DIETARY REFERENCE INTAKES

(DRIs)
1. Recommended Dietary Allowances (RDA)
• Guidelines for apparently healthy individuals

2. Adequate Intakes (AI)

• Guidelines for insufficient evidence for individuals

3. Estimated Average Requirements (EAR)

• Guidelines for age and gender groups

4. Tolerable Upper Intake Levels (UL)

• Guidelines for supplements
DIETARY REFERENCE INTAKES

Inaccurate View
vs
Accurate View
ESTIMATED ENERGY REQUIREMENT (EER)

• Total daily energy intake (kcals) that is predicted to

maintain energy balance

• Energy intake should equal energy expenditure

ACCEPTABLE MACRONUTRIENT
DISTRIBUTION RANGES (AMDR)
• Ranges (%ages) of intakes for the energy
yielding nutrients

• Adequate to provide energy and reduce risk of

chronic disease
ACCEPTABLE MACRONUTRIENT
DISTRIBUTION RANGES (AMDR)

•45 to 65% of kcals

from carbohydrate

•20 to 35% of kcals

from fat

•10 to 35% of kcals

from protein
 NATIONAL NUTRITION SURVEY
NHANES:
What we eat in America
Purposes:
• To determine kinds & amounts of foods that people eat
• To measure people’s knowledge, attitudes, & behaviors
r/t nutrition

Uses:
Setting public policy on nutrition education
Assessing food assistance programs
Regulating food supply
Guiding product development
Establishing research priorities
Developing & monitoring national health goals
 NATIONAL HEALTH GOALS
Healthy People
Based on national health survey

Under US Dept of Health & Human Services (DHHS)

Identifies nation’s health priorities

Sets objectives to promote health & prevent disease

Nutrition 1 of 42 topic areas

Updated every 10 years

www.healthypeople.gov
OVERNUTRITION (i.e., dietary excess),
especially of energy (total kcals), sodium, certain
fats, and alcohol contribute to many CHRONIC
DISEASES:
Cardiovascular Disease
Cancer
Stroke
Diabetes
Liver Disease
Kidney Disease
 DIETARY IDEALS*
Adequacy—the characteristic of a diet with necessary nutrients
& energy to maintain health & bodyweight

Balance—the characteristic of a diet with foods in proportion to

one another & to the body’s needs

Energy (kcals) Control—management of energy/caloric intake

such that not more, not less

Nutrient Density—a measure of the nutrients a food provides

relative to the energy it provides

Moderation—the act of only eating less nutrient dense foods

occasionally

Variety—a wide selection of foods within & among the major

food groups
NUTRIENT DENSITY*
DIETARY
GUIDELINES for
AMERICANS

• Follow a healthy dietary pattern at every

life stage.

• Customize and enjoy nutrient-dense food

& beverage choices to reflect personal
preferences, cultural traditions, and
budgetary considerations.

• Focus on meeting food group needs with

nutrient-dense foods & beverages and
stay within kcalorie limits.

• Limit foods & beverages higher in added

sugars, saturated fat, and sodium, and
limit alcoholic beverages.
 USDA FOOD PATTERNS
A food group plan to help ensure ADEQUACY &
VARIETY
Separates foods into 5 major groups
Fruits
Vegetables
Grains
Protein Foods
Milk and Milk Products

Each group similar in vitamin & mineral content

Includes recommended daily amounts from each group
 USDA Food Patterns:
Healthy Eating Patterns
Food Group 1600 kcal 1800 kcal 2000 kcal 2200 kcal 2400 kcal 2600 kcal 2800 kcal 3000 kcal

Fruit 1½ c 1½ c 2c 2c 2c 2c 2½ c 2½ c

Vegetables 2c 2½ c 2½ c 3c 3c 3½ c 3½ c 4c

Grains 5 oz 6 oz 6 oz 7 oz 8 oz 9 oz 10 oz 10 oz

Protein foods 5 oz 5 oz 5½ oz 6 oz 6½ oz 6½ oz 7 oz 7 oz

Milk 3c 3c 3c 3c 3c 3c 3c 3c

Oils 5 tsp 5 tsp 6 tsp 6 tsp 7 tsp 8 tsp 8 tsp 10 tsp

Limit on kcalories 130 kcal 170 kcal 270 kcal 280 kcal 350 kcal 380 kcal 400 kcal 470 kcal
available for other
uses*

Source: U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015–2020 Dietary
Guidelines for Americans, 8th ed. (2015): http://health.gov/dietaryguidelines/2015/guidelines/.
*The limit on kcalories for other uses describes how many kcalories are available for foods that are not in nutrient-
dense forms.
 MyPlate
Educational Tool for the USDA Food Plan

www.choosemyplate.gov
 PORTION SIZES
¼ c dried fruit = a golf ball
3 oz of meat = a deck of cards
1 ½ oz cheese = 6 stacked dice or = a 9-volt
battery
½ c ice cream = a racquetball
4 small cookies = 4 poker chips
 PORTION SIZES

¼ c dried fruit = a golf ball

3 oz of meat = a deck of cards
1 ½ oz cheese = 6 stacked dice or = a 9-
volt battery
½ c ice cream = a racquetball
4 small cookies = 4 poker chips
 FOOD LABELS

MANDATORY:
• Full ingredient list in descending order of
predominance by weight
• Nutrition facts panel
Serving size
Daily Values
Nutrient Quantities

OPTIONAL:
• Nutrient claims
• Health claims
• Structure-Function claims
 CLAIMS on LABELS
NUTRIENT CLAIMS
• Statements that characterize the quantity of a nutrient in
a food
• May only be used if the claims meet FDA definitions
• Terms used on food labels (Table 1-11)
 CLAIMS on LABELS
HEALTH CLAIMS
• Statement that describes the relationship of the food or
food component to a disease or health-related condition
• Must have high scientific validity or emerging evidence
 CLAIMS on LABELS
STRUCTURE-FUNCTION CLAIMS
• Statement that describe the effect that a substance has
on the structure/function of the body
• Can be made without FDA approval
• Cannot mention a specific disease or symptom
 FITNESS GUIDELINES

Type of Aerobic activity that uses large-muscle groups Resistance activity that is performed at a Stretching activity that uses the major muscle
activity and can be maintained continuously controlled speed and through a full range of groups
motion

Frequency 5 to 7 days per week 2 or more nonconsecutive days per week 2 to 7 days per week

Intensity Moderate (equivalent to walking at a pace of 3 Enough to enhance muscle strength and Enough to feel tightness or slight discomfort
to 4 miles per hour)a improve body composition

Duration At least 30 minutes per day 8 to 12 repetitions of 8 to 10 different 2 to 4 repetitions of 15 to 30 seconds per
exercises (minimum) muscle group

Examples Running, cycling, swimming, inline skating, Pull-ups, push-ups, weight-lifting, pilates Yoga
rowing, power walking, cross-country skiing,
kickboxing, jumping rope; sports activities
such as basketball, soccer, racquetball,
tennis, volleyball

Source: American College of Sports Medicine position stand, Quantity and quality of exercise for developing and maintaining
cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise, Medicine
and Science in Sports and Exercise 43 (2011): 1334–1359; W. L. Haskell and coauthors, Physical activity and public health: Updated
recommendation for adults from the American College of Sports Medicine and the American Heart Association, Medicine and Science
in Sports and Exercise 39 (2007): 1423–1434.
 BENEFITS of EXERCISE
• Restful sleep • Lowers risk for CVD
• Expends energy (kcals) • Lowers risk for Type 2
• Improved body composition diabetes
• Improved bone density • Reduces risk for
gallbladder dx
• Enhances immunity
• Lowers incidence of
• Lowers risk of some anxiety & depression
cancers
• Strengthens self-image
• Stronger circulation & lung
• Promotes longevity and
function
improved quality-of-life
NUTRITION IN PRACTICE
Finding the Truth about Nutrition
Evaluating the Reliability
of Websites
Are the names and
credentials of the
Who is responsible
providers of the
for the site?
information
identified?

Does the site

provide links to Is the site updated
reputable regularly?
organizations?

Does the site

Is the site selling a
charge an access
product or service?
fee?
 Government Agencies (CDC,
DHHS, USDA, FDA)
Non-profit Organizations (ACS,
AHA, ADA)
Credible
Sources of Academy of Nutrition and
Information Dietetics (AND)
American Medical Assoc.
(AMA)
Reputable Consumer Groups
(ACSH)
 Registered
Dietitian
Nutritionist

Registered
Dietetic
Technician

Registered
Nutrition and
Dietetic
Technician
NUTRITION EXPERTS
Nutritionist
Roles of the NURSE
in Nutrition Care
Obtain diet histories
Measure height & weight
Monitor weight changes
Help with menus
Record food & drink
Monitor food & drug interactions
Answer questions about food and
diet
Provide patient education
Refeed
Understand vitamin/mineral
profiles
REFERENCE
DeBruyne, L. K., & Pinna, K. (2023). Nutrition
for Health and Healthcare (8th ed.), Cengage
Learning.