Dietary Recommendations, Life Stages, and Nutrition

Question 1

Nutrients

Answer 1

Nutrients provides structural or functional components or energy to the body.

Essential nutrients must be obtained from the diet.

Body unable to produce sufficient quantity to meet needs.

Important compounds which do not participate in metabolic pathways include antioxidants and dietary fiber.

Question 2

Food Regulation

Answer 2

Limited primarily to labeling and purity.

US Department of Agriculture (USDA) regulates safety, quality, and labeling of meat, poultry, and eggs.

Food and Drug Adminsitration (FDA) regulates all other foods.

Question 3

Nutritional Supplements

Answer 3

Labeling and advertising limited to structural claims and cannot make disease claims.

Question 4

Nutrient Recommendations

Answer 4

Made by the Food and Nutrition Board of the Institute of Medicine.

Dietary Reference Intakes (DRI) value for any given nutrient is continually reevaluated.

Goal to determine the amount high enough to prevent impairment of health even if intake is inadequate for a short period.

There are four seperate recommendations:

1. Estimated average requirement (EAR)
2. Recommended dietary allowance (RDA)
3. Adequate Intake (AI)
4. Tolerable Upper Intake Level (TUL)

Question 5

Estimated Average Requirement

(EAR)

Answer 5

Average daily intake level needed to meet the requirement of half of healthy individuals in a particular life stage and gender group.

Question 6

Recommended Dietary Allowance

(RDA)

Answer 6

Average daily intake level needed to meet the requirement of 97.5% of healthy individuals (mean ± 2 SD) in a particular life stage and gender group.

Applies to most micronutrients (vitamins and minerals).

RDA values have been set for carbohydrates and proteins but not most fats except for n-6 and n-3 polyunsaturated fatty acids.

Question 7

Adequate Intake (AI)

Answer 7

Recommended average daily intake level based on observed or experimentally determined approximations by groups of healthy people that are assumed to be adequate.

Used when RDA cannot be determined.

Most commonly seen for young infants.

Question 8

Tolerable Upper Intake Level

(UL or TUL)

Answer 8

Highest average daily intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population.

Question 9

Reference Daily Intake

(RDI)

Answer 9

The highest RDA value among the different age and gender groups.

Used to determine the micronutrient amount per serving for food labels.

Question 10

Acceptable Macronutrient Distribution Range

(AMDR)

Answer 10

The breakdown of the % of total calories provided by fat, carbohydrate, and protein.

Question 11

Nutrition Facts Label

Answer 11

Required on most types of packaged foods.

Contains 2 types of information in the US:

Nutrient content and list of ingredients

Based on serving size and number of servings per container

• Items above the heavy line:
  
  • Macronutrients
    
    • 100% daily value (%DV) represents an upper limit (DRV)
    • No RDA for these nutrients
    • Fiber
      
      • 100% daily value (%DV) based on recommendation of 25 g/day
    • ​Sugars ⇒ mono- and disaccharides
    • Remainder of carbs are complex carbs = total less sugars and fibers
  • Sodium
  • Cholesterol
• Items below the heavy line:
  
  • %DV is the mininum value for any individual
    
    • Based upon the highest RDA among age groups for micronutrients
    • Denominator used is RDI
    • Would be higher for someone with a lower RDA

Question 12

Food Label Revisions

Answer 12

1. Newer values for daily requirements used to calculate %DV
2. Added sugars now included
3. Vit D & potassium added. Vit A & C removed
4. Calories from fat removed ⇒ type more important than amount
5. Serving sizes revised to reflect what is actually eaten
   
   • Things usually consumed in one sitting now reported as single serving per container
   • Larger packages should clearly indicate “per serving” vs “per package”
6. Calories and serving sizes more prominent

Question 13

Healthy Eating Index

(HEI)

Answer 13

Used to assess whether individuals or populations are compliant with recommendations.

If they are, does this translate to getting enough nutrients.

Score on 0-100 scale.

All components of the nation’s intake inadequate (20% to 82%) except for proteins.

Question 14

Basal Metabolic Rate

(BMR)

Answer 14

The energy needed to carry out fundamental metabolic functions.

• Measured with subject fasted, laying quietly in a room of comfortable temperature
• Varies with age and sex
• Lean body mass major determinant (men with less body fat)
• Values normalized for surface area

Question 15

Allergy vs Intolerance

Answer 15

Food allergies are immune responses which can be life threatening.

Most common are eggs, peanuts, and milk.

Food intolerances are non-immune responses.

Question 16

Nutrition in Infancy

Answer 16

Ideal infant nutrition based on human milk.

Must provide for the greater metabolic needs and growth rates.

Question 17

Nutrition in 1 to 10 y/o Child

Answer 17

• Most children with access to a varied diet will choose adequate amounts of all nutrients.
• Major concerns:
  
  • iron deficiency anemia in 1-3 y/o
  • inadequate calcium intake for good bone development
  • inadequate protein intake in vegan children and those with allergies
  • over-nutrition (obesity)

Question 18

Nutrition in Adolescence

Answer 18

• Adolescence associated with intense anabolism
• Food habits can produce deficiencies in some nutrients:
  
  • Vit A & B₆
  • Calcium
  • Iron
  • Zinc
  • Folate
• Excess fats and sodium common
• Eating disorders a concern
• Obesity can be a significant problem

Question 19

Nutrition in the Elderly

Answer 19

Nutritional requirements unchanged or even increased (e.g. protein) at a time when total food consumption decreases resulting in unmet needs.

• High probability of malnutrition
• Decreased appetite ⇒ insufficient essential nutrient content in calorically adequate meals
• Changes in vitamin and mineral absorption ⇒ changes dietary requirements
• Greatest risk for inadequacy:
  
  • Proteins
  • Vit B₁₂
  • Calcium & Vit D
  • Vit C
  • Zinc
• Age-related achlorhydria ⇒ reduced output of stomach acid

Question 20

Nutritional Problems With Aging

Answer 20

• Sensory change: loss of smell, taste may make foods less appealing.
• Physical limitations can affect nutrition by affecting ease of obtaining and preparing foods.
• Social factors: Social isolation, loneliness, depression may result in inadequate diet, problems with transportation, financial problems.

Question 21

Vegetarianism

Answer 21

• Subject to individual preference and varies in strictness
  
  • vegan ⇒ no meat or dairy
  • lacto-ovo-vegetarianism ⇒ allows eggs and dairy
• Nutritional benefits:
  
  • lower saturated fats
  • higher fiber intake
  • higher antioxidants
  • lower body weight
  • lower incidence of heart disease
• Nutritional concerns:
  
  • deficient in some amino acids
  • may be deficient in Vit B₁₂, calcium, Vit D, iron, zinc
• Compensation for any deficiencies important in infants and children

Question 22

Drug-Nutrient Interactions

Answer 22

Drugs may interact with foods favorably or unfavorably.

Many drugs can cause nutritional problems.

Foods can interfere with or potentiate the actions of some drugs.

Question 23

Tyramine and MAO inhibitors

Answer 23

• Tyramine = monoamine that can induce the release of norepi from SNS terminals
  
  • Leads to ↑ BP and HR
  • Derived from tyrosine in foods via fermentation or decay
• Tyramine metabolized by monoamine oxidase
• Patients taking MAO inhibitors may have elevated tyramine levels
• Results in risk for increased BP ⇒ hypertensive crisis

Question 24

Effects of Health on Nutrition

Answer 24