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Chapter 1: Choosing What You Eat and Why

Professor R. I. Al-Nimr, MS, RD, LD NTRN 201 Spring 2014

Food for Thought
 What Affects Food Choices?  How do food choices play into health?  How much does income impact health?  How much money is spent on food advertisements every year?  How is the changing media landscape affecting our food choices?

Factors Affecting Food Choices
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Social needs Lifestyle Psychological needs Social network of family and friends

Social Media

Food customs and culture

Food flavor, texture, and appearance preferences

Food cost

Food availability

Education, occupation, and income

Food marketing Health and nutrition concerns, knowledge, and beliefs

Routines and habits

© BananaStock/ PunchStock RF

WHY DO YOU EAT THE FOODS YOU EAT?
 Flavor/texture  Convenience  Emotions  Availability  Advertisement  Social Media  Weight control  Health conditions • • • • • • • Religion Family/cultural Peers Nutritive value Cost Health Hunger

Food Spending in America
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.

Total food expenditures adjusted for inflation dipped during the 2007–09 recession 800
Total food 700 Annual food expenditures (2006 dollars, billions) 600 500 400 300 Food away from home 200 100

Recessionary periods Food at home

0

1990 91

92 93 94 95

96 97

98 99

2000

01 02

03 04 05

06

07 08 09

Years

Culture Affects Food Choice
• http://www.time.com/time/photogallery/0,29 307,1626519_1373664,00.html

Why Are You So Hungry?
• Hunger
– Physiological drive

• Appetite
– Psychological drive

Food Advertising
• More than $10 Billion a year is spent on food advertising to children alone. • “Food Styling”: pictures digitally doctored under very specific conditions to present food in the best possible light. • A health claim on the label does not necessarily make a food healthy. • The food industry has one of the most powerful lobbies in the United States Congress.

Food Styling

Social Media
• • • • • 1.15 Billion people use Facebook > 500 million people on Twitter 238 million on Linkedin > 130 million people on Instagram More than 69 % of Pinterest’s 70 million users are female. • There are over 1 billion visits a month on YouTube

Social Media
• • • • Approximately 20 million twitter accounts are fake. There are > 10 million Facebook apps. 81 % of Linkedin users belong to at least 1 group. More than 5 million pics a day are uploaded on Instagram, and 16 billion pictures are up there already. • Garlic Cheesy Bread is the most re-pinned Pinterest pin. • More than 4.2 billion people check their social media sites on their mobile phones – DAILY. • 60 % of consumers say that social media is more likely to make them share products and services.

Satiety
No longer a desire to eat Regulated by the brain Feeding center Satiety center

What is Nutrition?

Nutrition is
• 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.

Nutrients Come from Food
Provide energy Provide building blocks Vital for growth and maintenance Essential

Essential Nutrient
Omission leads to decline Regain normal function when restored to the diet Has specific biological function

Why Study Nutrition?

Nutrition and Health
• Poor diet and sedentary lifestyle are risk factors for chronic diseases:
– Disease of the heart (24.6% of all deaths) – Cancer (23.3%) – Stroke (5.3%) – Diabetes (2.8%) – Accounts for ~2/3 of all deaths

The Six Classes of Nutrients
 Carbohydrates  Lipids  Proteins  Vitamins  Minerals  Water

Nutrient Functional Categories
Provide calories For growth, development, and maintenanceprocesses Regulate body

Carbohydrates
 Major source of calories (~4 kcal/gm)  Simple sugars  Complex carbohydrates  Dietary fiber

Lipids
• • • • • • Fats and oils Do not dissolve in water Energy yielding (~9 kcal/gm) Animal fats (solid) Plant oils (liquid) Essential Fatty Acids

Proteins
 Structural material  Energy yielding (~4 kcal /gm)  Amino acids  Most Americans consume excess protein

Vitamins
Enable chemical reactions Fat soluble Water soluble Subject to cooking losses Yield no energy

Minerals
 Inorganic substances  Numerous functions in the body  Not destroyed during cooking  Major and trace minerals  Electrolytes  Yield no energy

Water
 Numerous vital functions in the body  Majority of our body weight  Recommended intake
– 9-13 cups/day

 Found in foods  Yields no energy

Other Components in Food
 Phytochemicals
– A chemical found in plants
– Not considered essential nutrients – May provide significant health benefits – Found in fruits and vegetables

Superfood De Jour? Kale
• Cancer prevention, eye health and lowered cholesterol. • 1 Cup:
– – – – – – 33 calories 9% of calcium 206% of Vitamin A 134% of Vitamin C 684% of Vitamin K Good source of copper, potassium, manganese, iron and phosphorus.

Transformation of Energy
Carbohydrate
4 kcal/gm

Protein
4 kcal/gm

Fat
9 kcal/gm

Alcohol
7 kcal/gm

ENERGY SOURCES
Build new compounds Nerve transmission Muscular movement electrolyte balance

What is a Calorie?
• Measurement of energy • “The amount of heat it takes to raise the temperature of 1 gram of water by 1 degree Celsius” • 1,000 calories = 1 kcal = 1(food) Calorie

Sample Calculation of a Nutrition Label

 Per serving
– Carbohydrate: 15g x 4 kcal/g = 60 kcal – PRO: 3g x 4 kcal/g = 12 kcal

– FAT: 1g x 9 kcal/g = 9 kcal
– TOTAL: 81 kcal, rounded down to 80

Contribution to Total Kcal
• • • • • One day’s intake = 1980 kcal 290 gm of carbohydrate (x 4 kcal/gm) 60 gm of fat (x 9 kcal/gm) 70 gm of protein (x 4 kcal/gm) % of kcal as carbohydrate = (290 x 4)/1980 = 0.59 or 59% • % of kcal as Fat= (60 x 9)/1980 = 0.27 or 27% • % of kcal as PRO= (70 x 4)/1980 = 0.14 or 14%

Prevalence of Obesity in America1990

Prevalence* of Self-Reported Obesity Among U.S. Adults
BRFSS, 2012 CDC data
*Prevalence reflects BRFSS methodological changes in 2011, and these estimates should not be compared to those before 2011.

15%–<20%

20%–<25%

25%–<30%

30%–<35%

≥35%

The Typical American Diet
 16% of kcal as proteins
– ~66% from animal sources – 10-35% advised

 50% of kcal as carbohydrate
– ~50% from simple sugars – 45-65% advised

 33% of kcal as fat
– ~60 % from animal fats – 20-35% advised

Assessing Our Diets
 National Health and Nutrition Examination Survey (NHANES)  US Dept. of Health & Human Services

Healthy People 2020 www.healthypeople.gov
 Attain high-quality, longer lives free of preventable disease and death  Achieve health equity  Create social and physical environments that promote good health  Promote quality of life

Improving Our Diets
• • • • • • • • Monitor energy intake Salt (sodium) in moderation Alcohol in moderation Fat in moderation Adequate fluids Eat more fruits and vegetables Use supplements wisely Mealtime is a social time

Eating Well in College
• The “Freshman Fifteen”
– Stressful situations – University environment – Peer pressure – Alcohol – Lack of Exercise

Eating Well in College
• Tips to avoid the freshmen fifteen
– Eat breakfast – Plan ahead – Limit liquid calories – Stock the fridge with healthy choices – Exercise regularly

Alcohol Consumption
 Ethanol is the chemical form of alcohol found in alcoholic beverages.  7 Kcal/gram  Accounts for 3% of total calories in the average North American diet.  Produced via fermentation- need yeast

Absorption and Metabolism of Alcohol
• Most efficiently absorbed of all calories sources. • Absorbed in the GI tract via diffusion. • Once absorbed:
– 1-3% is excreted via urine – 1-5% evaporates via the breath – 90-98% is metabolized
• Liver is the primary site; cells of the stomach lining is secondary

Alcohol Metabolism, Cont.
• Alcohol dehydrogenase and acetaldehyde dehydrogenase are the two main enzymes in alcohol metabolism. • Cannot be stored in the body. • Intoxication- when alcohol consumption exceeds the body’s capacity to metabolize. • Women metabolize differently than men.

Benefits of Moderate Use?
 1 drink per day for men; slightly less than one drink for women.  1 drink is:
– 12 oz bottle of beer/wine cooler – 5 oz of wine – 3 oz of liquor – 1.5 oz of 80 proof (+) distilled spirits

 Lower risk for developing cardiovascular disease and type 2 diabetes

Risks of Alcohol Abuse
• Risks outweigh benefits • Alcohol abuse highly preventable and contributes to many leading causes of death in America, including cirrhosis of the liver. • Alcohol abuse can reduce a person’s life expectancy by about 15 years.

Nutrient Deficiencies in Alcoholism
• Drink as a substitute for food • Alcoholics = increased urine output and fat malabsorption • Alcohol has very little nutritive value. • Most susceptible to depletion:
– Vitamins: A, D, E and K; B-6, B12, and C. thiamin, niacin, and folate. – Minerals: calcium, phosphorus, potassium, magnesium, zinc and iron.

Nutrient Toxicities?
 Also a concern for those who abuse alcohol.  Damage to the GI tract and liver and high levels of minerals in some beverages may promote toxicities.  Common toxicities: Vitamin A, lead, iron and cobalt.  Treatment: eliminate alcohol, replenish nutrient stores.

Alcohol Dependence
• Most common psychiatric disorder • Approximately 40% of risk- genetics. • Alcoholism:
– Psychological dependence on alcohol; withdrawal symptoms when intake is interrupted. – Tolerate to the effects of alcohol; higher intake needed. – Evidence of alcohol-associated illness. – Continued drinking, despite strong medical and social contraindications. – Depression, blackouts, and impairment in social and occupational settings.

Binge Drinking
• A “binge” is a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 gram-percent or above. For a typical adult, this pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours
– National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Effects of Binge Drinking
• Binge drinking negatively affects college students’ academic performance, social relationships and health. • Frequent binge drinkers are 21 times more likely than non-binge drinkers to miss classes, fall behind in schoolwork, engage in vandalism, be injured or hurt, engage in unplanned sexual activity, not use protection when having sex, get in trouble with campus police, or drive a car after drinking.

Freshmen- Alcohol Intake

Greenbaum, P.E.; Del Boca, F.K.; Darkes, J.; et al. Variation in the drinking trajectories of freshmen college students. Journal of Consulting and Clinical Psychology 73:229–238, 2005. Graph in NIAAA College Bulletin, NIH Publication No. 07–5010. Printed November 2007. Online at http://www.collegedrinkingprevention.gov/1College_Bulletin-508_361C4E.pdf

Guidance for Alcohol Use
• 1 drink a day for women; 2 drinks a day for men. • Women who are pregnant or may become pregnant, children, adolescents, individuals who take medications that might interact with alcohol and those with certain medical conditions should avoid alcohol. • For weight management- monitor calories from alcohol.

Alcohol Calorie Counter: National Institutes of Health
• Calories Add Up! • http://rethinkingdrin king.niaaa.nih.gov/to olsresources/caloriec alculator.asp

Influence on Food Choice In Older Adults
• • • • • • • • • Dental Health Ability to swallow Dexterity Eating Alone/Mental Health Ability to shop and cook Chronic Disease Medications Diminished ability to taste and smell Diminished appetite
– Changes in hormones and in CNS

Nutrients of Concern for Older Adults
 Calcium, Vitamin D, Vitamin B12  Increased fluid needs  Irregular meal patterns and weight loss may lead to malnutrition.  Congregate and home-delivered meals may assist.
– Meals on Wheels

In Summary
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Social needs

Psychological needs

Social network of family and friends

Food flavor, texture, and appearance preferences

Food customs and culture

Food availability

Food cost

Food marketing and Social Media

Education, occupation, and income

Health and nutrition concerns, knowledge, and beliefs

Routines and habits

Lifestyle

© BananaStock/ PunchStock RF

Video: Poverty and Obesity: When Healthy Food Isn’t an Option
• http://theweightofthenation.hbo.com/films/b onus-shorts/poverty-and-obesity-whenhealthy-food-isnt-an-option#/watch/bonusshorts/poverty-and-obesity-when-healthyfood-isnt-an-option