An Overview of

Nutrition

Chapter 1
 Introduction

• Daily food choices

• Benefit health
• Harm health
• Chronic disease
• Diet
• Foods and
beverages
 Food Choices, Part 1

• Choices are highly personal

• Social or behavioral motives
• Personal preference
• Taste
• Sweet and salty
• Genetics
• Habit
• Ethnic heritage or tradition
 Food Choices, Part 2

• Social interactions
• Availability, convenience, and economy
• Benefits of home-cooked meals
• Positive and negative associations
• Emotions
• Boredom, depression, anxiety
• Stress
 Food Choices, Part 3

• Values
• Religious beliefs, political views,
environmental concerns
• Body weight and image
• Nutrition and health benefits
• Functional foods
• Examples
 The Nutrients

• Water • Carbohydrates
• Hydrogen & • Organic
oxygen • Proteins
• Inorganic • Organic
• Minerals • Contains nitrogen
• Simplest nutrient • Lipids (fats)
• Inorganic • Organic
• Vitamins
• Organic
Body Composition of Healthy-
Weight Men & Women
 Elements in the Six Classes of
Nutrients
TABLE 1-1 Elements in the Six Classes of Nutrients
Notice that organic nutrients contain carbon

Carbon Hydrogen Oxygen Nitrogen Minerals

INORGANIC NUTRIENTS

Minerals ✓

Water ✓ ✓

ORGANIC NUTRIENTS

Carbohydrate ✓ ✓ ✓

Lipid (fat) ✓ ✓ ✓

Protein a ✓ ✓ ✓ ✓

Vitamins b ✓ ✓ ✓

a Some proteins also contain the mineral sulfur.

b Some vitamins contain nitrogen; some contain minerals.
 Energy-Yielding Nutrients

• Amount of energy in food

• Depends on macronutrient composition
• Using nutrients for energy
• Breaking of bonds
• Storage of excess energy
• Metabolism
• Materials for building body tissues
• Regulation of bodily activities
 Energy-Yielding Nutrients
(continued)

• Provide kcalories
• Carbohydrate = 4 kcal/g
• Protein = 4 kcal/g
• Fat = 9 kcal/g
• Alcohol
• Not a nutrient
• Yields energy – 7 kcal/g
• Macronutrients vs. micronutrients
 The Vitamins

• Thirteen organic vitamins

• Water-soluble vitamins
• Fat-soluble vitamins
• Facilitate energy release
• Almost every bodily action requires
assistance from vitamins
• Vulnerable to destruction
• Examples
 The Minerals & Water

• Minerals
• Do not yield energy
• Sixteen essential minerals
• Indestructible
• Causes of mineral losses from foods
• Water
• Medium for nearly all body activities
 The Science of Nutrition

• Foundation in several other sciences

• Biology, biochemistry, physiology
• Tremendous growth
• Sequencing of human genome
• Nutritional genomics
 Conducting Research

• Use of scientific method

• Systematic process for conducting research
• Research studies
• Controls
• Randomization
• Sample size
• Placebos
• Double-blind experiments
The Scientific Method
Conducting Research (continued)

• Epidemiological studies
• Cross-sectional studies
• Case-control studies
• Cohort studies
• Experimental studies
• Laboratory-based animal studies
• Laboratory-base in vitro studies
• Clinical trials
Examples of Research Designs
Examples of Research Designs
(continued)
Analyzing Research Findings

• Correlations – only show association

• Positive correlation
• Not necessarily a desired outcome
• Negative correlation
• No correlation
• Cautious interpretations and conclusions
• Accumulation of evidence
 Publishing Research

• Peer review
• Research has validity
• Findings are preliminary when published
• Not meaningful by themselves
• Findings need to be replicated
 Parts of a Research Article

TABLE 1-3 - Parts of a Research Article

• Abstract. The abstract provides a brief overview of the article.
• Introduction. The introduction clearly states the purpose of the current study.
• Review of literature. A comprehensive review of the literature reveals all that science
has uncovered on the subject to date.
• Methodology. The methodology section defines key terms and describes the
instruments and procedures used in conducting the study.
• Results. The results report the findings and may include tables and figures that
summarize the information.
• Conclusions. The conclusions drawn are those supported by the data and reflect the
original purpose as stated in the introduction. Usually, they answer a few questions
and raise several more.
• References. The references reflect the investigator's knowledge of the subject and
should include an extensive list of relevant studies (including key studies several years
old as well as current ones).
Dietary Reference Intakes, Part 1

• Standards defined for:

• Energy
• Nutrients
• Other dietary components
• Physical activity
• Collaborative effort of U.S. and Canada
• Recommendations apply to healthy people
• May be different for specific groups
Dietary Reference Intakes, Part 2

• Estimated Average Requirements (EAR)

• Average amount sufficient for half of
population
• Recommended Dietary Allowances (RDA)
• Recommendations to meet needs of most
healthy people
• About 98% of population
EAR and RDA Compared
Dietary Reference Intakes, Part 3

• Adequate Intakes (AI)

• Insufficient scientific evidence
• AI value set instead of RDA
• Expected to exceed average requirements
• Tolerable Upper Intake Levels (UL)
• Point where nutrient is likely to be toxic
• Helps protect against overconsumption
Inaccurate vs. Accurate View of
Nutrient Intakes
1. If a person’s usual intake falls
above the RDA, the intake is
probably adequate because the
RDA meets the needs of almost
all people.
2. A usual intake that falls between
the RDA and the EAR is more
difficult to assess; the intake may
be adequate, but the chances
are greater or equal that it is
inadequate.
3. If the usual intake falls below the
EAR, it is probably inadequate.
Dietary Reference Intakes, Part 4

• Estimated Energy Requirement (EER)

• Average dietary energy intake to maintain
energy balance
• Healthy body weight
• Physical activity
• No upper level
Dietary Reference Intakes, Part 5

• Acceptable Macronutrient Distribution

Ranges (AMDR)
• Adequate energy and nutrients
• Reduce risk of chronic diseases
• Range
• 45-65% kcalories from carbohydrate
• 20-35% kcalories from fat
• 10-35% kcalories from protein
Dietary Reference Intakes, Part 6

• Estimates apply to healthy people

• Needed adjustments
• Recommendations – not minimum levels nor
optimal levels
• Goals intended to be met through diet
• Apply to average daily intakes
• Each DRI category serves a unique purpose
 Nutrition Assessment –
Individual Level
• Deficiency or excess over time leads to
malnutrition
• Undernutrition and overnutrition
• Symptoms of malnutrition
• Diarrhea
• Skin rashes
• Fatigue
• Others
 Nutrition Assessment –
Individual Level (continued)
• Creating a “total picture” of the individual
• Historical information
• Health status, SES, drug use
• Diet history – intake over several days; portion
sizes; computer analysis
• Anthropometric measurements
• Height and weight – track to identify trends
• Physical examinations
• Laboratory tests
Stages in the Development of a
Nutrient Deficiency
 Nutrition Assessment –
Population Level
• National nutrition surveys
• National nutrition monitoring program
• Coordinates two major national surveys
• Oversample high-risk groups
• National health goals
• Healthy People
• National trends
 Healthy People 2020 Nutrition
& Weight Status Objectives
TABLE 1-4 - Healthy People 2020 Nutrition and Weight Status Objectives
• Increase the proportion of adults who are at a healthy weight
• Reduce the proportion of adults who are obese
• Reduce iron deficiency among young children and females of childbearing age
• Reduce iron deficiency among pregnant females
• Reduce the proportion of children and adolescents who are overweight or obese
• Increase the contribution of fruits to the diets of the population aged 2 years and older
• Increase the variety and contribution of vegetables to the diets of the population aged 2
years and older
• Increase the contribution of whole grains to the diets of the population aged 2 years and
older
• Reduce consumption of saturated fat in the population aged 2 years and older
• Reduce consumption of sodium in the population aged 2 years and older
• Increase consumption of calcium in the population aged 2 years and older
• Increase the proportion of worksites that offer nutrition or weight management classes
or counseling
Healthy People 2020 Nutrition &
Weight Status Objectives (continued)
• Increase the proportion of physician office visits that include counseling or education related
to nutrition or weight
• Eliminate very low food security among children in US households
• Prevent inappropriate weight gain in youth and adults
• Increase the proportion of primary care physicians who regularly measure the body mass
index of their patients
• Reduce consumption of kcalories from solid fats and added sugars in the population aged 2
years and older
• Increase the number of states that have state-level policies that incentivize food retail outlets
to provide foods that are encouraged by the Dietary Guidelines
• Increase the number of states with nutrition standards for foods and beverages provided to
preschool-aged children in childcare
• Increase the percentage of schools that offer nutritious foods and beverages outside of
school meals

NOTE: Nutrition and Weight Status is one of 38 topic areas, each with numerous objectives.
Several of the other topic areas have nutrition-related objectives, and these are presented in
Appendix J. SOURCE: www.healthypeople.gov
 Diet and Health

• Food plays vital role TABLE 1-5: Leading Causes of

Death in the United States
in supporting health Percentage of
Total Deaths
• Chronic disease – 1. Heart disease 24.1

epidemic levels 2. Cancers

3. Chronic lung diseases
23.3
5.6
4. Strokes 5.2
• Multiple factors 5. Accidents 4.8

over multiple years 6. Alzheimer's disease

7. Diabetes mellitus
3.4
2.8
8. Pneumonia and influenza 2.0
• Leading causes of 9. Kidney disease 2.0

death 10. Suicide 1.5

NOTE: The diseases highlighted in bold have relationships

with diet.
SOURCE: Deaths: Preliminary data for 2010. National Vital
Statistics Reports. January 11, 2012. Centers for Disease
Control and Prevention, www.cdc.gov/ncbs
 Diet and Health (continued)
TABLE 1-6: Factors Contributing to Deaths in
• Risk factors the United States
Factors Percentage of
• Persist over time Deaths

• Cluster Tobacco

Poor diet/inactivity
18

15

• Prominence of risk Alcohol 4

factors
Microbial agents 3
Toxic agents 2

• Tobacco Motor vehicles 2

Firearms 1
• Diet & activity Sexual behavior 1

patterns Illicit drugs 1

• Others SOURCE: A. H. Mokdad and coauthors, Actual causes of death in the

United States. 2000. Journal of the American Medical Association 291
(2004): 1238-1245, with corrections from Journal of the American Medical
Association 293 (2005): 298.
Nutrition Information
& Misinformation

Highlight 1
 Nutrition Information &
Misinformation, Part 1

• Validity of information
• Who is providing information?
• Qualifications
• Internet
• Anyone can publish anything
• No guarantees of accuracy
• Evaluate websites
• Who, When, Where, Why, and What?
 Nutrition Information &
Misinformation, Part 2
• News
• Often tell lopsided story
• Testimonials
• Tight deadlines
• Limited understanding
• Current and controversial
 Nutrition Information and
Misinformation, Part 3
• Identifying nutrition experts
• Physicians & other health-care professionals
• Training in nutrition is limited
• Registered Dietitian (RD)
• Degree and clinical internship
• National exam
• Maintain up-to-date knowledge
• Dietetic Technician Registered (DTR)
 Nutrition Information and
Misinformation, Part 4
• Identifying fake credentials
• Accreditation
• Diploma mills
• Fraudulent businesses
• Red flags of nutrition quackery
• Misinformation
Nutrition Information and
Misinformation, Part 5