Nutrient-based approaches
Includes (Dietary Reference Intakes) DRi’s and focuses on specific nutrients
Food-based approaches
Includes MyPlate as well as other food-based plans.
Focuses on food groups and basing dietary intake around the food groups
Dietary Reference Intakes
Set of 4 nutrient-based reference values used for nutrition based approaches. Useful when concerned about intake of specific nutrients
4 reference values of DRIs
Recommended Dietary Allowance (RDA)
- EAR + 2SD
Adequate Intake (AI)
Tolerable upper intake level (UL)
Estimated average requirement (EAR)
- average daily amount required to meet 50% of the populations energy needs
MyPlate
Tool for Food-based approach that evaluates dietary intake and based on the 2015 dietary guidelines for Americans.
Translates this into a meal plan that meets all nutrient requirements
Uses 9inch plate as the guide
Food intake patterns
identify what and how much for an individual should intake for good health
- amounts vary based on sex, age and activity level.
Food groups included in MyPlate
Grains (1/4 plate)
Beans & Meat (1/4 plate “protein”)
Vegetables & fruit (1/2 plate)
Discretionary calories & Dairy (not included on plate)
DASH diet
Dietary Approaches to Stop Hypertension (DASH) eating plan.
- used for people with hypertension or pre-hypertension, or general pop.
- designed to promote HIGH calcium and potassium intake w/ LOW Na & dairy intake
ADA Exchange Plan
American Diabetes Association (ADA)
Used for individuals with diabetes and weight loss issues.
- organizes foods into groups based on macronutrient & energy content allows for substituting between groups.
Main Food label information
- Single serving size and total number of servings
- Kcals per serving
- Key nutrient %’s
- List of ingredients
What percentages are considered low Daily value and high Daily value?
> 5% = low intake
<20% = High intake
Serving size vs portion size
Serving size = standardized portion of food (used in food labels)
Portion size = portion of food someone chooses to eat
Medical Nutrition Therapy (MNT)
Diet modifications used as a result of a specific illness or disease.
Can be modified in 3 different ways
- Basic components (macronutrients)
- consistency of food
- feeding approach (route of delivery)
Goals of MNT
Supply needed nutrients to the body in a way it can most efficiently use the nutrients without straying to far from a normal diet.
Individual requirements related to MNT
- digestive & absorption capacity
- alleviation/aren’t of a disease process
- psychosocial factors
Seven methods to modifying a normal diet
- Change consistency of foods
- change energy content
- change in the physical type of food
- omit specific foods
- change in energy distribution
- change in number of frequency of meals
- change in route of delivery
Enteral nutritional support (EN)
Method used when patients cant ingest or digest sufficient amounts of food
- uses GI tubes to directly feed patient
- requires adequate absorptive capacity (at least 100cm small bowel)
- always preferred over PN unless not possible
Parenteral nutrition (PN)
Used when patient cant be nourished via oral or enteral feeding methods.
- uses IV to directly put nutrients into systemic circulation
How to determine energy needs?
Based on individual energy expenditure and protein utilization
- calculate energy needs by REE x stress factor
Normalized factors of stress
Low stress = 1.1
Sepsis/trauma = 1.4
Burns of >40% = 1.6
Needing to gain wt. = 2.0
How to calculate protein balance
Protien intake - protein catabolic rate
Positive protein balance
(Protein intake -Catabolic rate) = +10g
