = all sugars added to foods and bevs during processing or preparation –> all added sugars are also free sugars
  • FREE = added sugars as well as sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates
  • TOTAL = all sugars present in foods and bevs regardless of source. includes added, free as well as naturally occuring sources of sugars found in fruits & vegs and unsweetened milk
34
Q

Canada’s food guide:
- describes pattern of eating that (4)
- emphasizes that healthy eating and regular _______ ________ are important for health

A
  1. is sufficient to meet nutrient needs
  2. contributes to reduced risk of nutrition-related health problems (+ promotes health!)
  3. supports achievement and maintenant of healthy body weight
  4. reflects diversity of foods available to Canadiens
    - regular physical activity!
35
Q

why were serving size recs in previous food guides criticized?
- what do we have now?
- limitations?

A
  • bc ppl didn’t know what a serving size was and would often end up eating more
  • how to separate your plate! 1/2 f&v, 1/4 proteins, 1/4 whole grain foods + water = drink of choice
  • limitation: no more dairy category! health can took it out bc ppl though they were promoting dairy industry. but now they’re still critiqued bc dairy useful for pediatric and elderly populations
36
Q

what is a food biomarker for fruits and vegetable consumption?

A

carotenoids! potent health benefits against eye disease and skin health!
- check how much carotenoids deposited in skin level –> correlate to how much f&v eaten
- more f&v consumption = more attractive lol

37
Q

healthy eating is more than the foods you eat!
- 4 recs from canada’s food guide

A
  1. be mindful of your eating habits –> mindfulness will probs make you eat less
  2. cook more often
  3. enjoy your food
  4. eat meals with others! especially in elderly setting
38
Q

is it good to only eat whole grain foods?

A

no! because folate is limited!
- need to get folate from fortified refined flour!
- OR make the government fortify whole grain foods with folate too

39
Q

what are the differences between American and Canadian food guide? (2)

A

American has dairy + separate fruits and vegs ish

Nutrition through life (13 decks)

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