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CONTEMPORARY NUTRITION ISSUES

DIET AND HEALTH IN AUSTRALIA (I) EFFECTS AND COSTS OF MALNUTRITION AND DIET RELATED DISORDERS

Malnutrition: when nutrients are not supplied to the body in the correct amounts  over nutrition or under nutrition

Diet related disorders OVERNUTRITION: intake of nutrients is oversupplied. The amount of nutrients exceeds

the amount required for normal growth, development, and metabolism OBESITY: energy intake is greater than energy expenditure, being stored as adipose tissue. This imposes extra workload for cardiovascular system creating stress on body joints. 20% of ideal weight. Increases risk of long term health conditions like hyperextension and cardiovascular disease. The Australian Diabetes, Obesity and Lifestyle Study estimated direct cost of obesity was $21 billion disease

HYPERTENSION: high blood pressure because of excess sodium that can cause an imbalance of water in body cells therefore retaining water causing the heart to pump blood under pressure. Causes stroke, heart failure. -> Flora reduced salt margarine DENTAL CARIES: tooth decay from poor dental practices, diet high in sugar. There is bad breath and loss of teeth tooth decay or cavities. Dental caries develop The bacteria in plaque use carbohydrates in the form of sugars in food and drinks to produce acid. This acid dissolves the tooth's strengthening minerals (calcium and phosphate) from the tooth surface. . Must eat dairy produce or foods that supply calcium and phosphorous (protein rich foods like meat) to strength teeth  In 2013 total spending on dental services was around 8700$

CARDIOVASCULAR DISEASE: groups of conditions that narrow or block blood vessels leading to pain, stroke or heart attack. Caused by a collection of fat/cholesterol along artery walls restricting blood flow to heart. Characterised by an excessive intake of fats especially harmful fats such as saturated and trans fat

Physical effects  Angina; chronic condition of periodic short episodes of chest pain  High blood pressure  Formation of blood clots

Economic costs  Highest expenditure of any disease group ($7 billion per year 12% of all health care expenditure)  Ageing population has put economic pressure on expenditure of CBD but often they don’t have disposable income to cope with finances of CVD 

UNDERNUTRITION  Under nutrition results when insufficient nutrients are supplied to the body which leads to weight loss or nutrient deficiencies such as anaemia or scurvy.  caused by

weakened immune function and loss of muscle function ANAEMIA: low iron in blood that results from inadequate absorption and intake of iron and blood loss.

 formation of haemoglobin relies on supply of iron in diet. Lack of iron means heart has to work harder to meet body’s needs and carry enough oxygen. More tired = decreased productivity at work ANOREXIA NERVOSA: self induced weight lose with rigorous exercise extreme reduction of nutrients (reduction in fat which is necessary to allow the body to absorb vitamin A D K E) o Reduction of bone density (osteoporosis o Increased risk of heart failure because of slow heart rate + low blood pressure

BULIMIA NERVOSA: eating disorder marked by bingeing, followed by methods to avoid weight gain. Involves fasting and misuse of laxatives. OSTEOPOROSIS: porous bones from long term deficiency of calcium, physical inactivity and inadequate formation of basic bone structure  causes osteoporosis where bones are more fragile because of loss of calcium. Must have calcium rich foods and regular activity during first 20 years of life to achieve healthy maximum bone density. Broken bones common.  5-10 yrs. post menopause  amount of hormone oestrogen so they loose

bone mass  

Ageing population has increased prevalence of osteoporosis Undernutrition can come from physocolical causes such as anorexia nervosa and bulimia nervosa.

LOW FIBRE DIET/CONSTIPATION: causes bulking of faeces in intestine and is difficult to remove -> waste remains in intestine longer increased potential of contact with the cells lining of the walls which may result in colon cancer.  Inadequate fibre: dietary fibre is vital to keep the digestive system healthy and stabilises glucose and cholesterol levels. It aids in digestion by adding bulk to the digestive tract and pass waste. A lack of fibre can cause o Constipation o Haemorrhoids o Diverticular disease – small pouches form in intestine and become inflamed

TYPE 2 DIABETES: the cells in the body stop responding to insulin and therefore the body stops producing enough insulin in the pancreas. Caused by oversite and a high fat, low fibre diet. Physical effects  Older adults and ATSI are prone  Caused by a lifestyle disease; wrong foods and lack of exercise  To manage  healthy eating and

physical activity

Economic costs  Impacts productivity of individual  Total annual cost is $6 billion  Increased health care costs due to cost of carers and medication  Around 1.7 million Australians have

 Dizziness when sugar levels low  Sweats and may go into coma if high sugar levels

diabetes 

(I I) NUTRITIONAL CONSIDERATIONS FOR SPECIFI C G ROUPS

Group Pregnant and lactating women

Infancy and childhood

Adolescent

Nutritional considerations  Protein for the growth of new tissue  Calcium for maximum bone strength and formation of tooth buds  Iron and vitamin C and B for increased blood supply and to avoid anaemia  Floating to reduce risk of child having neural tube defect  Zinc because there is rapid cell growth and zinc supports immune system function  Nutrient dense foods. While extra energy is required for the extra body tissue excess weight should be avoided to prevent obesity and diabetes  Energy giving foods and foods containing vitamin b that help to release energy. To prevent childhood obesity, limit foods high in sugars and fats  Protein for growth  Calcium and phosphorous for strengthening bones and teeth. Avoid refined sugars to prevent dental decay and caries  Fluorinated water to avoid dehydration and dental decay     

Adults/elderly

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Athletes

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Energy giving foods Protein for growth Calcium for strong bones and ensure maximum bone density Iron for girls because of the onset of menstruation which causes a loss of iron due to blood loss and prevent anaemia Girls protein and B group vitamins to increase growth as they hep with protein synthesis and energy release To prevent obesity, select nutrient dense foods rather than energy dense such as choosing eggs, lean meats and low fat dairy foods as opposed to cakes, sweet biscuits and high carbohydrate foods Naturally high fibre foods to encourage bowel health Foods high in calcium and phosphorous to prevent osteoporosis Limit sat fats Limit salt Increased protein post comp for quick recovery through repair and maintenance of muscle Water to prevent dehydration Energy giving foods for extra energy expenditure – high in complex carbs and low fat e./g/ wholegrains (quinoa) sweet potato Increased carbs prior comp to improve energy stores

MEAL PLAN ATSI BREAKFAST

Wholemeal bread, Eggs

Porridge oats + Eggs

LUNCH

Asian noodle salad with crispy salmon

Brown rice and barley salad with lettuce, spinach tomato, carrot and cucumber with sardines

DINNER

Chicken and roast vegetable quinoa salad (protein + complex carbs + b6 IRON AND FIBRE IN QUINOA + low in fat for ATSI

Tuna egg bake

SNACKS

Fruits and dried nut mix

(III) THE ROLE OF DIFFERENT GROUPS IN PROMOTING HEALTH

The promotion of nutritional health and improved dietary practices by a range of organisations is a positive approach in providing education and knowledge as to the causes and effects of these diet-related disease Community groups Community groups are non government organisations non profit that operate in society to assist individuals affected by diet related conditions, providing educational material and working with the food industry to encourage foods modified to suit members. Heart Foundation: BMI Calculator, encourage activity Coeliac Australia: resources, awareness, recipes, acreddited dining outlets Cancer Council: bowel cancer and colon cancer Meals on Wheels: provide a service of nutritious meals while monitoring the physical and psychological wellbeing of people who are frail, recovering from an illness or have a disability CHOICE: is a consumer advocacy group that provides information and advice for consumers free from commercial bias and lobbys government on food related issues Government organisations The governments agenda on promotion of health is ‘prevention > cure’ as the high health care expenditure reduces money available for other health care services and education. The main motivation for promoting health is because industry is less productive and less competitive when the workforce is in poor health. Strategies include: 1. Issue environmental health officers 2. Health and nutrition policies such as National Food and Nutrition Policy 1992  Australian Dietary Guidelines which influence the food industry by encouraging

produces that target health conscious consumers and dietary disorders. These guidelines differ according to each group and promote aware consumption of food  Australian Guide to healthy eating (the plate) 3. Health experts such as CSIRO make health recommendations on standards (GM Food) as well as looking at health claims like Gogi Berries which say they have 50x vitamin C in oranges, and NHMRC which assess safety of vitamin and mineral supplements 4. Funding for school based programs in primary, secondary and tertiary 5. Auditing procedures and inspection to assess business and safety of imported food under Department of Agriculture and Water Resources and Imported Food Act 1992

Food industry: Business and products in the food industry have a direct impact on customers choices as customer demand for good food = more food products therefore indirectly promoting health. These companies have a nutrition policy based on ADG to promote a strong health image: o Sanitarium: ‘Weetbix’ which is high fibre, ‘Protein blend’ with increased calcium protein and amino acids for muscle recovery, ‘So Good’ for dairy intolerance o The Chia Co: ‘Chia pod blend’ in pouches with crew top (DF+GF, omega 3, fibre and calcium, and plant based), ‘Breakfast booster’ with complete protein and fibre) o Liddels: yoghurt tubs, lactose free products, pizza blend cheese o Freedom Foods: Gluten free muesli with added fibre and probiotics Business’ also promote health by having nutrition labelling in response to legal requirements for mandatory kilojoule labelling. In regards to the sectors of AFI, they promote health in:  A&F: Increasing production of salmon which has high levels of omega 3 fatty acids in aquaculture as it promotes health AND organic food (no chemicals)  FP&M: Added folate, fibre, lw salt margarine and B group vitamins in cereals  FS&C: Vegan & GF+DF, Soul origin  FR: raw chicken, fruit and veg Professional associations  CHOICE  Professional associations such as ACA ( ion – supported by consumer members to protect consumer interests regarding health and safety e.g. test products Private agencies These are professional and non government organisations that requite payment for their services Doctors and dentists: promote health by diagnosis and treatment of problems linked to diet and health (CVD AND DENTAL CARIES) Dieticians: give advice in planning meals for institutions such as Sports Dieticians Australia (pregame food, travel and hydration) and also meal planning for aged care centres and childcare centres

Weight Reduction programs: educate clients on good eating practices and exercise programs and may deliver meals e.g. Hello Fresh emphasise local suppliers and fresh food and pre portioned Fitness programs: such as Zoo fitness and also their promotion of sugar free sweets and juices Individual Individuals initiative to promoting health within their own lifestyle based on knowledge of the causes of illness and poor health with individuals having the ability to access health services and health personnel to achieve higher levels of health Individuals also have a role in promoting health by reporting unhygienic practices in the food retail and catering industry as well as making healthy lifestyle choices to promote health to others in your sphere of influence. (IV) PRODUCTION OF NUTRIT IONALLY MODIFIED FOODS & FUNCTIONAL FOOD

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Food manufacturers have responded to consumer demand for healthier food through nutritionally modified foods and functional foods. They are designed to assist a persons health in a curative or preventative manner, improving consumers health with fat replacements, artificial sweeteners, added micro-nutrients (enriched/fortified), added fibre Functional foods contain extra health benefits along with essential macro and micro nutrients. There are 3 groups: 1. Foods that contain natural preventative or curative substances (fruits, vegetables, fermented foods which have antioxidants) 2. Modified processed foods like fat reduced and calcium enriched. 3. Foods containing active non ingredients which enhance the functioning of the body i.e. phytochemicals Food examples: fibre food -> maintains gut health, quicker satiety High omega 3 fatty acid ->

Nutritional modification are manufactured by altering the original food to incorporate wanted nutrients or remove unwanted ones. There are 2 types o

Fortified foods: enhancing the original levels of a certain nutrient  Voluntary fortification: manufacturers can decide to fortify the product with additional nutrients, abiding by FSANZ  Mandatory fortification: certain products have been identified by the governments to need to be fortified so the manufacture must comply. E.g. public health need for Vitamin D so all margarines needed to be fortified with vitamin D. all wheat flours for bread must be fortified with thiamine and folic acid. EG. Fruit juice with added vitamin C to prevent scurvy and aid calcium absoption Breakfast with B group vitamins for energy release from carbs Margarine vitamin A and D for osteoporosis

o

Enriched: Nutrients are replaced that may have been lost during the manufacturing process

E.G. Bread -> dietary fibre and B group vitamins -> fibre helps satiety (obesity) and energy release from carbs Fruit juice with added vitamin C to prevent scurvy and aid calcium absoption Proactiv margarine with added plant sterols to lower cholestorol and prevent CVD Reduced sugar soft drinks (use sorbitol) to prevent diabetes, obesity and dental caries  The primary production of the food, e.g: lowfat meats such as lean pork can be bred in the Agriculture and Fisheries sector.  Preparation for retail sale, e.g: protein powder can be added to fresh fruit juice in the Food Service and Catering sector. For Helps to meet nutrient requirement and prevent malnutrition e.g. omega 3 eggs for elderly cater to fussy people high calcium chocolate milk for kids who don’t have plain milk caters to people with special diet e.g. high iron cereal for vegetarians

Against Health benefits can be misleading Chocolate drink high in calcium is high in sugar Can cause negative nutrient interrelationships e.g. fibre in iron enriched breakfast cereals inhibits absorption can cause dependence on processed foods e.g. eating bread fortified with folate instead of leafy green vegetables

(V) ROLE OF ACTIVE NON ING REDIENTS

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Active non nutrients: Substances that are not necessarily essential in the diet, but can enhan ce the functioning of the body or contribute to the promotion of good health. Types of active non ingredients include:

Phytochemicals  Chemicals found in plant foods that have a beneficial role in the body. Examples include antioxidants and phytoestrogens.  Antioxidants: Antioxidants are chemicals that stop oxidation and prevent oxidative damage in the body.  Carotenoids: Chemicals that contribute to yellow, orange and some red colours of fruits and vegetables. Carotenoids can deactivate free radicals Lycopene is a dark red carotenoid foundnaturally in tomatoes. It is believed to protect against prostate and breast cancer  Vitamin E  Vitamin C  Vitamin A  Phyto-oestrogens: hormone like chemicals that imitate the role and effects of oestrogen in the body. This helps treat menopausal symptoms and fight prostate cancer. e.g. Isoflavonoids: Found in fruits, vegetables, seeds, nuts and legumes. Soya beans being the best source Dietary fibre 

Dietary fibre encompases all the components of plant food that pass through the stomach and small intestine undigenseted where they are subject to varying degrees of breakdown by

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bacteria. Improves gut health. Is an active non ingredient because it is not absorbed in the digestive system. You can boost your fibre by choosing fresh fruits>fruit juices because there is less processing and you can use cooked, cold wholegrains as cold potato has more resistant starch than when first cooked Need 30 grams a day Soluble fibre: digested by bacteria in small intestine. It is made up of things like pectin in fruit and gums in grain-> reduces cholesterol levels (to lower cholesterol you need high soluble foods) -> provides satiety Insoluble fibre: prompts a flushing of the gut and provides bulk in stool to clean gut and prevent cell damage by reducing time toxins are in contact with gut cells -> prevents colon cancer and constipation. Examples: broccoli, carrots, wholegrain breakfast cereals, barley and rye Resistant starch: this is a type of starch that is digested and ends up as food for bacteria in the large intestine. It acts in a similar wat to traditional fibre by improving bowel health -> mild laxative affect by increasing mass of bacteria and adding to faecal bulk -> reduces rise in glucose after eating so demands less insulin which is important for diabetes e.g. Hi Maize which is a variety of corn that is high in resistant starch and is the main ingredient in high fibre white breads and hamburger buns.

Pectin is a component of fibre important as it creates a thick gelatinous mass which traps bile acids and sterols and slows down their absorption from entering the blood stream, preventing cholesterol. Found in apples and citrus fruits

Helps manage blood-glucose levels: slows down the absorption of glucose during digestion making less demand on insluin production

maintains health: prevent illnesss like gallstones and colon cancer by diluting bowel content and shortening time for food to pass through thus minimising contact with carinogens

Reasons to have fibre

flushes out cholesterol: soluble types of fibre bind and hold bile acids and sterols, end products of cholesterol metabolism and prevent them from reentering the blood stream (reducing cholesterol

keeps you regular: increases bulk of stool giving faeces correct consistency to be eliminated

Omega-3 fatty acids

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Found in foods containing lipid. The fatty acids can be converted into hormone-like substances that aid the cardiovascular system. Also reduced levels of trigylcerides and prevents increased risk of heart disease from accumulation of fat. Prostaglandins anti-inflammatory and may reduce formation of blood clots Omega 3 fatty acids naturally found in oily fish and fortified foods like margarine

Probiotics  

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Beneficial bacteria that help with the synthesis of some vitamins and nourish the gut cells Probiotics are live microorganisms intended to provide health benefit...