An Overview of Nutrition

MPU 3343 NUTRITION & PUBLIC HEALTH
Chapter 1 An Overview of Nutrition
CHAPTER 1 An Overview of Nutrition

Introduction
1.1 Food Choices
1.2 The Nutrients
1.3 The Science of Nutrition
1.4 Dietary Reference Intakes (DRI)
1.5 Nutrition Assessment
1.6 Diet and Health
Highlight 1 Nutrition Information & Misinformation
For Internal Circulation Only

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CHAPTER 1 An Overview of Nutrition
Introduction
- What is Nutrition?
~ The study of food, including how food nourishes our bodies and how food
influences our health
- Daily food choices
~ Benefit health
~ Harm health
~ Chronic disease
- Diet
~ Foods and beverages a person consumes
1.1 Food Choices

- Preferences
~ Taste: Sweet and salty, genetics
- Habit
- Ethnic heritage and regional cuisines (tradition)
~ Prefer the foods they grow up eating
- Social interactions
- Marketing
- Availability, convenience and economy
~ Benefits of home-cooked meals
- Positive and negative associations
~ Hot dogs at ball games or cake and ice cream at birthday parties
~ Plain porridge when felt sick
~ Rewards or punishments
- Emotions
~ Boredom, depression, anxiety, stress
- Values
~ Religious beliefs, political views, environmental concerns
- Body weight and health
- Nutrition
~ Functional and fortified foods

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1.2 The Nutrients

1. Carbohydrates
~ Organic (contains carbon)
2. Proteins
~ Contains nitrogen
3. Lipids (Fats)
4. Vitamins
5. Minerals
~ Simplest nutrient
~ Inorganic (no carbon)
6. Water
~ Hydrogen & oxygen
~ Inorganic (no carbon)

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- Organic vs inorganic
- Macronutrients vs micronutrients
~ Macronutrients: nutrients required in relatively large amounts; yield energy
~ Carbohydrates, lipids, proteins, water
~ Most provide energy to our bodies
~ Water and minerals do not yield energy
~ Micronutrients: nutrients required in smaller amounts
~ Vitamins and mineral
~ Human body needs small amounts
Nutrients in Foods and in the Body

- Nutrient composition of foods
~ Chemical analysis
- Nutrient composition of the body
~ (see Figure 1-1)
- Chemical nature of nutrients
~ Each mineral is a chemical element; its atoms are all alike
- Essential nutrients
~ Needed from outside the body

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The Energy-yielding Nutrients: Carbohydrate, Fat and Protein

- Energy measured in kCalories
~ Macronutrients: source of kcalories
~ Carbohydrate = 4 kcal/g
~ Protein = 4 kcal/g
~ Fat = 9 kcal/g
~ Higher energy density
~ Alcohol
~ Not a nutrient
~ Yields energy = 7 kcal/g
- Energy from foods
~ Lower energy density foods
~ Contribute to weight loss
- Energy in the body
~ Body uses macronutrients
~ Bonds between the nutrients’ atoms break
~ Energy is released
~ Can then be used or stored
~ Macronutrients
~ Provide raw material for building tissue and regulating body activities
~ Proteins regulate digestion and energy metabolism
- Other roles of energy-yielding nutrients
~ Serve as raw materials for building the body’s tissues and regulating its many
activities
~ Protein form structures such as the muscles and skin and help regulate activities
such as digestion and energy metabolism

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The Vitamins
- Thirteen organic vitamins
~ Each has a special role to play
- Facilitate energy release
~ Almost every bodily action requires assistance from vitamins
- Vulnerable to destruction
~ Heat (as from cooking), light and chemicals

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The Minerals
- Do not yield energy
- Sixteen essential minerals
- Other minerals are environmental contaminants
~ Example: Lead
- Indestructible
~ But can be lost into cooking water, for example
Water
- Environment for nearly all body processes
1.3 The Science of Nutrition

- Foundation in several other sciences
~ Biology, biochemistry, physiology
- Tremendous growth
~ Knowledge gained from sequencing the human genome
~ Nutritional genomics
Conducting Research
- Anecdotes
~ Personal experience
- Use of scientific method
~ Systematic process for conducting research
- Research studies
~ Controls (subjects)
~ Control group
~ Experimental group
~ Randomization
~ Sample size
~ Placebos
~ Double blind
- Types of research studies
~ Epidemiological studies
~ Experimental studies
- Epidemiological studies

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~ Cross-sectional studies
~ Case-control studies
~ Cohort studies
- Experimental studies
~ Laboratory-based animal studies
~ Laboratory-based in vitro studies
~ Human intervention (clinical) trials

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Analyzing Research Findings

- Correlations and causes – 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
- Gold Standard
~ Placebo
~ Double-Blind

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1.4 Dietary Reference Intakes

- Standards defined for:
~ Energy
~ Nutrients
~ Other dietary components
~ Physical activity
- Collaborative effort of United States and Canada
- Recommendations apply to healthy people
~ May be different for specific groups
Establishing Nutrient Recommendations

- Estimated Average Requirements (EAR)
~ Average amount sufficient for half of population
- Recommended Dietary Allowances (RDA)
~ Recommendations to meet needs of most healthy people
~ Set near the top end of the range of EAR
~ About 98% of population
- Adequate Intakes (AI)
~ Insufficient scientific evidence to establish EAR
~ 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
- Chronic Disease Risk Reduction Intakes (CDRR)
~ Deficient or excessive intakes of nutrients likely to cause harmful symptoms
Establishing Energy Recommendations

- Estimated Energy Requirement (EER)
~ Average dietary energy intake to maintain energy balance
~ Healthy body weight
~ Physical activity
~ No upper level
- Acceptable Macronutrient Distribution Ranges (AMDR)

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~ Adequate energy and nutrients

~ Reduce risk of chronic diseases
~ Ranges
~ 45-65% kcalories from carbohydrate
~ 20-35% kcalories from fat
~ 10-35% kcalories from protein

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Using Nutrient Recommendations

~ Estimates apply to healthy people
~ Needs adjusting for medical problems, malnourishment or other condition
~ 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

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Comparing Nutrient Recommendations

- More than 80 nations published nutrient standards similar to those used in U.S.
- Slight differences are in the food habits and physical activities of the population
- Developed by 2 international groups: FAO (Food and Agriculture Organization) and
the WHO (World health Organization)
1.5 Nutrition Assessment

- Deficiency or excess over time leads to malnutrition
~ Undernutrition and overnutrition
- Symptoms of malnutrition
~ Diarrhea
~ Skin rashes
~ Fatigue
~ Others
Nutrition Assessment of Individuals

- 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
- Signs/ symptoms: Overt/ Covert
- Deficiency
~ Primary deficiency - lacking in the diet
~ Secondary deficiency - the body doesn’t absorb enough, excretes too much, uses
inefficiently
~ Subclinical deficiency

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Nutrition Assessment of Populations

- National nutrition surveys
~ Conducted by various agencies
~ One survey collects data on food types and amounts
~ Another collects data about people themselves
~ Oversample high-risk groups
- National health goals
~ Healthy People program
- National trends

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- 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 Weight Objectives:
~ 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
1.6 Diet & Health

- Food plays vital role in supporting health
- Chronic diseases – epidemic levels
~ Multiple factors over multiple years
~ Leading causes of death
- Risk factors for chronic diseases
~ Risk factors persist
~ Risk factors cluster
~ Risk factors in perspective
~ Tobacco

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~ Diet & activity patterns

~ Others
~ Health behaviours
~ Smoking, consume alcohol, inactive, sleep less of 7 hours per day, diet
Highlight 1
Nutrition Information & Misinformation
- Validity of information
~ Who is providing information?
~ Qualifications
- Nutrition on the internet
~ Anyone can publish anything
~ No guarantees of accuracy
~ Evaluate websites
~ Who, when, where, why and what?

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- Nutrition in the news

~ Often tell lopsided story
~ Testimonials
~ Tight deadlines
~ Limited understanding
~ Current and controversial
- Identifying nutrition experts
~ Physicians & other health-care professionals
~ Training in nutrition is limited
~ Registered Dietician (RD)
~ Degree and clinical internship
~ National exam
~ Maintain up-to-date knowledge
~ Dietetic technician registered (DTR)
- Identifying fake credentials
~ College accreditation
~ Diploma mills
~ Fraudulent businesses
- Red flags of nutrition quackery
~ Misinformation
~ Consider the source
~ Buyer beware

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Glossary
No Term / Word Definition / Meaning

Glossary
1 Acceptable Ranges of intake for the energy nutrients that provide adequate
Macronutrient energy and nutrients and reduce the risk of chronic diseases.
Distribution Ranges
(AMDR)
2 Adequate Intakes The average daily amount of a nutrient that appears sufficient to
(AI) maintain a specified criterion; a value used as a guide for nutrient
intake when an RDA cannot be determined.
3 Anthropometric Relating to measurement of the physical characteristics of the
(AN-throw-poe- body, such as height and weight.
MET-rick) Anthropos = human
Metric = measuring
4 Calories Unit by which energy is measured. Energy provided by foods and
beverages is measured in kilocalories (1000 calories equal 1
kilocalorie), abbreviated kcalories or kcal. One kcalorie is the
amount of heat necessary to raise the temperature of 1 kilogram
(kg) of water 1ºC. The scientific use of the term kcalorie is the
same as the popular use of the term calorie.
5 Chronic diseases Diseases characterized by slow progression and long duration.
Examples include heart disease, diabetes and some cancers.
Chronos = time
6 Covert (KOH-vert) Hidden, as if under covers.
Couvrir = to cover
7 Cultural competence Having an awareness and acceptance of cultures and the ability to
interact effectively with people of diverse cultures.
8 Deficient Inadequate; a nutrient amount that fails to meet the body’s need
and eventually results in deficiency symptoms.
9 Dietary Reference A set of nutrient intake values for healthy people in the United
Intakes (DRI) States and Canada. These values are used for planning and
assessing diets and include:
 Estimated Average Requirements (EAR)
 Recommended Dietary Allowances (RDA)
 Adequate Intakes (AI)
 Tolerable Upper Intake Levels (UL)
10 Diet The foods and beverages a person eats and drinks.
11 Energy density A measure of the energy a food provides relative to the weight of
the food (kcalories per gram).
12 Energy yielding The nutrients that break down to yield energy the body can use:
nutrients carbohydrate, fat and protein.
13 Energy The capacity to do work. The energy in food is chemical energy.
The body can convert this chemical energy to mechanical,
electrical or heat energy.
14 Essential nutrients Nutrients a person must obtain from food because the body cannot
make them for itself in sufficient quantity to meet physiological

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needs; also called indispensable nutrients. About 40 nutrients are

currently known to be essential for human beings.
15 Estimated Average The average daily amount of a nutrient that will maintain a
Requirements (EAR) specific biochemical or physiological function in half the healthy
people of a given age and gender group.
16 Estimated Energy The average dietary energy intake that maintains energy balance
Requirement (EER) and good health in a person of a given age, weight, height and
level of physical activity.
17 Ethnic foods Foods associated with particular cultural groups.
18 Foods Products derived from plants and animals that can be taken into
the body to yield energy and nutrients for the maintenance of life
and the growth and repair of tissues.
19 Functional foods Foods that contain bioactive components that provide health
benefits beyond their nutrient contributions.
20 Genome (GEE- The complete set of genetic material (DNA) in an organism or a
nome) cell. The study of genomes is called genomics.
21 Healthy people A national public health initiative under the jurisdiction of the US
Department of Health and Human Services (DHHS) that identifies
the most significant preventable threats to health and focuses
efforts toward eliminating them.
22 Inorganic Not containing carbon or pertaining to living things.
In = not
23 Malnutrition Any condition caused by excess or deficient food energy or
nutrient intake or by an imbalance of nutrients.
Mal = bad
24 Minerals Inorganic elements. Some minerals are essential nutrients required
in small amounts by the body for health.
25 Nutrients Chemical substances obtained from food and used in the body to
provide energy, structural materials and regulating agents to
support growth, maintenance and repair of the body’s tissues.
Nutrients may also reduce the risks of some diseases.
26 Nutritional genomics The science of how nutrients affect the activities of genes
(nutrigenomics) and how genes affect the interactions between diet
and diseases (nutrigenetics).
27 Nutrition assessment A comprehensive analysis of a person’s nutrition status that uses
health, socioeconomic, drug and diet histories; anthropometric
measurements; physical examinations and laboratory tests.
28 Nutrition The science of the nutrients in foods and their actions within the
body. A broader definition includes the study of human behaviours
related to food and eating.
29 Organic In chemistry, a substance or molecule containing carbon-carbon
bonds or carbon-hydrogen bonds. This definition excludes coal,
diamonds and a few carbon-containing compounds that contain
only a single carbon and no hydrogen, such as carbon dioxide
(CO2), calcium carbonate (CaCO3), magnesium carbonate
(MgCO3) and sodium cyanide (NaCN).
30 Overnutrition Excess energy or nutrients.
31 Overt (oh-VERT) Out in the open and easy to observe.
Ouvrir = to open

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32 Phytochemicals Non-nutrient compounds found in plants. Some phytochemicals

(FIE-toe-KEM-ih- have biological activity in the body.
cals) Phyto = plant
33 Primary deficiency A nutrient deficiency caused by inadequate dietary intake of a
nutrient.
34 Recommended The average daily amount of a nutrient considered adequate to
Dietary Allowances meet the known nutrient needs of practically all healthy people; a
(RDA) goal for dietary intake by individuals.
35 Requirement The lowest continuing intake of a nutrient that will maintain a
specified criterion of adequacy.
36 Risk factor A condition or behaviour associated with an elevated frequency of
a disease but not proved to be causal. Leading risk factors for
chronic diseases include obesity, cigarette smoking, high blood
pressure, high blood cholesterol, physical inactivity and a diet high
in saturated fats and low in vegetables, fruits and whole grains.
37 Six classes of Carbohydrates, lipids (fats), proteins, vitamins, minerals and
nutrients water.
38 Secondary A nutrient deficiency caused by something other than an
deficiency inadequate intake such as a disease condition or drug interaction
that reduces absorption, accelerate use, hastens excretion or
destroys the nutrient.
39 Subclinical A deficiency in the early stages, before the outward signs have
deficiency appeared.
40 Tolerable Upper The maximum daily amount of a nutrient that appears safe for
Intake Levels (UL) most healthy people and beyond which there is an increased risk of
adverse health effects.
41 Undernutrition Deficient energy or nutrition.
42 Vitamins Organic, essential nutrients required in small amounts by the body
for health.
Glossary of Research Terms
43 Anecdote A personal account of an experience or event, not reliable;
scientific information.
44 Blind experiment An experiment in which the subjects do not know whether they are
members of the experimental group or the control group.
45 Control group A group of individuals similar in all possible aspects to the
experimental group except for the treatment. Ideally, the control
group receives a placebo while the experimental group receives a
real treatment.
46 Correlation (CORE- The simultaneous increase, decrease or change in two variables. If
ee-LAY-shun) A increases as B increases, or if A decreases as B decreases, the
correlation is positive. (This does not mean that A causes B or vice
versa). If A increases as B decreases or if A decreases as B
increases, the correlation is negative. (This does not mean that A
prevents B or vice versa). Some third factor may account for both
A and B.
47 Double-blind An experiment in which neither the subjects nor the researchers
experiment know which subjects are members of the experimental group and
which are serving as control subjects, until after the experiment is
over.

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48 Experimental group A group of individuals similar in all possible respects to the

control group except for the treatment. The experimental group
receives the real treatment.
49 Hypothesis (hi- An unproven statement that tentatively explains the relationships
POTH-eh-sis) between two or more variables.
50 Peer review A process in which a panel of scientists rigorously evaluates a
research study to assure that the scientific method was followed.
51 Placebo (pla-SEE- An inert, harmless medication given to provide comfort and hope;
bo) a sham treatment used in controlled research studies.
52 Placebo effect A change that occurs in response to expectations about the
effectiveness of a treatment that actually has no pharmaceutical
effects.
53 Randomization A process of choosing the members of the experimental and
(RAN-dom-ih-ZAY- control groups without bias.
shun)
54 Replication (REP- Repeating an experiment and getting the same results.
lih_KAY-shun)
55 Subjects The people or animals participating in a research project.
56 Theory A tentative explanation that integrates many and diverse findings
to further the understanding of a defined topic.
57 Validity (va-LID-ih- Having the quality of being founded on fact or evidence.
tee)
58 Variables Factors that change. A variable may depend on another variable
(for example, a child’s height depends on his age), or it may be
independent (for example, a child’s height does not depend on the
colour of his eyes). Sometimes both variables correlate with a third
variable (a child’s height and eye colour both depend on genetics).
Additional Glossary
59 Academy of The professional organization of dietitians in the United States;
Nutrition and formerly the American Dietetic Association. The Canadian
Dietetics equivalent is Dietitians of Canada, which operates similarly.
60 Accredited Approved; in the case of medical centres or universities, certified
by an agency recognised by the US Department of Education.
61 Certified Nutritionist A person who has been granted a document declaring his or her
or Certified authority as a nutrition professional.
Nutritional
Consultant or
Certified Nutrition
Therapist
62 Dietetic technician A person who has completed a minimum of an associate’s degree
from an accredited university or college and an approved dietetic
technician program that includes a supervised practice experience.
See also dietetic technician, registered.
63 Dietetic technician, A dietetic technician who has passed a national examination and
registered (DTR) maintains registration through continuing professional education.
64 Dietitian A person trained in nutrition, food science and diet planning. See
also registered dietitian.
65 Diploma mills Entities without valid accreditation that provide worthless degrees.
66 DTR See dietetic technician, registered.

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67 Fraudulent The promotion, for financial gain, of devices, treatment, services,

plans or products (including diets and supplements) that alter or
claim to alter a human condition without proof of safety or
effectiveness.
68 Internet (the Net) A worldwide network of millions of computers linked together to
share information.
69 License to practise Permission under state or federal law, granted on meeting
specified criteria, to use a certain title (such as dietitian) and offer
certain services. Licensed dietitians may use the initials LD after
their names.
70 Misinformation False or misleading information.
71 Public health Dietitians who specialise in providing nutrition services through
dietitians organise community efforts.
72 RD See registered dietitian.
73 Registered dietitian A person who has completed a minimum of a bachelor’s degree
(RD) from an accredited university or college, has completed approved
course work and a supervised practice program, has passed a
national examination and maintains registration through
continuing professional education.
74 Registration Listing; with respect to health professionals, listing with a
professional organisation that requires specific course work,
experience and passing of an examination.
75 Websites Internet resources composed of text and graphic files, each with a
unique URL (Uniform Resource Locator) that names the site (for
example, www.usda.gov).

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MPU 3343 NUTRITION & PUBLIC HEALTH

Chapter 1 An Overview of Nutrition

CHAPTER 1 An Overview of Nutrition

For Internal Circulation Only

CHAPTER 1 An Overview of Nutrition

1.1 Food Choices

For Internal Circulation Only

1.2 The Nutrients

For Internal Circulation Only

Nutrients in Foods and in the Body

For Internal Circulation Only

The Energy-yielding Nutrients: Carbohydrate, Fat and Protein

For Internal Circulation Only

For Internal Circulation Only

1.3 The Science of Nutrition

For Internal Circulation Only

For Internal Circulation Only

For Internal Circulation Only

Analyzing Research Findings

For Internal Circulation Only

1.4 Dietary Reference Intakes

Establishing Nutrient Recommendations

Establishing Energy Recommendations

For Internal Circulation Only

~ Adequate energy and nutrients

For Internal Circulation Only

Using Nutrient Recommendations

For Internal Circulation Only

Comparing Nutrient Recommendations

1.5 Nutrition Assessment

Nutrition Assessment of Individuals

For Internal Circulation Only

Nutrition Assessment of Populations

For Internal Circulation Only

- Healthy People 2020 Nutrition and Weight Status Objectives:

1.6 Diet & Health

For Internal Circulation Only

~ Diet & activity patterns

For Internal Circulation Only

- Nutrition in the news

For Internal Circulation Only

For Internal Circulation Only

No Term / Word Definition / Meaning

For Internal Circulation Only

needs; also called indispensable nutrients. About 40 nutrients are

For Internal Circulation Only

32 Phytochemicals Non-nutrient compounds found in plants. Some phytochemicals

For Internal Circulation Only

48 Experimental group A group of individuals similar in all possible respects to the

For Internal Circulation Only

67 Fraudulent The promotion, for financial gain, of devices, treatment, services,

For Internal Circulation Only

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