Unit 7
Edelman: Ch 11 (Skipped Food, Nutrition, and Poverty Part and parts in Nutritional Risk
Factors and last few sections)
1. Nutrition in the US: Looking Forward from the Past
a. Classic Vitamin-Deficiency Diseases
i. 1940s, many nutrient-deficiency diseases, such as rickets, pellagra, scurvy,
beriberi, xerophthalmia, and goiter, were still prevalent in US
1. Disappeared because of availability of abundant food supply,
fortification of some foods with critical nutrients, and the
implementation of better methods of determining and improving
the nutrient contents of foods
2. introduction of iodized salt in the 1920scontributed greatly to
eliminating iodine-deficiency goiter
3. pellagra disappeared after discovery that inadequate niacin levels
4. few cases of protein-energy malnutrition that are listed annually as
causes of death generally occur as secondary results of severe
illness or injury, premature birth, child neglect, problems of the
homebound aged, alcoholism, or some combination
ii. once-prevalent diseases of nutritional deficiency have been replaced by
diseases of dietary excess and imbalance
2. HEALTH PROBLEMS RELATED TO POOR NUTRITION
HEALTH PROBLEM ∗
CONTRIBUTING LIFESTYLE AND NUTRITION PRACTICES †
Anemia Diet with inadequate iron, folate, or vitamin B intake (de- 12
pending upon type of anemia)
Cancer (breast, cervi- Excessive calorie intake, belly fat; low fiber intake
cal, and colon)
Cirrhosis Excessive alcohol intake
Constipation Inadequate fiber or fluid intake; high fat intake; sedentary life-
style
Dental caries Excessive, frequent consumption of concentrated sweets or
,HEALTH PROBLEM ∗
CONTRIBUTING LIFESTYLE AND NUTRITION PRACTICES †
sugar-sweetened beverages; lack of fluoride; poor dental hy-
giene
Type 2 diabetes Excessive calorie intake; excessive fat intake (in particular
saturated fat, trans fat); sedentary lifestyle
Osteoporosis Low calcium intake; low vitamin D intake; excessive intake of
protein, sodium, and caffeine; sedentary lifestyle; excessive
alcohol intake
Underweight and Inadequate calorie intake; poor diet
growth failure
a. Dietary Excess and Imbalance
i. Four leading causes of death directly associated with diet are coronary
heart disease (CHD), some types of cancer, stroke, and diabetes mellitus
ii. Four more major causes of death (accidents, cirrhosis of the liver, suicide,
and homicide) are associated with excessive alcohol intake
iii. two in three American adults and one in three children are either
overweight or obese
3. Healthy People 2020: Nutrition Objectives
a. food insecurity- access to adequate food is limited by lack of money and other
resources, so are more likely to be overweight because the relatively lower cost
of junk foods can promote overconsumption of calories
b. Food and Nutrition Recommendations
,i. Dietary reference intake (DRI)
1. reflect the latest understanding about nutrient requirements based
on optimizing health
2. developed to reflect a range of values with lower and upper limits
to mitigate risk of adverse effects
3. micronutrients- vitamins and minerals
4. Macronutrients- typically provide calories (energy) such as
carbohydrates, protein, and fat
5. intended to be applied to healthy people
6. Estimated average requirement (EAR)
a. intake that meets the estimated nutrient needs of one half of
the individuals in a particular life stage and gender group
b. used as a basis for developing the RDA and is especially
useful for evaluating adequacy of nutrient intake of a group
and for planning how much the group should consume
7. Recommended Dietary Allowance (RDA)
a. average dietary intake level that is sufficient to meet the
nutrient requirement of nearly all (97% to 98%) healthy
individuals in a particular life stage and gender group
b. computed using the EAR
c. should not be used to assess or plan nutrient intake for
groups but may be useful in some individual applications
8. Adequate Intake (AI)
a. set to fill the gap (ex: infants) when there is not enough
scientific evidence to determine the RDA
b. based on estimates of observed or experimentally
determined mean nutrient intake eaten by a of healthy
people and assumes that the amount consumed is adequate
to promote health
c. most controversial
9. Tolerable Upper Intake Level (UL)
, a. highest average daily intake that can be safely eaten
continuously and still be considered safe for almost all
healthy individuals in a specified group
b. not intended to be a recommended level of intake
c. As intake increases above the UL, the potential risk of
adverse health effects increases
d. include total intakes from any of the following (alone or in
combination): food, fortified food, and nutrient
supplements
c. Dietary Guidelines for Americans
i. Nutrition recommendations stated in terms of ranges or milligrams of
vitamin C are useless unless people are advised as to what types and
quantities of foods should be consumed to obtain recommended nutrients
ii. intent has been to translate science-based nutrition recommendations into
healthy eating guidelines that can be adopted by the public to maximize
healthy habits and minimize chronic disease
iii. every 5 years the U.S. Department of Agriculture (USDA) and the U.S.
Department of Health and Human Services (USDHHS) must jointly
review, update, and publish a new Dietary Guidelines for Americans
iv. Dietary Guidelines Advisory Committee (DGAC)- conducts analysis of
relevant new scientific info and writes report summarizing its findings
v. acknowledge the importance of a coordinated, system-wide approach that
engages all sectors of influence
1. principal messages for consumers:
a. Balancing calories (Enjoy your food, but eat less; Avoid
oversized portions)
b. 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)
c. Foods to reduce (Compare sodium in foods such as soup,
bread, and frozen meals and choose the foods with lower
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