HUN 4296 Nutrition & Health IssuesHUN 4296 Nutrition & Health IssuesWeek 1 Day 1 Part 1Week 1 Day 1 Part 1

Foundations to sort Facts from FadsFoundations to sort Facts from Fads

Based on Chapter 1: Nutrition: Concepts & Controversies, 12e Sizer/WhitneyBased on Chapter 1: Nutrition: Concepts & Controversies, 12e Sizer/Whitney

Our “practice environment” …Our “practice environment” …

Controversy → CompetitionControversy → Competition

Where do people get their Where do people get their nutrition advice? nutrition advice?

What makes nutrition a What makes nutrition a fertile field for controversy?fertile field for controversy?

Nutrition Science Active, changing, and growing body of

knowledge The scientific approach

Systematic , methodical, slow Scientific challenges

Paradigm shifts to respected theories Evidence-based v Practice-based

What’s at stake?What’s at stake?

Four of the top 10 causes of death are directly related to nutrition.• Accidents are

related to drinking alcohol.

Bottom line: the Standard American Diet is killing us.

Lifelong impact of nutritionLifelong impact of nutrition

Chosen foods have a cumulative effect Your body continuously renews itself Best foods

Support your body’s growth & maintenance No “good” or “bad” foods – depends on

circumstance and individual Malnutrition

Deficiencies, imbalances, and excesses

Genetics and IndividualityGenetics and Individuality

Genetics and nutrition affect diseases to varying degrees

Human genome DNA

Impact of geneticsImpact of genetics

Genetics play a role in 9 of the 10 leading causes of death, including:CancerHeart diseaseStrokeDiabetesAlzheimer’s disease

National Nutrition SurveillanceNational Nutrition Surveillance

National Health and Nutrition Examination Surveys (NHANES) Recording of health status and intake

Behavioral Risk Factor Surveillance System (BRFSS) Telephone survey of adults 18 y.o. and older

Continuing Survey of Food Intakes by Individuals (CSFII) What people eat for two days Comparing foods eaten with recommendations

Our national health agenda: The evolution of Healthy People 2020

Target Year 1990 2000 2010 2020

Overarching Goals

• Decrease mortality: infants–adults

• Increase independence among older adults

• Increase span of healthy life

• Reduce health disparities

• Achieve access to preventive services for all

• Increase quality and years of healthy life

• Eliminate health disparities

• Attain high-quality, longer lives free of preventable disease

• Achieve health equity; eliminate disparities

• Create social and physical environments that promote good health

• Promote quality of life, healthy development, healthy behaviors across life stages

# Topic Areas 15 22 28 39*

# Objectives/Measures 226/NA 312/NA 467/1,000 >580/1200

* With objectives

Selected Nutrition and Body Weight Objectives from HP 2020

2000

Obesity Trends* Among U.S. AdultsBRFSS, 1990, 2000, 2010

(*BMI 30, or about 30 lbs. overweight for 5’4” person)

2010

1990

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Bottom line: Despite our best efforts, the epidemic continues…

Reviewing the basics…Reviewing the basics…

Your body uses energy that comes indirectly from the sun

Six kinds of nutrients Four are organic (contain carbon) Three provide energy

Nutrient BasicsNutrient Basics

Human body & food Same materials Different

arrangements

Nutrient BasicsNutrient Basics

Energy-yielding nutrients Carbohydrates – 4 cal/g Fats – 9 cal/g Proteins – 4 cal/g

Vitamins and minerals Provide no energy Some are essential

Scientists calculate needs

Quiz!Quiz!

The 20 oz. “Activator” from Smoothie King has•1g Fat•105 g CHO•19g Pro

How many total calories? How many calories would it be if you drank only 16 oz? If you had 3 CHO / starch exchanges, how much could

you drink?Under what circumstances would this be a good choice

to drink?

Can I Live on Just Supplements?Can I Live on Just Supplements?

Elemental diets Administered to severely ill people

“Real food” is superior to supplements Nutrient interactions

Phytochemicals Physical contributions Psychological contributions

The Abundance of Foods to The Abundance of Foods to Choose FromChoose From

Whole foods Typical

consumption Fruits Vegetables

Types of foods Fast, processed,

functional, staple

Recognizing a Nutritious DietRecognizing a Nutritious Diet

Five characteristics Adequacy Balance Calorie control

Intakes should not exceed need

ModerationNot abstinence

Variety

A Way to Judge Which Foods Are A Way to Judge Which Foods Are Most NutritiousMost Nutritious

Knowledge is not enoughKnowledge is not enough

Factors influencing food-related choices Traditional and ethnic foods Convenience Physical factors Psychological factors Social factors Philosophical factors

A Guide for Behavior ChangeA Guide for Behavior Change

Behavior change takes substantial effort Six stages of change Assessment and goals

Realistic goals Obstacles to change

Competence Confidence Motivation

Stages of Behavior ChangeStages of Behavior Change

Sorting the Imposters from the Sorting the Imposters from the Real Nutrition ExpertsReal Nutrition Experts

Controversy 1

Can I Trust the Media to Deliver Can I Trust the Media to Deliver Nutrition News?Nutrition News?

Training of news media Sensationalism

Be a trend watcher Read news with an educated eye

Published in peer-reviewed journal Description of research methods & subjects Findings presented in context of previous

research

Information Sources & Costs of Information Sources & Costs of Wrong ChoicesWrong Choices

Quackery Sources of nutrition information

Television and magazines Nutrition-related products and services

Billions in customer dollars Identifying quackery

Earmarks of Nutrition QuackeryEarmarks of Nutrition Quackery

Identifying Valid Nutrition Identifying Valid Nutrition Information Information

Characteristics of scientific research Properly designed scientific experiments Inadequacy of anecdotal evidence Animal findings applied to humans Careful with generalizations Report of findings in scientific journals

Credible Source of Nutrition Credible Source of Nutrition InformationInformation

American Dietetic Association www.eatright.org

National Council Against Health Fraud www.ncahf.org

American Council on Science and health www.acsh.org

Nutrition on the NetNutrition on the Net

Judging website credibility Who is responsible for the site? Do the names and credentials of information

providers appear? Are links with other reliable information sites

provided? Is the site updated regularly? Is the site selling a product or service? Does the site charge a fee to gain access?

True Nutrition ExpertsTrue Nutrition Experts

American Dietetic Association (ADA) Registered dietitian (RD) Certified diabetes educator Public health nutritionist Dietetic technician

Dietetic technician registered

True Nutrition ExpertsTrue Nutrition Experts

Credentials Accredited

institution Licensing

Dietetics and Nutrition Practice ActTitle XXXII

REGULATION OF PROFESSIONS AND OCCUPATIONS

Chapter 468 MISCELLANEOUS PROFESSIONS

AND OCCUPATIONSPART X

DIETETICS AND NUTRITION PRACTICE (ss. 468.501-468.518)

http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0468/0468PARTXContentsIndex.html

468.502 Purpose and intent

The Legislature finds that:• the practice of dietetics and nutrition or nutrition counseling by unskilled and incompetent practitioners presents a danger to the public health and safety. •it is difficult for the public to make informed choices about dietitians and nutritionists •the consequences of wrong choices could seriously endanger the public health and safety. •The sole legislative purpose in enacting this part is to ensure that every person who practices dietetics and nutrition or nutrition counseling in this state meets minimum requirements for safe practice.

468.503 Definitions

• “Dietetics” means the integration and application of the principles derived from the sciences of nutrition, biochemistry, food, physiology, and management and from the behavioral and social sciences to achieve and maintain a person’s health throughout the person’s life. It is an integral part of preventive, diagnostic, curative, and restorative health care of individuals, groups, or both.

“Dietetics and nutrition practice”…

…shall include assessing nutrition needs and status using appropriate data; recommending appropriate dietary regimens, nutrition support, and nutrient intake; improving health status through nutrition research, counseling, and education; and developing, implementing, and managing nutrition care systems, which includes, but is not limited to, evaluating, modifying, and maintaining appropriate standards of high quality in food and nutrition care services.

• “Nutrition assessment” means the evaluation of the nutrition needs of individuals or groups, using appropriate data to determine nutrient needs or status and make appropriate nutrition recommendations.

• (9) “Nutrition counseling” means advising and assisting individuals or groups on appropriate nutrition intake by integrating information from the nutrition assessment.

468.504 License required

No person may engage for remuneration in dietetics and nutrition practice or nutrition counseling or hold himself or herself out as a practitioner of dietetics and nutrition practice or nutrition counseling unless the person is licensed in accordance with the provisions of this part.

468.505 Exemptions; exceptions.

• Those licensed in Chapters 457-466, 480, 490, or 491 and rendering services within the scope of their practice

• Persons employed in government, cooperative extension home economist, a student or trainee under supervision, someone from out of state taking a course of study… an educator in the employ of a not-for-profit,, employed by a hospital, nursing home, assisted living facility, or is a dietetic technician

Also exempted: g) A person who markets or distributes food, food materials, or

dietary supplements, or any person who engages in the explanation of the use and benefits of those products or the preparation of those products, if that person does not engage for a fee in dietetics and nutrition practice or nutrition counseling.

(j) Any person who provides weight control services or related weight control products, provided the program has been reviewed by, consultation is available from, and no program change can be initiated without prior approval by a licensed dietitian/nutritionist, a dietitian or nutritionist licensed in another state that has licensure requirements considered by the council to be at least as stringent as the requirements for licensure under this part, or a registered dietitian.

468.516 Practice requirements.—

A licensee under this part shall not implement a dietary plan for a condition for which the patient is under the active care of a physician licensed under chapter 458 or chapter 459, without the oral or written dietary order of the referring physician. In the event the licensee is unable to obtain authorization or consultation after a good faith effort to obtain it from the physician, the licensee may use professional discretion in providing nutrition services until authorization or consultation is obtained from the physician.