Chapter 1: Introduction to Nutrition and

Nutrition guidelines
Terms defined…what is the difference?

Nutrition Nutrients

Malnutrition Diet
 What is
Nutrition?
Nutrition defined

The science that links foods to health and disease.

It includes the processes by which the human organism ingests, digests,
absorbs, transports, and excretes food substances.
 Mortality Lebanon

About 80% of tot deaths in Lebanon are due

to conditions influenced by nutrition

WHO country profile. http://www.who.int/countries/lbn/en/ accessed September 2016

 Nutrition and Diseases

Not all diseases are equally influenced by the diet

 Some are purely genetic, some may be influenced by diet, some are
purely dietary
What is Malnutrition?
Disease/condition highly nutrition related. It is caused by:

Excess food energy or nutrient intake (overnutrition)

Deficient food energy or nutrient intake (undernutrition)
Nutrient imbalance
 Nutrients vs food

Food: any substance that the body can take in and assimilate
that will enable it to stay alive and to grow. It is the carrier of
nourishment.

Nutrients: components of food that are vital for the body’s

functioning, growth and maintenance

Diet: The foods a person usually eats and drinks.

Human body and food:
same material different
arrangement
Nutrients
6 classes:
4 organic (contain Carbon)
2 inorganic (do not contain carbon)

Micronutrients (Small Amounts) Macronutrients (Large Amounts

Carbohydrate
Vitamins Minerals
Fat
Protein
Water
Chapter 1 Part 2 Nutrients and Energy
Where does our energy
come from?

Energy in Food fuels our body

This energy is measured in Calories (Cal) which is a unit of energy

A Calorie: the amount of heat energy necessary to raise the temperature of 1 kg water 1
degree Celsius
 Energy-Yielding nutrients

The nutrients the body can use as energy source:

Carbohydrates, fats (lipids) and proteins
Nutrient Energy
Carbohydrate 4 Cal/g (Kcal/g)
Protein 4 Cal/g (Kcal/g)
Fat 9 Cal/g (Kcal/g)

Alcohol: 7Cal/g but alcohol is not considered a nutrient

Water, Vitamins and minerals do not yield energy
 Calculating calories

How many calories in a typical deluxe hamburger

sandwich?

-Carbohydrate: 39 grams
(39 x 4= 156 kcal)

-Fat:32 grams
(32x 9= 288 kcal)

-Protein: 30 grams
(30 x 4= 120 kcal)

Total calories=156+288+120=564 kcal

 Why do we
need energy?
 Metabolism
= The sum of all chemical reactions
in the body

Anabolism : synthesis reactions (require

energy)
Catabolism: break down reactions (release
energy)

Enzymes: Proteins that catalyze metabolic

reactions in the body. They are specific for
their substrate and for the chemical reaction
that they catalyze.
 How do we judge which
foods are most nutritious?

Foods that offer the most nutrients per calorie count are considered the most nutritious
 Nutrient Density
Nutrient density is used to determine the nutritional quality of a food

Foods rich in nutrients relative to their energy contents are nutrient dense

amount of nutrients
amounts of calories

Hence, the more nutrients and the fewer the Calories, the higher the nutrient
density
Comparison
of Nutrient
Density
 Empty calories?

Very low nutrient density

In addition to nutrients, foods may contain additional
beneficial non-nutrients called phytochemicals
Phytochemicals

Compounds in plant-derived foods that have biological

activity in the body

Confer color, taste, etc. on foods

Many are thought to affect health by reducing disease

Capsaicin: a compound in
pepper that gives burning
taste with heart health
benefits

Allicin: a compound in
garlic that gives pungent
flavor and has antimicrobial
properties

Tannins: Antioxidants
found in wine and tea that
may prevent some cancers
Chapter 1 Part 3 Nutrition Guidelines
The challenge of
choosing foods
All foods once looked like this...
...but now
many foods
look like this
The variety of foods available to
the consumer today makes it
harder, rather than easier to plan
a nutritious diet.
Factors Affecting Food Choices
Social needs

Social network
Psychological
of family
needs
and friends

Food customs
Food flavor, texture,
and appearance and
preferences
culture

Food availability Food cost

Education,
Food marketing occupation,
and income

Health and nutrition Routines

concerns, knowledge, and
and beliefs habits

Lifestyle
 The challenge of choosing foods

Selecting foods that support good health requires

knowledge about caloric density, and nutrient
and non-nutrient contents of foods.

Even more importantly is the knowledge of how to

combine different food groups into a nutritious
diet.
 How, Exactly,
Can I Recognize
a Nutritious
Diet?
 The 5 characteristics
of a NUTRITIOUS DIET

Adequacy (Provides enough of the essential nutrients)

Balance (do not overemphasize one nutrient or food type at the expense of another)
Calorie control (foods should contain the right amount of energy to maintain a healthy
weight- adjusted to energy expenditure)

Moderation (stay moderate with salt, sugar, lipids)

Variety (different food choices each day to ensure intakes of all nutrients)
Nutrition standards, tools
and guidelines
 Dietary
Dietary Pictorial
Reference
Guidelines guidelines
Intakes
Scientists & Government Government
Researchers Agencies Agencies

Nutrient needs for Nutrient needs are

Dietary Guidelines
each nutrient translated into
are transformed into
determined through guidelines of food
easy to read images
research intakes

Grams & milligrams Food is categorized Made for the

& micrograms for into groups and consumer & include
nutrients to avoid portions are examples like the
deficiency & toxicity recommended pyramid, the plate…
 Dietary Reference Intakes
Reference values that are quantitative estimates of nutrient intakes to be used for planning and
assessing diets for apparently healthy people

Estimated Average Requirements (EAR)-for research only

Recommended Dietary Allowances (RDA)-for public as target intakes
Adequate Intakes (AI)- for public as target intakes
Tolerable Upper Intake levels (UL)- for safety
Estimated Energy Requirements (EER)
http://fnic.nal.usda.gov/interactive-dri-glossary. Retrieved September 2014
 Recommended Daily (or Dietary)
Allowance (RDA)

Values intended to be used as nutrient goals in planning nutritious

diets for individuals

The quantity of a particular nutrient which should be consumed

daily in order to maintain good health.

Classified according to gender, age, pregnancy/lactation

http://fnic.nal.usda.gov/interactive-dri-glossary. Retrieved September 2014

Dietary Guidelines
 Dietary guidelines
Different countries have different guidelines and
different pictorial representations
 Lebanon has its own dietary guidelines (the Cedar)
Some other Arab countries also have dietary
guidelines
US & Canada, European countries etc.
 Have you seen these before?

1992 pyramid 2005 pyramid

 MyPlate
 Current American pictorial
guide

MyPlate is divided into sections of

approximately 30% grains, 30%
vegetables, 20% fruits and 20%
protein, and a smaller circle for
dairy, such as a glass of low-
fat/nonfat milk or a yogurt cup.
 MyPlate
MyPlate illustrates the five food groups that are the building
blocks for a healthy diet using a familiar image – a place
setting for a meal.

Fruits Vegetables Grains Protein Foods Dairy

Make at Go lean with
Get your
Focus Vary your least half protein. Vary your
calcium-rich
on fruits. veggies. your grains protein food
foods.
whole. choices
 Myplate: Three Main Points

1. Balancing calories
• Enjoy your food, but eat less
• Avoid over-sized portions
2. Foods to increase
• Make half your plate fruits and vegetables
• Make at least half your grains whole grains
• Switch to fat-free or low-fat (1%) milk
3. Foods to decrease
• Compare sodium in foods like soup, bread, and frozen meals ― and
choose the foods with lower numbers
• Drink water instead of sugary drinks
Dietary guidelines
 14 main points
1. Enjoy and maintain a healthy body
weight
2. Be Physically Active Every Day
3. Eat a Variety of Nutritious Foods Every
Day for a Balanced Diet
4. Eat Cereals, Especially Whole Grains,
as the Basis of Daily Meals
5. Enjoy More Fruit and Vegetables Daily
6. Consume Legume-Based Dishes
Regularly and Enjoy Some Unsalted
Nuts and Seeds
7. Consume Low-Fat Milk and Dairy
Products Every Day
8. Consume at Least Two Servings of Fish,
Including Fatty Fish, Every Week
9. Consume Lean Red Meat and Poultry
10. Limit Intake of Sugar, Especially Added
Sugar from Sweetened Foods and
Beverages
11.Limit Intake of Solid Fats and Replace with
Vegetable Oils
12.Limit Intake of Table-Salt and High-Salt
Foods
13.Drink Plenty of Safe Water Every Day
14.Eat Safe Food
Chapter 1 Part 4 The Mediterranean Diet and
Nutrition Information
The Mediterranean
Diet
 Mediterranean diet?

 Acciaroli, a southern Italian town with about

300 people who have hit 100 years of age!!

 Lower rates of Alzheimers & lower rates of

heart disease!

 People who eat traditional Mediterranean

diets die much less frequently than those
eating the American diet and Northern
Europe diet.

 Why??
The Mediterranean Food Guide Pyramid

=> physical activity + Social Aspect

 The Mediterranean diet is:
Higher in fat than the usual (>40% of calories from fat)
Low in saturated fats, high in monounsaturated fats (olive oil).
Food and Drug Administration (FDA) has approved a qualified health claim for
olive oil: 2 tbsp of olive oil daily may reduce the risk of coronary heart disease
Low in meat & meat products and
High in legumes & grains
High in fruits & vegetables (contain phytochemicals, antioxidants)
Moderate in milk & milk products (yogurt)
Moderate in alcohol Milk
 Spotting accurate
nutrition information
Elements of Nutritional
Quackery in a nutshell

Claim is too good to be true

Claims to have a secret formula
Makes unrealistic guarantees
Claims weight loss much greater than half a kilogram in a
week
Uses “Star” testimonials
 Scientific Challenge

One experiment does not “prove” or “disprove”

anything

A finding that has stood up to repeated rigorous testing

may become a theory

Information must be looked at with an educated eye

 How to determine if a
website is reliable?

WHO? Is the owner of the website qualified to speak on nutrition

(Dietitian? Physician? Other?)
WHEN? When was the website updated?
WHERE? .gov/ .org/ .edu/
WHY? selling of a product?
WHAT? What is the message-beware of information that
contradicts common knowledge
 Reliable Websites:
Examples
Credible Website/Scientific Databases
www.lebanondiet.org www.googlescholar.com
www.medlineplus.gov www.pubmed.gov
www.eatright.org www.who.int
www.dietitians.ca www.sciencedirect.com
ww.usda.gov www.fda.org
www.os.dhhs.gov www.hc-sc.gc.ca
www.americanheart.org www.cancer.org
www.acsh.org www.diabetes.org
Chapter 1 Part 5 Food Labelling
 Food Label

Helps in food choice selection and in planning a nutritious and balanced diet
Information on the label should contain:
Name of product
Name and address of manufacturer
Net content (weight)
Expiry and manufacturing dates
An ingredient list
A nutrition facts panel

The label may also contain one or more nutritional claims or Health claims
 Food labels in Lebanon
• According to the Lebanese Law the following must be displayed on a label:

• The goods' ingredients and/or composition

• The net weight, volume or number of the goods
• The shelf life of the goods
• The country of origin, or the place of origin with regard to recognized
Countries Unions
• The name and address of the manufacturer or supplier
• The side effects and the safety instructions of the goods
• NUTRITION FACTS LABEL IS NOT MANDATORY

http://www.trade.gov/td/standards/markets/Africa,%20NearEast%20and%20South%20Asia/Lebanon/Lebanon.pdf Retrieved January 2017

How to read nutrition
facts

 Check the serving size &

servings/container (metric system)

 Check calories & nutrients

 Let Daily values be your guide

Serving size & calories The number of servings you
consume determines the
per serving number of calories you
actually eat

Pay attention to the

serving size

So if you had 2 servings you

How many servings would get 500 Cal
there are in the food
package.
General Guide to Calories
40 Calories is low
100 Calories is moderate
400 Calories or more is high
 Nutrients? How much?
Limit These Nutrients Quick Guide to %DV

• The 5-20 Guide

• 5%DV or less is low

• 20%DV or more is high

Get Enough of These
• Aim for 5% or less from the fats,
cholesterol & sodium

• Aim for 20% or more from Fiber,

Vitamins and minerals
 What are (%) Daily Values?

Unlike RDA, DV do not vary among age groups and life stages

Reflect the needs of an “average” person – a person eating 2000-

2500 Cal/d (no gender difference, set close to RDA)

Because the DV apply to all people, they are much less useful as
nutrient intake goals for individuals

http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition
Retrieved January 2017
Example DV and %DV

Nutrient DV %DV Goal

Total Fat 65g = 100%DV Less than

Sat Fat 20g = 100%DV Less than
Cholesterol 300mg = 100%DV Less than
Sodium 2400mg = 100%DV Less than
Total 300g = 100%DV At least
Carbohydrate
Dietary Fiber 25g = 100%DV At least

http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition Retrieved January 2017

Attention to portion sizes
1 serving

2 servings
 Nutrients without (%DV)

Trans fat, Sugars and, Protein do not list a %DV on the

Nutrition Facts label

1. trans fats should be kept as low as possible…setting

a daily value is like allowing some intake

2. Sugars include the natural sugars and the added

sugar together so no recommended intake

3. Proteins recommendations are per kg body weight

http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition Retrieved January 2017

 Ingredients

The product’s ingredients must be listed

in descending order of predominance
by weight

Whole grain oats highest by weight and Vitamin E lowest

http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition Retrieved January 2017

 Nutrient Claims

If a food meets specified criteria, the

label may display certain approved
nutrient claims concerning the
product’s nutritive value
http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition Retrieved January 2017
 Nutrient Claims

They have very precise/approved nutritional meanings.

– Reduced calories: at least 25% lower in Cal than regular food

– Low Cal: not more than 40 kcal/serving
– Fat free: less than 0.5g of fat per serving
– Low sodium: 140 mg or less sodium/serving
– Low cholesterol: < 20mg of cholesterol/ serving
 Health Claims

Health claims describe a relationship between a food substance (a

food, food component, or dietary supplement ingredient), and reduced
risk of a disease or health-related condition

Claims on labels should be from a list of approved Health Claims

Any additional claims must be reviewed and evaluated prior to use

http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition Retrieved January 2017

 Health Claims
Some approved health claims

•Diet with enough calcium and risk of osteoporosis

•Diet low in total fats and reduced risk of some cancers

•Diet low in saturated fat and cholesterol and reduced risk of cardiovascular
disease

•Diet low in sodium and high in potassium and reduced risk of hypertension

•“May” or “Might” qualifier must be present in the statement

 New food label…
what is different?

http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition Retrieved January 2017

 New food label law

New label law issued in

2016

The FDA extended the

compliance dates from July
2018 to January 2020/2021

http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition Retrieved January 2017