NUtritional Guidelines

Question 1

Dietary Reference Intakes (DRI)

Answer 1

 Estimate the nutritional requirements of
healthy people
 Include separate recommendations for
different groups of people of a specific age &
gender
 Encompasses four sets of reference values:
i) RDA
ii) AI
iii) UL
iV) EAR

Question 2

Recommended Dietary Allowances (RDA):

Answer 2

Daily dietary intake levels sufficient to meet
the nutrient requirements of approximately
98% of healthy people

Question 3

Adequate Intakes (AI):

Answer 3

The amount of a nutrient thought to be
adequate for most people; used when EAR &
RDA can not be determined

Question 4

Estimated Average Requirements (EAR):

Answer 4

The amount of a nutrient that meets the requirement of 50% of the people of a particular age & gender

Question 5

Tolerable Upper Intake Levels (UL):

Answer 5

The maximum amount of a nutrient that is unlikely
to pose risk of harm in healthy people when consumed daily; intake above the UL can be harmful

Question 6

RDA for Calories

Answer 6

• RDA set at the mean, not above, to ward off greater chance for obesity
• Calorie RDA calculated for the reference man & woman

Question 7

Recommended Dietary Allowance (RDA)

Answer 7

• Prepared by the United States Food and Nutrition
Board (FNB) since 1941.
• The first edition was published in 1943 to provide
“standards to serve as a goal for good nutrition.”

Question 8

Recommended Nutrient Intakes for Malaysia
2005

Answer 8

• RNI = Recommended Nutrient Intake.
• Malaysian RNI was published by the MOH in 2005.
• RNI is the daily intake corresponding to RDA.
• Meets the nutrient requirements of almost all
(97.5%) apparently healthy individuals.

Question 9

Coverage of nutrients in RNI 2005

Answer 9

• Energy
• Macronutrients including protein, fat, and CHO
• Vitamins:
– Thiamin (Vit B1)
– Riboflavin (Vit B2)
– Niacin (Vit B3)
– Folate
– Vit C
– Vit A
– Vit D
– Vit E
• Minerals
– Calcium, Iron, Iodine, Zinc, Selenium

Question 10

How does RNI differ from RDA?

Answer 10

• Nomenclature: RDA/RDI for Malaysia now known as RNI for Malaysia.
• For age-categories, infants are grouped into 0-5
month and 6-11 month.
• Adults are divided into two groups (19-29 years; 30-59 years).
• While elderly are those 60 years and above.
• Reference body weights are established based on
local studies.
• Additional nutrients are included.

Question 11

The Challenge of Dietary Guidelines

Answer 11

• Provide only general guidelines for calorie intake
• Do not address the hazards of nutrient excesses

Question 12

There are 8 principles in the Malaysian Dietary Guidelines:

Answer 12

1) Enjoy a variety of foods.
2) Maintain healthy body weight by balancing food
intake with regular physical activity.
3) Eat more rice and other cereals products, legumes, fruits and vegetables.
4) Minimize fat in food preparation and choose foods that are low in fat and cholesterol.
5) Use small amounts of salts and choose foods low in salt.
6) Reduce sugar intake and choose foods low in sugar
7) Drink plenty of water daily
8) Practice and promote breastfeeding

Question 13

Ministry of Health through its Division of Family Health Development implements several nutrition intervention programs and activities as follows:

Answer 13

A. Supplementary Feeding Programs
B. Multiple Nutrient Supplementation
C. Nutrition Rehabilitation Program.

Question 14

A. Supplementary Feeding Programs:

Answer 14

1) MOH provided full cream milk powder to undernourished children under 7 years of age, pregnant and lactating mothers.
2) Ministry of Education provides subsidized milk and free meals to primary school children from poor families.
3) The Ministry of Rural development through its KEMAS programs provide meals for preschool children, and food assistance to poor families.

Question 15

B. Multiple Nutrient Supplementation

Answer 15

The Ministry of Health distributes iron, folic acids,
vitamin C and B complex to pregnant women
during their antenatal check-ups.

Question 16

C. Nutrition Rehabilitation Program.

Answer 16

Moderately and severely malnourished children
under 7 years of age are given food aid
comprising essential items such as rice,
anchovies, biscuits, milk powder, cooking oil,
sugar and green gram worth RM 60 every month.

Question 17

Tools Used in Diet Planning

Answer 17

A. Food Group Plans
B. Exchange Lists
C. Food Composition Tables

Question 18

A. Food Group Plans

Answer 18

 Tool that group foods according to similar
origin & nutrient content
 Specifies the number of foods from each group
a person should eat
 Provides a pattern for diet planning to ensure
adequacy & balance
• The Four Food Group Plan
• The Food Guide Pyramid
• The Eatwell plate
• Food Guide

Question 19

B. Exchange Lists

Answer 19

 Lists of foods with portion sizes specified
 The foods on a single list are similar with
respect to nutrient & calorie content & therefore can be mixed & matched In the diet
 Provide help in food selection for calorie control, moderation, balance & variety

Question 20

C. Food Composition Tables

Answer 20

 Tables that list the nutrient profile of commonly
eaten foods
 Includes number of calories, grams of fat, milligrams of sodium, etc.

Question 21

A. Required Information

Answer 21

 Name of the product (statement of identity)
 Name & address of the manufacturer
 Net contents in terms of weight, measure or
count
 Ingredients list with items listed in descending
order by weight
 The Nutrition Facts Panel, unless the package
is too small

Question 22

Nutrition Fact Panel

Answer 22

• Area on the food label that provides a list of
specific nutrients obtained in one serving of food
• Very few foods are exempt from carrying the nutrition fact panel
• Use as a shopping guide to make healthier decisions

Question 23

B. Nutrition Fact Panel

Answer 23

 Serving or portion size
 Servings or portions per container
 Calories per serving
 Calories from fat
 The amounts of total fat, saturated fat, cholesterol, sodium, total carbohydrate, dietary fiber, sugars, protein, vitamin A, vitamin C, calcium & iron

Question 24

Mandatory Components of the Nutrition Facts Panel

Answer 24

1) Total Calories
2) Calories from fat
3) Tota Fat
4) Saturated Fat
5) Cholestrol
6) Sodium
7) Total Carbohydrate
8) Dietary FIber
9) Sugars
10) Protein
11) Vitamin A
12) Vitamin C
13) Calcium
14) Iron

Question 25

C. Daily Values

Answer 25

 Compares the amounts of specific nutrients in
one serving to the amount recommended for
daily consumption
 Provided for both a 2,000-calorie diet & a 2,500-calorie diet
 Food is considered high in nutrient if DV is > 20%
 Food is considered low in nutrient if DV is < 5%

Question 26

D. Nutrient & Health Claims

Answer 26

i. Nutrient content claims: claims such as “lowfat”
& “low-calorie” used on food labels to give consumers an idea of a food’s nutritional profile without having to look at the Nutrition Facts Panel
• These claims must adhere to specific definitions established by the Food & Drug Administration

ii. Health Claims: a statement on the food label
linking the food to a reduced risk of a particular
disease
• The claim must be supported by scientific evidence
• These claims must adhere to specific definitions established by the Food & Drug Administration

Question 27

1. Bread, cereal, rice, noodles and tubers

Answer 27

• 6-11 servings/day
• These foods provide complex carbohydrates and fiber, vitamins (riboflavin, thiamin, niacin and folic acid), minerals (iron and magnesium) and protein.
• Main source of energy.

Question 28

2. Fruits and vegetables

Answer 28

• 3-5 servings/day
• These foods provide fiber, vit. A, vit. C, folate, potassium, iron, and magnesium.

Question 29

3. Fish, poultry, meat and nuts

Answer 29

• 2-3 servings/day
• These foods contribute protein, phosphorus, vit B6, vit B12, zinc, magnesium, iron, niacin, and thiamin.

Question 30

4. Milk and milk products

Answer 30

• 2-3 servings/day
• These foods provide calcium, riboflavin, protein,
vitamin B12, when fortified, vitamin D and A.

Question 31

5. Fat, oil, sugar and salt

Answer 31

• Use sparingly
• Supply calories but little or no vitamins.
• High intake may lead to CVD, diabetes and other
chronic disease in a long term usage.

Question 32

Portion Distortion

Answer 32

• Portion – the amount of food eaten in one sitting
• Serving size – the standard amount or
recommended portion of food for which the nutrient composition is presented
• Portion sizes have increased over the years

Question 33

• Increased portion sizes have contributed to

Answer 33

– Increased kcal intake
– Increased weight
– Increased risk of developing
• Cardiovascular disease
• Diabetes
• Joint problems
• Cancers

Question 34

Nutrient dense

Answer 34

– Measurement of the nutrients in a food compared to the kilocalorie content
– High in nutrients and low in kilocalories
– Provide more nutrients per kilocalorie
– Low in fat and added sug

Question 35

• Energy density

Answer 35

– Measurement of kilocalories compared with
weight (grams) of the food
– Most high-fat foods

Question 36

Low-energy-dense foods

Answer 36

– Lower in fat and high in nutrient content
– Means larger portions for the same number of kilocalories

Question 37

Time of Day and Eating: Does It Impact Your Health?

Answer 37

• Eat breakfast may decreases the total number of
kilocalories you eat in a day
– Increased satiety with breakfast foods
– May be a good strategy for weight control
• Eating later in the day may increase kilocalorie
intake
• Eating more fat and consuming more alcohol on
the weekends can result in weight gain

Question 38

Determination of Food Energy

Answer 38

Energy in foods
 Measured in kilocalories (kcal)
Definition of a calorie:
 A unit of measure for energy in food.
 Energy needed to raise the temperature of 1 ml/gram of water by one degree Celsius. This unit is used as a measure of the energy released by food as it is digested by the human body.
Nutrients that have Calories:
 Proteins
 Carbohydrates
 Fats

Question 39

Calories per gram:

Answer 39

Protein 1 Gram = 4 calories
Carbohydrates 1 Gram = 4 calories
Fat 1 Gram = 9 calories