P19 Food for Health 3 CE hours
Description: You will learn to eat plenty of a variety of vegetables, fruits and whole-grain products and little of foods with much fat, sugar and salt.
Objectives: At the end of this course, you will 1) select the foods that promote health, 2) describe the foods that impair health, and 3) develop a weight management plan.
You may want to start by seeing how much you know about nutrition and weight management.
FOOD BASICS: Memorize them.
Eat plenty of a variety of vegetables, fruits and whole-grain products and little of foods with much fat, sugar and salt. Exercise half-hour or more daily. If overweight, reduce your eating-out, sodas-consumption and enjoy three small-plate sit-down meals a day without seconds or deserts, and without snacks in between.
The six basic nutrients are carbohydrates, fats, protein, vitamins, minerals and water. (Mnemonics help: the first letters of “Could fanny play violin much worse”). In the USA, the typical diet in 1993 consisted of 42% carbohydrates, 38% fats, and 17% protein. A better diet would generally be about 65-70% carbohydrates, 15-20% fats and 15% protein (or 0.75 gram per kilogram of bodyweight). The macro-minerals are calcium, chloride, magnesium, potassium, phosphorus, sodium and sulfur.
Questions for Self-study
Do the following for self-study. Do not submit the answers.
1. HEALTHY EATING
Nutrition is both a science and an art. Most of us eat without thinking much about nutrition and how all that food we eat fits together to keep us alive and gives us energy. Here is your opportunity to see how our foods provide our needed nutrients.
To explore the new food pyramid, go to www.mypyramid.gov
2005 USDA Update:
FOOD GROUPS TO ENCOURAGE: Key Recommendations
- Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and 21/2 cups of vegetables per day are recommended for a reference 2,000-calorie intake, with higher or lower amounts depending on the calorie level.
- Choose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week.
- Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products. In general, at least half the grains should come from whole grains.
- Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.
Consider a new vegetarian diet.
New 2002 Diet and Exercise Recommendations from the Institute of Medicine, National Academy of Sciences: Carbohydrates 45-65% of adult’s daily caloric intake; Fat 20-35%, Protein 10-35%, Fiber per day for men 38 g, for women 25 g, exercise one hour daily of moderately intense activity. (In fat and protein, many may target the lower percentage. These recommendations seem to be right on target and individual food intake may be analyzed in light of these recommendations.)
The 2005 USDA Guidelines recommend just 10% fat. Source:http://www.health.gov/dietaryguidelines/dga2005/document/html/executivesummary.htm
How can you read food labels intelligently?
For best health, you may consider a daily food intake (with a Percent Daily Values based on a 2000 calorie diet) that stays in the lower part of the range of total fat 25-65g, saturated fat 5-20g, cholesterol 0-300mg, and sodium 500-2,400mg.
What are some good alternative diets and ethnic foods?
How does good nutrition prevent heart disease and cancer?
What are some recent nutritional developments?
Foods to choose
Fats and oils: Margarine (diet, tub, liquid) Vegetable oils (like canola, corn, olive, peanut, safflower, or sesame) Low fat peanut butter.
Fruits and Vegetables: Fruits: fresh, frozen, canned, or dried Vegetables: fresh, frozen, or canned without cream or cheese sauces Juices: fresh or frozen
Breads, Cereals, Rice, Pasta and Dry Peas and Beans: Breads* (like whole wheat, rye, pumpernickel)
Buns, dinner rolls, bagels, English muffins, pita breads* Low fat crackers (like bread sticks or saltines)* Tortillas Hot & cold cereals* (except granola and meusli) Plain pasta (like spaghetti or macaroni) Rice Dry peas & beans (like black-eyed peas, chick peas, kidney beans, lentils, navy beans, sybeans, or split peas) Refried beans made with vegetable oil (instead of lard) Tofu
Healthy Eating Tips from www.CDC.gov
Here are some tips for healthy eating at home, work, and elsewhere to help you get started. Try some of these ideas.
Start your day off right!
- Eat breakfast!
- Drink 100% fruit juice (canned, from a carton, or freshly squeezed) with breakfast, or take a can to drink at work.
- Spruce up your breakfast—a banana or handful of berries will liven up your cereal, yogurt, waffles, or pancakes.
- Take a piece of fruit to munch on during your commute.
What can we say about fried foods? They taste great, but are not great for you. They’re high in fat. We’ve come up with a few suggestions that will save your arteries. Use oils sparingly (try olive and canola oils). Substitute a potato for french fries.
Why do we eat snacks? They taste great, they’re easy, and they satisfy our sweet and salt cravings. And, let’s face it, crunchy food is fun. So why not make your own snacks by packing healthy, quick, and easy-to-grab foods such as little bags or containers of ready-to-eat vegetables (e.g., celery sticks, cucumber wedges, and cherry tomatoes).
If you’re like most people, no matter how much you’ve eaten at dinner, there’s always room for desserts and sweets. “I’m stuffed. Couldn’t eat another bite. What’s that? You’ve got ice cream? Well, okay.” You can still say “okay,” just
- Cut down on the portion size and how often you eat these items.
- Substitute low-fat or fat-free baked goods, cookies, and ice cream. They still taste great.
- Choose fruit. It tastes great, is filling, and provides energy.
One word of caution: just because something is fat free or low fat doesn’t mean you can eat as much as you want. Many low-fat or nonfat foods are also high in calories. Eat everything in moderation.
You’re in a restaurant or ordering in. When the food arrives, it’s piled so high you think there’s no way you can finish it. Sometimes it tastes so good you can’t stop. But then you’re too full. Typical restaurant servings are often twice the size of a single serving. Try this: When dining out or ordering in, ask for half of a serving or a “doggy bag.” That way you won’t be as full, and you can have some tomorrow.
Calculating Nutrient Intake
2. UNHEALTHY EATING
The foods you eat can both help you or hurt you. All the food sold in a grocery store may not the best for you. You need to be selective in both your food and in the way you eat. Food can make you sick and, in some cases, even kill you.
What foods and eating patterns are unhealthy?
What foods are unsafe to eat?
What factors influence unhealthy food consumption?
What are the symptoms of some eating disorders?
Fats: Here are brief definitions of the key terms important to an understanding of the role of fat in the diet.
A chemical compound manufactured in the body. It is used to build cell membranes and brain and nerve tissues. Cholesterol also helps the body make steroid hormones and bile acids.
Cholesterol found in animal products that are part of the human diet. Egg yolks, liver, meat, some shellfish, and whole-milk dairy products are all sources of dietary cholesterol. Cut down on them or avoid them altogether.
A molecule composed mostly of carbon and hydrogen atoms. Fatty acids are the building blocks of fats.
A chemical compound containing one or more fatty acids. Fat is one of the three main constituents of food (the others are protein and carbohydrate). It is also the principal form in which energy is stored in the body.
A fat that has been chemically altered by the addition of hydrogen atoms (see trans fatty acid). Vegetable shortening and margarine are hydrogenated fats.
A chemical compound characterized by the fact that it is insoluble in water. Both fat and cholesterol are members of the lipid family.
A chemical compound made of fat and protein. Lipoproteins that have more fat than protein are called low-density lipoproteins (LDLs). Lipoproteins that have more protein than fat are called high-density lipoproteins (HDLs). Lipoproteins are found in the blood, where their main function is to carry cholesterol.
Monounsaturated fatty acid
A fatty acid that is missing one pair of hydrogen atoms in the middle of the molecule. The gap is called an “unsaturation.” Monounsaturated fatty acids are found mostly in plant and sea foods. Olive oil and canola oil are high in monounsaturated fatty acids. Monounsaturated fatty acids tend to lower levels of LDL-cholesterol in the blood.
Polyunsaturated fatty acid
A fatty acid that is missing more than one pair of hydrogen atoms. Polyunsaturated fatty acids are mostly found in plant and sea foods. Safflower oil and corn oil are high in polyunsaturated fatty acids. Polyunsaturated fatty acids tend to lower levels of both HDL-cholesterol and LDL-cholesterol in the blood.
Saturated fatty acid
A fatty acid that has the maximum possible number of hydrogen atoms attached to every carbon atom. It is said to be “saturated” with hydrogen atoms. Saturated fatty acids are mostly found in animal products such as meat and whole milk. Butter and lard are high in saturated fatty acids. Saturated fatty acids tend to raise levels of LDL-cholesterol (“bad” cholesterol) in the blood. Elevated levels of LDL-cholesterol are associated with heart disease.
Trans fatty acid
A polyunsaturated fatty acid in which some of the missing hydrogen atoms have been put back in a chemical process called hydrogenation, resulting in “straighter” fatty acids that solidify at higher temperatures. Trans fatty acids are under study to determine their effects on cholesterol.
3. WEIGHT MANAGEMENT
You may be among the group of people that can eat all they want and never gains weight. Or you may be among those that gains weight easily. Here are the basics for a weight management program. Explore them.
How do you determine ideal body weight?
What is the relationship of obesity to genetics, lifestyle, and major health problems?
What is the harm of fad diets?
The new Body Mass Index, BMI =703x weight in pounds/divided by height in inches. (The index should be 24 or below.)
At 5 feet, 123 lbs is healthy, 128 lbs is overweight
At 5’11”, 172 lbs is healthy, 179 lbs is overweight.
Aim for a Healthy Weight, from www.nih.gov
Weight loss to lower elevated blood pressure in overweight and obese persons with high blood pressure.
Weight loss to lower elevated levels of total cholesterol, LDL-cholesterol, and triglycerides, and to raise low levels of HDL-cholesterol in overweight and obese persons with dyslipidemia.
Weight loss to lower elevated blood glucose levels in overweight and obese persons with type 2 diabetes.
Use the BMI (Body Mass Index) to assess overweight and obesity. Body weight alone can be used to follow weight loss, and to determine the effectiveness of therapy.
The BMI to classify overweight and obesity and to estimate relative risk of disease compared to normal weight.
The waist circumference should be used to assess abdominal fat content.
The initial goal of weight loss therapy should be to reduce body weight by about 10 percent from baseline. With success, and if warranted, further weight loss can be attempted.
Weight loss should be about 1 to 2 pounds per week for a period of 6 months, with the subsequent strategy based on the amount of weight lost.
Low calorie diets (LCD) for weight loss in overweight and obese persons. Reducing fat as part of an LCD is a practical way to reduce calories.
Reducing dietary fat alone without reducing calories is not sufficient for weight loss. However, reducing dietary fat, along with reducing dietary carbohydrates, can help reduce calories.
A diet that is individually planned to help create a deficit of 500 to 1,000 kcal/day should be an intregral part of any program aimed at achieving a weight loss of 1 to 2 pounds per week.
Physical activity should be part of a comprehensive weight loss therapy and weight control program because it: (1) modestly contributes to weight loss in overweight and obese adults, (2) may decrease abdominal fat, (3) increases cardio-respiratory fitness, and (4) may help with maintenance of weight loss.
Physical activity should be an integral part of weight loss therapy and weight maintenance. Initially, moderate levels of physical activity for 30 to 45 minutes, 3 to 5 days a week, should be encouraged. All adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week.
The combination of a reduced calorie diet and increased physical activity is recommended since it produces weight loss that may also result in decreases in abdominal fat and increases in cardio-respiratory fitness.
Behavior therapy is a useful adjunct when incorporated into treatment for weight loss and weight maintenance.
Weight loss and weight maintenance therapy should employ the combination of LCD’s, increased physical activity, and behavior therapy.
After successful weight loss, the likelihood of weight loss maintenance is enhanced by a program consisting of dietary therapy, physical activity, and behavior therapy which should be continued indefinitely. Drug therapy can also be used. However, drug safety and efficacy beyond 1 year of total treatment have not been established.
A weight maintenance program should be a priority after the initial 6 months of weight loss therapy.
|Meal||Foods, in number of servings||Calories||Fat grams||Calories from Fat||Food group||Vitamins/Minerals|
|Example||Orange, 1Oat Bran Bagel, 1||40180||<11||110||FruitsGrain Products||A, C, PotassiumE, B6, Thiamin, Riboflavin|
|Total for Day|
|Evaluation/Level of Adequacy|
Update yourself with the latest developments in nutrition: Finder Dietitian – Healthy, Ask the Nutritionist (About Food for Babies), http://www.committed-to-kids.com/. Explore also a companion LearnWell course called Better-Weight.
Take this course for free. Or study this web-site for an approved (RN-CEP 11430, MFT- PCE 39) 3-hours Continuing Education Certificate (0.3 CEUs) and take the quiz.
TEST: Study this web-site for 3 hours for an approved (RN-CEP 16144) 3-hours Continuing Education Certificate (0.3 CEUs). Click here for the self-correcting test