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.
