CHAPTER 1CHAPTER 1

OVERVIEW OF HEALTHYOVERVIEW OF HEALTHYEATING HABITSEATING HABITS

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Role of the Dental HygienistIdentify harmful dietary habits that may initiate

oral diseasePromote health and wellness as a health

professionalOpportunity to see patients on a more regular basis

than many other health professionalsSupport interventions initiated by other healthcare

professionalsIdentify patients needing referral to a registered

dietitian for complex nutrition needs that may ultimately affect general health

2

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Basic Nutrition

NutritionProcess by which living things use food to obtain

nutrients for energy, growth, and maintenance

Essential nutrientsSubstance obtained from food that the body cannot

produce in sufficient quantities to meet physiological requirements

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Classes of Nutrients

MacronutrientsWater*ProteinsCarbohydratesFatsAlcohol

MicronutrientsMineralsVitamins

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Basic Conceptsof Nutrition

Good nutrition evaluated in context of patient’s:Physiological needs for essential nutrientsNutrient content of the foodCultural or environmental circumstancesPersonal preferences

Encourage variety of foods to minimize nutrient deficiencies or excesses

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US Governmental Nutrition ConcernsBefore 1977, concern was nutritional

deficienciesCurrent concerns outlined by the Surgeon

General include prevention of chronic diseases related to dietary intake, including:Cancers, stroke, diabetes mellitus, atherosclerosis,

and coronary heart disease

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Objectives involving nutrition include:22 objectives relate to nutrition/weight; 17 objectives

relate to oral health Increase Quality of Life (QoL) & length of lifespan Eliminate health disparities among racial/ethnic groups Create social/physical environments promoting good health Promote QoL, health development, healthy behaviors for all

age groups Reduce childhood obesity Increase numbers of community water systems containing

optimal amounts of fluoride Increase proportion of children with dental sealants

Healthy People 2020 Nutrition Objectives

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Dietary Reference Intakes (DRIs)Estimated average requirement (EAR)

Amount of nutrients estimated to meet needs of half of healthy individuals in specific age and gender group

Recommended dietary allowances (RDAs)Sufficient amount of nutrients to meet requirements of

nearly all (97% to 98%) healthy individuals

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Dietary Reference Intakes (DRIs)Adequate intake (AI)

Average amount of nutrient that appears to maintain a defined nutritional state; more tentative than an RDA

Tolerable upper intake level (UL)Maximum daily level of nutrient intake that probably

will not cause adverse health or toxic effects for most individuals

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Acceptable macronutrient distribution range (AMDR) (see Table 1-1)Ensures sufficient intake of essential nutrients while

reducing risk of chronic disease

Estimated energy requirementEnergy intake that is predicted to maintain energy

balance

Dietary Reference Intakes (DRIs)Dietary Reference Intakes (DRIs)

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DRIs: Dental Hygiene Considerations

Guidelines apply to average daily intakesIndividual’s specific requirement unknown

Encourage a variety of healthy food choicesDRIs are guidelines for healthy peopleUL may be used to warn patients against

megadoses of nutrients

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Dietary Guidelines for Americans 2010

Issued by USDA and HHS; updated every 5 yearsAuthoritative advice for people

2 years and older about how good dietary habits can promote health and reduce risk for major chronic diseases

Address diet, physical activity, and other issues promoting healthy eating and food safety

U.S. Department of Health and Human Services and U.S. U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans, 2005. Department of Agriculture. Dietary Guidelines for Americans, 2005.

6th ed. Washington, D.C.: U.S. Government Printing Office, 6th ed. Washington, D.C.: U.S. Government Printing Office, January 2005 January 2005

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Dietary Guidelines for Americans 2010

Key recommendationsAdequate nutrients within

kilocalorie needsWeight managementPhysical activityFood groups to encourageFats and carbohydratesSodium and potassiumAlcoholic beveragesFood safety

From U.S. Department of Health and Human Services and U.S. From U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans, Department of Agriculture. Dietary Guidelines for Americans, 2005. 6th ed. Washington, D.C.: U.S. Government Printing 2005. 6th ed. Washington, D.C.: U.S. Government Printing

Office, January 2005. Office, January 2005.

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Dietary Guidelines for Americans 2010: Dental Hygiene Considerations

Apply only to healthy individuals >2 years of ageEncourage nutrient-dense food: whole grains,

fruits, and vegetablesEncourage moderation in salt, sugar, and

alcohol intakeEncourage intake of fluoridated water

MYPLATE

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Food Pyramid System

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Food Pyramid System: Guiding Food Pyramid System: Guiding PrinciplesPrinciples

Overall Health

Up-to-Date Research

Total Diet

Useful Realistic

Flexible Practical

Evolutionary

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Food Pyramid SystemMyPyramid was

designed to help people make food choices for meeting nutrient requirements

Foods are grouped according to nutrient content

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Total estimated Discretionary = energy — Essentialcalories requirement calories

Discretionary calories* may be used to:Discretionary calories* may be used to:Increase amount of food selected from a food groupIncrease amount of food selected from a food groupConsume foods that are not in the lowest fat form—Consume foods that are not in the lowest fat form—

such as 2% milk or items that contain added sugarssuch as 2% milk or items that contain added sugarsAdd oil, fat, or sugar to foodsAdd oil, fat, or sugar to foodsConsume alcohol (for those who consume alcohol)Consume alcohol (for those who consume alcohol)

Food Pyramid System Message: Food Pyramid System Message: Discretionary CaloriesDiscretionary Calories

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Food Pyramid System Message: Physical Activity

In the Dietary Guidelines:Engage in regular physical activity

and reduce sedentary activities to promote health, psychological well-being, anda healthy body weight

In MyPyramid and MyPlate graphics:Steps and person on them symbolize

physical activity should be a part of everyday healthy living

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Food Pyramid System Message: Proportionality

In the Dietary Guidelines: Adopt a balanced eating pattern

Sufficient amount of fruits and vegetables 3 or more ounce equivalents of whole-grain products

per day3 cup equivalents per day of fat-free or low-fat milk or

milk productsIn MyPyramid and MyPlate graphics: Color bands clarify proportionality

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Food Pyramid System Message: Moderation

In the Dietary Guidelines:Limit intake of saturated and trans fats, and choose

products low in these fats Make choices of meat, poultry, dry beans, and milk

products that are lean, low fat, or fat freeChoose and prepare foods and beverages with little

added sugars or calorie sweetenersIn MyPyramid and MyPlate graphic:Food group bands narrow from

bottom to top suggesting to eat nutrient-dense forms of foods

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Food Pyramid and MyPlate Systems: Dental Hygiene Considerations

Provide information to patients about relating positive changes in dietary lifestyle changes

Use the systems for evaluating adequacy of a patient’s dietEliminating food groups may lead to inadequate intake of

nutrientsIf only nutrient-dense foods are selected,

discretionary kcal can be used on other foods

The slogan “Steps to a Healthier You” suggests improvement should happen in stages over time

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1. Start with exercise

2. Focus on food, not grams

3. Go with plants • Eat a plant-based diet 

4. Cut back on American staples, e.g., red meat, refined sugars, and grains

5. Take a multivitamin and alcohol use in moderation

Copyright © 2008 Harvard University. For more information about the Healthy Eating Copyright © 2008 Harvard University. For more information about the Healthy Eating Pyramid, please see The Nutrition Source, Department of Nutrition, Harvard School Pyramid, please see The Nutrition Source, Department of Nutrition, Harvard School of Public Health, of Public Health, www.thenutritionsource.org; and Willett W, Skerrett P: Eat, Drink, ; and Willett W, Skerrett P: Eat, Drink,

and Be Healthy. Free Press/Simon & Schuster Inc, 2005. and Be Healthy. Free Press/Simon & Schuster Inc, 2005.

Other Food Guides: Healthy Eating Pyramid

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Other Food Guides: Eating Well with Canada’s Food Guide

Steps toward better health and a healthy body weight include:Eat recommended amount and

types of food each dayLimit foods and beverages high

in calories, fat, sugar, or salt (sodium)

Be active every day

From Eating Well With CanadaFrom Eating Well With Canada’’s Food Guide (2007), Health s Food Guide (2007), Health Canada. Reproduced with permission of the Minister of Public Canada. Reproduced with permission of the Minister of Public

Works and Government Services Canada, 2009.Works and Government Services Canada, 2009.

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FDA-Authorized Health Claims

Qualified health claims Cancer riskCardiovascular disease riskCognitive functionDiabetesHypertensionNeural tube birth defects

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Daily reference valuesBased on 2000-calorie

diet% DV helps determine

if a serving of food is high or low in a nutrient

From theFrom the Department of Health and Human Services, Food Department of Health and Human Services, Food and Drug Administration. How to Understand and Use the and Drug Administration. How to Understand and Use the Nutrition Facts Label. June 2000, updated July 2003 and Nutrition Facts Label. June 2000, updated July 2003 and

November 2004. Available: November 2004. Available: www.cfsan.fda.gov/~dms/foodlab.html..

Nutritional Labels

Reading Nutritional LabelsWhich has more calories?

Which one has more saturated fat? Which one has more calcium?

From theFrom the Department of Health and Human Services, Food Department of Health and Human Services, Food and Drug Administration. and Drug Administration. How to Understand and Use the How to Understand and Use the Nutrition Facts Label.Nutrition Facts Label. June 2000, updated July 2003 and June 2000, updated July 2003 and

November 2004. Available: November 2004. Available: www.cfsan.fda.gov/~dms/foodlab.html..

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