MyPlate.The proportions of food content and food groups are suggested by the MyPlate diagram. (United States Department of Agriculture [USDA], 2011, www.choosemyplate.gov.)

A diet that

• Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products
• Includes lean meats, poultry, fish, beans and peas, eggs, and nuts
• Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added

TABLE 30-1. MyPlate.gov Food Groups
GRAINS	VEGETABLES                     FRUIT	DAIRY	PROTEIN
Goal• Whole grains should be at least ½ of total grain intake.	Goals• Make ½ of plate fruits and vegetables. • Include fresh, frozen, canned, or dried.	Goals• Include calcium-rich foods. • Use fat-free (skim) or low-fat (1%) milk.	Goals• Include lean protein foods. • Include seafood that is rich in omega-3 fatty acids.

*Whole grains contain the entire grain kernel e.g. the bran, germ, and the endosperm.

*Refined grains have been milled which is a process that removes the bran and the germ. Refined grains have a longer shelf life and a finer texture but are often lacking in dietary fiber, iron, and many B vitamins. Most refined grains are enriched which means that some B vitamins (e.g. thiamin, riboflavin, niacin, folic acid) and iron are added back into the processed product.

**Beans & Peas are considered unique foods because they are a good source of plant proteins, minerals such as zinc and iron, and many B vitamins.

Source: Adapted from www.choosemyplate.gov/foodgroups.

Whole Grains*

• Whole—wheat flour
• Bulgur (cracked wheat)
• Oatmeal
• Whole cornmeal
• Brown rice
• Millet
• Popcorn
• Amaranth
• Some ready-to-eat breakfast cereals

Refined Grains*

• White flour
• White bread
• Crackers
• Grits
• Noodles
• Pasta
• White rice
• Cornbread
• Some ready-to-eat breakfast cereals

Dark Green

• Bok choy
• Broccoli
• Collard greens
• Dark green lettuce
• Kale
• Romaine lettuce
• Spinach
• Turnip greens
• Watercress

Red & Orange

• Acorn squash
• Butternut squash
• Carrots
• Hubbard squash
• Pumpkin
• Red peppers
• Sweet potatoes
• Tomatoes
• Tomato juice

Starchy

• Cassava
• Corn
• Fresh cowpeas, field peas, or black-eyed peas (not dry)
• Green bananas
• Green peas
• Green lima beans
• Plantains
• Potatoes
• Taro
• Water chestnuts

Beans & Peas**

• Black beans
• Black-eyed peas (mature, dry)
• Garbanzo beans (chickpeas)
• Kidney beans
• Lentils
• Navy beans
• Pinto beans
• Soy beans
• Split peas
• White beans

Other

• Artichokes
• Asparagus
• Avocado
• Bean sprouts
• Beets
• Brussels sprouts
• Cabbage
• Cauliflower
• Celery
• Cucumbers
• Eggplant
• Green beans
• Green peppers
• Iceberg (head) lettuce
• Okra
• Onions
• Parsnips
• Turnips
• Wax beans
• Zucchini

Fruits

• Apples
• Apricots
• Bananas
• Berries:
  1. Strawberries
  2. Blueberries
  3. Raspberries
• Cherries
• Grapefruit
• Grapes
• Kiwi fruit
• Lemons
• Limes
• Mangoes
• Melons:
  1. Cantaloupe
  2. Honeydew
  3. Watermelon
• Mixed fruits (fruit cocktail)
• Nectarines
• Oranges
• Peaches
• Pears
• Papaya
• Pineapple
• Plums
• Prunes
• Raisins
• Tangerines
• 100% fruit juice:
  1. Orange
  2. Apple
  3. Grape
  4. Grapefruit

Dairy

Milk

• Fat-free (skim)
• Low fat (1%)
• Reduced fat (2%)
• Whole milk
• Lactose-reduced
• Lactose-free
• Flavored milk
• Milk-based desserts:
  1. Puddings
  2. Ice milk
  3. Frozen yogurt
  4. Ice cream
• Calcium-fortified soymilk/soy beverage

Cheese

Hard natural cheeses:

• Cheddar
• Mozzarella
• Swiss
• Parmesan

Soft cheese:

• Ricotta
• Cottage

Processed cheeses:

• American

Yogurt

• Fat-free
• Low fat
• Reduced fat
• Whole milk yogurt

Meats

Lean cuts of:

• Beef
• Ham
• Lamb
• Pork
• Veal

Game meats:

• Bison
• Rabbit
• Venison

Lean ground meats:

• Beef
• Pork
• Lamb

Lean luncheon or deli meat

Organ meats:

• Liver
• Giblets

Poultry

• Chicken
• Duck
• Goose
• Turkey
• Ground chicken and turkey

Beans & Peas**

• Black beans
• Black-eyed peas
• Chickpeas (garbanzo beans)
• Falafel
• Kidney beans
• Lentils
• Lima beans (mature)
• Navy beans
• Pinto beans
• Soy beans
• Split peas

Nuts and seeds

• Almonds
• Cashews
• Hazelnuts (filberts)
• Mixed nuts
• Peanuts
• Peanut butter
• Pecans
• Pistachios
• Pumpkin seeds
• Sesame seeds
• Sunflower seeds
• Walnuts

Seafood

Finfish such as:

• Catfish
• Cod
• Flounder
• Haddock
• Halibut
• Herring
• Mackerel
• Pollock
• Porgy
• Salmon
• Sea bass
• Snapper
• Swordfish
• Trout
• Tuna

Shellfish such as:

• Clams
• Crab
• Crayfish
• Lobster
• Mussels
• Octopus
• Oysters
• Scallops
• Squid (calamari)
• Shrimp

Canned fish such as:

• Anchovies
• Clams
• Tuna
• Sardines

Eggs

• Chicken eggs
• Duck eggs

FOOD GROUP	MAJOR VITAMINS PROVIDED WITHIN THIS FOOD GROUP	MAJOR MINERALS PROVIDED WITHIN THIS FOOD GROUP
Grains	Thiamine Riboflavin Niacin Folate Pyridoxine Vitamin E	Magnesium Potassium Selenium Zinc Iodine Iron Chromium
Vegetables	Beta-carotene Vitamin C Vitamin K Folate	Magnesium Potassium Calcium Iron
Fruits	Beta-carotene Vitamin C	Potassium
Dairy	Vitamin A Vitamin D Pyridoxine Cobalamin Riboflavin	Phosphorus Potassium Calcium Iodine
Protein	Pyridoxine Cobalamin Niacin Riboflavin	Phosphorus Selenium Copper Zinc Iron Potassium
Oils not a food group to be used with discretion are a major source of polyunsaturated fatty acids, including the essential fatty acids	Vitamin E	No minerals

Choose a diet with plenty of whole grain products, vegetables, and fruits. Plant foods provide fiber, complex carbohydrates, vitamins, minerals, and other sub- stances important for good health.They are also generally low in fat.

Balance the foods you eat with physical activity to maintain or improve your weight. Excess weight increases the risk of numerous chronic diseases, such as hypertension, heart disease, and diabetes.

TABLE 30-3. Summary of Nutrients: Carbohydrates, Fats, and Proteins
NUTRIENT	RECOMMENDED % OF TOTAL CALORIES	SOURCES	FUNCTIONS
Carbohydrate	45%–65%	Bread and cereals Pasta and rice Potato, lima beans, corn Dried beans and peas Fruits, vegetables, milk Sugar, syrup, jelly, jam, honey	Major source of energy (glucose) Provides fiber Spares protein Excess is stored as fat
Fat	20%–35%	Butter and cream Salad oils and dressings Cooking and table fats Fat in meats Olives, avocados Fried foods	Supplies large amount of energy in a small amount of food Excess fat stored as adipose tissue Conserves body heat Helps keep skin healthy by supplying essential fatty acids Carries vitamins A, D, E, and K Important in structure of nerve tissue; protects and insulates body parts
Protein	10%–35%	Meat, fish, poultry, eggs Milk and cheese Dried beans and peas Peanut butter and nuts Fortified bread and cereals	Builds and repairs all tissues Helps build blood and forms antibodies to fight infections Supplies energy; excess stored as fat Assists in acid–base and fluid balance

• Sugars and syrups are added to foods during process- ing or
• Limiting simple sugar intake (monosaccharides or di- saccharides) can reduce overall calories, decrease or maintain weight, and decrease dental
• Read the Nutrition Facts Label on food products for sugar
• Naturally occurring sugars, such as those that occur in milk and fruits, are not listed on the Nutrition Facts Label.
• Note that added sugars in processed foods may be listed as various names:
  1. Beet sugar
  2. Brown sugar
  3. Cane sugar
  4. Confectioner’s sugar
  5. Corn sweetener
  6. Corn syrup
  7. Dextrose
  8. Fructose
  9. Fruit juice concentrates
  10. Glucose
  11. High-fructose corn syrup
  12. Honey
  13. Invert sugar
  14. Lactose
  15. Levulose
  16. Maltose
  17. Malt syrup
  18. Maple syrup
  19. Molasses
  20. Powdered sugar
  21. Raw sugar
  22. Sucrose
  23. Sugar
  24. Sugar cane syrup
  25. Syrup
  26. Table sugar
  27. Turbinado sugar

• Monounsaturated fatty acids (MUFAs)—Have one double bond. Plant sources that are rich in MUFAs include vegetable oils that are liquid at room temper- ature (e.g., canola oil, olive oil, high oleic safflower and sunflower oils), avocados, and
• Polyunsaturated fatty acids (PUFAs)—Have two or more double bonds and may be of two types, based on the position of the first double
  • Omega-6 PUFAs—Linoleic acid, one of the omega- 6 fatty acids, is required but cannot be synthesized by humans and thus is considered essential in the diet. Primary sources are liquid vegetable oils including soybean oil, corn oil, and safflower
  • Omega-3 PUFAs—Linolenic acid is an omega-3 fatty acid that is required because it is not synthe- sized by humans and thus is considered essential in the It is obtained from plant sources including soybean oil, canola oil, walnuts, and flaxseed. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are long chain omega-3 fatty acids that are contained in all fish and shellfish.
• Saturated fatty acids—Have no double bonds. They primarily come from animal products, such as meat and dairy In general, animal fats are solid at room temperature.
• Trans fatty acids or trans fats—Unsaturated fatty acids that contain at least one non-conjugated double bond in the trans Sources of trans fatty acids include hydrogenated/partially hydrogenated vegetable oils that are used to make shortening and commercially prepared baked goods, snack foods, fried foods, and margarine.Trans-fatty acids also are present in foods that come from ruminant animals (e.g., cattle and sheep). Such foods include dairy products, beef, and lamb.
• Solid fats—Fats that are solid at room temperature, such as butter, lard, and These fats may be visible or may be a constituent of foods such as milk, cheese, meats, or baked products. Solid fats come from many animal foods and can be made from vegetable oils through hydrogenation. Solid fats are generally higher than oils in saturated and/or trans fatty acids.
• Oils—Fats that are liquid at room temperature, such as the vegetable oils used in Oils come from many different plants and from fish. Some common oils are corn, soybean, canola, cottonseed, olive, safflower, sunflower, walnut, and sesame. Some foods are naturally high in oils, such as nuts, olives, some fish, and avocados. Most oils are high in monounsaturated or polyunsaturated fats and low in saturated fats. A few plant oils, including coconut oil and palm kernel oil, are high in saturated fats and, for nutritional purposes, should be considered to be the same as solid fats.

TABLE 30-4. Summary of Major Electrolytes
ELECTROLYTE AND SOURCES	FUNCTIONS	DEFICIENCY/TOXICITY SIGNS AND SYMPTOMS
Sodium (Na)Adult • 1 tsp salt = 2,400 mg Na • 75% of Na intake is from processed foods, • Canned soups, meats, or vegetables • Convenience foods • Restaurant foods • Pizza • Processed meats	• Fluid and electrolyte balance• Acid–base balance • Maintains muscle irritability • Regulates cell membrane permeability and nerve impulse transmission	Deficiency Can occur with Chronic diarrhea Excessive vomiting Renal disorders Nausea Dizziness Muscle cramps Apathy Toxicity Hypertension Edema
Potassium (K) Fruits and vegetables Dried peas and beans Whole grains Milk Meats	Fluid and electrolyte balance Acid–base balance Nerve impulse transmission Catalyst for many metabolic reactions Involved in skeletal and cardiac muscle activity	Deficiency Muscular weakness Paralysis Anorexia Confusion (occurs with dehydration) Toxicity (from supplements/drugs): Muscular weakness Vomiting
Chloride (Cl) 1 tsp salt = 3,600 mg Cl Same sources as sodium	Fluid and electrolyte balance Acid–base balance Component of hydrochloric acid in stomach	Deficiency (Rare) May occur secondary to chronic diarrhea or vomiting and certain renal disorders Muscle cramps Anorexia Apathy Toxicity Normally harmless Can cause vomiting

TABLE 30-5. Summary of Major Minerals
MINERAL AND SOURCES	FUNCTIONS	DEFICIENCY/TOXICITY SIGNS AND SYMPTOMS
Calcium (Ca) Milk and milk products Fortified orange juice Green leafy vegetables Dried peas and beans	Bone and teeth formation and maintenance Blood clotting Nerve transmission Muscle contraction and relaxation Cell membrane permeability Blood pressure	Deficiency Children: impaired growth Adults: osteoporosis Toxicity Constipation Increased risk of renal stone formation Impaired absorption of iron and other minerals
Phosphorus (P) All animal products (meat, poultry, eggs, milk) Bread Ready-to-eat cereal	Bone and teeth formation and maintenance Acid–base balance Energy metabolism Cell membrane structure Regulation of hormone and coenzyme activity	Deficiency Unknown Toxicity Low blood calcium
Magnesium (Mg) Green leafy vegetables Nuts Dried peas and beans Whole grains Seafood Chocolate, cocoa	Bone formation Nerve transmission Smooth muscle relaxation Protein synthesis CHO metabolism  Enzyme activity	Deficiency Weakness Confusion Growth failure in children Severe deficiency: convulsions, hallucinations, tetany Toxicity No toxicity demonstrated from food Supplemental Mg can cause diarrhea, nausea, and cramping Excessive Mg in Epsom salts causes diarrhea
Sulfur (S) All protein foods	Component of disulfide bridges in proteins Component of biotin, thiamin, and insulin	Deficiency Unknown Toxicity In animals, excessive intake of sulfur-containing amino acids impairs growth

• Individuals with hypertension, African Americans, and middle-aged and older adults are often more sensitive to table salt (NaCl) than others.
• Increasing the dietary intake of potassium can lower blood pressure and blunt the effects of salt on blood pressure in some individuals.
• Salt substitutes containing potassium chloride (KCl) may be useful for some individuals who want to limit sodium intake, but the increase in potassium can be harmful. A healthcare professional needs to be consulted before using salt substitutes.

Source: United States Department of Agriculture, 2010.

TABLE 30-6. Summary of Trace Minerals
MINERAL AND SOURCES	FUNCTIONS	DEFICIENCY/TOXICITY SIGNS AND SYMPTOMS
Iron (Fe) Beef liver Red meats Fish Poultry Clams Tofu Dried peas and beans Fortified cereals Bread Dried fruit	Oxygen transport via hemoglobin and myoglobin Constituent of enzyme systems	Deficiency Impaired immune function Decreased work capacity Apathy Lethargy Fatigue Itchy skin Pale nailbeds and eye membranes Impaired wound healing Intolerance to cold temperatures Toxicity Increased risk of infections Apathy Fatigue Lethargy Joint disease Hair loss Organ damage Enlarged liver Amenorrhea Impotence Accidental poisoning in children causes death
Zinc (Zn) • Oysters • Red meat • Poultry • Dried peas and beans • Certain seafood • Nuts • Whole grains • Fortified breakfast cereals • Dairy products	• Tissue growth •Wound healing • Sexual maturation and reproduction • Constituent of many enzymes in energy and nucleic acid metabolism • Immune function • Vitamin A transport • Taste perception	Deficiency • Growth retardation • Hair loss • Diarrhea • Delayed sexual maturation • Impotence • Eye and skin lesions • Anorexia • Delayed wound healing • Taste abnormality • Mental lethargy Toxicity • Anemia • Elevated low-density lipoprotein (LDL) • Lowered high-density lipoprotein (HDL) • Diarrhea • Vomiting • Dizziness • Fever • Impaired calcium absorption • Renal failure • Muscle pain • Reproductive failure
Iodine (I) • Iodized salt • Seafood • Bread • Dairy products	Component of: • Thyroid hormones that regulate growth, development, and metabolic rate	Deficiency • Goiter •Weight gain • Lethargy • During pregnancy may cause severe and irreversible mental and physical retardation (cretinism) in fetus Toxicity • Enlarged thyroid gland • Decreased thyroid activity
Selenium (Se) • Seafood • Liver • Kidney • Other meats • Grains grown in selenium-rich soil • Brazil nuts •Walnuts	Component of: • Antioxidant enzymes • Immune system functioning • Thyroid gland activity	Deficiency • Enlarged heart • Poor heart function • Impaired thyroid activity Toxicity (Rare) • Nausea • Vomiting • Abdominal pain • Diarrhea • Hair and nail changes • Nerve damage • Fatigue
Copper (Cu) • Organ meats • Seafood • Nuts & seeds • Whole grains • Drinking water	• Used in the production of hemoglobin • Component of several enzymes • Used in energy metabolism	Deficiency (Rare) • Anemia • Bone abnormalities Toxicity • Vomiting • Diarrhea • Liver damage
Manganese (Mn) • Widely distributed Best sources: • Whole grains • Tea • Pineapple • Kale • Strawberries	Component of: • Enzymes involved in the metabolism of carbohydrates, protein, and fat • Bone formation	Deficiency (Rare) Toxicity (Rare) • Nervous system disorders
Fluoride (Fl) • Fluoridated water •Water that naturally contains fluoride • Tea • Seafood	• Formation and maintenance of tooth enamel • Promotes resistance to dental decay • Bone formation and integrity	Deficiency • Susceptibility to dental decay • May increase risk of osteoporosis Toxicity • Fluorosis (mottling of teeth) • Nausea • Vomiting • Diarrhea • Chest pain • Itching
Chromium (Cr) • Meat • Whole grains • Nuts • Cheese	• Cofactor for insulin	Deficiency • Insulin resistance • Impaired glucose tolerance Toxicity • Dietary toxicity unknown • Occupational exposure to chromium dust damages skin and kidneys
Molybdenum (Mo) • Milk • Legumes • Bread • Grains	• Component of many enzymes •Works with riboflavin to incorporate iron into hemoglobin	Deficiency • Unknown Toxicity • Occupational exposure to molybdenum dust causes gout-like symptoms

TABLE 30-7. Summary of Fat-Soluble Vitamins
VITAMIN AND SOURCES	FUNCTIONS	DEFICIENCY/TOXICITY SIGNS AND SYMPTOMS
Vitamin A RETINOL • Liver • Dairy products • Egg yolk • Rready-to-eat cereals BETA-CAROTENE • Green leafy vegetables • Broccoli • Carrots • Peaches • Pumpkin • Red peppers • Sweet potatoes • Winter squash • Mango •Watermelon • Apricots • Cantaloupe	• Enables the eye to adapt to dim light • Normal growth and development of bones and teeth • Formation and maintenance of mucosal epithelium to maintain healthy functioning of skin and membranes, hair, gums, and various glands • Important role in immune function	Deficiency • Night blindness • Slow recovery of vision after flashes of bright light at night • Bone growth ceases • Bone shape changes • Enamel-forming cells in the teeth malfunction • Teeth crack and tend to decay • Skin becomes dry, scaly, rough, and cracked • Keratinization or hyperkeratosis develops • Mucous membrane cells flatten and harden • Xerosis (eyes become dry) • Irreversible drying and hardening of the cornea can result in blindness • Decreased saliva secretion S difficulty chewing, swallowing S anorexia • Decreased mucous secretion of the stomach and intestines S impaired digestion and absorption S diarrhea, increased excretion of nutrients • Susceptibility to respiratory, urinary tract, and vaginal infections increases. Toxicity • Headaches • Vomiting • Double vision • Hair loss • Bone abnormalities • Liver damage • Can cause birth defects during pregnancy
Vitamin D • Sunlight on the skin • Liver • Some fish • Egg yolks • Fortified milk • Some ready-to-eat cereals • Margarine	• Maintains serum calcium concentrations by: • Stimulating gastrointestinal (GI) absorption • Stimulating the release of calcium from the bones • Stimulating calcium reabsorption from the kidneys	Deficiency • Rickets (in infants and children) • Retarded bone growth • Bone malformations (bowed legs) • Enlargement of ends of long bones (knock-knees) • Deformities of the ribs (bowed, with beads or knobs) • Delayed closing of the fontanel S rapid enlargement of the head • Decreased serum calcium and/or phosphorus • Malformed teeth; decayed teeth • Protrusion of the abdomen related to relaxation of the abdominal muscles • Increased secretion of parathyroid hormone • Osteomalacia (in adults) • Softening of the bones S deformities, pain, and easy fracture • Decreased serum calcium and/or phosphorus, increased alkaline phosphatase • Involuntary muscle twitching and spasms Toxicity • Kidney stones • Irreversible kidney damage • Muscle and bone weakness • Excessive bleeding • Loss of appetite • Headache • Excessive thirst • Calcification of soft tissues (blood vessels, kidneys, heart, lungs) • Death
Vitamin E • Vegetable oils • Margarine • Salad dressing • Foods made with vegetable oil • Nuts & seeds • Wheat germ • Dark green vegetables • Whole grains • Enriched cereals	• Acts as an antioxidant to protect vitamin A and polyunsaturated fatty acid (PUFA) from being destroyed • Protects cell membranes	Deficiency • Increased red blood cell (RBC) hemolysis • In infants: anemia, edema, and skin lesions Toxicity • Relatively nontoxic • High doses enhance action of anticoagulant medications
Vitamin K • Bacterial synthesis • Green leafy vegetables • Liver • Eggs • Cabbage-related vegetables	Synthesis of blood clotting proteins • Synthesis of a bone protein that regulates blood calcium	Deficiency • Hemorrhaging Toxicity • No symptoms have been observed from excessive vitamin K

TABLE 30-8. Summary of Water-Soluble Vitamins
VITAMIN AND SOURCES	FUNCTIONS	DEFICIENCY/TOXICITY SIGNS AND SYMPTOMS
Thiamin (Vitamin B1) • Whole grain • Enriched breads and cereals • Liver • Nuts • Wheat germ • Pork • Dried peas and beans	• Coenzyme in energy metabolism • Promotes normal appetite • Promotes nervous system functioning	Deficiency • Beriberi • Mental confusion • Decrease in short-term memory • Fatigue • Apathy • Peripheral paralysis • Muscle weakness and wasting • Painful calf muscles • Anorexia, weight loss • Edema • Enlarged heart • Sudden death from heart failure Toxicity • No toxicity symptoms reported
Riboflavin (Vitamin B2) • Milk and other dairy products • Whole grain • Enriched breads and cereals • Eggs • Meat • Green leafy vegetables	• Coenzyme in energy metabolism • Aids in the conversion of tryptophan into niacin	Deficiency • Dermatitis • Cheilosis • Glossitis • Photophobia • Reddening of the cornea Toxicity • No toxicity symptoms reported
Niacin (Vitamin B3) • All protein foods • Whole grain • Enriched breads and cereals	• Coenzyme in energy metabolism • Promotes normal nervous system functioning	Deficiency • Pellagra (4 Ds) • Dermatitis and glossitis • Diarrhea • Dementia, irritability, mental confusion S psychosis • Death, if untreated Toxicity (from supplements/drugs) • Flushing • Liver damage • Gastric ulcers • Low blood pressure • Diarrhea • Nausea • Vomiting
Vitamin B6 • Meats • Fish • Poultry • Fruits • Green leafy vegetables • Whole grains • Nuts • Dried peas and beans	• Coenzyme in amino acid and fatty acid metabolism • Helps convert tryptophan to niacin • Helps produce • Insulin • Hemoglobin • Myelin sheaths • Antibodies	Deficiency • Dermatitis • Cheilosis • Glossitis • Abnormal brain wave pattern • Convulsions • Anemia Toxicity • Depression • Fatigue • Irritability • Headaches • Sensory neuropathy characteristic
Folate • Leafy vegetables • Dried peas and beans • Seeds • Liver • Orange juice • Some fruits • Breads • Cereals and other grains fortified with folic acid	• Coenzyme in DNA synthesis, therefore vital for new cell synthesis and the transmission of inherited characteristics	Deficiency • Glossitis • Diarrhea • Macrocytic anemia • Depression • Mental confusion • Fainting • Fatigue Toxicity • Too much can mask B12 deficiency
Vitamin B12 • Meat • Fish • Poultry • Shellfish • Milk & dairy products • Eggs • Some enriched foods	• Coenzyme in the synthesis of new cells • Activates folate • Maintains nerve cells • Helps metabolize some fatty acids and amino acids	Deficiency • GI changes • Glossitis • Anorexia • Indigestion • Recurring diarrhea or constipation • Weight loss • Anemia • Pallor • Dyspnea • Weakness • Fatigue • Palpitations • Neurologic changes • Paresthesia of the hands and feet • Decreased sense of position • Poor muscle coordination • Poor memory • Irritability • Depression • Paranoia • Delirium • Hallucinations Toxicity • No toxicity symptoms reported
Pantothenic Acid Widespread in foods • Meat • Poultry • Fish • Whole grain cereals • Dried peas and beans	• Part of coenzyme A used in energy metabolism	Deficiency (Rare) • General failure of all body systems Toxicity • No toxicity symptoms reported, although large doses may cause diarrhea
Biotin Widespread in foods • Eggs • Liver • Milk • Dark green vegetables • Synthesized by GI flora	Coenzyme in: • Energy metabolism • Fatty acid synthesis • Amino acid metabolism • Glycogen formation	Deficiency (Rare) • Anorexia • Fatigue • Depression • Dry skin • Heart abnormalities Toxicity • No toxicity symptoms reported
Vitamin C • Citrus fruits and juices • Red and green peppers • Broccoli • Cauliflower • Brussels sprouts • Cantaloupe • Kiwi fruit • Mustard greens • Strawberries • Tomatoes	• Collagen synthesis • Antioxidant • Promotes iron absorption • Involved in the metabolism of certain amino acids • Thyroxin synthesis • Immune system functioning	Deficiency • Bleeding gums • Pinpoint hemorrhages under the skin • Scurvy, characterized by • Hemorrhaging • Muscle degeneration • Skin changes • Delayed wound healing • Reopening of wounds • Softening of the bones S malformations, pain, easy fractures • Soft, loose teeth • Anemia • Increased susceptibility to infection • Hysteria and depression Toxicity • Diarrhea • Abdominal cramps • Nausea • Headache • Insomnia • Fatigue • Hot flashes • Aggravation of gout symptoms

Dietary Guidelines and Key Recommendations for the General Population

Nutrients and Caloric Needs

• Consume a variety of nutrient-dense foods and bever- ages within and among the basic food groups while choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol.
• Adopt a balanced eating pattern such as that recom- mended by the United States Department of Agriculture (USDA) and the MyPlate.gov guidelines.
• Maintain a body weight in a healthy range.
  1. Balance calories from foods and beverages with the amount of calories expended.
  2. To prevent gradual weight gain over time, make small decreases in food and beverage calories and increase physical activity.
  3. Engage in regular physical activity.
  4. Promote physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance.
• Consume a sufficient amount of fruits and vegetables while staying within calorie/energy needs.
  1. Choose a variety of fruits and vegetables each day.
  2. Include all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and others).
• Consume three or more ounce-equivalents of whole- grain products per day.
  1. The remaining grains should come from enriched or whole-grain products.
  2. At least half of the grains per day should come from whole grains.
• Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.
• Consult and use the Nutrition Facts Label found on food products.

Fats

• Consume less than 10% of calories from saturated fatty acids.
• Keep total fat intake between 20% and 35% of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.
• Minimize daily intake of cholesterol (<300 mg/d) and trans fatty acids.
• Select meat, poultry, dry beans, milk and milk products that are lean, low fat, or fat free.
• Limit intake of fats and oils that are high in saturated or trans fatty acids.

Carbohydrates

• Choose fiber-rich fruits, vegetables, and whole grains often.
• Choose and prepare foods and beverages with little added sugars or caloric sweeteners.
• Reduce the incidence of dental caries by practicing good oral hygiene and reducing the consumption of sugar- and starch-containing foods.

Sodium and Potassium

• Consume less than 2,300 mg (about 1 teaspoon of table salt) of sodium per day.
• Choose and prepare foods with little salt.
  1. About 75% of salt consumption in the American diet is derived from salt added by manufacturers.
  2. Natural salt (sodium) content in food accounts for only about 10% of total intake.
• Consume foods that are rich in potassium, such as fruits and vegetables, including leafy green vegetables, fruit from vines, and root vegetables.

Alcoholic Beverages

• Individuals who drink alcoholic beverages should do so in moderation and sensibly, which is defined as up to one drink per day for women and up to two drinks per day for men.
• Certain individuals should abstain from any alcoholic beverages, including women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions.

Food Safety

• To avoid microbial food-borne illnesses
  1. Clean hands, food contact surfaces, and fruits and veg- etables.
  2. Wash or rinse meat and poultry.
  3. Separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods.
• Cook foods to a safe temperature to kill microorgan- isms.
• Refrigerate perishable food promptly and defrost foods properly.
• Avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, unpasteurized juices, and raw sprouts.

Children and Fat

Fat is an important energy source for children because they have small stomachs and high energy needs. Children, especially those under 2 years of age, need fat in their diets for growth and brain development. Children between the ages of 1 and 2 years should consume whole milk. Children over 2 years should drink low-fat milk. Failure to thrive has been seen in children whose families are overly concerned about avoiding obesity in children and therefore severely restrict fat in the child’s diet.

BOlder adults should choose a diet low in fat, saturated fat, trans fat, and cholesterol. High-fat diets increase the risk of obesity and its health complications, heart disease, and certain types of cancer.

Calcium and Osteoporosis

Estrogen-deficient osteoporosis, a disease characterized by a decrease in total bone mass and deterioration of bone tissue, affects women. Although symptoms may not appear until old age, osteo- porosis begins to develop much earlier in life. Although an adequate calcium intake is important throughout life, many researchers believe that the biggest impact on preventing osteoporosis is made between 4 and 20 years of age, when calcium retention in girls is at its peak.

Consuming an adequate calcium intake before and after puberty helps maximize peak bone mass, which is the greatest amount of bone mass an individual will ever have.Then, after the age of 35 when bone loss exceeds bone gain, the body is better equipped to withstand the loss without adverse side effects. Unfortunately, few women consume the current RDA for calcium. Many women feel they do not want to add the extra calories in milk to their diet.

Without milk or milk products in the diet, calcium needs are unlikely to be met. Encourage women to drink skim milk, to use skim milk yogurt for dessert, and to use calcium-fortified orange juice and calcium supplements, all excellent sources of calcium that the body absorbs well. Other types of osteoporosis affect men.

Calcium supplements should be considered in people above 35 years of age.There are several types of calcium supplements, each with advantages and indications for use.

• Some vitamins are lost by exposure to air or during food storage. Fresh foods retain most vitamins when properly stored. Frozen foods are second, although their vitamin C content may be higher than that of improperly handled fresh food. Canned foods are third. (Canned foods should be processed carefully and not stored too long.)
• Some vitamins are fat soluble and are stored in the body in this form. The diet must include sufficient fat to carry an adequate supply of these vitamins (15–20 g).
• Some vitamins are water soluble. Cook foods in a small amount of water and use the cooking water, if possible, in gravies, sauces, and soups.
• High temperatures destroy vitamins. Do not over- cook food, and serve it at once.
• Avoid discarding the high-nutrient portion of some foods. The highest concentration of some vitamins may be found in the outer leaves of lettuce and veg- etable peels.
• A clinical condition called hypervitaminosis can occur as a result of an excess of a particular vitamin or vitamins. Hypervitaminosis occurs almost exclusively from supplement use, not from dietary intake.

VITAMINS

Encourage people who take vitamin supplements to consider the following:

• Freshness: Vitamin pills can lose their potency over time, especially when stored in a bathroom medicine Look for pills with an expiration date on the label. Do not use after the expired date.
• Price: In most cases, cost has little to do with vitamin quality
• Supplements should provide no more than 100% Daily Value, because more is not necessarily better and in some instances is toxic

Supplements should contain no unnecessary ingredients. The average diet supplies enough biotin, pantothenic acid, phosphorus, iodine, and chloride. Trace minerals, such as nickel, silicon, and zinc may be unnecessary. Sugar in vitamins is safe because the small amount contained within a vitamin pill is not harmful.

Salts and Sugar

Older adults may have a decreased ability to differentiate tastes, especially salts and sugars. Some adults compensate for this loss by increasing their intake of salts and sugar, which can be detrimental to their health.Too much salt can promote hypertension.Too much sugar can lead to weight gain and the effect of obesity.