HNSC 2170 Midterm Study Guide PDF

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HNSC 2170 – NUTRITION FOR HEALTHCARE PROVIDERS – MIDTERM STUDY GUIDE WEEK ONE Student Learning Outcomes: 1. Define the common terms in nutrition listed in the course notes. 2. Discuss the factors that play a role in food choices. 3. List the six classes of nutrients; their division into two subgroups, and differentiate between essential and non-essential nutrients. 4. Define calorie and recall the food energy provided by carbohydrates, protein, fat and alcohol. 5. Define the Dietary Reference Intake (DRI) terms – RDA, EAR, AI, UL and AMDR, and describe their use. 6. Discuss the factors considered in the creation of the DRIs and the populations for which these recommendations would not apply. 7. Describe the six characteristics of a healthy diet. 8. Describe how Canada’s Food Guide (CFG) can help Canadians to achieve the six characteristics of a healthy diet. 9. Identify the food groups that should fill our plate according to CFG's Eat Well Plate, the key nutrients found in each group, food sources and the recommendations that CFG makes for each food group. 10. Discuss the standards for Canadian food labelling and identify the nutrients found on a Nutrition Facts label. 11. Identify the nutrient content claims and diet related health claims allowed in Canada. 12. Identify characteristics of valid nutritional information and nutrition quackery. 13. Discuss the differences between registered dietitian and nutritionist.

Textbook Readings: 2-10 (up to the end of the AMDR section) 12-13 (up to Dietary Guidelines for American) 16-17 (up to the USDA Food Patterns) 34-37 391-394 (Nutritional Genomics) Asynchronous Course Notes: NUTRITION DEFINITIONS, STANDARDS AND GUIDELINES Topic 1: Nutrition for Health and Wellness As health professionals, you will likely encounter patients who will either ask you questions about nutrition, or who would benefit from making dietary and lifestyle changes. Nutrition and lifestyle interventions can provide

HNSC 2170 – NUTRITION FOR HEALTHCARE PROVIDERS – EXAM STUDY GUIDE benefit for common disease states. However,in many cases a referral to a Registered Dietitian would be warranted. Health = range of states with physical, mental, emotional, spiritual, social components. Wellness = maximum well-being - the top range of health states Choice of diet can profoundly affect long-term health prospects. Many chronic diseases (e.g., diabetes, heart disease, some types of cancer, dental disease, adult bone loss, etc.) have a connection to poor diet. These diseases cannot necessarily be prevented by a good diet alone, as other factors like genetic and lifestyle play a role as well. For example, forms of heart disease can vary—some are nutrition related, others are not. Health and wellness are outlined on a spectrum. Nutritional genomics = The science of how nutrients affect the activities of genes and how genes affect the activity of nutrients. Nutritional genomics or “Nutrigenomics” is a hot topic right now. This may be the reason behind the often-conflicting nutrition claims.

Topic 2: Food Choices Food plays an important role in everyone’s life—we depend on it for survival. It is important for everyone to have some basic nutrition knowledge, because the foods we choose have an effect on our body and our health. Eating well may seem easy in theory, but if you do not have an understanding of how much of each nutrient you need, or what foods are a source of needed nutrients, it can be hard to do. Nutrition = science of foods and nutrients and other substances they contain Cultural Competence = awareness and acceptance of one's own and other's cultures and skills needed to interact with people of diverse cultures Phytochemicals = compounds in plants that confer taste and other characteristics Foodways = eating habits and culinary practices of a people, region, or historical period - reflect cultural and ethnic backgrounds of inhabitants Ethnic Diets = foodways and cuisines typical of national origins, races, cultural heritages, or geographic location Functional Foods = foods that provide health benefits beyond their nutritional content

Topic 3: The Nutrients Metabolism = processes where nutrients are rearranged into body structures or broken down to yield energy o Food energy is measured in kilojoules (kJ). One kcalories = 4.2 kJ Nutrients = substances obtained from foods and used in the body to provide energy and structural materials and to serve as regulating agents to promote growth, maintenance, and repair; may also reduce the risk of disease Essential nutrients = nutrients a person must obtain from food because the body cannot make them for itself in sufficient quantities There are 6 classes of nutrients that can be divided into 2 groups:

HNSC 2170 – NUTRITION FOR HEALTHCARE PROVIDERS – EXAM STUDY GUIDE 1. A. Energy providing (meaning that the body can use the energy they contained) 1. carbohydrate 2. fat 3. protein 2. B. Other nutrients (or non-energy containing) 1. Water *inorganic, medium for all body processes 2. vitamins 3. minerals *inorganic, help regulate release of energy Within the 6 classes of nutrients, there are essential and non-essential nutrients. Calories = units in which energy is measured - food energy is measured in kilocalories (kcalories/kcal) o One kCal is the amount of heat necessary to raise the temperature of 1kg of water by 1 degree C o Carbohydrates and proteins yield 4kcal/gram. Fats yield 9kcal/gram. o Fats have a higher energy density - measure of energy of a food relative to amount of food eaten  To figure out how many calories in a food, just multiply the weight (g) of carbs/proteins by 4kcal and fats by 9kcal  Sugar (pure carbohydrate) and oil (pure fat)  Alcohol, not a nutrient: Body derives 7kcal/gram o Not a nutrient because it does not support the body's growth or repair

Topic 4: Nutrient Recommendations DRI = set of values for the dietary nutrient intakes for healthy people in the US and Canada… values used for planning and assessing diets DRI terms 

RDA (Recommended Dietary Allowances): intake goals for individuals.

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AI (Adequate Intakes): goals for individuals when insufficient scientific data exists to set an RDA.

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EAR (Estimated Average Requirements): intake goals for given stages of life and gender groups. They are population wide average nutrient requirements used by researchers and policymakers, and can form the basis upon which the RDAs are set.

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UL (Tolerable Upper Intake Levels): maximum amount that is safe. Absence of an UL does not mean that it is safe to consume in any amount, rather it means insufficient data / evidence exists to set value.

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AMDR (Acceptable Macronutrient Distribution Ranges): Ranges of recommended intake for Carbohydrates, Fat and Protein, expressed as % of total daily calorie intake. o Ranges of intakes for the energy-yielding nutrients that provide adequate energy and nutrients and reduce risk of chronic disease: o 45-65% of kCal from carbohydrates; 20-35% of kCal from fats; 10-35% of kCal from proteins

HNSC 2170 – NUTRITION FOR HEALTHCARE PROVIDERS – EXAM STUDY GUIDE Using nutrient recommendations: ○ EAR mostly used to develop and evaluate nutrition programs for groups like children or military personnel ○ RDA/AI used to set goals for individuals ○ UL help keep nutrient intakes below amounts that cause toxicity ○ Values reflect daily intakes to be achieved on average, takes into account storage and days of low intakes ○ Medical problems alter your daily needs

Estimated Energy Requirement (EER) = dietary energy intake level predicted to maintain energy balance in a healthy adult of a defined age, weight, gender, physical activity level consistent with good health o Not generous - extra energy is not excreted and is eventually stored as fats o No UL because any excess leads to production of body fat

Topic 5: Dietary Guidelines, Fitness Guidelines and Food Guides Over nutrition = overconsumption of food energy or nutrients sufficient to cause disease or increased susceptibility to disease; a form of malnutrition Undernutrition = under consumption of food energy or nutrients severe enough to cause disease or increased susceptibility to disease; a form of malnutrition o Dietary excesses, especially fats, sodium, energy, alcohol, contribute to chronic diseases (heart disease, cancer, stroke, diabetes, liver disease) o Smoking and alcohol use influence health more than diet Chronic diseases = diseases characterized by slow progression, long duration, and degeneration of body organs due in part to personal lifestyle elements Healthy diets We often think that we know everything there is to know about choosing foods, but with the high number of choices available, it is easy to lose track of what individual foods contain, and how to put them together into a health promoting diet. The basis of Canada’s Food Guide is to highlight the characteristics of a healthy diet: 

Adequate in essential nutrients, fiber and energy

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Balance in nutrients and food types

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Calorie control: foods provide amount of energy to maintain healthy body weight

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Moderation in fat, salt, sugar or other unwanted constituents

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Variety: choose different foods each day

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Nutrient Density: compares the nutrients within a food to the calories the food provides.

HNSC 2170 – NUTRITION FOR HEALTHCARE PROVIDERS – EXAM STUDY GUIDE Canadian Fitness Guidelines The guideline for adults 18-64 years of age is to get 150 minutes of moderate to vigorous intensity activity each week to achieve health benefits. Please see the Canadian Society for Exercise Physiology (CSEP) website for the physical activity guidelines for different ages: https://www.csep.ca/en/guidelines/guidelines-otherlanguages

Canada’s Food Guide (CFG) Canada’s Food Guide is designed to promote healthy eating for healthy Canadians 2 years of age and above (it is not meant for individuals with chronic diseases). Canada’s Food Guide uses the latest nutrition research to give Canadians clear messages about making healthy food choices, and support overall nutritional well-being. 

Read through the following sections about Canada’s Food Guide on the Government of Canada’s website: o Canada's Food Guide Snapshot: https://food-guide.canada.ca/en/food-guide-snapshot/ o Healthy Eating Recommendations: https://food-guide.canada.ca/en/healthy-eatingrecommendations/ o Make Healthy Meals with the Eat Well Plate: https://food-guide.canada.ca/en/tips-for-healthyeating/make-healthy-meals-with-the-eat-well-plate/? _ga=2.162342844.1624052502.1499958649-955066057.1499958649

Serving recommendations CFG describes the amount and type of food for a healthy eating pattern. The Eat Well Plate provides guidance on how to make healthy meals and snacks. Half of your plate should be filled with vegetables and fruits. These recommendations on the type and amounts of food to choose help you to: 

Get enough vitamins and minerals in your diet

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Reduce your risk of some health conditions such as obesity, type 2 diabetes, heart disease, osteoporosis and some types of cancer

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Contribute to your overall health and vitality

It is important to realize that there is no magic food that will give us all of the nutrients our body needs. We need to eat a variety of different foods to ensure that we are getting all nutrients. For example, if we did not eat any Vegetables or Fruits, we would be missing our key source of Vitamin C. If we did not eat any Protein Foods, we would be missing one of our key sources of Vitamin B6 and B12. For some nutrients (like potassium) all food groups are a key source.

HNSC 2170 – NUTRITION FOR HEALTHCARE PROVIDERS – EXAM STUDY GUIDE Vegetables and Fruits Some of the key nutrients provided by this food group include: carbohydrates, fibre, vitamins such as folate, vitamin B6, vitamin C, and vitamin A, and minerals such as magnesium and potassium. Try to choose a variety of different vegetables and fruits. Choose fresh, frozen or canned vegetables and fruits, preferably canned vegetables with little to no added sodium and canned fruits with little to no added sugars. Read through the Eat Vegetables and Fruits page: https://food-guide.canada.ca/en/healthy-eatingrecommendations/make-it-a-habit-to-eat-vegetables-fruit-whole-grains-and-protein-foods/eat-vegetables-andfruits/

Whole Grain Foods Some of the key nutrients provided by this food group include: carbohydrates, fibre, vitamins such as thiamin, riboflavin, niacin, and folate, and minerals such as iron, zinc, magnesium and potassium. Whole grain foods include quinoa, wild rice, brown rice, buckwheat, farro, amaranth, barley, bulgur, whole grain pasta, whole grain bread, and whole oats. Choose whole grain foods, preferably: 

options with little to no added sodium

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naturally sodium-free grains such as rice, barley or quinoa

Foods that are labeled as whole wheat or multi-grain may not be whole grain foods. It is important to read the ingredient list on foods and choose foods that have the word “whole grain” followed by the name of the grain as one of the first ingredients (e.g. whole grain wheat or whole grain oats). Read through the Eat Whole Grain Foods page: https://food-guide.canada.ca/en/healthy-eatingrecommendations/make-it-a-habit-to-eat-vegetables-fruit-whole-grains-and-protein-foods/eat-whole-grainfoods/

Protein Foods Some of the key nutrients provided by this food group include: protein, fat, vitamins such as thiamin, riboflavin, niacin, vitamin B6, and vitamin B12, and minerals such as iron, zinc, magnesium and potassium. Protein foods include tofu, legumes, seeds, nuts, fish, shellfish, eggs, poultry, lead read meats including wild game, fortified soy beverage, lower fat milk, lower fat yogurts, lower fat kefir, and cheeses lower in fat and salt. It is recommended to choose plant-based protein foods more often because they often provide more fibre and less saturated fat. Choose protein foods, preferably: 

unsalted nuts and seeds

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unseasoned meats, poultry and fish

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lower fat dairy products

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HNSC 2170 – NUTRITION FOR HEALTHCARE PROVIDERS – EXAM STUDY GUIDE canned or dried beans, peas and lentils with little to no added sodium

Read through the Eat Protein Foods page: https://food-guide.canada.ca/en/healthy-eatingrecommendations/make-it-a-habit-to-eat-vegetables-fruit-whole-grains-and-protein-foods/eat-protein-foods/

Other Recommendations from CFG Water should be the beverage of choice. Read through the Make Water Your Drink of Choice page: https://foodguide.canada.ca/en/healthy-eating-recommendations/make-water-your-drink-of-choice/. Foods that contain mostly unsaturated fat should replace foods that contain mostly saturated fat (we will be discussing different types of fat in unit 5). Read through the Choosing Foods with Healthy Fats page: https://food-guide.canada.ca/en/healthy-eating-recommendations/make-it-a-habit-to-eat-vegetables-fruitwhole-grains-and-protein-foods/choosing-foods-with-healthy-fats/ Highly processed foods are processed or prepared foods and drinks that add excess sodium, sugars or saturated fat to the diets of Canadians. Intake of these foods should be limited because they are not part of a healthy eating pattern. Highly processed foods can include: 

sugary drinks

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deep-fried foods

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bakery products like cookies, muffins and cakes

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ice cream and frozen desserts

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processed meats like deli meats and sausages

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chocolate and candies

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sweetened breakfast cereals

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ready-to-heat packaged meals and dishes

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fast foods like burgers and French fries

What you eat on a regular basis matters for your health. Choose foods that have little to no added sodium, sugars or saturated fat. Compare the nutrition facts table on foods to choose products that are lower in sodium, sugars or saturated fat. Read through the Limit Highly Processed Foods page: https://foodguide.canada.ca/en/healthy-eating-recommendations/limit-highly-processed-foods/. Healthy Eating Habits -

Be Mindful of Your Eating Habits

Being mindful of your eating habits means paying attention to when you eat, where you eat, what you eat, how much you eat, how you eat and why you eat. Doing this can result in many positive benefits. Read through the following pages on the Government of Canada website: 

Be Mindful of your Eating Habits page: https://food-guide.canada.ca/en/healthy-eatingrecommendations/be-mindful-of-your-eating-habits/

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HNSC 2170 – NUTRITION FOR HEALTHCARE PROVIDERS – EXAM STUDY GUIDE Take Time to Eat: https://food-guide.canada.ca/en/healthy-eating-recommendations/be-mindful-of-youreating-habits/take-time-to-eat/

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Hunger Cues: https://food-guide.canada.ca/en/healthy-eating-recommendations/be-mindful-of-youreating-habits/hunger-cues/

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Cook More Often

Cooking and preparing food more often can help to support healthy eating habits. Read through the following pages on the Government of Canada website: 

Cook More Often page: https://food-guide.canada.ca/en/healthy-eating-recommendations/cook-moreoften/

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Plan What You Eat: https://food-guide.canada.ca/en/healthy-eating-recommendations/cook-moreoften/plan-what-you-eat/

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Involve Others in Planning and Preparing Meals: https://food-guide.canada.ca/en/healthy-eatingrecommendations/cook-more-often/involve-others-in-planning-and-preparing-meals/

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Enjoy Your Food

Part of healthy eating is enjoying your food. Read through the following pages on the Government of Canada website: 

Enjoy Your Food: https://food-guide.canada.ca/en/healthy-eating-recommendations/enjoy-your-food/

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Cultures, Food Traditions and Healthy Eating: https://food-guide.canada.ca/en/healthy-eatingrecommendations/enjoy-your-food/cultures-food-traditions-and-healthy-eating/

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Eat Meals With Others

Enjoying meals with others is a part of healthy eating and can contribute to a healthy lifestyle. Read through the Eat Meals with Others page: https://food-guide.canada.ca/en/healthy-eating-recommendations/eat-meals-withothers/. -

Pay Attention to Food Marketing

Food marketing (advertising) can take on many different forms and can influence our food choices. Read through the following page on the Government of Canada website: https://food-guide.canada.ca/en/healthyeating-recommendations/marketing-can-influence-your-food-choices/

Topic 6: Nutrition Labelling in Canada Standardized nutrition labels must be on almost all food packages in Canada. The purpose of this is to: 

standardize nutrition labelling and food claims

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help consumers make informed choices

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Understanding food labels o Nutrition facts tables o List of ingredients

HNSC 2170 – NUTRITION FOR HEALTHCARE PROVIDERS – EXAM STUDY GUIDE o Percent daily value o Serving size o Nutrition claims: 

View the nutrient content claims and what they mean

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View the health claims and what they mean

o About food labels Health Canada is in the process of making changes to the nutrition facts table and ingredient list on food labels to make them easier to use.

Topic 7: Who can you trust for accurate nutrition information? Nutrition Misinformation Everywhere you loo...