MPU 3343 NUTRITION & PUBLIC HEALTH

CHAPTER 1 An Overview of Nutrition

Introduction
What is Nutrition?
- The study of food, including how food nourishes our bodies and how food influences our
health

Diet & Health

- Food plays vital role in supporting health
~ Chronic disease – epidemic levels
~ Multiple factors over multiple years
~ Leading causes of death
- Risk factors
~ Persist over time
~ Cluster
- Prominence of risk factors
~ Tobacco
~ Diet & activity patterns
~ Others

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The Nutrients
1. Carbohydrate
2. Protein
3. Lipid (Fat)
4. Vitamins
5. Minerals
6. Water

Elements in the Six Classes of Nutrients

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Macro vs Micro
- Macronutrients: nutrients required in relatively large amounts
~ Carbohydrates, lipids, proteins, water
~ Most provide energy to our bodies
- Micronutrients: nutrients required in smaller amounts
~ Vitamins and mineral

Energy-Yielding Nutrients
- Carbohydrate: 1 g = 4 kcal
- Protein: 1 g = 4 kcal
- Fat: 1 g = 9 kcal
- Alcohol
~ Not a nutrient
~ 1 g = 7 kcal

Why do you eat what you eat?

Daily food choices
- Social factors
- Behavioural factors
- Genetics

Food Choices
- Personal preference
~ Taste
~ Sweet and salty
~ Genetics
- Habit
- Ethnic heritage or tradition
- Social interactions
- Availability, convenience and economy
~ Benefits of home-cooked meals
- Positive and negative associations
- Emotions
~ Boredom, depression, anxiety
~ Stress

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- Values
~ Religious beliefs, political views, environmental concerns
- Body weight and image
- Nutrition and health benefits
~ Functional foods

Conducting Research
- Use of scientific method
~ Systematic process for conducting research
- Research studies
~ Experimental
~ Epidemiological
- Epidemiological studies
~ Cross-sectional studies
~ Case-control studies
~ Cohort studies
- Experimental studies
~ Laboratory-based animal studies
~ Laboratory-based in vitro studies
~ Clinical trials

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Examples of Research Designs

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Analyzing Research Findings

- Correlations – only show association
~ Positive correlation
~ Not necessarily a desired outcome
~ Negative correlation

Publishing Research
- Findings are preliminary when published
~ Not meaningful until replicated
- Peer review
~ Research has validity
- Gold Standard
~ Placebo
~ Double-Blind

Dietary Reference Intakes

- Standards defined for:
~ Energy
~ Nutrients
~ Other dietary components
~ Physical activity
- Collaborative effort of U.S. and Canada
- Recommendations apply to healthy people
~ May be different for specific groups
- Estimated Average Requirements (EAR)
~ Average amount sufficient for half of population
- Recommended Dietary Allowances (RDA)
~ Recommendations to meet needs of most healthy people
~ About 98% of population
- Adequate Intakes (AI)
~ Insufficient scientific evidence
~ AI value set instead of RDA
~ Expected to exceed average requirements
- Tolerable Upper Intake Levels (UL)
~ Point where nutrient is likely to be toxic
~ Helps protect against overconsumption
- Estimated Energy Requirement (EER)
~ Amount of calories needed for all daily functions
~ Includes calories needed for both vital functions of life and physical activity
- Acceptable Macronutrient Distribution Ranges (AMDR)
~ Adequate energy and nutrients
~ Reduce risk of chronic diseases
~ Range
~ 45-65% kcalories from carbohydrate
~ 20-35% kcalories from fat
~ 10-35% kcalories from protein

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Nutrition Assessment – Individual Level

- Deficiency or excess over time leads to malnutrition
~ Undernutrition and overnutrition
- Symptoms of malnutrition
~ Diarrhea
~ Skin rashes
~ Fatigue
~ Others
- Creating a “total picture” of the individual
~ Historical information
~ Health status, drug use
~ Diet history
- Anthropometric measurements
~ Height and weight – track to identify trends
- Physical examinations
- Laboratory tests

Nutrition Assessment – Population Level

- National nutrition surveys
~ National nutrition monitoring program
~ Coordinates two major national surveys
~ Oversample high-risk groups
- National health goals
~ Healthy People
- National trends

Healthy People 2020 Nutrition & Weight Status Objectives

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Nutrition Information & Misinformation

Highlight 1
- Validity of information
~ Who is providing information?
~ Qualification
- Internet
~ Anyone can publish anything
~ No guarantees of accuracy
~ Evaluate websites
~ Who, when, where, why and what?
- News
~ Often tell lopsided story
~ Testimonials
~ Tight deadlines
~ Limited understanding
~ Current and controversial
- Identifying nutrition experts
~ Physicians & other health-care professionals
~ Training in nutrition is limited
- Registered Dietician (RD)
~ Degree and clinical internship
~ National exam
~ Maintain up-to-date knowledge
- “Nutritionist” is not a regulated title
~ No required training or education

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