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Week 2

Nutrition GSCI 1045 (George Brown College)

Introduction to Module 2: Population Health

Population Health: Achieving a Healthy Diet
Welcome to Module 2
In this module we'll explore a number of topics that will be particularly relevant to your Diet
Analysis Assignment that will be due in week 9.
Firstly, we'll look at exactly what a healthy diet is.
o You'll learn about the 5 basic principles: adequacy, balance, calorie control,
moderation, and variety.
o Next, we'll have a look at the Dietary Reference Intakes; these nutrient-intake
recommendations, also known by the acronym "DRIs," can act as guides for us to assess
and plan our diets in order to achieve adequate nutrition. Health care professionals and
policy makers use the guides to make nutritional recommendations for everyday people
as well as special groups of people who may need help reaching nutritional goals.
o You'll learn about the Estimated Average Requirement, the Recommended Dietary
Allowance, Adequate Intake, Upper Tolerable Limit, the Estimated Energy
Requirement and the Acceptable Macronutrient Distribution Range.
o Next, you'll take a tour through Canada's Food Guide, the second most requested
government document. It's right after income tax forms! The food guide, produced by
Health Canada, provides guidance to promote healthy eating for optimal health and the
avoidance of nutrition-related diseases. The previous guide, last updated in 2007, was
under fire by different groups. In 2019 the Guide was revised to include a focus on more
vegetables and less meat.
o In this module, you'll get a chance to evaluate some of the opinions on what's good and
not so good about the previous guide, the current version and its recommendations and
you'll get to see a few alternatives to our food guide from around the world.
o Did you ever wonder what a serving size actually is? In a short video created by Eat Right
Ontario, you'll learn to easily determine various serving sizes by using just your hands.
And lastly, you'll learn about a few of the tools to get you started on your own healthy
diet plan.
Things to do this module:
o Read the content and review the video content, and complete the activities included in
the pages of this module.
o Read Chapter 2: Achieving a Healthy Diet in the Essentials of Nutrition: A Functional
Approach textbook.
o Complete the Module 2 Practice Test to check your understanding of key concepts.
o Begin work on your Diet Analysis Assignment due week 9.
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What are the Signs of a Healthy Diet?

A healthy diet provides all the nutrients for optimal health and quality of life.
The signs of a healthy diet include five basic principles:
1. ADEQUACY
A healthy diet is required to provide all the essential nutrients in enough quantity that there
are no deficiencies as well as allowing the body to store nutrients for later use.
2. BALANCE
Nutrients need to be provided in a balanced way so that the correct portions of a variety of
foods can fulfill nutritional requirements. This means that a food rich in one type of nutrient
doesn't replace foods that are rich in other types of nutrients e.g., eating both green and red
vegetables in the same day to get a better nutrient profile.
3. CALORIE CONTROL
The energy needed by the human body is measured in calories. This is central in maintaining
body weight and involves calculating the energy required by an individual to complete their
day to day activities and ensuring that they receive those calories in their diet.
4. MODERATION
All the food portions should be within the set limits avoiding an excess of any one type of
food. Too much of any one type of food can cause nutritional excesses and block the
absorption of other nutrients.
5. VARIETY
There should be a range of different foods to avoid monotony. This boosts the absorption of
nutrients in the body as it may receive the same nutrient from a variety of sources.
An Introduction to Dietary Reference Intakes
DRI or Dietary Reference Intake - is an umbrella term for a list of acronyms that we use as
guides or tools to determine the amount of nutrients or calories that the general healthy
population should on average consume per day in order to obtain optimal health. These
numbers are created by the DRI committee and are based on solid scientific research. Their
main objective is to ensure the general population obtain sufficient nutrients to prevent
disease, to help the general population avoid potentially toxic levels of nutrients and to
minimize the general population’s chance of nutrient deficiencies. Below are the 5 main
acronyms that require your attention.
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Estimated Average Requirement (EAR) - is the median daily value of a given nutrient that is
estimated to meet 1/2 of a healthy individual’s needs for a specific gender or during a
specific life-stage like infancy. At this level of intake, the other half of the individuals in the
specified group would not have their nutritional needs met.
Recommended Dietary Allowance (RDA) – is the average daily dietary intake that is
sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy
individuals in a particular life-stage and gender group. The RDA is the goal for usual intake
by a healthy individual. However, it is controversial as to whether this should be our goal or
our minimum intake. This does not necessarily meet the needs of unhealthy individuals.
Adequate Intake (AI) – is used if sufficient scientific evidence is not available to establish an
EAR on which to base an RDA. Instead, an AI is derived using observed or experimentally
determined approximations or estimates of nutrient intake by a group (or groups) of
apparently healthy people who maintain an adequate nutritional state. It is educated
guesswork. The AI is not equivalent to an RDA. The AI is expected to meet or exceed the
needs of most individuals in a specific life-stage and gender group.
Upper Tolerable Limit (UL) – is the highest average daily nutrient intake level likely to pose
no risk of adverse health effects to almost all individuals in a given life-stage and gender
group. This is not a recommended level of intake and as your intake increases above the UL,
the potential risk of adverse effects also increases.
Estimated Energy Requirement (EER) – is the average dietary energy intake that is
predicted to maintain energy balance in healthy, normal weight individuals of a defined age,
gender, weight, height, and level of physical activity consistent with good health. In children
and pregnant and lactating women, the EER includes the needs associated with growth or
secretion of milk at rates consistent with good health.
Acceptable Macronutrient Distribution Range (AMDR) - is the value of the energy-yielding
nutrients carbohydrates, protein, and fat, expressed as percentages of total daily calorie
intake, sufficient to provide total adequate energy needs; staying within the AMDR is
associated with reducing the risks for developing chronic disease. The percentage ranges are
Protein - 20-35%, Carbohydrates - 45-65%, Fat- 20-35%.
View a slideshare on the DRIs here https://www.slideshare.net/secret/dBNcDUMtdJ3Xyo
And on the next page view the short video that explains more about the DRIs
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Dietary Reference Intakes: EAR, RDA, AI & UL

Dietary Reference Intakes (DRIs)
Review:
The dietary reference intakes or DRIs are a set of recommendations for the proper intake of
nutrients. By meeting them, you ensure that your body is getting the nutrients it needs for
good health and the prevention of disease.
The DRIs include four sets of values:
o The estimated average requirements or EARs are the intake level for nutrients estimated
to meet the needs of half of the healthy individuals in a particular group. These values
help establish the adequacy of a populations’ food supply and are used as the basis for
calculating the next DRI value we discussed which was the recommended dietary
allowances or RDAs.
o RDAs are the intake levels for nutrients that meet the needs of nearly all healthy
individuals in a particular group. When there is not enough data to set the RDA for
nutrient, we use different values namely the adequate intakes or AIs.
o The AIs are the approximations of the needed nutrients intakes when no RDA's exist.
The final set a dietary reference intake values we discussed was the tolerable upper intake
levels or ULs. This is the highest level of nutrients that nearly all healthy individuals in a
particular group can reach without adverse effect.
Before proceeding to the next page take the short quiz below.
Check your knowledge of the DRIs
1. The ________ are a set of recommendations for the proper intake of nutrients. By
meeting them, you ensure that your body is getting the nutrients it needs.
RDAs (Recommended Dietary Allowance)
EARs (Estimated Average Requirements)
DRIs. (Dietary Reference Intake)
2. The ______ are the intake level for nutrients estimated to meet the needs of half of the
healthy individuals in a particular group.
EARs (Estimated Average Requirements)
ULs (Tolerable upper intake levels)
RDAs (Recommended Dietary Allowance)
3. The ______ are the intake levels for nutrients that meet the needs of nearly all healthy
individuals in a particular group.
DRIs (Dietary Reference Intake)
AIs (Adequate Intake)
RDAs (Recommended Dietary Allowance)
4. The ______ are the approximations of the needed nutrients intakes when no RDA's
exist.
AIs (Adequate Intake)
ULs (Tolerable upper intake levels)
RDAs (Recommended Dietary Allowance)
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5. . This is the highest level of nutrients that nearly all healthy individuals in a particular
group can reach without adverse effect.
ULs (Tolerable upper intake levels)
AIs (Adequate Intake)
RDAs (Recommended Dietary Allowance)

For more information on Canadian DRIs see DRI Questions & Answers from Health Canada

Answers:
The DRI Values: Definitions
1. What are Dietary Reference Intakes?
The Dietary Reference Intakes (DRIs) are a set of scientifically based nutrient reference
values for healthy populations. The DRIs for various groups of nutrients have been
developed over a span of time, with reports on all of the nutrients published between 1997
and 2004. Recently, Dietary Reference Intakes for Calcium and Vitamin D have been re-
examined, with an updated report on those two nutrients released by the IOM on
November 30, 2010.
DRIs are used by nutrition practitioners, governments, and non-governmental organizations
to assess and plan the nutrient intakes of individuals and population groups.
"Dietary Reference Intakes" (DRIs) is an umbrella term that describes four types of
reference values:
o Estimated Average Requirement (EAR)
o Recommended Dietary Allowance (RDA)
o Adequate Intake (AI)
o Tolerable Upper Intake Level (UL)
The DRIs replace the 1990 Recommended Nutrient Intakes (RNIs) in Canada and the 1989
Recommended Dietary Allowances in the United States. The DRIs are established through a
process overseen by the National Academy of Sciences, which is a private, non-profit society
of distinguished scholars with a mandate to advise the US government on scientific and
technical matters. Both American and Canadian scientists have participated in the
development of the DRIs.
DRIs are established using an expanded concept that includes indicators of good health and
the prevention of chronic disease, as well as possible adverse effects of excess intakes of
nutrients. Each type of DRI refers to the average daily nutrient intake of healthy individuals
over time.
Key differences in the DRI approach compared to the former RNIs include:
o working together with American scientists and harmonizing nutrient recommendations
for Canada and the United States
o making use of the concepts of probability and risk to underpin the determination of DRIs
and their application in assessment and planning
o considering the risks of excessive nutrient intakes and establishing upper levels of intake
where data exist regarding risk of adverse health effects
o establishing multiple reference values for each nutrient, allowing for more diverse
applications in assessing and planning diets
o reviewing components of food that may not meet the traditional concept of a nutrient
but are of possible benefit to health
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o making recommendations for future research directions based on the knowledge gaps
identified
2. What is an Estimated Average Requirement (EAR)?
An Estimated Average Requirement (EAR) is the median usual intake value that is estimated
to meet the requirement of half the healthy individuals in a life-stage and gender group. At
this level of intake, the other half of the individuals in the specified group would not have
their needs met. The EAR is based on a specific criterion of adequacy, derived from a careful
review of the literature. Reduction of disease risk is considered along with many other
health parameters in the selection of that criterion. The EAR is used to calculate the RDA.
In the case of energy, an Estimated Energy Requirement (EER) is established rather than an
EAR. An EER is defined as the average dietary energy intake that is predicted to maintain
energy balance in healthy, normal weight individuals of a defined age, gender, weight,
height, and level of physical activity consistent with good health. In children and pregnant
and lactating women, the EER includes the needs associated with growth or secretion of
milk at rates consistent with good health.
3. What is a Recommended Dietary Allowance (RDA)?
A Recommended Dietary Allowance (RDA) is the average daily dietary intake level that is
sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy
individuals in a particular life-stage and gender group.
o If the distribution of requirements in the group is assumed to be normal, then the RDA
can be calculated from the EAR and the standard deviation of requirements (SDREQ) as
follows: RDA = EAR + 2 SDREQ
o If the distribution of requirements is known to be skewed, other methods are used to
identify the 97th to 98th percentile of the requirement distribution and to set the RDA
at this level.
The RDA is used as a goal for the usual intake of individuals. Because the RDA is calculated
based on the EAR, an RDA can only be set for a particular nutrient if there is sufficient
scientific evidence to establish an EAR for that nutrient.
4. What is an Adequate Intake (AI)?
If sufficient scientific evidence is not available to establish an EAR and set an RDA, an AI is
derived for the nutrient instead. An AI is based on much less data and incorporates
substantially more judgment than is used in establishing an EAR and subsequently the RDA.
The issuance of an AI indicates that more research is needed to determine, with some
degree of confidence, the mean and distribution of requirements for that specific nutrient.
The AI is a recommended average daily nutrient intake level based on observed or
experimentally determined approximations or estimates of nutrient intake by a group (or
groups) of apparently healthy people who are assumed to be maintaining an adequate
nutritional state. Examples of adequate nutritional states include normal growth,
maintenance of normal levels of nutrients in plasma, and other aspects of nutritional well-
being or general health. For example:
o For young infants, the AI is usually based on the daily mean nutrient intake supplied by
human milk for healthy, full-term infants who are exclusively fed human milk.
o For adults, the AI may be based on data from one type of experiment (e.g., the AI for
choline), based on estimated dietary intakes in apparently healthy population groups
(e.g., the AIs for biotin and pantothenic acid), or result from a review of data from
different approaches (e.g., the AI for calcium, based on calcium retention, factorial
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estimates of requirements, and limited data on bone mineral density and bone mineral
content changes in adult women).
The AI is expected to meet or exceed the needs of most individuals in a specific life-stage
and gender group. When an RDA is not available for a nutrient (because there is no EAR),
the AI can be used as the goal for an individual's intake. However, the AI has very limited
uses in assessments of any type.
5. What is a Tolerable Upper Intake Level (UL)?
A Tolerable Upper Intake Level (UL) is the highest level of continuing daily nutrient intake
that is likely to pose no risk of adverse health effects in almost all individuals in the life-stage
group for which it has been designed.
o As intake increases above the UL, the potential risk of adverse effects increases.
o The term "tolerable" intake was chosen to avoid implying a possible beneficial effect.
Instead, the term is intended to specify a level of intake with a high probability of being
tolerated biologically. The UL is not intended to be a recommended level of intake.
o Unless specifically identified in the nutrient reports (e.g., for folate in the prevention of
neural tube defects), there is no currently established benefit to healthy individuals of
ingesting nutrients in amounts exceeding the RDA or AI.
o At intakes between the RDA and UL, the risks to the individual of inadequacy and of
excess are both close to zero.
The need to establish ULs grew out of the increasingly common practice of fortification of
foods with nutrients and the increased use of dietary supplements. The adverse health
effects used to determine a UL vary from nutrient to nutrient. ULs are based on evaluations
conducted using the Dietary Reference Intakes: A Risk Assessment Model for Establishing
Upper Intake Levels for Nutrients adopted in 1998 for the DRI process by the Institute of
Medicine. The risk assessment model was designed specifically to address the potential for
adverse effects from overconsumption of nutrients.
6. Are ULs set for all nutrients?
No. For some nutrients, the data are not sufficient at this time to establish a UL. This
indicates the need for caution in consuming high intakes of those nutrients. It should not be
interpreted as meaning that high intakes pose no risk of adverse effects. For example,
arsenic is known to be toxic in high doses, but it has no UL because not enough data exist on
chronic intake of lower doses to set a UL. When a UL cannot be determined, it is important
to be careful about consuming levels above the RDA or AI.
7. What is an Acceptable Macronutrient Distribution Range (AMDR)?
An Acceptable Macronutrient Distribution Range (AMDR) is defined as a range of intakes for
a particular energy source that is associated with reduced risk of chronic disease while
providing adequate intakes of essential nutrients. An AMDR is expressed as a percentage of
total energy intake. If an individual consumes below or above this range, there is a potential
for increasing the risk of chronic diseases shown to affect long-term health, as well as
increasing the risk of insufficient intakes of essential nutrients. AMDRs have been
established for protein, carbohydrate, fat, and linoleic (n-6) and alpha-linolenic (n-3)
polyunsaturated fatty acids.
The DRI Review Framework
1. Who is responsible for developing the Dietary Reference Intakes?
The Dietary Reference Intakes are established by expert panels of Canadian and American
scientists, through a review process overseen by the US Food and Nutrition Board of the
Institute of Medicine, National Academy of Sciences (NAS). The NAS is a private, non-profit
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society of distinguished scholars with a mandate to advise the US government on scientific

and technical matters.
2. What are the National Academy of Sciences, the Institute of Medicine and the Food and
Nutrition Board?
The National Academy of Sciences (NAS) is an American, private, non-profit society of
distinguished scholars engaged in scientific and engineering research, dedicated to the
advancement of science and technology and to their use for the general welfare of the
public. The Academy's mandate requires it to advise the US federal government on scientific
and technical matters.
For more information, visit National Academy of Sciences.
The Institute of Medicine was established by the National Academy of Sciences to secure
the services of appropriate experts in the examination of policy matters pertaining to the
health of the public. The Institute acts under the mandate of the NAS as an adviser to the US
federal government and, upon its own initiative, to identify issues of medical care, research,
and education.
For more information, visit Institute of Medicine.
The Food and Nutrition Board (FNB) is a unit of the Institute of Medicine, which is part of
the NAS in the US. The FNB is a multidisciplinary group of scientists with expertise in
nutrition, food sciences, biochemistry, medicine, public health, epidemiology, food
toxicology and food safety. Its major focus is to evaluate emerging knowledge of nutrient
requirements and relationships between diet and reduction of chronic disease risk. It also
relates this knowledge to strategies for promoting health and preventing disease. (Note: The
FNB was responsible for developing the previous RDAs in the United States.)
For more information, visit Food and Nutrition Board.
Health Canada's Role in the DRI Development Process
1. Why did Health Canada decide to collaborate with the US to review nutrient
requirements?
Health Canada has reviewed and made recommendations on nutrient requirements on a
periodic basis since 1938. The last update on nutrient requirements, which were termed
Recommended Nutrient Intakes (RNIs), was published in 1990 as part of Nutrition
Recommendations: The Report of the Scientific Review Committee. There were rapid
advances in nutritional science and by 1994, it was clear that it was time to initiate another
review of the scientific data.
At the same time, the Food and Nutrition Board of the National Academy of Sciences was
beginning a consultation process on the review of the 1989 Recommended Dietary
Allowances. Health Canada considered that participating in a joint review with the US would
offer several advantages to Canada.

These were as follows:

o The science underlying nutrient requirements knows no borders. Scientists everywhere
are utilizing the same knowledge produced from studies conducted all over the world.
o The knowledge base on nutrients and foods and their impact on health is increasing
rapidly in scope and complexity. This increases the need for specialized expertise.
Participating in the US review permits Canada to expand the base of scientific expertise
that can be utilized.
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o International trade considerations, including NAFTA, suggest that the harmonization of

the science base underlying nutrition policy will facilitate harmonization of such trade-
related matters as nutrition labelling and food composition.
2. Did Health Canada consult with stakeholders before embarking on this process?
Health Canada and the National Institute of Nutrition co-sponsored a forum in April 1995 to
consider the issue of harmonization of nutrition recommendations. Representatives of the
dietetic and medical professions, academic research community, food industry, and other
levels of government attended. From this dialogue between users of the Nutrition
Recommendations emerged a general agreement that it would be desirable to achieve a
unified set of reference intake values between Canada and the US.
3. Are Health Canada scientists members of the review committees?
No. The National Academy of Sciences operates at arm's length from government and
neither Canadian nor US government scientists can take part in the review.
4. What has Health Canada funded?
Health Canada has provided funds to support the work of various expert panels and
subcommittees over the length of the DRI process. Financial contributions from the Public
Health Agency of Canada have also been made in the last several years.
Reports on the Dietary Reference Intakes
1. What reports on the Dietary Reference Intakes have been issued?
The DRI reports contain substantial information reflecting the current state of knowledge on
nutrients, the indicators used to establish nutrient requirements, the influence of nutrition
on health and disease, as well as identifying knowledge gaps and potential areas for future
research. The reports are valuable resources for practitioners, researchers and students.
For a list of reports that have been published, including links to the available online versions,
see the Dietary Reference Intake Report List.
2. How can the reports on the Dietary Reference Intakes be accessed?
Electronic versions of and ordering information for the DRI publications are available
through the website of the National Academy Press.
Use of the Dietary Reference Intakes by Health Canada
1. How does Health Canada use the Dietary Reference Intakes?
Health Canada uses the DRIs in a variety of policies and programs that benefit the health
and safety of Canadians. The DRIs are an important part of the totality of evidence
examined when considering policy options. As such the DRIs influence the development of
regulatory standards, assessment of dietary intakes, and the development of dietary
guidance for the general population and for specific life stages.
2. What is the Canadian Inter-Departmental/Inter-Agency DRI Steering Committee?
Health Canada chairs the Canadian Inter-Departmental/Inter-Agency DRI Steering
Committee on Dietary Reference Intakes (Canadian DRI Steering Committee).
This group is made up of representatives from various Federal departments and agencies,
including Health Canada, the Public Health Agency of Canada, the Canadian Institutes of
Health Research, Agriculture and Agri-Food Canada, the Canadian Food Inspection Agency,
the Department of National Defense, and Correctional Services Canada.
Meetings are held several times a year, where information is exchanged on the role and
application of the DRIs in policies and programs in each department and agency. This group
also works to determine the extent and type of participation of the Government of Canada
in DRI review activities. Linkages with the U.S. Federal DRI Steering Committee allow
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coordination of Canadian and U.S. support and funding of DRI-related work as well as
discussions on future work needed.
3. How does Health Canada obtain expert advice on implementation of the DRIs into
Canadian policies, regulations, and guidance?
Health Canada will be making use of an Expert Advisory Committee on Dietary Reference
Intakes to advise on potential intervention options, which could include changes to dietary
guidance, policies related to the food supply, or targeted education.
The Expert Advisory Committee advising on the implementation of the 2010 Dietary
Reference Intakes for Calcium and Vitamin D is independent of government and is managed
by the Canadian Academy of Health Sciences.

Equations to estimate energy requirement throughout the lifecycle

Determining Estimated Energy Requirements (EER)
On this page you'll learn about the math behind determining EER. You'll need this for your
Diet Analysis Assignment.
Tips for Calculation Success:
• Don't ignore the large brackets
• Use BEDMAS (Brackets, Exponents, Division and/or Multiplication, Addition and/or
Subtraction) to help navigate through the problem.
• Remember to complete the math within brackets first
Conversion Factors:
1 kg = 2.2lb
3.28084 feet = 1 m

Basic Formula
Total Energy Energy Estimated Energy Requirement
+
Expenditure Deposition = (kcal/day)

Infants and Young Children

Estimated Energy Requirement (kcal/day) = Total Energy Expenditure + Energy Deposition

0-3 months EER = (89 x weight [kg] -100) + 175
4-6 months EER = (89 x weight [kg] -100) + 56
7-12 months EER = (89 x weight [kg] -100) + 22
13-35 months EER = (89 x weight [kg] -100) + 20

Children and Adolescents (3-18 years)

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Estimated Energy Requirement (kcal/day) = Total Energy Expenditure + Energy Deposition

Boys
3-8 years
EER = 88.5 - (61.9 x age [y])+ PA x { (26.7 x weight [kg]) + (903 x height [m]) } + 20
9-18 years
EER = 88.5 - (61.9 x age [y]) + PA x { (26.7 x weight [kg]) + (903 x height [m]) } + 25
Girls
3-8 years
EER = 135.3 - (30.8 x age [y]) + PA x { (10.0 x weight [kg])+ (934 x height [m]) } + 20
9-18 years
EER = 135.3 - (30.8 x age [y]) + PA x { (10.0 x weight [kg]) + (934 x height [m]) } + 25

Adults 19 years and older

Estimated Energy Requirement (kcal/day) = Total Energy Expenditure + Energy Deposition
Men
EER = 662 - (9.53 x age [y]) + PA x {(15.91 x weight [kg]) + (539.6 x height [m])}
Women
EER = 354 - (6.91 x age [y]) + PA x {(9.36 x weight [kg]) + (726 x height [m])}

Pregnancy
Estimated Energy Requirement (kcal/day) = Non-Pregnant EER + Pregnancy Energy Deposition
1st trimester
EER = Non-pregnant EER + 0
2nd trimester
EER = Non-pregnant EER + 340
3rd trimester
EER = Non-pregnant EER + 452
Lactation
Estimated Energy Requirement (kcal/day) = Non-pregnant EER + Milk Energy Output - Weight Loss
0-6 months postpartum
EER = Non-pregnant EER + 500 - 170
7-12 months postpartum
EER = Non-pregnant EER + 400 – 0

Estimated Energy Requirement chart (Health Canada website): http://www.hc-sc.gc.ca/fn-

an/food-guide-aliment/basics-base/1_1_1-eng.php

Resource: Health Canada, 2015. Dietary Reference Intake Tables. Retrieved

from: http://www.hc-sc.gc.ca/fn-an/nutrition/reference/table/index-eng.php
 Page 12 of 20

Eating Well with Canada's Food Guide

Canada’s Food Guide was developed with the purpose of helping Canadians make healthy
food choices that promote their nutritional health and prevent chronic diseases such as
diabetes and heart disease.
In 2007, the Guide split food into groups “Vegetables and Fruit”, “Grain Products”, “Milk
and Alternatives” and “Meat and Alternatives”. The recommended servings were broken
down by age and gender. Each food group was classified as high in certain nutrients, but no
food group alone would provide all of the nutrients required in a day. Avoiding an entire food
group would result in deficiencies of key nutrients. The recommendation was to choose a
variety of foods from each food group, every day.
Canada's 2007 Food Guide Focused on the following:
o Nutritionally adequate diet consisting of a wide variety of foods
o Eating less “bad” fats
o Proper energy balance
o Eating mostly fruits, vegetables, and whole grains
o Specifically, 1 green and 1 orange veg/day
o Reducing sodium intake
o Increasing physical activity to at least 30 min/d
o Minimizing alcohol consumption
Take a guided tour of Canada’s 2007 Food Guide and think about the things you like and
dislike about it. Take a guess what things were soon about to change.
What do you think about serving sizes? Do any of the serving sizes surprise you? Remember,
the serving sizes listed are not necessarily the portions a person would consume at one time!
Canadian 2007 food guide
Transcripts to follow along with slides Canadas-Food-Guide-Slides-Narration.docx Canadas-
Food-Guide-Slides-Narration.docx - Alternative Formats Next Up- Canada's Food Guide
2019

Canada's 2019 Food Guide:

The 2019 Canada Food Guide eliminates the traditional 4 food groups that had been part of
the guide since 1942. Also removed from the guide is advice on how much to eat, portion
size and specific recommendations by age and gender.
The guide puts emphasis on what we eat when we eat and how we eat.
Looking at the plate above, you can see that the guide recommends eating lots of fruit and
vegetables --half your plate - and less grains and meat. In the past meat and alternatives and
milk and alternatives had been emphasized. Looking above you can see the emphasis is
on vegetable and fruits; protein foods and whole grains. The guide recommends these
protein sources: lentils, lean meats, fish, unsweetened milk and fortified soy. Protein is
important but it is based more on plant-based proteins while cutting down on processed
meats and saturated fats.
As far as drinks are concerned, the focus is on water as the beverage of choice. Fruit juices
which were previously recommended are now not recommended due to their high sugar
content. The reduction of sugar, saturated fats and processed foods are key goals.
The guide also focuses on healthy eating habits such as taking time to eat, noticing when
you are hungry or full, planning meals and cooking at home more and eating with others.
Take a tour of Canada's New Food Guide Here https://food-guide.canada.ca/en/ to learn
more of the specifics. Be sure to click each area to learn more.
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A Simple Method to Determine Food Portions Sizes: Video

Size Up Your Food Portions From UnlockFood.ca
(Previously Eat Right Ontario)
The most accurate way to measure food portions involves weight and measurements. In day
to day situations always being able to measure food portions is not an option; a more
convenient alternative is to use our hands. The following video highlights some of the
simple techniques to use hand measurements.
"Are you wondering if you’re eating too much or too little?
Are you looking for an easy way to size up your portions?
Then give yourself a hand! Use your hand to estimate different amounts of food and
manage your portions wherever you are."
(Unlock Food) The video should play if you are using Firefox browser; however, if it does not
play, please see this page at:
Unlock Food https://www.unlockfood.ca/en/Videos/Food-Portions-Toolkit/Video-Size-up-
your-food-portions#.VjOaGqJGO-N
See also Eat Right Ontario's Handy Serving

Controversy - Canada's Food Guide

Canada's Food Guide in the Media

Guide here http://www.eatrightontario.ca/EatRightOntario/media/ERO_PDF/Por

tions%20toolkit/Handy-Servings-Guide-English-for-web-FINAL-October-
2015.pdf http://www.eatrightontario.ca/EatRightOntario/media/ERO_PDF/Portio
ns%20toolkit/Handy-Servings-Guide-English-for-web-FINAL-October-2015.pdf -
Alternative Formats
The first food guide was developed in 1942 and has undergone many revisions since then.
(See the original 1942 Guide to the right and an interactive timeline on CBC's website)
The 2007 Food Guide was based on the scientific evidence available at the time. That food
guide came under fire for being outdated and unrealistic.
 Page 14 of 20

One of the main criticisms was that people did not understand how to apply the serving
recommendations. For example, 125ml 100% fruit juice was considered a serving of
“vegetables and fruit”. This was an issue because Canadians didn’t understand that most
juices in the grocery store are not 100% juice and contain large quantities of added sugar
that would be equivalent to a bottle of soda. This lead people to believe that drinking 4-5
boxes of “fruit punch” would help them achieve their “vegetable and fruit” servings which
was not true.
Our latest revision to the guide does away with portion sizes and speaks out against fruit
juices, but does our new guide do enough for all Canadians?
Read the two articles listed below and think about the claims being made about our food
guide.
Do you agree? Disagree? What, if any, improvements could be made to our guide?
1. Canada's new Food Guide is a good upgrade, but it skirts around issues of equality. (Jan
22, 2019) by Andre Picard ,The Globe & Mail
https://www.theglobeandmail.com/canada/article-canadas-new-food-guide-is-a-good-
upgrade-but-skirts-around-issues-of/
2. Canada's Food Guide - a new dish with a dash of condescension (Jan 22, 2019) by
Sylvain Charlebois, Ottawa Citizen
https://ottawacitizen.com/opinion/columnists/charlebois-canadas-food-guide-a-new-
dish-with-a-dash-of-condescension

In 2014, Brazil released their updated food guide. Many scholars in the nutrition community
applauded Brazil for their more practical approach to nutrition and health promotion.
Brazil’s 10 Steps to a Healthy Diet
1. Make natural or minimally processed foods the basis of your diet.
2. Use oils, fats, salt and sugar in small amounts.
3. Limit consumption or processed foods.
4. Avoid consumption of ultra-processed foods.
5. Eat regularly and carefully in appropriate environments and in company.
6. Shop in places that offer a variety of natural or minimally-processed foods.
7. Develop, exercise and share cooking skills.
8. Plan your time to make food and eating important in your life.
9. Out of home, prefer places that serve freshly made meals.
10. Be wary of food advertising and marketing.

What do you like/dislike about Brazil’s food guide? How close is it to Canada's most recent
guide? How much influence do you think this guide had on The 2019 version of Canada's
Food Guide? What specific parts are the same as Canada's new guide?
For more information on this topic, you can also review some of the articles below:
Brazil Guidelines http://www.foodpolitics.com/wp-content/uploads/Brazilian-Dietary-
Guidelines-2014.pdf3.
Kirkey, Sharon. (May 22,2015) Canada's Food Guide has been around for 73 years- Critics
say it's due for an overhaul. http://news.nationalpost.com/news/canada/0523-naa-food-
guide
 Page 15 of 20

Alternatives to Canada's Food Guide: Mediterranean Diet

The Mediterranean Diet

Have you read the news lately? It seems like everyone is talking about the Mediterranean
diet. Many people claim the Mediterranean diet is the healthiest diet in the world and they
may not be wrong! Studies have shown that following this diet helps protect against heart
disease, obesity and diabetes among many other health benefits.
The Mediterranean diet focuses on whole, minimally processed food that includes fresh
vegetables and fruits, legumes, whole grains, nuts and olive oil as the main fat. The
Mediterranean diet is primarily a plant-based diet but does include poultry, fish and dairy.
Red meat is limited to a few times per month and eggs are also limited. The Mediterranean
diet usually includes a moderate amount of wine (no more than 5oz per day for women and
10oz per day for men), although this is optional and may not be recommended for
everyone.
This pattern of eating is rich in monounsaturated fat, low in the artery clogging saturated
fat, high in fibre and rich in phytochemicals. Together, these effects decrease inflammation
that is associated with many chronic diseases.

The following video by Leslie Beck, RD gives more details on how to follow the
Mediterranean diet:
Beck, L. (February 26, 2013). Leslie Beck shows you how to eat a Mediterranean diet.
Retrieved from http://www.theglobeandmail.com/life/life-video/video-leslie-beck-shows-
you-how-to-eat-a-mediterranean-diet/article8596126/
View or download a larger copy of the Mediterranean Diet Pyramid here and learn more
about the diet plan at Oldways: Mediterranean Diet
 Page 16 of 20

Alternative Guides: The Healthy Eating Plate and the Healthy Eating Pyramid
The healthy eating plate and food pyramid are some alternative tools that can be used in
meal planning.
The Healthy Eating Plate
The Harvard healthy eating plate provides an easy to follow visual of what a typical meal
should look like and the best options for each food group. It recommends half of the plate
be a variety of fruit and vegetables, ¼ whole grains, ¼ mostly non red-meat based protein
and healthy oils in moderation.

The Healthy Eating Pyramid

Research has shown that the healthy eating pyramid can reduce heart disease, chronic
illness and boost life span. It can be considered a powerful visual of the proportions of
various foods and lifestyle activities that promote optimal conditions for health.
The recommendations are similar to the healthy eating plate which promotes eating only
whole grains while limiting refined carbohydrates, red meat, dairy and commercial fruit
juices. There is also an emphasis on nuts and seeds as a source of protein and healthy fats.
Vitamin D supplementation as well alcohol in moderation coupled with staying active are
also recommended for optimal health.
For more information about The Healthy Eating Plate and Healthy Eating pyramid, please
see The Nutrition Source, Department of Nutrition, Harvard School of Public
Health, http://www.thenutritionsource.org, and Harvard Health
Publications, http://www.health.harvard.edu.

Sources for Healthy Diet Planning

Healthy Diet Planning: Sources and Tools
 Page 17 of 20

What sources of information and tools are available to help you make healthy choices and
to live well?

Dietitians Of Canada
Representing professional dietitians, Dietitians of Canada support ethical, evidence-based
best practice, advance knowledge of food and nutrition, support their members as leaders
in health and wellness and also mentor those interested in beginning nutritional careers.
They also manage the website EatRight Ontario and have created eaTracker, a
free online tool that lets you track and analyze your food intake and physical activity.
UnlockFood

Funded by the Dietitians of Canada, UnlockFood.ca (formally known as EatRight Ontario) is a

service and website that provides advice on healthy food choices and gives opportunities to
connect with Registered Dietitians. The website has reliable and up-to-date articles, tips and
recipes.
Cronometer
Tracks your nutrition, fitness and health information; tracks 60 nutrients and 300,00 foods;
logs diet, biometrics and exercise. Includes mobile apps. For the Diet Analysis Assignment,
you will need to sign up for the free app Cronometer at https://cronometer.com/
The video below is the same one posted on the Assessment/Assignment Information page
URL: https://youtu.be/ouf6XNcYvrE

Additional Key Terms for Module 2

Additional Key Terms
Malnutrition - Refers to a condition where one does not receive proper amounts of
nutrients. This condition may have resulted from an inadequate or unbalanced diet,
digestive and absorption problems, or other medical issues.
Undernutrition - A condition where a person is not consuming enough nutrients, which
leads to malnutrition.
Overnutrition - A condition where a person is consuming too much food and too many
nutrients, which may lead to malnutrition. It can result in obesity, a growing global health
threat.
Obesity - A metabolic disorder that leads to the overaccumulation of fat tissue,
compromising overall health.
Solid fat and added sugar (SoFAS)
A new acronym that describes foods with added solid fats and sugars.
Calorie - The name calorie is used for two units of energy.
o The small calorie or gram calorie (symbol: cal) is the approximate amount of energy
needed to raise the temperature of one gram of water by one degree Celsius at a
pressure of one atmosphere.
o The large calorie, kilogram calorie, dietary calorie, nutritionist's calorie, nutritional
calorie, Calorie (capital C)[2] or food calorie (symbol: Cal) is approximately the amount
of energy needed to raise the temperature of one kilogram of water by one degree
Celsius. The large calorie is thus equal to 1000 small calories or one kilocalorie (symbol:
kcal).
 Page 18 of 20

Eating Positively: Intuitive and Mindful Eating

How Can We Eat Positively ?
Food was never meant to be associated with shame, guilt, punishment, or restriction. It
should bring us joy and pleasure while nourishing our bodies.
Two concepts that go with positive eating are Mindful Eating and Intuitive Eating.
Intuitive Eating is eating in response to our innate hunger and satiety signals. In other
words, eating when we are hungry and stopping when we are satiated.
The idea is that the body intuitively knows how much and the types of foods it needs to
maintain health. It is also called 'body wisdom.' Intuitive eating also includes rejecting the
‘diet mentality’, being active for feeling good, eating for physical hunger rather than
emotional, and using nutrition information without judgement. Mindful eating is more
about the eating experience.
As children, we all start off as intuitive eaters. We eat when we are hungry and it
doesn't matter what we are offered after we are full, we will refuse it. Toddlers and young
kids are an example of this. Unfortunately, we all stop being this way after a few years of
life.
Intuitive Eating Motto: Eat What You Love. If You Don't Love it, Don't Eat it, and if You
Love it, Savor it.
A big part of eating positively is eating foods you really like as opposed to things you think
you should be eating. For example, if you are at a restaurant, you may order a salad because
you think you should vs. ordering something you really want--You leave feeling unsatisfied
and craving something even though you are actually not hungry anymore.
Honor Your Hunger
Keep your body biologically fed by getting enough energy and carbohydrates. When you
don’t get enough food, you have a primal drive to overeat, and your body naturally
compensate with physical and psychological mechanisms.
o Listen for it….signs vary for each person
o Every time you eat, ask yourself “Am I hungry?”
o Hunger sensations: gurgling or gnawing in the stomach, growling noises, light-
headedness, difficulty concentrating, uncomfortable stomach pain, irritability, feeling
faint, headache
o General guideline: no more than 5 waking hours without eating (5 hours is based on
the biology that our liver, which stores carbs, will deplete in about 3-6 hours)
Once you are able to recognize your physical hunger signs, it becomes easier to distinguish
other reasons for overeating. Sometimes we forget what gentle hunger is. if we’re only
eating when we are ravenous, we may end up overeating.
Take a minute to watch this very short video on Intuitive Eating

URL: https://youtu.be/4ugf9s0GFGI

Mindful Eating
Mindless vs Mindful Eating
Have you ever eaten past the point of feeling full? Looking for something to eat when you
were bored, sad, or feeling stressed out? Looked down at the bag of chips you were eating
while watching TV and wondered where the chips went? Eaten lunch at your desk while
working?
If you have done any of these, they are examples of not eating mindfully.
 Page 19 of 20

According to research, every day we make more than 200 food decisions. Many of these
decisions are overlooked. Decisions about whether to eat, what to eat, and how much to eat
are based on what we usually do. We are influenced by external cues such as seeing or
smelling food, or we may simply eat what is around.
Mindless eating occurs when we eat without thinking. We can be influenced by the people
around us, the packaging, the portions or the distractions.
Serving dishes and glassware can affect us. That snack food in easy reach can influence us to
eat more. And eating in front of the TV or computer can cause us to eat mindlessly.
And food advertisements may encourage us to eat whether we are hungry or not.
What is Mindful Eating?
Mindful eating is more about how we eat than what we eat. It is about eating with attention
and intention by becoming more aware of our physical hunger cues verses non-hunger
eating cues (ex. eating because something is there, emotions, etc.) It is eating for both
enjoyment and nourishment.
Mindfulness comes from principles found in Buddhism and means living with greater
awareness of moment-to-moment thoughts, feelings, and actions. Mindful eating may be a
step towards healthy eating. The concept of mindful eating means paying close attention to
every detail of the eating experience. Being mindful can increase our awareness of the
internal and external cues that guide eating behavior. These cues may be physical,
emotional, or cognitive.
Often, we eat almost automatically giving little thought to what or how much we are eating.
The candy jar is there so you grab some. You are served a large plate of food and you eat it
all. You order the number one combo because that is what you usually eat. Mindfulness can
lead to making intentional choices in eating instead of responding to external cues,
emotions, or your environment.
Part of mindful eating is that nothing is off limits. Sometimes people think that if they allow
themselves to eat whatever they want, they will eat, as an example, chocolate bars all day.
However, when people try this approach and become more in tune with their hunger, they
find they don’t actually want to eat chocolate all day.
The Mindful Eating Cycle
Consider these questions:
Why do I eat? - Before eating, ask yourself if you are truly hungry, or if you are experiencing
another emotion. Was it an environmental trigger – ex. bowl of candy in the lounge
When? - By yourself? When are you with others?
What? - Specific foods – good verses bad
How? - Fast verses slow
How much? - Did you finish your plate?
Where? - At your desk, at a dining table, in the car?
Tips
o Ask yourself if you are truly hungry, if you are, go ahead and eat
o Get rid of distractions – turn off the tv, get away from the computer, put your cellphone
away Eat sitting down
o Set a place for yourself and use tableware and utensils that appeal to you
o Eat slowly
o Notice textures, aroma, flavors
o Start slowly – pick a meal, or even a mouthful or two at each meal to practice
mindfulness
 Page 20 of 20

Eating should be a pleasurable and satisfying experience. You should never feel “guilty”
about eating. Eat slowly and without distraction to savor and enjoy every bite. Eat what
appeals to you and try to get in-touch with your internal hunger and satiety cues to prevent
mindless eating.
Checkout this short video reviewing tips for Mindful Eating
URL: https://youtu.be/oJSpQHcJfKs

Checklist Week 2
Before proceeding to the next module check that you have completed all of these things:
o Reviewed all the content of this module. Read pages and watched video, completed
activities.
o Read Chapter 2 Achieving a Healthy Diet Essentials of Nutrition: A Functional Approach
text
o Taken Module Practice Quiz 2 to check your knowledge of the module
o Begun work on Diet Analysis Assignment.