Nutritional Needs Presentation - HLTH 104

Nutritional Needs and Food Safety

1. Nutritional Needs Info from Chapter 11 and other sources

2. Introduction Proper nutrition is essential to overall health Having good nutrition: Means that a person's diet supplies the essential nutrients needed to carry out normal tissue growth and repair. Supplies enough substrates to fuel all body processes. The USDA provides nutrition guidelines and recommended daily food amounts according to various caloric requirements.

3. Nutrient s Macronutrients – needed in proportionally large amounts daily Carbohydrates (4 kcal per gram) Protein (4 kcal per gram) Lipids (9 kcal per gram) Water (no caloric value) Micronutrients - required in small amounts daily (no caloric value Vitamins Minerals

4. Nutrients Nutrient Density Foods packed with nutrients but with low or moderate calories are classified as having high nutrient density. Calorie: The simplified term for a kilocalorie (kcal), the amount of heat necessary to raise the temperature of 1 kilogram of water 1 degree Centigrade.

5. MyPlate food plan

6. Proteins Essential for the growth and maintenance of tissue Cell structures, enzymes, hormones, neurotransmitters, carriers for substances in the bloodstream (osmotic pressure), antibodies Of the 20+ Amino Acids (AA) eight are essential isoleucine, leucine, lysine, threonine, tryptophan, methionine, histidine, valine and phenylalanine In developed countries, adequate amounts of protein are usually obtained However, not all AA are consumed Contrary to popular belief, all may be obtained through plant sources Meat products tend to be overused for protein sources Excess proteins can be converted to glucose or fat, or excreted in urine Daily consumption of beef, poultry, or fish should be limited to 3 ounces to 6 ounces. 15%-20% of total calories should come from protein

7. Carbohydrates Body’s primary source of energy Help regulate fat and protein metabolism Broken down in the mouth and small intestines Sugars Simple (monosaccharide), disaccharide Glucose, Fructose, and Galactose; Maltose, Sucrose, Lactose Glucose is our main energy source Avoid these carbs except when found in fresh fruit Starches Complex ( polysaccharride ) Create sustained energy and better blood sugar levels Best choices are found in root vegetables, legumes, whole grains, and corn 55%-65% of calories should come from Carbohydrates Most from complex sources

8. Carbohydrates Fiber Form of complex carbohydrates with little to no caloric value Present mainly in plant leaves, skins, roots, and seeds Processing and refining foods removes most of their natural fiber Dietary sources include Whole-grain cereals and breads Fruits and vegetables Legumes Other good sources include carrageen, guar gum, pectin and agar and alginate

9. High-fiber foods are essential in a healthy diet Age 50 and under Women = 25 g/day Men = 38 g/day Over age 50 Women = 21 g/day Men = 30 g/day Current average daily U.S. intake About 15 g/day

10. Lipids (Fat) Stored in Adipose Tissue Retains heat, supports & protects organs, energy reserve Needed for cell membrane structure, transport roles within the blood stream, myelin sheath production Triglycerides Form of fat that provides energy 95% of lipid content of food and easily stored Saturated (mostly animal sources) Unsaturated (plant sources) Help lower blood cholesterol Monousaturated found in avocados and olive, almond, canola oils Polyunsaturated found in safflower, corn, sesame and soybean oils EFA – linoleic and aracnidonic (omega-6) and linolenic (omega-3) Cholesterol Naturally produced in the body and is important for Vit D production, cell membrane function, and formation of some androgens 20 to 30% of the diet should be comprised of lipids and 15% or more of that should come from essential fats

11. Fats (Lipids) Trans fatty acids The result of partial hydrogenation to increase shelf life. Provide no known health benefit. The words " partially hydrogenated " and "trans fatty acids" indicate that the product carries a health risk just as high as or higher than that of saturated fat. Found in Margarine and spreads, shortening, some nut butters, crackers, cookies, dairy products, meats, processed foods, and fast foods

12. Vitamins Essential for proper regulation of metabolic reactions and biochemical processes Most cannot be synthesized in the body Fat soluble – A, D, E, K, and Carotenoids Can be stored in the body and in excess can be toxic Water soluble – All B vitamins, C, and bioflavonoids Needs to be replenished daily because they are broken down easily and the body does not store them No storage capacity makes them less likely to be toxic Refer to handout on website

13. Vitamins and Minerals Needed to provide Antioxidants Vitamin C & E, Beta-Carotene, and Selenium are most recommended Free radicals attack and damage proteins, lipids, cell membranes, and DNA Minerals are required for many vital processes Macrominerals comprise at least .01 % of bodyweight Ca, Cl , Mg, P, K, and Na Microminerals (trace) comprise less than .01 % of bodyweight Cr, Co, Cu, I, Fe, Mn , Mo, Se, S, Zn

14. Water Most important nutrient Studies show people are getting enough water from the liquids and the moisture content of solid foods. To avoid dehydration, use the thirst signal Exception is exercise

15. Balancing the American Diet National Academy of Sciences created guidelines for a well-balanced diet The ranges allow for flexibility in planning diets for individual health and physical activity needs The source of fat calories is critical USDA website which is full of great information: ChooseMyPlate.org

16. Intake RDA – Recommended Daily Allowances Since 1940, the U.S. government provided suggested intake of certain nutrients RDI - Reference Daily Intakes In 1993, the FDA took over Nutrient intake based on a 2000 calories diet, no age, gender differences SONA – Suggested Optimal Nutrient Allowance Formulated by holistic physicians because some RDIs were not sufficient enough Still take into account individual differences

17. Food Label with U.S. Recommended Daily Values

18. Look at the Ingredient List for Added Sugars Plain Yogurt INGREDIENTS: CULTURED PASTEURIZED GRADE A NONFAT MILK, WHEY PROTEIN CONCENTRATE, PECTIN, CARRAGEENAN. Fruit Yogurt INGREDIENTS: CULTURED GRADE A REDUCED FAT MILK, APPLES, HIGH FRUCTOSE CORN SYRUP, CINNAMON, NUTMEG, NATURAL FLAVORS, AND PECTIN. CONTAINS ACTIVE YOGURT AND L. ACIDOPHILUS CULTURES Just beware that added sugar comes in many forms, but this is one of the worst.

19. Nutrient Analysis Keep a 3-day record of all foods and beverages consumed Includes measurements of calories, carbohydrates, fats, protein, cholesterol, sodium, vitamins, and minerals. Going through this is the only way that you can say you are truly watching your diet.

20. Organics and GMOs Genetically modified organism (GMO) benefits: Resist disease and extreme environmental conditions better. Require less fertilizers and pesticides. Last longer. Have better nutrient content and taste. Save billions of dollars and help feed the hungry. Debate over GM foods Genetic modifications create new "transgenic" organisms that have potentially unpredictable effects on the environment and on humans. Illnesses or allergies in humans; destruction of other plants or herbicide-resistant " superweeds " may emerge. Avoiding GM foods Buy organic foods; organic trade organizations will not certify GM foods. Buy from local markets; small farmers are less likely to use this technology.

21. Organics and GMOs According to the USDA, organic foods are described as: Organic meat, poultry, eggs and dairy products come from animals that are given no antibiotics or growth hormones. Organic food is produced without using most conventional pesticides, fertilizers made with synthetic ingredients or sewage sludge, bioengineering or ionizing radiation. Organically grown foods are safer and more nutritious than foods raised with non-organic methods such as pesticides, non-organic fertilizers, antibiotics and hormones National Organic Program - USDA

22. Organics and GMOs To be certified as organic, food products need to come from farms and processing plants that are certified as organic. Foods that are organically grown can state that fact on the label. "100% Organic" Foods that are labeled as 100% Organic must contain all organically grown ingredients except for added water and salt. "Organic" Foods that are labeled as Organic need to contain at least 95% organic ingredients, except for added water and salt, plus they must not contain sulfites added as a preservative. Sulfites have been known to provoke allergies and asthma in some people. Up to 5% of the ingredients may non-organically produced. "Made with Organic Ingredients" Product labels that claim Made with Organic Ingredients need to contain at least 70% organic ingredients, except for added water and salt. Food products made with less than 70% organic ingredients may state which ingredients are organic, but they can not claim to be organic food products.

23. Organics and GMOs Links to local farms that produce environmentally responsible products Maryland Organic Farms Eat Wild Link

24. Things You Can Do You can vote to change this system. Three times a day. Buy from companies that treat workers, animals, and the environment with respect. When you go to the supermarket, choose foods that are in season. Buy foods that are organic. Know what’s in your food. Read labels. The average meal travels 1,500 miles from the farm to the supermarket. Buy foods that are grown locally. Shop at farmers’ markets. Plant a garden. (Even a small one.) Cook a meal with your family and eat together. Everyone has a right to healthy food. Make sure your farmers’ market takes food stamps. Ask your school board to provide healthy school lunches. The FDA and USDA are supposed to protect you and your family. Tell Congress to enforce food safety standards and re-introduce Kevin’s Law. If you say grace, ask for food that will keep us and the planet healthy. You can change the world with every bite. Hungry for change ? Go to www.takepart .com / foodinc .

25. Antimicrobials in Meat Antimicrobials that are similar or identical to those used by humans are employed for disease prevention and growth enhancement among animals Cattle, swine, poultry and fish Some U.S.-approved antimicrobials given to food animals: Amoxicillin Penicillin Bacitracin Erythromycin In many countries, this practice in banned

26. Why Is the Use of Antimicrobials a Potential Problem? Residues of antimicrobial agents may persist in meat that is destined for human consumption. Possible indirect toxicity, which causes loss of effective therapeutic interventions For example, through microorganisms that are resistant to antimicrobial drugs. Antimicrobials in Meat

27. Food Additives Intentional (direct) additives are added to foods in order to improve their quality. Too many to list for an example Incidental (indirect) additives may be present in foods as a result of unintentional contamination during packaging, storage, and handling. Pesticides or Insects in food Malicious additives include substances such as poisons that saboteurs introduce into foods for various reasons. Poisonings

28. Generally Recognized as Safe (GRAS) The GRAS rule permitted the use of additives that had an established history of safe use in foods. Click here to go to the FDA's section on GRAS

29. Dietary Guidelines for Americans Nine Key Recommendations for the General Population about Foods and Nutrients to Increase Increase vegetable and fruit intake. Eat a variety of vegetables. Consume at least half of all grains as whole grains. Increase intake of fat-free or low-fat milk and milk products. Choose a variety of protein foods from the plant and animal kingdoms. Replace some meat and poultry with a variety of seafood. Replace protein foods with more solid fat with those containing less solid fat. Use oils to replace solid fats where possible. Choose foods containing more potassium, dietary fiber, calcium, and vitamin D.

30. Foodborne Diseases and Infections “illnesses acquired by consumption of contaminated food . . .” Frequently and inaccurately referred to as food poisoning A major cause of morbidity (and occasionally mortality) in the United States and other countries of the world. May cause more than the occasional upset stomach Affects about ¼ of the population and causes about 9,000 deaths annually Incidence of foodborne illnesses has increased in industrialized nations.

31. Regulation of Food Safety Food and Drug Administration (FDA) is the U.S. agency charged with regulation and enforcement of food safety. U.S. Department of Agriculture (USDA) regulates the safety of meat and poultry products.

32. Four Major Categories of Food Hazards Biological Microorganisms Physical Stone, glass, metal Chemical Pesticides, Additives, etc Nutritional Presence of nutrients and other food constituents in excessive or deficient an=mounts that lead to disease.

33. Salmonella The bacteria infection is called salmonellosis. Most frequent foodborne disease Over 2000 different serotypes Over a third of the cases in U.S. are serotypes: Salmonella serotype Enteritidis Salmonella serotype Typhimurium Approximately 1 million cases of salmonellosis are estimated to occur each year in the U.S. Causes about 380 deaths each year

34. How are Salmonella Bacteria Transferred? To environmental surfaces at work and at home (kitchen primarily) from raw meats, poultry, and seafood From animal feces From contaminated water and soil Found commonly in raw milk, fruits and vegetables (that are generally not washed or cooked)

35. Symptoms of Salmonellosis Acute symptoms (onset time 6-48 hours) Nausea Vomiting Abdominal cramps Diarrhea Fever Headache Chronic symptoms May include arthritic-like symptoms that occur 3-4 weeks after an acute infection

36. Clostridium botulinum Causes the foodborne disease botulism, a form of foodborne intoxication. Grows in an anaerobic (oxygen-free) environment and produces a potent toxin (a neurotoxin) that affects the nervous system. Found in a variety of foods that are not low acidic. < 4.6 pH are okay About 10-30 outbreaks per year

37. Effects of Botulism “Onset of symptoms in foodborne botulism is usually 18 to 36 hours after ingestion of the food containing the toxin, although cases have varied from 4 hours to 8 days.” Early signs: Marked lassitude Weakness and vertigo Double vision Progressive difficulty in speaking and swallowing Difficulty in breathing Weakness of other muscles Abdominal distention Constipation See the Case Studies in exhibit 11-1 page 281

38. Clostridium perfringens The CDC estimates that about 1 million cases occur each year in the U.S. C. perfringens is anaerobic, rod-shaped, and forms spores. Occurs commonly in the environment (e.g., soil and sediments), especially in those areas contaminated with feces Also found in the intestines of humans and animals Most complications occur during the storage and cool down of foods (e.g., food warmers)

39. Effects of Infection with C. Perfringens Symptoms Mild to Intense abdominal cramps Watery Diarrhea Onset 8-22 hours after consumption of incriminated food Duration Approximately 24 hours. Mild symptoms may last for 1 or 2 weeks.

40. Escherichia coli ( E. coli O157:H7) A pathogenic strain of E. coli Shiga-toxin producing strain (STEC) Note that many E. coli strains reside harmlessly in the intestinal tract. Causes hemorrhagic colitis, linked to bloody diarrhea U.S. about 73,000 cases and 61 deaths yearly Major outbreaks in restaurant chains Can be transmitted by hamburger meat See exhibit 11-3 page 285

41. Tapeworms Taeniasis is a parasitic disease caused by tapeworms. One form is caused by the beef tapeworm ( Taenia saginata ) and the other by the pork tapeworm ( Taenia solium ). These organisms may induce human illness following the consumption of raw or undercooked infected beef or pork. Life cycle next slide…

42. Tapeworms

43. Effects of Infection with Tapeworms Symptoms of taeniasis usually are limited to mild abdominal distress. One of the main symptoms is the passage of the proglottids (the section of the worm that contains eggs) of T. saginata and T. solium in stools. Many grow the length of the intestinal tact (20ft)

44. Viral Agents: Hepatitis A Foods that are associated commonly with HAV outbreaks include fruits, sandwiches made with cold cuts, dairy products, vegetables, and shellfish. Common mode for contamination of foods is by HAV-infected workers in food processing plants and restaurants. Of the 23,000 cases of hepatitis A reported in the U.S. annually, about 7% are believed to be food- or waterborne.

45. Viral Agents: Norovirus Transmitted easily within closed environments, such as cruise ships May be brought on board by passengers who fall ill just before embarking on a cruise Crew members and shipboard environmental contamination may act as disease reservoirs. Symptoms Vomiting, Diarrhea, Dehydration, Abdominal cramps Duration 1–2 days

46. Bovine Spongiform Encephalopathy BSE An extensive outbreak among cattle occurred in the United Kingdom beginning in 1970s Reported in 20 European countries as well as Japan, Israel, and Canada Cases have been reported in the U.S. (2003 and later). Appears to be spread among cattle by feeds that contain rendered cattle products

47. Metal Poisoning Can cause vomiting in high concentrations Occurs a few minutes to several hours (but in most cases in less than 1hour) after ingestion Metals that have leached into foods (especially acidic foods) from metal containers and cooking vessels. Candy wrappers from Mexico made with lead Chicken may contain high levels of arsenic, which is used as an approved food supplement for chickens to control intestinal parasites. Certain species of fish—shark, swordfish, king mackerel, and tilefish—have levels of mercury that may be high enough to be harmful to developing human fetuses.

48. Pesticides in Foods Applied to crops to reduce the impact of insects and other hazards May leave residues that remain on food crops Dietary sources are one of the principal means of exposure of the population to persistent organic chemicals, which include the family of organochlorine pesticides and polychlorinated biphenyls.

49. Foodborne Disease Prevention Inadequate cooling and cold holding temperatures is the top risk factor. Inadequate hot holding temperatures is also a risk factor. Safe holding temperatures Keep foods above 140˚F for hot foods and below 40˚F for foods that are kept in cold storage. The range between 40˚F and 140˚F is the danger zone.

50. Preventing Growth of Foodborne Pathogens Thorough hand washing Prevention of cross-contamination Cooking at sufficiently high temperatures Storing cooked and vulnerable foods at proper temperatures in a refrigerator

51. Irradiation of Foods During the process, energy from ionizing radiation passes through foods and destroys bacteria and other pathogens. Procedure does not cause food to become radioactive. Referred to as cold pasteurization Certified as a safe method for reducing the risk of foodborne disease

52. Food Insecurity Supplies of wholesome foods are uncertain or may have unlimited availability Food insecurity dangers as much as one-third of Africa, the prognosis for increasing the food supply is poor. Socio-economical food insecurities do exist in the U.S.

53. Local Hunger Maryland Food Bank, Baltimore, MD People Served: Annual estimated number of clients: 357,400 Weekly estimated number of clients: 72,100 Percentage under 18: 29.0% Percentage of elderly: 8.0% Poverty Statistics: Percentage below poverty line in previous month: 67.0% Percentage who are homeless: 6.0% Percentage who are food insecure: 77.0% Percentage who are food insecure with kids: 81.0% Percentage who are food insecure with hunger: 45.0% Percentage with hunger with kids: 40.0% Percentage who receive Food Stamps: 25.0% Percentage who received General Assistance, welfare, or Temporary Assistance for Needy Families (TANF) in the past two years: 8.5%

54. Local Hunger Working Poor: Percentage of households with at least one employed adult: 48.0% Median monthly income: $700 Choices: Percentage who made the choice between food and utilities: 52.0% Percentage who made the choice between food and housing: 48.0% Percentage who made the choice between food and health care: 40.0% Learn more and find out what you can do locally at http://www.mdfoodbank.org