Dietary Planning, Canadas Food Guide and Nutritional Requirements

Dr. Terry McCurdy September 2012

Dietary Guidelines
Canadas food guide just turned 70 Began as Canadas Official Food Rules in 1942, for population health during the war (especially the soldiers who were being recruited) it d) Now Eating Well with Canadas Food Guide, there have been a number of versions Unfortunately the guide has been affected by the interest of lobby groups, see the twitter post entitled The politics of food guides
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Dietary Recommendations
Nutritional science has determined required nutrients Governments have established dietary standards, the WHO global standards Canada and the US have collaborated on Dietary Reference Intakes

Evidence used to develop Canadas Food Guide

Dietary Reference Intakes (DRIs) (a set of nutrient reference values for vitamins, minerals, macronutrients and energy) , gy) Based on association between foods and chronic diseases Guide used modelling to develop the eating pattern
Examined food combinations (500+ generated) for eating pattern to meet nutrient needs, using DRI nutrient reference values
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Association between foods and chronic diseases

Convincing evidence
Vegetables and fruit: CVD and Cancer Whole grains: CVD Fish: CVD

Dietary Reference Intakes

4 categories for DRIs 1.Estimated average requirement or EAR, estimates amount of a nutrient to meet needs of 50% of the population 2.Recommended Dietary Allowance or RDA, based on EAR, but higher to encompass needs of 97% of the population

Food recommendations needed consistency with evidence

Consistent with vegetables, fruit and whole grains Newest version added recommendations for fish
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Dietary Reference Intakes continued

3. Adequate intake or AI, value used if there is insufficient data to calculate RDA 4. 4 Tolerable upper intake le el or UL amo nt pper level UL, amount below which there is little chance of adverse health effect

Dietary Reference Intakes (DRIs)

Vitamins and minerals
RDA is assessed against Estimated Average Requirement (EAR) when available or Adequate Intake (AI)
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DRIs
EARs, requirement of 50% of the population RDAs meets needs of 97% UL, max amount of nutrient with no toxicity AI exists if no EAR and RDA

Estimated Energy Requirements

Used to calculate calories to maintain stable weight in healthy individual Based on age, gender, weight, height and activity level Calculation you will use in the Diet & Activity exercise in tutorial

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AMDRs

Eating Well with Canadas Food Guide

Rainbow design emphasizes vegetables, fruit, and grains, size of band reflects amount of food from that group Describes overall eating pattern for good health

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Estimating Serving Sizes

Estimating Serving Sizes

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Food Labels

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Food Guide website

Includes interactive tools:
Guided tour My Food Guide

Mnemonic for Diet Planning

Adequacy Balance Calorie control Nutrient Density Moderation Variety

Links to Dietitians of Canada EaTracker www.healthcanada.gc.ca/foodguide www.eatracker.ca

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Resource for Educators and Communicators

Provides background information on the content of the Food Guide Can be viewed or downloaded from the Food Guide site
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US Dietary Recommendations
US new graphic is ChooseMyPlate Tool helpful in explaining proportions

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Other Useful Tools

Just the Basics factsheet for those newly diagnosed with type 2 diabetes posted on A2L Text has appendix for using Beyond the Basics Both of these from the CDA

Assessment of Nutritional Health

Determination of dietary intake Analysis of nutrients in dietary intake Anthopometric Measurements Medical History Laboratory Measurements

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Nutrient Deficiency
Can be due to inadequate intake primary deficiency Secondary deficiency may be due to drug or illness Easy to detect if there are clinical signs Subclinical deficiency occurs before outward signs appear

Normal Blood Values of Nutritional Relevance

Text Appendix C Hematocrit (ml/100 ml)
Men 0.43 - 0.52 Women 0.37 - 0.46

Hemoglobin (g/L)
Men Women 140 - 174 123 157 10-250 g/L 7-36 nmol/L
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Ferritin Iron
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Assessing Nutrient Deficiencies

Nutritional Status of Populations

In the US the National Health and Nutrition Examination Survey or NHANES collects population data In Canada the Canadian Community Health Survey is used to monitor trends in the countrys health and nutritional status

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Canadian Community Health Survey

CCHS began in 2000 Created to examine nutritional status in this country Looks at trends in food intake and effect on health Is ongoing

Canadian Healthy Eating Index

CHEI compares diets to Canadas Food Guide Average CHEI score for Canadians is 58.8% Govt response is to set goals for 2015 to increase by 20%
Healthy food choices by Canadians Physical activity of 30 mins/day Canadians with BMIs in optimal range

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