The Cost of Poor Nutrition. Achieving Wellness. Did You Know? 5/29/2014. Reduced. Significant. Chronic. Financial Risk. Quality of. Life.

Transcription

1 Dietary Guidelines: From Pyramids to Plates Achieving Wellness UCSF Osher Mini Medical School Proper Diet Positive Lifestyle Wellness Katie Ferraro, MPH, RD, CDE Poor Diet Negative Lifestyle Death & Disease Did You Know? o 65% of the world s population live in countries where overweight and obesity kill more people than underweight o More people are overweight than underweight in the world The Cost of Poor Nutrition Chronic Reduced Significant Disease Quality of Financial Risk Life Impact World Health Organization, Media Centre, Obesity and Overweight, May 2012 Centers for Disease Control and Prevention,

2 Diet Planning Guides: History o 1 st rec., USDA, 1894 o 1917, How to Select Foods o 1930s: scarcity, cost o WWII: health of troops o Evolved into RDAs 2010 DGAs: Key Recommendations Balancing Calories Enjoy your food, but eat less Avoid oversized portions Foods to Increase Make half your plate fruits and vegetables Switch to fat free or low fat (1%) milk Foods to Reduce Compare sodium in foods like soup, bread, and frozen meals and choose the foods with lower numbers Drink water instead of sugary drinks DGAs 2010: Nutrients of Concern DGAs 2010: Sodium Guidelines Nutrients of Public Health Concern Potassium Dietary fiber Calcium Vitamin D New Sodium Guidelines in 2010 DGA 2,300 mg per day for general population 1,500 mg for aged 51+, African Americans & HTN, diabetes & CKD 2

3 Food Guides: The 4 Food Groups Food Guides: USDA FGP (1992) Actual US FGP Intake Food Guides: MyPyramid.gov (2005) 3

4 Food Guides: MyPlate (2011) ChooseMyPlate Food Groups Healthy Eating Plate (Harvard) World Cancer Research Fund/American Institute for Cancer Research 4

5 Canada s Food Guide Chinese Food Pagoda 5

6 An Understandable Food Pyramid? Food Labels Dr. Ancel Keys o o University of Minnesota o WWII infamous K ration o Post WWII Biology of Human Starvation (1950) o Seven Countries Study Research: The 7 Countries Study o , men in 18 areas of 7 countries o First to explore associations among diet, risk & disease in contrasting populations o Chemical analysis of foods + diet recall o Demonstrated degree to which the diet and in particular saturated fatty acids and cholesterol levels predict present and future CAD University of Minnesota, School of Public Health Our History available at: 6

7 Principles of the Med Diet o Plant based diet with herbs & spices for flavor o Limited red meat intake, focus on fish & poultry o Low processed food intake, emphasizes fresh o Includes foods from the sea o Moderate dairy and wine o Activity is part of a healthy lifestyle o Focus on good fats: olive oil Reproduced with permission of Oldways Preservation and Exchange Trust Med Diet: Focus on Fats o Total fat is 25 35% of calories o Saturated fat is no more than 7 8% of calories o Olive oil, nuts, seeds o Limited animal foods o Monounsaturated fats are not alone protective against CVD, but lifestyle + foods together are Med Diet: Focus on Alcohol o Moderate consumption of wine o Normally consumed with meals o Moderation defined as: No more than 1 glass wine per day for women 1 2 glasses wine per day for men 7

8 Research: PREDIMED vs. Low-Fat o 2006, PREDIMED Prevención con Dieta Mediterránea o N=722 asymptomatic persons, at high CVD risk, randomized to low fat or 1 of 2 Med diets o After 3 months follow up: Weight/BMI same in 3 groups Lower BG, lower systolic BP, lower t chol/hdl ratios in 2 Med diet groups than low fat Inflammation markers also lower in 2 Med diets Research: Metabolic Syndrome o 2011, Meta Analysis of 50 studies and 534,906 individuals o Effect of Mediterranean diet on metabolic syndrome and its components o Adherence to Mediterranean diet was highly protective o Showed 31% lower risk of developing metabolic syndrome Ann Intern Med Jul 4;145(1):1 11 J Am Coll Cardiol. 2011;57(11): Research: Heart Disease o 2013, n=7447 enrolled, aged 55 80, 57% female o Smokers, overweight, diabetes or risk factors o Low fat diet group or 1 of 2 Med diet groups o Meaningful endpoints: MI, stroke, death o Findings: 30% of MI, stroke, death can be prevented if switch to Mediterranean diet For More Information o University of Minnesota The Seven Countries Study in Brief: o Oldways What is the Mediterranean Diet? foodsalliance/what mediterranean diet o American Heart Association Mediterranean Diet: itioncenter/mediterranean Diet_UCM_306004_Article.jsp N Engl J Med. 2013;368:

9 Coursera Nutrition Class o o Nutrition for Health Promotion & Disease Prevention o 6 week, free, massive open online course (MOOC) taught in conjunction with UCSF o 21 CEUs for MDs, RDs, PharmDs, RNs, PAs o Next start date: Late