# Nutrition (NUT200) # AFTERMID

1- 2015-2020 Dietary Guidelines (Myplate)

* These Guidelines embody the idea that a healthy eating pattern is not a rigid prescription, but
rather, an adaptable framework in which individuals can enjoy foods that meet their personal,
cultural, and traditional preferences.
The 2015-2020 Dietary Guidelines provides FIVE overarching Guidelines
1. Follow a healthy eating pattern across the lifespan. All food and beverage choices matter.
Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a
healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease.
2. Focus on variety, nutrient density, and amount. To meet nutrient needs within calorie limits,
choose a variety of nutrient-dense foods across and within all food groups in recommended
amounts.
3. Limit calories from added sugars and saturated fats and reduce sodium intake. Consume an
eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and
beverages higher in these components to amounts that fit within healthy eating patterns.
4. Shift to healthier food and beverage choices. Choose nutrient-dense foods and beverages
across and within all food groups in place of less healthy choices. Consider cultural and
personal preferences to make these shifts easier to accomplish and maintain.
5. Support healthy eating patterns for all. Everyone has a role.
Dietary Guidelines’ Key Recommendations:-
1- Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate
calorie level.
-A healthy eating pattern includes:
 A variety of vegetables e.g. dark green, red and orange, legumes (beans and peas)
 Fruits, especially whole fruits
 Grains, at least half of which are whole grains
 Fat-free or low-fat dairy, including milk, yogurt and cheese
 A variety of protein foods e.g. seafood, lean meats, eggs, legumes (beans and peas) and nuts
 Oils
2- A healthy eating pattern limits:
 Saturated fats and trans fats, added sugars, and sodium
 Consume less than 10 percent of calories per day from added sugars.
 Consume less than 10 percent of calories per day from saturated fats.
 Consume less than 2,300 milligrams (mg) per day of sodium.
3- Meet the Physical Activity Guidelines for Americans.
The relationship between diet and physical activity contributes to calorie balance, managing body
weight, to promote health and reduce risk of chronic diseases.

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2- Mediterranean Diet
- Definition: It is the dietary pattern found in the olive-growing areas of the Mediterranean region.
- Components:
 High monounsaturated/saturated lipid ratio (e.g. Olive oil), high consumption of plant sources of
foods e.g. legumes, cereals (including bread), fruits and vegetables.
 Low consumption of animal sources of foods e.g. meat and meat products.
 Moderate consumption of milk and dairy products and ethanol.
 Physical activity
3- Vegetarian Diets
Definition: Diets that focus on foods that are left after others have been omitted from the diet.
Types: Meat avoiders - Lacto-ovo vegetarians - Lacto vegetarians - Macrobiotics - Vegans.
4- Dietary Antioxidants
A- Cofactors
1- Zinc (found especially in lamb, leafy and root vegetables, and shellfish)
2- Selenium (found especially in beef, cereals, nuts, and fish)
B- Enzymes
1- Superoxide dismutase (SOD) 2- glutathione peroxidase
C- Vitamins
1- Ascorbic acid (Vit. C), 2- α-tocopherol (Vit. E), 3- folic acid, 4- carotenoids, and flavonoids
5- There are a number of reasons for recommending dietary changes in preference to
supplementation for achieving increased antioxidant status, as follows.
1. It is not clear which antioxidants confer protection.
2. The hierarchy of protection may vary depending on body conditions.
3. A cooperative mix of antioxidants is likely to be more effective than an increased intake of one
antioxidant.
4. Antioxidants, including vitamin A, β-carotene, vitamin C, selenium, and copper, can be harmful
in large doses.
5. Antioxidant status is likely to be affected by the overall composition of the diet e.g., the fatty
acid and phytochemical mix.
6. The iron status of the body, environmental conditions, and lifestyle undoubtedly affect antioxi-
dant demand.
- It is recommended generally that at least five servings of fruits and vegetables are eaten each day.

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6- BMI
- Weight is measured by body mass index (BMI), which is calculated by dividing weight in kilograms by
square height in meters
BMI (kg/m2)
Underweight <18.5
Normal +18.5 – 24.9
Overweight 25.0 – 29.9
Obesity 30.0 – 34.9 (obesity Class I)
35.0 – 39.9 (obesity Class II)
Extreme Obesity >40 (obesity Class III)
7- How to achieve weight loss?
1. Dietary Therapy 2. Physical Activity
3. Behavior Therapy 4. Lifestyle Therapy
5. Pharmacotherapy 6.Weight Loss Surgery
8- For most people, it's hard to cut out sweets completely, so try to follow these more
realistic guidelines:
 Eat carbohydrates (sugars and starches) with a meal.
 If you can't brush your teeth after eating, rinse your mouth with water or mouthwash,
or chew sugarless gum.
 Don't eat sugary foods between meals.
 If you snack, eat non-sugary foods, such as cheese, popcorn, raw veggies, or yogurt.
9- The oral cavity is one of the first regions of the body to exhibit clinical sings of malnutrition.
 The lips, tongue, oral mucosa and gingiva may all reflect nutritional deficiencies.
 The oral epithelium acts as an effective barrier against the invasion of toxic substances,
particularly antigens derived from oral microbes into the underlying collagenous connective tissue.
 Inadequate nutrition can cause the oral epithelia to either break down or to be
compromised to increase the tissues susceptibility to infectious diseases.
 Many severe and even moderate nutrient deficiencies can results in defects in tooth development.
 Nutritional deficiencies weaken the resistance of oral tissue to plaque bacteria, causing an
increase in inflammation and infection.
10- Medical Nutrition Therapy for osteoporosis (ONlY 10 points)
i. Advise all patients to consume adequate amounts of calcium (>1200 mg/d, including
supplements if necessary) and vitamin D (400-800 I U / d for individuals at risk of deficiency).
ii. Women after menopause or over age 65 years will need 1500 mg calcium daily.
iii. For vitamin D, choose fortified milk, cod liver oil, egg yolks, and fatty fish; do not exceed 2000
IU/d.
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 iv. To fulfill the requirement, 1 quart of milk daily can be consumed.
v. If fluid milk is not consumed, dry skim milk powder can be added to many foods.
vi. Aged cheeses and yogurt are sources as well.
vii. Calcium supplements can be used if dairy products are not tolerated.
viii. Calcium absorption averages approximately 30-40% from most sources.
ix. Space the supplements throughout the day.
x. Take no more than 500-600 mg two or more times daily with meals.
xi. Use with calcium vitamin D and magnesium.
xii. Higher doses than the current recommendation of vitaminD in persons over age 65 years
may be required for optimal bone health; use 800-1000 IU/d.
xiii. Encourage use of vitamin D-fortified milk.
xiv. Extra protein may be needed for sufficient intake of vitamin B12, include dairy products,
meat, poultry, fish, and fortified cereals.
xv. Isoflavones may also prove to be beneficial (2-3 servings of soy foods daily).
11- Vitamins C, E and D
Primary Function Consequences of Deficiency
Vitamin C • Required for collagen synthesis. • Bleeding and bruising easily Due
• Acts as an antioxidant; protects LDL to weak-ended blood vessels,
cholesterol, eye Tissues, sperm proteins, cartilage and other tissues
DNA and lipids against oxidation. containing collagen.
• Required for the conversion of the Fe++ • Slow recovery from infections
to Fe+++. and poor wound healing.
• Required for neurotransmitters and • Fatigue, depression.
steroid hormone synthesis.
Vitamin E • Acts as an antioxidant. Prevents • Muscle loss, nerve damage.
damage to cell membranes in blood • Anemia.
cells, lungs and other tissues by repairing • Weakness.
damage caused by free radicals. • Many adults may have
• Reduces oxidation of LDL Cholesterol. No optimal blood levels.

Vitamin D • Required for calcium and phosphorus • Weak, deformed bones

metabolism in the intestines and bone
and for their utilization in bone and
teeth formation, nerve and muscle
activity.
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(Children), rickets, osteomalacia.
• Loss of calcium from bones
(adults), Osteoporosis.
12- Minerals Ca, Fe and Zn
Primary Functions Consequences of deficiency
Calcium  Component of bones and  Poorly mineralized, weak bones
teeth (osteoporosis)
 Required for muscle and  Rickets in children
nerve activity, blood  Osteomalacia (rickets in adults)
clotting  Stunted growth in children
 Convulsions, muscle spasms
Iron  Transport oxygen as a  Iron deficiency
component of  Iron-deficiency anemia
hemoglobin in red blood  Weakness, fatigue
cells  Pale appearance
 Component of myoglobin  Reduced attention span and resistance to
(a muscle protein) infection
 Required for certain  Mental retardation, developmental delay in
reactions involving children
energy formation
Zinc  Required for the  Growth failure
activation of many  Delayed sexual maturation
enzymes involved in the  Slow wound healing
reproduction of proteins  Loss of taste and appetite
 Component of insulin,  In pregnancy, low birth-weight infants and
many enzymes preterm delivery
13- Omega 3 functions
 Helps controlling blood cholesterol levels.
 Reduce the risk of heart diseases.
 The developing fetus and new- born require high amounts of omega-3 fatty acids
and receive them through placenta and breast milk respectively.
 Important for growth.
 For healthy skin.
 For proper function of eyes and nerves.
 Used by the body to make other types of fatty acids.
 Reduce osteoclastic activity and alveolar bone resorption in experimental periodontitis.
 Treatment of arthritis, diabetes, autoimmune disease, depression, psychiatric disease
and even cancer.
 Needed for normal nervous system, involved in mood regulation.

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 Essential for the efficient function of every cell in our body.
 Sharpen attention and enhance learning in those who had appropriate omega- 3
levels before the studies began.
 Protects us against Alzheimer disease.
 Reduces risk of brain damage and stroke.
14- Essential nutrients for oral cavity protection and health
Fats: Omega-3
Vitamins (Vit.): Vit. C, Vit. C, Vit. E, Vit. D, Vit. A, Vit. K, Vit.B12, Vit.B6 and Foliate
Minerals: Calcium, Zinc, Selenium and Iron
15- Quick Nutrition Tips for a beautiful smile
 Limit Soda, Coffee and Alcohol
 Drink Tap Water When Possible
 Monitor Your Low-Carb Lifestyle
 Increase Your Calcium Intake
 Take a Daily Dose of Vitamins C and D
 Put Out the Cigarette
16- Causes of fool breath
1-Vitamin C deficiency 2- Pus 3- Vomiting reflex 4- Sinusitis
17- Causes of xerostomia
1- Aging 2- Patients with bruxism 3- Diabetes 4- Vitamin A deficiency 5- Autoimmune diseases