Nutrition Flashcards
Learning outcomes
Explain how nutrient needs are derived and defined in the UK
Distinguish between appropriate and inappropriate use of UK Dietary Reference Values
Describe UK Food-based dietary guidelines
Recognise population groups at risk of dietary inadequacy
Define major dietary patterns for promotion of health and management of disease
Why are DRVs important?
-Requirements are different for each nutrient and vary between individuals and life stages
-The UK have set Dietary Reference Values (DRVs) for population
-DRVs are estimates of the amount of energy and nutrients needed by different groups of healthy people
-DRVs originally set to prevent nutritional deficiencies
A broader DRV approach now considers nutrient -needs for optimum health i.e. incorporating scientific evidence for nutrition and chronic disease prevention
-SACN advise on diet-health for UK population
DRV terminology
Estimated Average Requirement (EAR)
The average requirement for a nutrient for a group of individuals
By definition, will meet the needs of 50% of the population
Reference Nutrient Intake (RNI)
2 standard deviations above the EAR
Will meet the needs of 97.5% of the population i.e. nearly all
Lower Reference Nutrient Intake (LRNI)
2 standard deviations less than the EAR
Will meet the needs of 2.5% of the population
Safe intake
- Set where there is insufficient data to establish LRNI, EAR & RNI
- “A level or range of intake at which there is no risk of deficiency, and below a level where there is a risk of undesirable effects.”
Applications of DRVs
- Refer to average need over time – DRV’s do not have to be consumed every day
- DRVs set for groups not individuals - individual nutritional needs vary
- Refer to levels of intake needed to maintain health in healthy people – no allowances made for illness, malabsorption, genetic abnormalities that can affect nutrient requirements
- Based on best available evidence at the time of update for diff pop. groups– limited data exists for some nutrients ( e.g toxic effect of overconsumption of Vit A)
Sugar recommendations
- The higher the proportion of sugar in the diet, the greater the risk of high energy intake
- High levels of sugar consumption were associated with a greater risk of tooth decay
- Drinking high-sugar beverages results in weight gain and increases in BMI in teenagers and children
- Consuming too many high-sugar beverages increases the risk of developing type 2 diabetes
What is the SACN for salt?
4-6 years- 3g
7-10 years- 4g
11+- 6g
A minority of people intake the SACN for salt daily
Why is Vitamin D important?
- Important for musculoskeletal health
- RNI for vitamin D = 10 µg/d (400 IU/d) for those 4y and above, including pregnant and lactating women
- Safe Intakes rather than RNIs recommended for infants and children aged <4y in the range of 8.5-10 µg/d (340-400 IU/d)
- Difficult to meet requirement from dietary sources
- 30-40% population have low Vit D levels
- 10 µg/d supplement recommended, especially during autumn and winter months
- Supplement recommended all year for children <4years
Why are UK food based dietary guidelines important?
- Individuals do not purchase or consume nutrients as single items in isolation
- Typically multiple nutrients are consumed in one food item number of food items as part of one meal
- The combinations of foods and meals consumed day to day may also vary
- Focusing on single nutrients (e.g., saturated fat) or foods (e.g., free sugars) may not be easy messages for the general public to translate into dietary behaviour change
- Helps public to understand the combinations and proportions of foods/food groups required to achieve required nutrient targets for optimal health and prevention of chronic disease
Where can food standards be monitored and regulated?
- Policy making e.g school meals
- Food industry e.g food labelling
- Academics/research- strengthen evidence for diet and health outcomes in population
- Healthcare
Why is following the eatwell guide important? (Mainly carbohydrates/fruit and veg, some dairy and meat, little processed/junk food)
Eatwell Guide recommendations could reduce the emission of greenhouse gases—one of the biggest drivers of climate change.
High adherence was associated with 1.6kg less CO2 emissions per day, a 30% reduction compared to average daily CO2 emissions of diets with low adherence
Vegan diets and nutritional concerns associated with them
- Vegans do not eat animal foods including meat, fish, poultry dairy products and eggs
- Balanced vegan diets can support health at every age and life-stage
- Requires education and effective planning to ensure all nutrient needs are being met
Nutritional concerns-
Vit B12- Pernicious anaemia, nerve damage,
inc. homocysteine level
fortified foods e.g cereals or dairy free alternatives e.g soya/almond milk
Iron- Iron deficiency anaemia
Dried fruits, wholegrains, nuts, green leafy vegetables, seeds and pulses. Vit C can help absorption
Iodine- Goiter/ hypothyroidism
Iodised salts/ seaweeds
Calcium- Rickets, osteomalacia, osteoporosis
Calcium fortified bread, tofu, okra, kale and rocket
Fortified breakfast cereals
Vit D- Rickets, bone pain, osteomalacia
Fortified diary alternatives, fortified cereals, vegan-friendly vit D supplement
What factors affect diet quality in individuals?
- Diet quality in Northern Ireland worse than other parts of the UK
- Population subgroups more vulnerable to nutritional deficiency or chronic poor quality diet, include those who:
- Are pregnant
- Follow restrictive diets e.g. unplanned vegan diets
- Live alone/socially isolated
- Have low educational attainment
- Have low socioeconomic status
- Live with chronic pain/multimorbidity
- Live in care facilities
Impact of diet on global health
The Lancet Global Burden Disease Study
- Poor diet linked to one in five deaths globally
- Cardiovascular disease is the leading cause of diet-related deaths (10 million deaths), followed by cancers (913, 090 deaths) and Type 2 Diabetes (338, 714 deaths).
- High intake of salt, low intake of whole grains, and low intake of fruit were the leading dietary risk factors for deaths and disability globally
Impact of diet on preventable death in the UK
- 33,000 deaths/yr prevented if UK dietary recommendations were being met
- Most from: coronary heart disease = 20,800; stroke =5,876; cancer= 6,481
- Almost half (15K avoidable deaths) due to inc consumption of fruit and vegetables
- Dec. salt intake to 6g a day would avoid ~8,000 deaths
- Greatest number of deaths avoided would be in Northern Ireland and Scotland, whose populations are furthest from achieving dietary recommendations
The Mediterranean diet and its impact on health
- High intake of vegetables, legumes, fruit and cereals
- Moderate to high intake of fish
- Low intake of saturated lipids
- High intake of unsaturated lipids, particularly olive oil
- Low to moderate intake of dairy products
- Low intake of meat
- Moderate intake of alcohol, mostly as wine
