Lesson 3

NUTRITION TOOLS, STANDARDS AND

GUIDELINES

NUTRITION POLICY AND NATIONAL HEALTH PROBLEMS

Diet, Health, and Public Policy

 Public policy refers to the laws, regulations, and government programs
surrounding a certain topic.
 Nutrition policies are concerned with food guidance for the public, nutrition
standards for government food programs, and the health and well-being of the
population.
 nutritious diet has the six characteristics:
1. adequacy - the characteristic of a diet that provides all the essential
nutrients, fiber, and energy necessary to maintain health and body weight.
2. Balance - the dietary characteristic of providing foods in proportion to one
another and in proportion to the body’s needs
3. kcalorie (energy) control - management of food energy intake
4. nutrient density - a measure of the nutrients a food provides relative to
the energy it provides. The more nutrients and the fewer kcalories, the
higher the nutrient density.
5. moderation - the provision of enough, but not too much, of a substance
6. variety - consumption of a wide selection of foods within and among the
major food groups (the opposite of monotony).

RECOMMENDATIONS FOR DIETARY ENERGY INTAKE

 Growth Periods
o The most rapid growth occurs
during infancy and adolescence,
with continuous but slower
growth taking place between
these periods.
o The rapid growth of the fetus and
the placenta as well as other
maternal tissues makes increased
energy intake during pregnancy
and lactation highly important.
 Adulthood
o With full adult growth achieved,
energy needs level off to meet
requirements for tissue
maintenance and usual physical
activities.
o As the aging process continues, a
gradual decline in BEE and
physical activity decreases the
total energy requirement
o A more rapid decline occurs
around 40 years of age in men and
50 years of age in women.
NUTRIENT AND FOOD GUIDES FOR HEALTH PROMOTION
Healthy People 2020
 Established science-based, national
objectives for promoting health
 Examples of nutrition-related targets
from healthy people 2020:
a. Increase the contribution of total
vegetables to the diets of individuals
aged 2 and older from 0.8 cups
equivalent per 1000 calories to 1.1
cups equivalent per 1000 calories.
b.Reduce consumption of calories from
added sugars from 15.7% of total
calories to 10.8% of total calories in
the diets of individuals aged 2 and
older.
c. Increase the proportion of infants
who are breast-fed at 6 months from
43.5% to 60.6%.
d.Reduce the proportion of U.S.
households reporting food insecurity
from 14.6% to 6.0%.
e. Reduce the proportion of adults aged
18 years and older with hypertension
from 30% to 27% (10% reduction).

Food Guide – helps Americans meet their nutritional needs by preventing

undernutrition and controlling chronic diseases related to overnutrition

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 2

Three Types of Nutrition/Food Guide

1. NUTRITION STANDARDS
a. Dietary Reference Intakes
 The U.S. framework of nutrient standards that provide reference
values for use in planning and evaluating diets for healthy people.
 Categories of reference data:
i. Recommended Dietary Allowance (RDA): The average daily
intake of a nutrient that will meet the requirement of 97% to
98% (or two standard deviations of the mean) of healthy
people of a given age and sex.
ii. Adequate Intake (AI): A suggested daily intake of a nutrient
to meet body needs and support health. The AI is used when
there is not sufficient research available to develop an RDA
but the nutrient appears to have a strong health benefit. The
AI serves as a guide for intake when planning diets
iii. Tolerable Upper Intake Level (UL): The highest amount of a
nutrient that can be consumed safely with no risk of toxicity
or adverse effects. The UL is used to evaluate the nutrient
content of dietary supplements or review total nutrient
intake from food and supplements. Intakes exceeding the UL
usually result from concentrated supplements, not food.
iv. Estimated Average Requirement (EAR): The average daily
intake of a nutrient that will meet the requirement of 50% of
healthy people of a given age and sex. The EAR is used to
plan and evaluate the nutrient intakes of groups rather than
individuals.
v. Acceptable Macronutrient Distribution Range (AMDR): The
AMDR guides the division of kcalories among carbohydrate,
fat, and protein in ranges supportive of health; carbohydrate
should provide 45% to 65% of total kcalories, fat should
provide 20% to 35% of total kcalories, and protein should
provide 10% to 35% of total kcalories
2. DIETARY GUIDELINES
 provide the basis for nutrition messages and consumer materials
developed by government agencies
 Important dietary concepts in the 2010 Dietary Guidelines
Recommendations:
o Substitute lower calorie, nutrient-dense foods for refined grains
and snack foods high in solid fat and sugar (SoFAS).
o The minerals sodium and potassium are known to have opposite
effects on blood pressure, with potassium blunting the blood-
pressure-raising effect of sodium. All population groups are
encouraged to consume two servings of seafood each week to
obtain important fatty acids, selecting from fish low in mercury
content.
3. FOOD GUIDES
 Food guides are intended to help individuals with day-today meal
planning.
 They provide a practical interpretation of nutrition standards and
dietary guidelines that are useful in daily food selection.
 The most commonly used food group guides are
o USDA (United States Department of Agriculture) MyPlate
(ChooseMyPlate.gov)
o Choose Your Foods: Food Lists for Diabetes
o Pinggang-Pinoy

USDA Food Guide

 the USDA’s food group plan for ensuring dietary adequacy that assigns
foods to five major food groups.

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 3

USDA Food Patterns: Recommended Daily Amounts from Each Food Group

FIGURE 3.1. In the figure above, a person needing 2000 kcalories a day, would select 2
cups of fruit; 2½ cups of vegetables; 6 ounces of grain foods; 5½ ounces of protein
foods; and 3 cups of milk or milk products. Additionally, a small amount of
unsaturated oil, such as vegetable oil or the oils of nuts, olives, or fatty fish, is
required to supply needed nutrients.

MyPlate (ChooseMyPlate.gov)
 icon released in 2010, illustrates the five major food groups using a
familiar mealtime visual—a place setting
 The general themes of MyPlate are eat smaller portions, and choose
lower calorie, nutrient-dense foods.

FIGURE 3.2. MyPlate

Note that vegetables and fruits
occupy half the plate and that the
grains portion is slightly larger than
the portion of protein foods.

Source: USDA,
www.chosemyplate.gov

 Pinggang-Pinoy - A visual too guide for Filipinos that tells how much you
should eat in one meal in order to be healthy

FIGURE 3.3. Pinggang-Pinoy

Source:https://
www.fnri.dost.gov.ph/
index.php/tools-and-standard/
pinggang-pinoy

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 4

MyPyramid
- The general messages in the MyPyramid symbol are: physical activity, variety,
proportionality, moderation, gradual improvement, and personalization.
- The specific messages are about healthy eating and physical activity, which
apply to everyone.
- MyPyramid helps consumers find the kinds and amounts of foods they should
eat each day
- Food groups included are:
o Calories and Physical
Activity
o Grains
o Vegetables
o Fruits
o Milk, Yogurt, and Cheese
o Meat, Poultry, Fish, Dry
Beans, Eggs, and Nuts
o Fats and Oils
o Sugars and Sweets
o Salt
o Alcohol

FIGURE 3.4. MyPyramid

Source: https://www.fns.usda.gov/mypyramid

See Appendix C for information on Daily Nutritional Guide Pyramid for Filipinos
or you can check this website, https://www.fnri.dost.gov.ph/index.php/tools-and-
standard/nutritional-guide-pyramid for supplementary data.

Food Lists for Meal Planning

 The Food Lists for Diabetes (formerly called the Exchange Lists) were
introduced in 1950 by the American Diabetes Association and the
American Dietetic Association as a meal-planning tool for people with
diabetes
 Choose Your Foods: Food Lists for Diabetes are grouped in three:
1. Carbohydrates: includes starches (grains, starchy vegetables,
crackers, snacks, and legumes), fruits, milk, sweets, and
nonstarchy vegetables.
2. Proteins: includes animal protein foods arranged by fat content
(lean, medium fat, and high fat) and plant-based proteins
3. Fats: includes both animal and plant fats arranged by degree of
saturation—unsaturated (monounsaturated and polyunsaturated)
and saturated.

Food Labels
 appear on virtually all packaged foods, and posters or brochures provide
similar nutrition information for fresh fruits, vegetables, and seafoods
 Contents:
o The Ingredient List
- All packaged foods must list all ingredients on the label in
descending order of predominance by weight
o Nutrition Facts Panel
- provides such information as serving sizes, Daily Values,
and nutrient quantities
- Serving Sizes
 must be based on the amounts of food or beverage
people actually consume, not what they “should”
consume
- The Daily Values

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 5

 set adequacy standards for nutrients that are

desirable in the diet such as protein, vitamins,
minerals, and fiber
 set moderation standards for other nutrients that
must be limited, such as fat, saturated fat,
cholesterol, and sodium.

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 - Nutrient Quantities
 Nutrition Facts panel must provide the nutrient
amount, percent Daily Value, or both for the
following:
o Total food energy (kcalories)
o Total fat (grams and percent Daily Value)—
note that the proposed revision does not
include kcalories from fat
o Saturated fat (grams and percent Daily
Value)
o Trans fat (grams)
o Cholesterol (milligrams and percent Daily
Value)
o Sodium (milligrams and percent Daily
Value)
o Total carbs, including starch, sugar, and
fiber (grams and percent Daily Value)
o Dietary fiber (grams and percent Daily
Value)
o Sugars, which includes both those naturally
present in and those added to the foods
(grams)
o Added sugars (grams)—note that the
original label does not include a line for
added sugars
o Protein (grams)
o The following vitamins and minerals
(percent Daily Value): vitamin D,
potassium, iron, and calcium
- Front-of-Package Labels
 presentation of nutrient information called
Facts Up Front which provides easier and
quicker way to interpret information and
select product

FIGURE 3.5. This example of front-of-package labeling presents key nutrient

facts.

 Claims on Labels
o Nutrient Claims
- statements that characterize the quantity of a nutrient in a
food

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 7

- e.g. “rich in calcium” on a package of cheese; “good source

of fiber” on a box of cereal
FIGURE 3.6. Nutrient
claims characterize the
level of a nutrient in the
food—for example, “fat
free” or “less sodium.”

o Health Claims
- statements that characterize the relationship between a
nutrient or other substance in food and a disease or health-
related condition.
FIGURE 3.7. Health claims
ocharacterize the
orelationship of a food or
ofood component to a
disease or health-related
o
condition—for example,
o“soluble fiber from oatmeal
odaily in a diet low in
saturated fat and
cholesterol may reduce the
risk of heart disease” or “a
diet low in total fat may
o Structure-
o
o
o Function Claims
- statements that describe how a product may affect a
structure or function of the body; for example, “calcium
builds strong bones.” Structure-function claims do not
require FDA authorization
- The only criterion for a structure-function claim is that it
must not mention a disease or symptom

FIGURE 3.8.
Structure-function
claims describe the
effect that a
substance has on the
structure or function
of the body and do not
make reference to a
disease—for example,
“supports immunity
and digestive health”
or “calcium builds

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 8

FIGURE 3.9. Original and proposed nutrition facts panel

Terms Used on Food Labels

General Terms
 Free: “nutritionally trivial” and unlikely to have a physiological consequence;
synonyms include without, no, and zero. A food that does not contain a
nutrient naturally may make such a claim but only as it applies to all similar
foods (for example, “applesauce, a fat-free food”).
 good source of: the product provides between 10 and 19 percent of the Daily
Value for a given nutrient per serving.
 healthy: a food that is low in fat, saturated fat, cholesterol, and sodium, and
that contains at least 10 percent of the Daily Values for vitamin D, iron,
calcium, potassium, protein, or fiber.
 high: 20 percent or more of the Daily Value for a given nutrient per serving;
synonyms include rich in or excellent source of.
 less: at least 25 percent less of a given nutrient or kcalories than the
comparison food (see individual nutrients); synonyms include fewer and
reduced.
 light or lite: one-third fewer kcalories than the comparison food; 50 percent or
less of the fat or sodium than the comparison food; any use of the term other
than as defined must specify what it is referring to (for example, “light in
color” or “light in texture”).

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 9

 low: an amount that would allow frequent consumption of a food without

exceeding the Daily Value for the nutrient. A food that is naturally low in a
nutrient may make such a claim but only as it applies to all similar foods (for
example, “fresh cauliflower, a low-sodium food”); synonyms include little, few,
and low source of.
 more: at least 10 percent more of the Daily Value for a given nutrient than the
comparison food; synonyms include added and extra.
 organic (on food labels): at least 95 percent of the product’s ingredients have
been grown and processed according to USDA regulations defining the use of
fertilizers, herbicides, insecticides, fungicides, preservatives, and other
chemical ingredients.
Energy
 kcalorie-free: fewer than 5 kcalories per serving.
 low kcalorie: 40 kcalories or less per serving.
 reduced kcalorie: at least 25 percent fewer kcalories per serving than the
comparison food.
Fat and Cholesterol
 percent fat free: may be used only if the product meets the definition of low
fat or fat free and must reflect the amount of fat in 100 grams (for example, a
food that contains 2.5 grams of fat per 50 grams can claim to be “95 percent
fat free”).
 fat free: less than 0.5 gram of fat per serving (and no added fat or oil);
synonyms include zero-fat, no-fat, and nonfat.
 low fat: 3 grams or less fat per serving.
 less fat: at least 25 percent less fat than the comparison food.
 saturated fat free: less than 0.5 gram of saturated fat and 0.5 gram of trans
fat per serving.
 low saturated fat: 1 gram or less saturated fat and less than 0.5 gram of trans
fat per serving.
 less saturated fat: at least 25 percent less saturated fat and trans fat
combined than the comparison food.
 trans fat free: less than 0.5 gram of trans fat and less than 0.5 gram of
saturated fat per serving.
 cholesterol free: less than 2 milligrams cholesterol per serving and 2 grams or
less saturated fat and trans fat combined per serving.
 low cholesterol: 20 milligrams or less cholesterol per serving and 2 grams or
less saturated fat and trans fat combined per serving.
 less cholesterol: at least 25 percent less cholesterol than the comparison food
(reflecting a reduction of at least 20 milligrams per serving), and 2 grams or
less saturated fat and trans fat combined per serving.
 extra lean: less than 5 grams of fat, 2 grams of saturated fat and trans fat
combined, and 95 milligrams of cholesterol per serving and per 100 grams of
meat, poultry, and seafood.
 lean: less than 10 grams of fat, 4.5 grams of saturated fat and trans fat
combined, and 95 milligrams of cholesterol per serving and per 100 grams of
meat, poultry, and seafood. For mixed dishes such as burritos and sandwiches,
less than 8 grams of fat, 3.5 grams of saturated fat, and 80 milligrams of
cholesterol per reference amount customarily consumed.
Carbohydrates:
 Fiber and Sugar high fiber: 5 grams or more fiber per serving. A high-fiber
claim made on a food that contains more than 3 grams fat per serving and per
100 grams of food must also declare total fat.
 sugar-free: less than 0.5 gram of sugar per serving.
Sodium

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 10

 sodium free and salt free: less than 5 milligrams of sodium per serving.
 low sodium: 140 milligrams or less per serving.
 very low sodium: 35 milligrams or less per serving

THE NUTRITIONAL GUIDELINES FOR FILIPINOS (NGF)

 The Nutritional Guidelines for Filipinos (NGF) is a set of dietary guidelines
based on the eating pattern, lifestyle, and health status of Filipinos.
 The NGF contains all the nutrition messages to healthy living for all age
groups from infants to adults, pregnant and lactating women, and the
elderly.
 The first NGF released in 1990 was composed of five messages called
“Dietary Guidelines for Filipinos.”
 The 2012 NGF now includes the basis and justification for each of the ten
nutritional and health message.

Below are the new messages of the 2012 NGF:

1. Eat a variety of foods everyday to get the nutrients needed by the body.
- There is no single food that contains all the nutrients that our body
needs so eating a variety of food ensures that daily nutritional needs
are met.
- Based on the said survey, the Filipino household diet fell below the
recommended levels except for niacin, which is above the
recommended.
- all nutrients and energy were below the 100 percent adequacy levels
2. Breastfeed infants exclusively from birth up to six months and then give
appropriate complementary foods while continuing breastfeeding for two
years and beyond for optimum growth and development.
3. Eat more vegetables and fruits to get the essential vitamins, minerals, and
fiber for regulation of body processes.
- There was also a decrease in consumption of fruits from 77 grams in
205 to 54 grams in 2008 and also a decrease in milk consumption from
44 grams to 42 grams.
4. Consume fish, lean meat, poultry, egg, dried beans or nuts daily for growth
and repair of body tissues.
5. Consume milk, milk products, and other calcium-rich food such as small fish
and shellfish, everyday for healthy bones and teeth.
- Vegetables and fruits are the main sources of vitamins, minerals, and
fiber, while milk is a good source of calcium.
6. Consume safe foods and water to prevent diarrhea and other food-and
water-borne diseases.
7. Use iodized salt to prevent Iodine Deficiency Disorders.
- Low urinary iodine excretion is still a prevalent problem among
pregnant and lactating mothers, indicating to low iodine intake. Iodine
is important during pregnancy because it is needed for the brain
development of the infant while lactating mothers must have
adequate supply of iodine in their breastmilk
8. Limit intake of salty, fried, fatty, and sugar-rich foods to prevent
cardiovascular diseases.
- heart diseases ranked first among the causes of death based on the
2005 Department of Health survey
- Salt and soy sauce were among the top 10 widely used miscellaneous
food items used by Filipinos

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 11

- Excessive intake of salt and soy sauce can result to high blood pressure
especially to salt-sensitive individuals. Persistent high blood pressure
can result to cardiovascular diseases.
- High cholesterol level may be attributed to the high consumption of
sodium rich foods by Filipinos
- The total cholesterol level among Filipino adults increased from 8.5
(mg/dL) in 2003 to 10.2 (mg/dL) in 2008.
9. Attain normal body weight through proper diet and moderate physical
activity to maintain good health and help prevent obesity.
- There is also a decreasing trend of physical inactivity among Filipinos
and also a large percentage of Filipino smokers at 31.0% and drinkers
at 26.9%.
10. Be physically active, make healthy food choices, manage stress, avoid
alcoholic beverage, and do not smoke to help prevent lifestyle-related non-
communicable disease.
- People are always encouraged to exercise at least thirty minutes a
day, three to five times a week.
- Limit alcohol drinking to one drink per day for women and two drinks
for men is also advised.
- One alcoholic drink is equivalent to one and half ounce distilled
beverage such as gin or 12 ounces or a bottle of beer or four ounces
wine or half glass wine or an ounce of 100 proof whiskey.

Concept Check!

Gather at least 10 food labels with health claims, nutrient claims or

structure-function claims and paste it in a long coupon bond. Choose at
least one (1) food label which you think will benefit you most and why.

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 12

Laboratory Activity
1. Using a 1,500 caloric requirement, calculate and plan a high carbohydrate diet
allowing 70% of total caloric requirement for carbohydrates. Prepare a sample
menu for lunch.

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023

 13

MODULE SUMMARY

In Module I, you have learned about important nutrition concepts, how food
is processed in the digestive system and the tools and standards used for nutrient
recommendations.

There are three lessons in module I. Lesson I consists of basic nutrition

concepts. Health and malnutrition are defined and overnutrition and undernutrition
are differentiated.

Lesson II entails the process of digestion, the function of each digestive

organ and the enzymes and other substances involved.

Lesson III deals with the nutritional tools and standards, dietary guidelines
and food labels. It defined the four categories of the DRI, the Estimated Energy
Requirement (EER), and the Acceptable Macronutrient Distribution Ranges (AMDR),
and explain their purposes.

Congratulations! You have just studied Module I. now you are ready to
evaluate how much you have benefited from your reading by answering the
summative test. Good Luck!!!

SUMMATIVE TEST
Via google classroom

Module I Nutrition and Diet Therapy, 1st Semester AY 2022-2023