Box – Nutrition

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
• Increasing the dietary intake of potassium can lower blood pressure and blunt the effects of salt on blood pressure in some
• 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

Source: United States Department of Agriculture, 2010.

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
• Supplements should provide no more than 100% Daily Value, because more is not necessarily better and in some instances is

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.

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