Assignment notes for food diary PDF

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assignment 1, grade: first...

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Introduction: Dietary assessment is a way that the food consumption by individuals can be analysed quantitatively and qualitatively. A 20-year-old female completed a three-day food diary and dietary analysis was assessed through DietPlan 6 Software. The female has a weight of 53 kg, heights 171cm, and her estimated body fat (BMI) is 18.1. A detailed analysis was made for the macronutrients and some other important nutrients, which where compared to the Dietary Reference values for quantitative analysis and to the 8 tips and eat-well plate for the qualitative analysis. Various limitations of DietPlan software and improvement methods were also observed.

Method: The intake of food was measured mostly using household measures and scale. The food weighted with scale, was uncooked weight. For more accurate results every ingredient used in recipes was included on the diary as well.

Table 2 showing the comparison of the average food intake for the three days to the recommendations from Eat –well plate for each category along with what could be improved. Food group

1.

Recommended number of portions

Average number of portions eaten by female in 3-days

6 or more

Day1: 3 Day2: 5 Day3: 4 Average: 4 portions

Bread, rice, pasta and other starchy foods

2.

5 or more

Fruit and vegetables

Day1: Day2: Day3: 5 4 6 Average: 5 portions

3.

Meat, fish, eggs, beans and other nondairy sources of protein

2-3 portions

Day1: 4 Day2: 3 Day3: 2 Average: 3 portions

4.

Milk and dairy foods

2-3 portions

Day1: 4 Day2: 3 Day3: 2 Average: 3 portions

5.

Foods and drinks high in fat and/or sugar

Minimal

Day1: 3 Day2: 5 Day3: 5 Average: 4 portions

Types of food consumed through the 3-day diary 100g Bran Flakes (3) 100g wholemeal bread toasted (4), 150g wholemeal spaghetti (1), 200g white rice fried (2) 40g onions, 120 broccoli raw (2), 140g cherry tomatoes (2), 150g orange juice unsweetened (1), 240g sweet-cornon-the-cob (2), 300g apples (3), 100g chips oven frozen, baked (1) 30g almonds (2), 120g omellete plain (2 eggs)(1), 200g fish fingers (2), 300g chocken breast (3) 40g cheese edam (1), 120g low fat yoghurt (3), 400g semi-skimmed milk (2) 20g honey (1), 33g olive oil (3), 2 kit kat fingers (2), chocolate chip cookies (4), 60g ice cream dairy flavoured (1), 60g cereal crunchy bar (2)

Recommend n - Replace som of

- Replace food and drinks hig in fat and sug with fruits

- Replace food high in fat wit starchy foods - Choose low spread

Table 3: showing the dietary intake compared to the NHS 8 Tips.

Tip

Achieved Not achieved

1) Base your meals on starchy foods 2) Eat lots of fruits and vegetables 3) Eat more fish,2 portions per week including 1 portion of oily fish 4) Cut down on saturated fat and sugar 5) eat less saltno more than 6g/day Get active and be a healthy weight

✗

Was DietPlan effective Recommendations for gaining information for that tip? Yes

✓

Yes

✓

No

✗

yes

??

Yes

Don’t get thirsty

??

No

Don’t skip breakfast

✓

yes

-Increase your non-animal protein sources

Add extra herbs and spices such as black pepper

No -Drink plenty of water -Avoid sugary drinks

Quantitative analysis: Table 4. Nutrient content for energy, proteins, fats and carbohydrates of a three-day diary for a 20years old female

Day 1 (Thursday) Breakfast Lunch Evening meal Snacks Total

304 445 243 119 1441

Day 2 (Friday) Energy (kcal) 304 519 575 361 1759

Day 3 (Saturday) 425 850 165 367 1807

Table 5. Nutrient content for energy, proteins, fats and carbohydrates of a three-day diary for a 20years old femal Intake per day (g)

Energy

-

Protein

82.1

Carbohydrate

DRV (g)

Average calories per day from: (kcal)

As a percentage of total calories (%)

UK food (%)

Main source

1660

-

-

-

RNI: 45.0

328

19.8

15

Chicken breast and fish fingers

208.6

EAR: 207.5

782

47.1

50

Spaghetti an Bran Flakes

Fat

61.1

EAR:64.5

550

33.1

35

Olive Oil an omelette

Saturated fat

19.1

21.5

171.9

194

-

Chocolate biscuits, cheese Cereal crunchy bar, cheese,

Trans Fatty acids

Table 6: Nutrient composition for iron, calcium, vitamin C, folate and fibre of a 3-day diary for a 20-years old woman

Intake per day

DRV

As a percentage of total intake (%)

16.36

14.80*RNI

Calcium (mg)

605

Vitamin C (mg) Folate (mg)

Iron (mg)

-

More (+) or Less (-)

Main sources

+1.6

Bran Flakes, Spaghetti, wholemeal

700*RNI

-95

Milk, Cheese

115

40*RNI

+74

Broccoli, Bran Flakes

295

200

+95

Bran Flakes,

Broccoli Fibre (g)

24.3

18

+6.3

Spaghetti,

Discussion: Qualitative Discussion: The qualitative discussion assesses the quality of the diet and whether recommendations are met if compared to the Eat well plate and the NHS 8 tips. According to table 2, most of the recommendations are met except the food group one that should be increased and five that should be reduced. The meals were not based on starchy foods and on average there were only 4 portions provided each day, the same portions as foods high in fat and sugar that should be minimal. If looked at table 1, although white rice was used, all the other varieties are made from wholemeal flour, an important factor for maintaining the healthy parts of the wholegrain, fibre and other micronutrients that refined ones miss out. It is suggested, that the rice is not fried but baked and that wholemeal or basmati rice is used. The fruit and vegetables intake was as recommended but a rainbow of fruits is suggested for obtaining a greater variety of micronutrients. The third group of table 2, and the third tip of table 3 show that the recommendation for 2-3 portions of high protein foods intake per day, together with a regular intake of fish and oily fish was achieved. Healthier choices can be made if the chicken breast with meat and skin is replaced with the leanest option, and meat without the skin to reduce the amount of fat. Fish fingers could be switched to salmon, which is a fish of great nutritional value and rich in omega 3 fatty acids. Also, non-animal protein sources could be eaten in place of high saturated fat protein sources. If the high protein meals are reduced in fat quantity, then the fourth tip for cutting down saturated fat could be accomplished. No added sugar does not equate low sugar or now sugar. Although, the main recommendation for cutting down saturated fat and sugar would be the reduction, if not the removal of chocolates and sweets such as kit kat, chocolate chip cookies, cereal crunchy bars and ice creams which offer a great amount of energy derived from fat, and more specifically saturated fat and sugar without any other significant nutritional value. Alternatives to replace them would be foods from the first and second food groups of table 2, starchy foods, fruits and vegetables. The intake of salt per day should not exceed the 6g , which is on average, one level teaspoon. (portion sizes page 69) . Usually, 75% of total salt intake per day is already present in foods and an individual can easily surpass the maximum recommended of 6g without realizing (manual of nutrition page 141) , So, the minimal quantity of sodium should be the target. Ways for reducing the salt intake would be the addition of extra herbs and spices such as black pepper when preparing food, and the restriction of adding extra salt to the prepared meal. In addition, especially if the individual drinks tap water, which is reach in sodium, the salt intake would be more than the amount analyzed in DietPlan. (manual of nutrition 141). Referring to table 2, the portions given from the milk and milk products equal the recommended but a low fat version of cheese could be chosen

to decrease the amount of saturated fat. In addition, natural yoghurts, with natural sugars could be consumed more, to replace foods high in fat and sugar in a combination with fruits and nuts. Even if not removed from the diet, the foods high in fat and sugar could be replaced by low fat varieties. As shown on the appendices, the tip for not skipping breakfast was not only achieved, but a rich breakfast with wholemeal cereals and fruits was included every day. ( in some cases the portion sizes was more than recommended, so try to reduce the amount for each meal, for example , or stay the same because the calorie intake was ok, maybe use less quantity of meat, and increase the quantity of vegetables and starchy foods and pulses.

Quantitative Discussion: According to table 3 it could be concluded that 19.8%(328kcal) of total energy (1660kcal per day) comes from protein and 47.1% (782kcal) and 33.1% (550kcal) from carbohydrates and fats respectively. Compared to the average energy profile for the UK excluding alcohol, only the energy sources from proteins were in excess with an increased percentage of 4.8% and fats and carbohydrates to have a slight decrease of 2-3%. From the macronutrients, only proteins have the purposes of growth, repair and maintenance and have a significant role in the human’s diet. The majority of the protein intake came from the consumption of some protein-rich foods of animal origin, such as chicken breast and fish fingers and the quantity in which they were eaten which was more than a portion in some cases. Although the energy intake from protein is greater than the R.N.I, which covers for about 97% of the people in a population it is much lower than the safe upper intake level for protein, which is 1.5-2g per kg per day, namely 106g in this case. In addition, this excess of protein can possibly be used to provide energy and heat by their conversion into glucose. However, this increased intake of proteins might contribute to the high saturated fat content observed. It is very important that most energy is supplied sufficiently by carbohydrates and fats, so that the protein utilisation not to be affected. (Manual of Nutrition) The total fat intake per day was 61.1g and made up the 33.1% of the total calories (1660kcal), 2% below the UK Food Total Calcium, one of the major minerals in terms of quantity and significance is present in many milk and milk-products and is an essential mineral for bones and teeth but also plays a role in the contraction of muscles (and heart muscles). As shown on table xx on the appendices calcium intake from foods is lower than the R.N.I and the shortage of it can result to softened and weakened bones, a situation called osteomalacia. However, the amount of calcium that is absorbed in the body depends upon the vitamin D quantity, where if there is a deficiency only a small amount of calcium will be absorbed. As shown on appendices xx vitamin D coming from diet is very low but there is not enough evidence to support its actual amount as vitamin D also depends on sun exposure. Calcium absorption also depends on the amount of dietary fibre obtained from the diet. It will be discussed later on, that the amount of dietary fibre in this specific diet is great so even less calcium is absorbed in the organism compared to what is eaten. 26.5% from calcium intake comes from semi-skimmed milk and 17% from cheese. It is recommended that .. Iron, a component of haemoglobin in red blood cells, an oxygen storage in muscle protein, myoglobin, in enzymes is stored in humans as ferritin is important in terms of maintaining

health of red blood cells and blood. Although minerals are very important, high levels of them may give adverse effects. Vitamin C is meeting the requirements of 40mg about 3 times more. The amount is very high mostly due to the range of fruits and vegetables in the diet such as broccoli, bananas, tomatoes, apples and unsweetened orange juices. Humans cannot synthesise their own vitamin C, so if the intake is not above 1000mg adverse effects would possibly not appear. Instead, Vitamin C is considered to be a watersoluble antioxidant and is said to maintain healthy tissues and to cure colds in great amounts. A recommendation involving vitamin C would be to continue to consume such great amounts of it and even more, by eating fruits and to have in mind that most of the vitamin C is destroyed during boiling storage and during preparing. Iron is greater than recommended but that is not bad for a 20-year-old girl as it is not greater than the Guidance level of 17 mg per day (manual of nutrition page 48). Also due to the loss of blood each girl experiences during menstruation, is important that the iron quantities are not lower than needed so that anaemia is not caused, but not too high because adverse effects of constipation, nausea, diarrhoea and vomiting might be caused. The quantity of iron absorbed by the body will always depend on the needs and the circumstances, such as menstruation, pregnancy. (Especially in heavy period). Fifty per cent of the iron intake came from cereals (bran flakes) and a smaller proportion of 3-4% came from meat and fish (chicken breast and fish fingers). Folate, or else called Vitamin B9, is an important vitamin that is of an increased need in women, especially in pregnant women. It is of major importance in young women due to the fact that most of them will probably become pregnant at some point in their life so it important that they achieve the required folate intake throughout their life. That is why folate was chosen to be analysed on the diet of the 20-year old girl. The recommended daily amounts for folate is 200mg per day, 95 mg less than the actual intake. The recommended amount is much greater when a woman is pregnant to 400mg, and most of it consumed via supplements. 38% (of folate was obtained from bran flakes and an average of 24% is due to the great amount of fruits and green-leafy vegetables such as broccoli, but other fruit and vegetables as well such as bananas and tomatoes. However, when vegetables are cooked some of the folate might be destroyed and that will be discussed on the limitations later on. Recommendations would be to use less water when cooking the vegetables so that it will not lose their significant nutrient composition. Fibre is a non-starch polysaccharide that is essential for a healthy diet. It is not absorbed into the body, not digested in the stomach , but it helps other . It is recommended that the minimum amount of fibre eaten each day to be 18g. (Manual of Nutrition page 9)    

The fibre speeds the passage of intestinal contents and may reduce absorption in general Fibre reduces the absorption of specific minerals including calcium and zinc The diet high in fibre can cause makes the entire pathway from mouth to anus to take less time and to speed up (generally 1-3 days) Body fat is more easily formed from dietary fat than the carbohydrate present in foods. Calcium absorbion is also reduced with high fibre intake so

-

(What foods to decrease, what foods to increase and say the implication of these changes on Methods and limitations, was the diet plan analysis accurate? (no because some foods were not present, and if they were, some did not contain all the composition of the food ) Any patterns changed or food choices changed because a food diary was being kept? Are 3 days representative of usual intake?

-

Was the weekend da different compared to the weekday?

If under recommended but ok in weight then ok , if way under calorie requirement , calorie intake low ways to increase calories

RNI covers the majority of the population, half population would be met by the EAR , think of it in the contex of food diery

If calorie intake is below, maybe achiening enough proteins Energy requirement I was actually eating 42% of calories as fat , General comments for diseases , may leed to deficiency etc

Limitations Dietary assessment cannot always determine a deficiency of a specific nutrient, because the physiological needs differ between people. ( Manual of nutrition page 94) As shown on table xxx of the qualitative assessment, some of the data could not be compared to the 8 Tips of the NHS, just because the data could not be collected from the DietPlan Software 6. For example, the tip “get active and be healthy weight” could not be neither ticked or not ticked on the table because the program does nor include measurements including exercise and how regular or intense the exercise was during the days that the diary was taken. (activity cannot be measured with the DietPlan. The tip that says “ eat fish at least twice a weak” could not be criticised on this type of assessment, as the 3 days do not include all the week, but also not all the weeks contain the same type of meals. So , the 3 days cannot always represent the daily intake of someone. In addition, not all the foods were included on the DietPlan Software leading to small changes in plenty of products and the next best alternative most similar to the food intake was chosen. This could lead to underreporting and distortion of the data inserted and nutrients composition outcome. Other factors also take part on the food intake, such as how busy the day of someone’s is and how much time is available to be spent on cooking. On this diary there was not any ready meal included, because maybe the weak tested was not a busy weak, so other factors should be considered when assessing data. Adding to that, the fact that the individual was aware that the food eaten would be written on a diary could make him (athela) to avoid some “unhealthy” stuff that could be present on his diet otherwise. (dietplan could not assess if supplements of vitamins or minerals were taken)

Conclusion: Summarise your practical suggestions for improving the diet in line with recommendations based on your qualitative and quantitative assessment in a brief conclusion at the end

 

Overall the nutrient composition was good, because most of the nutrients met recommendations and if not, they were more close to the RNI and not the LRNI. Increase the amount of milk and milk products that contribute to calcium

Understood assessment methods and giving advise to an individual

References

Arial Food diary (original documents) in and dietary report...