St.

Paul University Philippines

Tuguegarao City, Cagayan 3500
SCHOOL OF NURSING AND ALLIED HEALTH SCIENCES
COLLEGE OF NURSING
1ST SEMESTER, AY 2019-2020
BACHELOR OF SCIENCE IN NURSING – LEVEL II

NUTRITION FOR HEALTH AND FITNESS

INTRODUCTION:

Good nutrition is one of the keys to a healthy life. You can improve your health by keeping a
balanced diet. You should eat foods that contain vitamins and minerals. This includes fruits,
vegetables, whole grains, dairy, and a source of protein.
Eating a healthy balanced diet accompanied by regular exercise is essential in maintaining
physical and mental health and well-being. Not only are these effective in preventing excess
weight gain or in maintaining weight loss, but healthier lifestyles are also associated with
improved sleep and mood. Physical activity particularly improves brain-related function and
outcomes.
While most of us know that good nutrition is essential in helping us feel our best and reach our
optimal health; finding time to eat a balanced diet on a daily basis seems a formidable task in this
fast-paced, affluent society. Yet, though your life may be hectic, there are still many good things
to do, healthy choices which can help you lose weight and improve your health.
A. NUTRITION AND WEIGHT MANAGEMENT
Weight management is the phrase used to describe both the techniques and underlying
physiological processes that contribute to a person's ability to attain and maintain a certain
weight. Most weight management techniques encompass long-term lifestyle strategies that
promote healthy eating and daily physical activity. Moreover, weight management involves
developing meaningful ways to track weight over time and to identify ideal body weights for
different individuals. Due to the rising obesity rates in many parts of the world, proper weight
management strategies most often focus on achieving healthy weights through slow but steady
weight loss, followed by maintenance of an ideal body weight over time.

7 COMPONENTS OF SUCCESSFUL WEIGHT PLAN

Reasonable weight loss expectations. 

Avoid the weight loss equivalents of “get rich quick” schemes. These are popular diet plans and
exercise programs that guarantee you large and rapid weight losses in short time periods, such as
“Lose 30 Pounds in 30 Days!” or “Get Slim by Saturday!” Instead, look for programs that have
you aim for about a pound per week of weight loss. While people do tend to lose larger amounts
of weight the first week or two of a new weight loss program this rate is often not sustainable
longer term. Assuming that you will continue to lose weight at that rate can lead to you feeling
frustrated and giving up completely.
 
A diet that fits with your preferences. 

In head-to-head comparisons, weight loss diets have been shown to work about the same in terms
of weight loss success. Most important is choosing a program that has a diet that you ENJOY!
Do you like vegetables? If so, maybe a vegetarian diet will work for you. Are you able to not eat
over long periods of time without getting “ ”? If so, intermittent fasting might be
worth a try. The program should focus on dietary changes that you can stick with long-term.
Enjoying what you eat is really important. Who wants to feel deprived for even short periods of
time?
 
Keeping your favorite foods. 

Along with choosing an overall diet that fits your preferences, make sure your program leaves
room for your favorite foods. For example, having a bowl of ice cream in the evening may be
really important to you, so trying to cut it out completely may lead you to give up on weight loss
entirely. Instead, try having a smaller serving (a half a cup, for example), filling your bowl with
fruit and a small dollop of ice cream, substituting a lower-calorie option (such as frozen yogurt),
or having it less frequently (such as once per week at a restaurant, so as not to tempt you each
night at home).
 
Focus on changing both eating and activity patterns. 

Many people try to lose weight by increasing physical activity alone. However, weight loss is
primarily driven by dietary changes. So you might ask, “Why exercise at all?” Exercise is a
major driver of weight maintenance. That is, being active can help prevent you from regaining
weight once you’ve lost it. Keeping this in mind, choose a program that has you getting into the
swing of both diet and exercise at the start, when you are the most motivated.
 
Tracking your weight.

 A good program should have you tracking the changes that you are trying to make. Think about
tracking your weight in the same way as you think about checking your bank account balance.
Even though it may not be pleasant at times to know the balance, you need that information to be
able to adjust your “spending” of calories and “banking” of exercise. Whether you use a
smartphone app or just a piece of paper, tracking allows you to see what strategies are working to
help you lose weight and what strategies are not.
 
Tracking your diet. 

In addition to tracking your weight, a good program should also have you track what you eat and
drink. It can be really easy to forget about the calories in that coffee drink, the mayonnaise in
your sandwich, or the chocolates you grabbed off a colleague’s desk. Track your diet to know
where you can trim calories with the least amount of pain. Apps or websites can make tracking
easier than ol’ paper and pencil. They can remember your frequently consumed foods or meals,
utilize barcode scanners for packaged foods, and import recipes.
 
Accountability and support over the long-term.

 Finally, the program you choose should provide the type of accountability and support that you
need. In-person and phone-based programs tend to lead to larger weight losses than online
programs because they have quite a bit of accountability and support. On the other hand, web-
based and smartphone programs can be helpful for those with challenging or unpredictable
schedules (especially if they have a way to provide accountability and support!). Be sure to look
for programs that continue to provide accountability and support over the long-term, which has
been shown to help maintain your initial success!

How much should I weigh?

There are several ways to determine whether or not you are a healthy weight, one of which is
calculating your Body Mass Index which helps to establish whether you are a healthy weight for
your height. Though this method may not be applicable to everyone for example those with a
higher than average muscle mass, it is fairly accurate in identifying an ideal weight for the
majority of people.
NHS guidelines currently define a healthy bodyweight range as anything between 18.5 and 25
and your BMI can be worked out using the following formula:
Work out your BMI
Firstly, find your weight in kilograms and your height in metres. E.g. weight =75kg height =
1.8m
Multiply your height by itself. E.g. 1.8 x 1.8 = 3.24
Divide your weight by that figure. E.g. 75 ÷ 3.24 = 23.2
23.2 is the BMI which is inside the healthy bodyweight range.
BMI guidelines also state that anything below 18.5 is classed as underweight, 25 to 30 is
overweight, between 30 and 35 is obese and anything above 40 is morbidly obese.

What Causes Weight Gain?

1. Diet: The quantity and quality of food in your diet has a strong impact on weight.
2. Genes: Some people are genetically predisposed to gain weight more easily than others or to
store fat around the midsection.
Genes do not have to become destiny, however, and studies suggest that eating a healthy diet,
staying active, and avoiding unhealthy habits like drinking soda can prevent the genetic
predisposition to risk for obesity. (10)
Read more about genetic risk for obesity on the Obesity Prevention Source.
3. Physical inactivity:
Exercising has a host of health benefits, including reducing the chances of developing heart
disease, some types of cancer, and other chronic diseases. Physical activity is a key element of
weight control and health.
4. Sleep:
Research suggests that there’s a link between how much people sleep and how much they weigh.
In general, children and adults who get too little sleep tend to weigh more than those who get
enough sleep.
For example, in the Nurses’ Health Study, researchers followed roughly 60,000 women for 16
years. At the start of the study, all of the women were healthy, and none were obese; 16 years
later, women who slept 5 hours or less per night had a 15 percent higher risk of becoming obese,
compared to women who slept 7 hours per night. Short sleepers also had 30 percent higher risk
of gaining 30 pounds over the course of the study, compared to women who got 7 hours of sleep
per night.
There are several possible ways that sleep deprivation could increase the chances of becoming
obese.
Sleep-deprived people may be too tired to exercise, decreasing the “calories burned” side of the
weight-change equation.
People who don’t get enough sleep may take in more calories than those who do, simply because
they are awake longer and have more opportunities to eat.
Lack of sleep also disrupts the balance of key hormones that control appetite, so sleep-deprived
people may be hungrier than those who get enough rest each night.

B. NUTRITION EATING DISORDERS

Eating disorders are a range of psychological conditions that cause unhealthy eating habits to
develop. They might start with an obsession with food, body weight, or body shape. In severe
cases, eating disorders can cause serious health consequences and may even result in death if left
untreated. Those with eating disorders can have a variety of symptoms. However, most include
the severe restriction of food, food binges, or purging behaviors like vomiting or over-exercising.
Although eating disorders can affect people of any gender at any life stage, they’re most often
reported in adolescents and young women. In fact, up to 13% of youth may experience at least
one eating disorder by the age of 20
Eating disorders are mental health conditions marked by an obsession with food or body
shape. They can affect anyone but are most prevalent among young women.
WHAT CAUSES THEM?
Experts believe that eating disorders may be caused by a variety of factors. One of these
is genetics. Twin and adoption studies involving twins who were separated at birth and adopted
by different families provide some evidence that eating disorders may be hereditary. This type of
research has generally shown that if one twin develops an eating disorder, the other has a 50%
likelihood of developing one too, on average. Personality traits are another cause. In particular,
neuroticism, perfectionism, and impulsivity are three personality traits often linked to a higher
risk of developing an eating disorder Other potential causes include perceived pressures to be
thin, cultural preferences for thinness, and exposure to media promoting such ideals. In fact,
certain eating disorders appear to be mostly nonexistent in cultures that haven’t been exposed to
Western ideals of thinness. That said, culturally accepted ideals of thinness are very present in
many areas of the world. Yet, in some countries, few individuals end up developing an eating
disorder. Thus, they are likely caused by a mix of factors. More recently, experts have proposed
that differences in brain structure and biology may also play a role in the development of eating
disorders. In particular, levels of the brain messengers serotonin and dopamine may be factors
However, more studies are needed before strong conclusions can be made.
Summary Eating disorders may be caused by several factors. These include genetics, brain
biology, personality traits, and cultural ideals.
A. ANOREXIA NERVOSA
Anorexia nervosa is likely the most well-known eating disorder. It generally develops
during adolescence or young adulthood and tends to affect more women than men.
People with anorexia generally view themselves as overweight, even if they’re
dangerously underweight. They tend to constantly monitor their weight, avoid eating
certain types of foods, and severely restrict their calories.
Common symptoms of anorexia nervosa include:
1. Being considerably underweight compared with people of similar age and
height
2. Very restricted eating patterns
3. An intense fear of gaining weight or persistent behaviors to avoid gaining
weight, despite being underweight
4. A relentless pursuit of thinness and unwillingness to maintain a healthy
weight
5. A heavy influence of body weight or perceived body shape on self-esteem
6. A distorted body image, including denial of being seriously underweight
Obsessive-compulsive symptoms are also often present. For instance, many people with
anorexia are often preoccupied with constant thoughts about food, and some may
obsessively collect recipes or hoard food. Such individuals may also have difficulty
eating in public and exhibit a strong desire to control their environment, limiting their
ability to be spontaneous. Anorexia is officially categorized into two subtypes — the
restricting type and the binge eating and purging type
Individuals with the restricting type lose weight solely through dieting, fasting,
or excessive exercise. Individuals with the binge eating and purging type may binge on
large amounts of food or eat very little. In both cases, after they eat, they purge using
activities like vomiting, taking laxatives or diuretics, or exercising excessively. Anorexia
can be very damaging to the body. Over time, individuals living with it may experience
the thinning of their bones, infertility, brittle hair and nails, and the growth of a layer of
fine hair all over their body
In severe cases, anorexia can result in heart, brain, or multi-organ failure and death.
Summary People with anorexia nervosa may limit their food intake or compensate for it
through various purging behaviors. They have an intense fear of gaining weight, even
when severely underweight.
B. BULIMIA NERVOSA
Bulimia nervosa is another well-known eating disorder. Like anorexia, bulimia tends to
develop during adolescence and early adulthood and appears to be less common among
men than women (7Trusted Source). People with bulimia frequently eat unusually large
amounts of food in a specific period of time. Each binge eating episode usually continues
until the person becomes painfully full. During a binge, the person usually feels that they
 cannot stop eating or control how much they are eating. Binges can happen with any type
of food but most commonly occur with foods the individual would normally avoid.
Individuals with bulimia then attempt to purge to compensate for the calories consumed
and relieve gut discomfort. Common purging behaviors include forced vomiting, fasting,
laxatives, diuretics, enemas, and excessive exercise.
Symptoms may appear very similar to those of the binge eating or purging subtypes of
anorexia nervosa. However, individuals with bulimia usually maintain a relatively normal
weight, rather than becoming underweight.
Common symptoms of bulimia nervosa include:
1. Recurrent episodes of binge eating with a feeling of lack of control
2. Recurrent episodes of inappropriate purging behaviors to prevent weight gain
3. A self-esteem overly influenced by body shape and weight
4. A fear of gaining weight, despite having a normal weight
Side effects of bulimia may include an inflamed and sore throat, swollen salivary glands,
worn tooth enamel, tooth decay, acid reflux, irritation of the gut, severe dehydration, and
hormonal disturbances. In severe cases, bulimia can also create an imbalance in levels of
electrolytes, such as sodium, potassium, and calcium. This can cause a stroke or heart
attack Summary People with bulimia nervosa eat large amounts of food in short periods
of time, then purge. They fear gaining weight despite being at a normal weight.
C. BINGE EATING DISORDER

Binge eating disorder is believed to be one of the most common eating disorders,
especially in the United States (10Trusted Source). It typically begins during adolescence
and early adulthood, although it can develop later on. Individuals with this disorder have
symptoms similar to those of bulimia or the binge eating subtype of anorexia. For
instance, they typically eat unusually large amounts of food in relatively short periods of
time and feel a lack of control during binges. People with binge eating disorder do not
restrict calories or use purging behaviors, such as vomiting or excessive exercise, to
compensate for their binges.

Common symptoms of binge eating disorder include:

1. Eating large amounts of foods rapidly, in secret and until uncomfortably full,
despite not feeling hungry.
2. Feeling a lack of control during episodes of binge eating
3. Feelings of distress, such as shame, disgust, or guilt, when thinking about the
binge eating behavior.
4. No use of purging behaviors, such as calorie restriction, vomiting, excessive
exercise, or laxative or diuretic use, to compensate for the binging.
 People with binge eating disorder often have overweight or obesity. This may increase
their risk of medical complications linked to excess weight, such as heart disease, stroke,
and type 2 diabetes Summary People with binge eating disorder regularly and
uncontrollably consume large amounts of food in short periods of time. Unlike people
with other eating disorders, they do not purge.
D. PICA

Pica is another eating disorder that involves eating things that are not considered food.
Individuals with pica crave non-food substances, such as ice, dirt, soil, chalk, soap, paper,
hair, cloth, wool, pebbles, laundry detergent, or cornstarch (8). Pica can occur in adults,
as well as children and adolescents. That said, this disorder is most frequently observed in
children, pregnant women, and individuals with mental disabilities (12Trusted Source).

Individuals with pica may be at an increased risk of poisoning, infections, gut injuries,
and nutritional deficiencies. Depending on the substances ingested, pica may be fatal.
However, to be considered pica, the eating of non-food substances must not be a normal
part of someone’s culture or religion. In addition, it must not be considered a socially
acceptable practice by a person’s peers. Summary Individuals with pica tend to crave and
eat non-food substances. This disorder may particularly affect children, pregnant women,
and individuals with mental disabilities.

E. RUMINATION DISORDER

Rumination disorder is another newly recognized eating disorder. It describes a condition

in which a person regurgitates food they have previously chewed and swallowed, re-
chews it, and then either re-swallows it or spits it out. This rumination typically occurs
within the first 30 minutes after a meal. Unlike medical conditions like reflux, it’s
voluntary. This disorder can develop during infancy, childhood, or adulthood. In infants,
it tends to develop between 3–12 months of age and often disappears on its own. Children
and adults with the condition usually require therapy to resolve it.

If not resolved in infants, rumination disorder can result in weight loss and severe
malnutrition that can be fatal. Adults with this disorder may restrict the amount of food
they eat, especially in public. This may lead them to lose weight and become underweight
Summary Rumination disorder can affect people at all stages of life. People with the
condition generally regurgitate the food they’ve recently swallowed. Then, they chew it
again and either swallow it or spit it out.

F. AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER

Avoidant/restrictive food intake disorder (ARFID) is a new name for an old disorder. The
term replaces what was known as a “feeding disorder of infancy and early childhood,” a
diagnosis previously reserved for children under 7 years old. Although ARFID generally
develops during infancy or early childhood, it can persist into adulthood. What’s more,
 it’s equally common among men and women. Individuals with this disorder experience
disturbed eating either due to a lack of interest in eating or distaste for certain smells,
tastes, colors, textures, or temperatures.

Common symptoms of ARFID include:

1. Avoidance or restriction of food intake that prevents the person from eating
sufficient calories or nutrients
2. Eating habits that interfere with normal social functions, such as eating with
others
3. Weight loss or poor development for age and height
4. Nutrient deficiencies or dependence on supplements or tube feeding
It’s important to note that ARFID goes beyond normal behaviors, such as picky eating in
toddlers or lower food intake in older adults. Moreover, it does not include the avoidance
or restriction of foods due to lack of availability or religious or cultural practices.
Summary ARFID is an eating disorder that causes people to undereat. This is either due
to a lack of interest in food or an intense distaste for how certain foods look, smell, or
taste.
Other Eating Disorder:
In addition to the six eating disorders above, less-known or less common eating disorders
also exist. These generally fall under one of three categories:
1. Purging disorder. Individuals with purging disorder often use purging
behaviors, such as vomiting, laxatives, diuretics, or excessive exercising, to
control their weight or shape. However, they do not binge.
2. Night eating syndrome. Individuals with this syndrome frequently eat
excessively, often after awakening from sleep.
3. Other specified feeding or eating disorder (OSFED). While not found in the
DSM-5, this includes any other conditions that have symptoms similar to
those of an eating disorder but don’t fit into any of the categories above.
a. One disorder that may currently fall under OSFED is orthorexia.
Although increasingly mentioned in the media and scientific studies,
orthorexia has yet to be recognized as a separate eating disorder by the
current DSM.
Individuals with orthorexia tend to have an obsessive focus on healthy eating, to an extent that
disrupts their daily lives. For instance, the affected person may eliminate entire food groups,
fearing they’re unhealthy. This can lead to malnutrition, severe weight loss, difficulty eating
outside the home, and emotional distress. Individuals with orthorexia rarely focus on losing
weight. Instead, their self-worth, identity, or satisfaction is dependent upon how well they
comply with their self-imposed diet rules
Summary Purging disorder and night eating syndrome are two additional eating disorders that
are currently not well described. The OSFED category includes all eating disorders, such as
orthorexia, that don’t fit into another category.
The bottom line. The categories above are meant to provide a better understanding of the most
common eating disorders and dispel myths about them. Eating disorders are mental health
conditions that usually require treatment. They can also be damaging to the body if left
untreated. If you have an eating disorder or know someone that might have one, seek help from a
healthcare practitioner that specializes in eating disorders.
C. NUTRITION EXERCISES AND SPORTS
NUTRITIONAL STRATEGIES
Athletes should pay careful attention to foods that can enhance, not hinder, their
preparation for, participation in and recovery from training and competition. Most
athletes obtain all the energy and nutrients they need by eating when they are hungry and
choosing a balanced and varied diet. Every sport requires sound nutritional strategies to
support successful performance, but with different considerations to be taken into
account. For example, with the 26 Nutrition for Sport and Exercise Performance
intermittent nature of team sports, intensity of performance can alter at any time. These
changes are irregular and can be random, and may draw significantly on the body’s
glycogen stores. Performance may be impaired towards the end of a match if glycogen
stores are running low. In contrast, weight-loss methods and restrictive dietary practices
are often used by athletes in weight category and aesthetic sports, with potential dangers
to both health and performance.
When developing nutritional strategies to support sport and exercise there should be no
conflict between eating for health and eating for performance. For a sport of your choice,
reflect on what matters to the athlete and how sound nutritional principles and practice
could help to maintain health and improve performance.
Application of Nutritional Strategies
The sections on weight loss and weight gain have hinted that different activities require
different dietary plans or strategies to optimise performance.
Endurance events
Endurance activities significantly challenge an athlete’s energy and fluid stores.
The longer and more intense the aerobic training or competition, the more depleted these
stores become. Endurance athletes should aim to maximise glycogen stores. Increasing
carbohydrate intake during the two or three days before competition is a useful strategy.
Carbohydrate supplements (energy drinks, bars or gels) may be a useful dietary addition.
Endurance athletes should start exercise fully hydrated. The longer the duration of the
activity, the more important it is to consume fluids during it. Sports drinks can provide
carbohydrate as well as replacing fluids
Strength and power events
In strength, power and sprint sports, nutritional strategies support the development of lean
body mass (muscle) as well as meeting energy demands. Although carbohydrate
requirements are not as great as for endurance events, they are still important. Combining
carbohydrate with protein post-exercise promotes an anabolic environment and increases
protein synthesis that helps promote muscle development. However, excessive protein
intake should be avoided.
Sports requiring strength and endurance
Many sports require high levels of both strength and endurance. For example, high levels
of muscular strength and endurance are required for rugby as well as weight-category
sports such as judo. Nutritional demands will be dictated by the nature of the individual
sport and participant requirements, but key nutrients in all cases are carbohydrate and
fluid.
Weight-category or weight-ccontrolled events
Leanness or a specific weight may be considered important for optimal performance,
placing greater emphasis on what the athlete eats. It is important to remember that the
fewer calories consumed, the fewer nutrients consumed. Calcium and iron intakes are
reported to be particularly low in studies investigating the diet of female participants in
these sports. Healthy eating and Eatwell Guide principles apply to the planning of dietary
intakes for these sports, but greater emphasis may be placed on a low-fat diet. However,
this should not be at the expense of essential nutrients such as carbohydrate, protein,
vitamins and minerals. Adequate fluid intake and hydration are also essential to maintain
concentration for the technical demands of these sports.
Supplements to support nutritional strategies
Athletes are always looking for something to give them a competitive advantage. The
financial cost of dietary manipulation and nutritional supplementation is often high.
Misinformation often supports questionable practices, some of which can be harmful.
The supplement market is worth millions but the manufacture, processing, labelling and
marketing of these products is poorly regulated with variable quality control. The
products available all make convincing claims including better recovery, increased
strength and size, loss of body fat and enhanced immune function.
Supplements can essentially be broken down into two main categories.
1. Nutrient or dietary supplements
- Help the athlete meet their overall nutritional needs, by providing a practical
alternative to food or by helping to meet higher than average requirements for
nutrients, particularly carbohydrate and protein.
2. Nutritional ergogenic aids
 - Generally aim to enhance performance through effects on energy, body composition
and alertness.
Nutrient or dietary supplements Nutrient supplements include:
1. Sports drinks, gels and bars
2. Liquid meal and protein supplements
3. Carbohydrate loaders and powders
4. Multivitamin and mineral supplements
Some athletes find these products help them to meet their nutritional goals during
particularly demanding periods of training and competition. For example, sports drinks
are a convenient way to meet the high energy demands of training or competition.
Athletes must know how and when to use them to get maximum benefit towards
supporting nutrition goals. If used in the correct way (time and amount), supplements can
assist athletes to train and compete at their best. However, poor regulation of the
supplement industry means marketing hype often overstates unproven benefits.
Supplements should be safe, effective and legal. Poor practice can lead to problems.
Athletes must balance the potential benefits against risks, particularly of anti-doping rule
violations: a significant number of supplements on the market contain doping agents that
will cause an athlete to fail a drugs test.
Nutritional intake during different phases of training and event
When developing sound eating habits and nutritional strategies to support training and
competition, you should consider the overall issues shown in Table 13.14.
The types of food eaten to support training The timing of meals and snacks around
and competition training and competition
Ensuring a balanced diet is achieved in The problems of travelling to training and
respect of all nutrients competition venues
Encouraging an adequate calcium and iron Promoting long-term health and reducing the
intake, particularly for females risk of chronic disease
Maintaining a sufficient fluid intake Minimising the risk of injury and illness

The nutritional requirements for different sports and individuals will vary
according to:
 The type of sport and training methods undertaken
 The intensity, duration and frequency of training or competition
 The training status and fitness level of the individual
 D. NUTRITION AND BONE HEALTH
In the growth and maintenance of bone mass, as well as the prevention of osteoporosis, nutrition
is a significant "modifiable" factor. Inadequate consumption of bone-building nutrients raises the
risk of bone loss and osteoporosis. The development of bones necessitates a steady supply of
nutrients including calcium, protein, magnesium, phosphorus, vitamin D, potassium, and
fluoride. Osteoporosis is a significant public health problem that affects millions of people
worldwide. Dietary consumption is a major factor that can be changed to improve bone health.
A healthy balanced diet will help you build healthy bones from an early age and maintain them
throughout your life.
 You need sufficient calcium to keep your bones healthy and vitamin D to help your body
absorb calcium.
 Poor bone health can cause conditions such as rickets and osteoporosis and increase the
risk of breaking a bone from a fall later in life.
 You should be able to get all the nutrients you need for healthy bones by eating a healthy
balanced diet.
 A good diet is only one of the building blocks for healthy bones, which also includes
physical activity and avoiding certain risk factors.
GENERAL POPULATION
Adults need 700mg of calcium a day. You should be able to get all the calcium you need
by eating a varied and balanced diet.
Good sources of calcium include:
 milk, cheese and other dairy foods
 green leafy vegetables, such as broccoli, cabbage and okra, but not spinach
 soya beans
 tofu
 soya drinks with added calcium
 nuts
 bread and anything made with fortified flour
 fish where you eat the bones, such as sardines and pilchards
Although spinach might appear to contain a lot of calcium, it also contains oxalic
acid, which reduces calcium absorption, and it is therefore not a good source of
calcium.
10 NATURAL WAYS TO BUILD HEALTHY BONES
1. Eat lots of vegetables
 - Consuming a diet high in vegetables has been shown to help create healthy bones
during childhood and protect bone mass in young adults and older women.
2. Perform strength training and weight bearing exercises
- This can help increase bone formation during bone growth and protect bone health
in older adults, including those with low bone density.
3. Consume enough protein
- High protein intake can help protect bone health during aging and weight loss.
4. Eat high-calcium foods throughout the day
- Calcium is the main mineral found in bones and must be consumed every day to
protect bone health. Spreading your calcium intake throughout the day will
optimize absorption.
5. Get plenty of Vitamin D and Vitamin K
- Getting adequate amounts of vitamins D and K2 from food or supplements may
help protect bone health.
6. Avoid very-low calorie diets
- Diets providing too few calories have been found to reduce bone density, even
when combined with resistance exercise. Consume a balanced diet with at least
1,200 calories daily to preserve bone health.
7. Consider taking a collagen supplement
- Emerging evidence suggests that supplementing with collagen may help preserve
bone health by reducing collagen breakdown.
8. Maintain a stable and healthy weight
- Being too thin or too heavy can negatively affect bone health. Furthermore,
maintaining a stable weight, rather than repeatedly losing and regaining it, can help
preserve bone density.
9. Include foods high in magnesium and zinc
- Magnesium and zinc play key roles in achieving peak bone mass during childhood
and maintaining bone density during aging.
10. Consume foods high in Omega-3 Fats
- Omega-3 fatty acids have been found to promote the formation of new bone and
protect against bone loss in older adults.

AT RISK GROUPS
Some groups of the population are at greater risk of not getting enough vitamin D, and
the Department of Health recommends that these people should take daily vitamin
supplements. These groups are:
 all babies and young children, from birth to 1 year of age, exclusively or partially
breastfed from 6 months to 5 years old – unless they are having 500ml or more a
day of infant milk formula
 all children aged 1 to 4 years old
 people who are frail or housebound
  people who are confined indoors, such as a care home
 people who usually wear clothes that cover up most their skin when outdoors
 people with dark skin such as those of African, African-Caribbean and south
Asian origin

E. NUTRITION ORAL AND DENTAL HEALTH

Diet and nutrition are significant influencers of oral health, and can affect the development and
progression of oral diseases and conditions such as caries, periodontal disease, erosion, and
others. While nutrition can be defined as the micro- (vitamins and minerals) and macro-
(carbohydrates, protein, and fat) nutrients as they relate to the body’s dietary needs, diet refers to
the specific foods consumed. The relationship that diet and nutrition have with oral health is
bidirectional, as compromised integrity of the oral cavity can also influence an individual’s
functional ability to eat. A variety of dietary factors are hypothesized to influence the oral cavity,
including macro- and micronutrients, vitamins, pH properties, as well as the behaviors associated
with their consumption. Additionally, factors such as stage of development, specific medical
conditions, and socioeconomic status may indicate particular diet and nutritional considerations.
Older patients, for example, may experience tooth loss, reduced masticatory ability, and
decreased appetite, which may, in turn, influence their nutritional statusA systematic review
examined the association between food intake and oral health in elderly found that tooth loss in
the older population was associated with changes in food intake and nutritional deficiency.

Foods for and against your teeth When you eat and drink sugary and starchy foods, you’re not
only feeding yourself — you’re potentially feeding the plaque that can cause problems in your
mouth. Learn more about the foods to seek out — and good dental hygiene tips for others — to
help keep your smile sparkling. Fight tooth decay with food

* Fiber-rich fruits and vegetables: Foods with fiber stimulate saliva flow, which is a natural
defense against cavities. Not only does saliva wash away food particles and clean your mouth,
about 20 minutes after you eat something, saliva begins to neutralize the acids attacking your
teeth. Opt for crisp fruits and vegetables like apples, carrots and celery.

* Cheese, milk, plain yogurt and other dairy products: The calcium, phosphates and vitamin
D in cheese, milk and other dairy products are important minerals for the health of your teeth.
Your teeth are made mostly of calcium, and without enough in your diet, you risk developing
tooth decay and other problems. An added benefit is that the calcium in these foods mixes with
plaque and sticks to teeth, protecting them from acids that cause decay and helping to rebuild
tooth enamel on the spot. Worried you won’t get enough calcium because you are allergic to
milk or just don’t like the taste? There are many calcium-fortified juices, soy milks and other
foods available that can supply as much calcium to your diet as milk does.

* Sugarless chewing gum: Chewing sugar-free gum after meals and snacks can help rinse
harmful acid off your teeth to help you preserve tooth enamel. But be sure it’s sugarless!
Chewing gum containing sugar may actually increase your chances of developing a cavity.
Sugarless gum containing xylitol, which has been shown to have decay-preventive qualities, may
even have an added benefit. Research indicates that xylitol most likely inhibits the growth of
Streptococcus mutans, the oral bacteria that cause cavities.
* Green and black teas: Tea contains compounds that suppress bacteria, slowing down the
processes responsible for tooth decay and gum disease. Depending on the type of water you use
to brew your tea, a cup of tea can also be a source of fluoride. If you add sugar to your tea, be
sure you rinse with water or brush afterward.

* Water with fluoride: Fluoridated drinking water, or any product you make with fluoridated
water, helps your teeth. This includes powdered juices and dehydrated soups. If fluoridated tap
water is not available where you live, ask your dentist about fluoride supplementation. Fight
tooth decay with good habits

* Sugary candies and sweets that stay in your mouth: If you eat sweets, go for those that clear
out of your mouth quickly. Those that stick around — lollipops, caramels, jelly beans and hard
candies — make it difficult for saliva to wash the sugar away. Snacks like cookies, cakes or
other desserts contain a high amount of sugar, which can cause tooth decay. If you eat these
foods, limit when you eat them, instead of snacking on them through the day, and brush your
teeth afterward.

* Starchy, refined carbohydrates: Foods such as chips, bread, pasta or crackers can be as
harmful to the teeth as candy. Starches made from white flour are simple carbohydrates and can
linger in your mouth and then break down into simple sugars. Bacteria feed on these sugars and
produce acid, which causes tooth decay. Avoid eating them throughout the day and brush
afterward.

* Beverages with added sugar: Be aware of the amount of sugar in your drinks by checking the
nutrition label. Consider alternatives such as water, tea, coffee and coconut water.

* Fruit juice: Fruit is an important part of a healthy diet. Whole fruits have fiber and are a less
concentrated source of sugar (and sometimes acids) than juice. When you drink fruit juice, use a
straw to keep it from having too much contact with your teeth or rinse with water afterward.

* Lemons, citrus fruits and other acidic foods: Avoid keeping these foods in your mouth for a
long period of time.

7 vitamins and minerals your mouth needs

Want healthy teeth and gums? Make sure your diet features these key ingredients. These
nutritional building blocks are essential for your dental health.
 Calcium- No surprises here — calcium is well known as a friend for teeth. Throughout
the body, the mineral helps build bones and provide structural support. In your mouth,
calcium helps harden your enamel and strengthen your jawbone.
What to eat: In addition to milk, good sources of calcium include cheese, yogurt,
broccoli and salmon.
 Vitamin D- helps the body absorb calcium while boosting bone mineral density, so it’s
crucial to get an adequate amount of vitamin D to get the most out of your calcium
intake.
What to eat: Your body naturally makes vitamin D when it’s exposed to sunlight, but the
vitamin can also be found in fatty fish, canned tuna and portobello mushrooms. You can
also look for foods and drinks that have been fortified with vitamin D, such as milk,
orange juice and cereal.
 Potassium- Like vitamin D, potassium improves bone mineral density. It also works
with magnesium to prevent blood from becoming too acidic, which can leach calcium
from your bones and teeth.
What to eat: Bananas are well known sources of potassium, but they’re not alone. Other
fruits and vegetables with high levels of the mineral include lima beans, tomatoes, Swiss
chard, potatoes, sweet potatoes, avocados and prunes.
 Phosphorus -supports calcium in building strong bones and teeth.
What to eat: Luckily, phosphorus is found in a wide range of foods. Rich sources of the
mineral include seafood, such as scallops, sardines, cod, shrimp, tuna and salmon. If
you’re looking to get your phosphorus from plant-based foods, consider soybeans, lentils
and pumpkin seeds. You can also find phosphorus in beef, pork and cheese.
 Vitamin K- Think of this vitamin as a shield – it helps block substances that break down
bone. It also helps your body produce osteocalcin, a protein that supports bone strength.
A vitamin K deficiency can slow down your body’s healing process and make you more
likely to bleed.
What to eat: Chowing down on leafy greens, such as kale, collards and spinach, can help
you increase your vitamin K quota. Other great sources include parsley, broccoli and
Brussel sprouts.
 Vitamin C- strengthen your gums and the soft tissue in your mouth. It can protect against
gingivitis, the early stage of gum disease, and can prevent your teeth from loosening.
What to eat: You probably already know that citrus fruits are rich in vitamin C, but you
can also find it in potatoes and leafy greens.
 Vitamin A- This vitamin helps keep mucous membranes healthy. It prevents dry mouth
and helps your mouth heal quickly.
What to eat: For strong gums and teeth, load up on fish, egg yolks and liver. You can
also find it in leafy green vegetables like spinach, kale and collard greens, or in orange-
colored fruits and oranges: think apricots, cantaloupe, pumpkin, carrots and sweet
potatoes. These fruits and veggies contain high levels of beta-carotene, which your body
converts into vitamin A.