Chapter 2
Nutrition Guidelines and Assessment
Important Math Calculations
Converting inches to centimeters: ____ in  2.54 = ____ cm
Converting pounds to kilograms: ____ lbs  2.2 = ____ kg
Chapter Outline
I. Linking Nutrients, Foods, and Health
A. Planning how you will eat
1. Adequacy
2. Balance
3. Calorie control
4. Nutrient density
5. Moderation
6. Variety
II. Dietary Guidelines. *The Dietary Guidelines for Americans provides science-based
advice to promote health and to reduce risk of chronic disease through diet and physical
activity.
A. Dietary Guidelines for Americans
1. Use the Dietary Guidelines for Americans, 2010 to guide personal choices
and make informed food and activity decisions.
a. integration of government, agriculture, health care, business,
educators, and communities (Figure 2.2)
B. Key Recommendations from the Dietary Guidelines for Americans (Table 2.1)
1. Overarching concepts
a. Six chapters, 23 recommendations
b. Maintain calorie balance over time
c. Focus on consuming nutrient-dense foods and beverages
2. Balancing calories to manage weight
3. Food and Food Components to Reduce
4. Foods and Nutrients to Increase
a. Recommendations for specific population groups
5. Building Healthy Eating Patterns
6. Helping Americans Make Healthy Choices
7. Ways to Incorporate the Dietary Guidelines into Your Daily Life
C. Canada’s Guidelines for Healthy Eating
Key terms: USDA, DHHS, DGAS, Eating Well with Canada’s Food Guide, Canada’s
Guidelines for Healthy Eating
III.
From Dietary Guidelines to Planning: What You Will Eat. *MyPlate is an
educational tool that helps consumers implement the principles of the Dietary Guidelines
for Americans, 2010.
A. A brief history of the food group plans
B. MyPlate (Figure 2.4)
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1. Eating Well With Canada’s Food Guide (Figure 2.5)
C. Using MyPlate or Canada’s Food Guide in diet planning (Table 2.3).
Key terms: food groups, FGP, MyPlate, Canada’s Food Guide
IV. Exchange Lists (Figure 2.6). *The Exchange Lists are a diet planning tool most often
used for diabetic or weight-control diets.
A. Using the exchange lists in diet planning, servings for each food in the exchange
lists are grouped so that equal amounts of carbohydrate, fat, and protein are provided
by each choice.
Key terms: Exchange Lists for Meal Planning
V. Recommendations for Nutrient Intake: The DRIs
A. Understanding dietary standards. *Dietary standards are values for individual
nutrients that reflect recommended intake levels. These values are used for planning
and evaluating diets for groups and individuals.
B. A brief history of dietary standards
C. Dietary Reference Intakes (Figure 2.7). *The Dietary Reference Intakes are the
current dietary standards in the United States. The DRIs consist of four EAR, RDA,
AI, and UL sets of values: EAR, RDA, AI, and UL.
1. Estimated Average Requirement (EAR)
2. Recommended Dietary Allowance (RDA)
3. Adequate Intake (AI)
4. Tolerable Upper Intake Level (UL)
5. Estimated Energy Requirement (EER)
6. Acceptable Macronutrient Distribution Ranges (AMDRs)
D. Use of dietary standards
Key terms: AMDRs, Recommended Nutrient Intake (RNI)
VI. Food Labels (Figure 2.8). *Nutrition information on food labels can be used to select a
more healthful diet.
A. Ingredients and other basic information
B. Nutrition Facts panel
C. Daily Values
D. Nutrient content claims
E. Health claims
F. Qualified health claims
G. Structure/function claims
H. Using labels to make healthful food choices
Key terms: U.S. Department of Agriculture (USDA), Department of Health and Human
Services (DHHS), Dietary Guidelines, food group, Food Guide Pyramid, Exchange Lists for
Meal Planning, Recommended Dietary Allowances (RDA), Food and Nutrition Board
(FNB), Dietary Reference Intake (DRI), requirement, Estimated Average Requirement
(EAR), Adequate Intake (AI), Tolerable Upper Intake Level (UL), food label, Food and
Drug Administration (FDA), Nutrition Labeling and Education Act (NLEA), statement of
identity, Nutrition Facts, Daily Values (DV), enrich, fortified, Reference Daily Intake
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(RDI), Daily Reference Values (DRV), dietary supplements, Dietary Supplement Health
and Education Act (DSHEA)
VII. Nutrition Assessment: Determining Nutritional Health. *Nutrition assessment is a
process of determining the overall health of a person as related to nutrition.
A. The continuum of nutritional status
B. Nutrition assessment of individuals
C. Nutrition assessment of populations
Key terms: nutrition assessment, marasmus, kwashiorkor, undernutrition, overnutrition
VIII. Nutrition Assessment Methods. *Nutrition assessment involves four major factors:
anthropometric measurements, biochemical tests, clinical observations, and dietary intake.
A. Anthropometric measurements (Table 2.7)
1. Height and weight
2. Skinfolds (Figure 2.13)
B. Biochemical tests
C. Clinical observations
D. Dietary intake
1. Diet history
2. Food record
3. Food Frequency Questionnaire
4. Twenty-four hour recall
F. Methods of evaluating dietary intake data
1. Comparison to dietary standards
2. Comparison to MyPyramid and the Dietary Guidelines for Americans
G. Outcomes of nutrition assessment
Key terms: ABCDs of nutrition assessment, anthropometric measurement, skinfold
measurement, biochemical assessment, clinical observation, diet history, food record,
weighed food record, Food Frequency Questionnaire, twenty-four hour recall
Classroom Activities
ACTIVITY 1: APPLYING THE FOOD LABEL TO YOUR EVERYDAY LIFE
The following are case studies that can be presented as critical thinking activities during the
lesson on the Food Label. Students can work in groups, individually, or the case studies can
be presented after the topic of relevance in the Food Label lesson. During this activity, the
importance of how the Food Label is used to identify nutrient dense foods can be emphasized.
Case Study 1
Jana buys a 1-pound bag of peanut M&M’s®. There are 11 servings in 1 bag and 1 serving
provides 17% of the Daily Value for fat. She ends up eating half of the bag, which is
approximately 5 servings. What % Daily Value of fat has Jana eaten if her needs are 2,000
kcal? Does she have much room left for additional fat in her diet for that day?
ANSWER: 17% 3–5 servings = 85% of kcal from fat
No, she doesn’t have much room left for additional fat in her diet (15% left).
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Case Study 2
An owner of a restaurant has heard that her clientele wants healthier alternatives on the
menu. She decides to offer a low-fat strawberry shortcake and include the terminology lowfat on the menu. In order to abide by the nutrient content claims created by the government,
how many grams of fat or less would this dessert have to contain?
ANSWER: 3 g or less per serving
Students can refer to page 50 in the text.
Case Study 3
A dietitian in a hospital plans therapeutic diets for patients. His director wants to increase
the calcium content in the breakfast meals. In order for the dietitian to provide the most
calcium from yogurt at the breakfast meal, should he suggest adding a yogurt that has the
claim “High in calcium” or “Good source of calcium?” Explain why.
ANSWER: The dietitian should suggest the “High in calcium” yogurt because it provides
greater than 20% or more of the Daily Value of calcium.
Case Study 4
Blake goes out to eat at Applebee’s® and while looking at the menu notices they have a
low-fat brownie sundae. He asks the waiter how many servings are in the sundae. The
waiter believes there are 4 servings in 1 sundae. How many fat grams or less would be in
this sundae?
ANSWER: 4 servings  3 g of fat = 12 g of fat or less
Case Study 5
Nutrient density means the measure of nutrients provided by a food relative to the energy it
contains. The Food Label can help you identify what foods are the most nutrient dense for a
diet.
Tricia is making a meal for a group of 5-year-old children. She wants the meal to include
foods the children like, but also wants the meal to be nutrient dense. Based on the following
foods, which would be the better choice to make the meal more nutrient dense? These foods
contain more nutrients in relation to their energy content.
a. 1 cup Kool-Aid® vs. 1 cup grape juice
b. 1 hot dog vs. 1 peanut butter and jelly sandwich
c. 1 cup of yogurt vs. 1 cup ice cream
ANSWERS: 1 cup grape juice, 1 peanut butter and jelly sandwich, 1 cup of yogurt
Case Study 6
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Craig decides to each lunch at McDonald’s®. He buys a cheeseburger and a small fry, but
can’t decide if he wants a small soda or a small low-fat milkshake. Which option should
Craig choose if he wants the drink with the most nutrient density?
ANSWER: The low-fat milkshake because it is a source of the micronutrients calcium,
phosphorus, potassium, vitamin A, and vitamin D whereas the soda has minimal
micronutrients.
Chapter 2: Spotlight on Complementary and Alternative Nutrition: Functional Foods
and Dietary Supplements
Chapter Outline
I. Functional Foods. *A functional food is considered to be a food that may provide a health
benefit beyond basic nutrition.
A. Phytochemicals make foods functional. *Phytochemicals are plant chemicals
responsible for the health-promoting properties of functional foods.
1. Benefits of phytochemicals (Table SAN.1). *Consumption of plant foods
containing multiple antioxidants is strongly associated with health benefits.
Scientific evidence strongly supports eating five servings of fruits and
vegetables daily and emphasizing whole grains.
2. Adding phytochemicals to your diet
B. Foods enhanced with functional ingredients
C. Regulatory issues for functional foods
Key terms: isoflavones, dietary supplements, complementary and alternative medicine
(CAM), functional food, lycopene, free radicals
II. Food Additives. *The federal government reviews the safety of new food additives before
they can be used in foods sold on the market.
A. Regulation by the FDA
B. Delaney Clause. *The Delaney Clause is a controversial food law that prohibits
the approval of a food additive if it has been found to cause cancer in humans or
laboratory animals, even if massive doses are required to produce the disease.
C. Additives in functional foods
Key terms: additives, direct additives, indirect additives, color additive, Generally
Recognized as Safe (GRAS), prior-sanctioned substance, Delaney Clause
III. Claims for Functional Foods
A. Structure/function claims for functional foods
IV. Strategies for Functional Food Use
V. Dietary Supplements: Vitamins and Minerals (Table SAN.3). *Dietary supplements
encompass vitamins, minerals, herbal products, amino acids, glandular extracts, enzymes,
and many other products.
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A. Moderate supplementation. *Vitamin and mineral supplements may be warranted
in certain circumstances, although the preferred mode of obtaining adequate
nutrition is through foods.
B. Megadoses in conventional medical management. *Megadose vitamin or mineral
therapy has not been proved effective in the treatment of cancer, colds, or heart
disease. Moreover, such megadoses act more like drugs than nutrients in the body
and should be approached with caution.
C. Megadosing beyond conventional medicine: orthomolecular nutrition
D. Drawbacks of megadoses
Key terms: megadoses, nucleic acids, malabsorption syndromes, orthomolecular medicine
VI. Dietary Supplements: Natural Health Products
A. Helpful herbs, harmful herbs. *Herbal medicine is a traditional form of healing
in many cultures. Some herbal medicines have shown enough promise to warrant
large-scale clinical studies involving supplements. However herbal products can
have side effects and can interfere with prescription medications.
B. Other dietary supplements
Key terms: herbal therapy, phytotherapy, National Center for Complementary and
Alternative Medicine (NCCAM), bioflavonoids
VII. Dietary Supplements in the Marketplace
A. The FTC and supplement advertising
B. The FDA and supplement regulation. *Dietary supplements are regulated
according to the provisions of the Dietary Supplement Health and Education Act of
1994. Unlike drugs and food additives, dietary supplements do not need premarket
approval.
C. Supplement labels (Figure SAN.12). *Claims for dietary supplements can include
health claims, structure/function claims, and nutrient content claims. Dietary
supplements must have a Supplement Facts panel on the label.
D. Canadian regulations
E. Choosing dietary supplements. *Consumers should carefully evaluate claims and
evidence for dietary supplements and consult their physician before taking a
supplement.
F. Fraudulent products
Key terms: Dietary Supplement Health and Education Act, Supplement Facts panel,
bioavailability, multilevel marketing, U.S. Pharmacopeia (USP)
VIII. Complementary and Alternative Medicine. *Complementary and alternative medicine
(CAM) comprises practices outside the medical mainstream that are becoming increasingly
popular. CAM includes a broad range of therapies, many of which include nutrition. People
seek them for a variety of reasons, including environmental concerns and a fear of aging.
A. Where does nutrition fit in?
1. Vegetarian diets
2. Macrobiotic diet
3. Food restrictions and food prescriptions
Key term: macrobiotic diet
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Classroom Activities
ACTIVITY 1: VITAMIN AND MINERAL SUPPLEMENTATION
The following worksheet can be used to identify the pros and cons of taking a vitamin and
or mineral supplement. Students can complete group work to answer the questions or the
instructor can use the questions as an outline for the lesson on vitamin and mineral
supplements.
Multivitamin/Mineral Supplements
1. Should a vitamin/mineral supplement be taken to achieve optimal health and nutrition?
Why or why not?
ANSWER: Not necessarily. The use of vitamin/mineral supplementation depends on the
individual. Diet, overall health, and lifestyle need to be evaluated. For most healthy adults,
MyPyramid can provide an individual with all of his or her nutritional needs.
2. Are there any dangers in taking additional vitamins and minerals in pill form?
ANSWER Yes! Fat-soluble vitamins are stored by the body. Some can cause toxic effects if
taken in large doses. Water-soluble vitamins tend to be less toxic because the body excretes
excess amounts rather than storing them. However, niacin can have pharmacological effects
and high doses of vitamin C can cause diarrhea.
3. Discuss specific instances when a person might need a vitamin/mineral supplement.
ANSWER Individuals who may need vitamin/mineral supplements are pregnant or lactating
women, older adults, individuals in disease states, those on strict weight-loss diets, vegans,
some children, lactose intolerant individuals, and women who experience heavy menstrual
bleeding.
4. Are there any advantages and/or disadvantages to relying on vitamin/mineral
supplementation for adequate micronutrient intake? What are they?
ANSWER
Advantages
 When one has a busy lifestyle and does not always consume MyPyramid
recommendations.
 Refer to question 3.
Disadvantages
 Supplementation may encourage a false sense of security.
 High doses of one type of micronutrient may interfere with absorption of another
micronutrient.
 Supplementation provides no fiber.
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