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• How Nutrition Affects Quality of Life

By Diane G Fager, LRD
admin@grovemenus.com
208-528-0690
What Are the Right Ingredients
In a Great Menu?
Aging is Experienced by Everyone
Factors in Aging
In your Control:
•Weight
•What you eat
•Exercise
•Smoking

Not in your Control:
•Disease
•Food Supply
•Disasters
•Environment
Adult Disease Statistics
How are these diseases affected by diet?
How do these disease affect functional status?
1.
2.
3.
4.

598,607 died from Diseases of the Heart.
568,668 died from Malignant Neoplasms (cancer)
128,603 died from Cerebrovascular Diseases (stroke) –
Diabetes Mellitus – 68,504. 1 in 13 people
has diabetes (1 in 4 pre-diabetes) Every
10 seconds a person dies from diabetes-related
causes
5. 34 % Americans have high blood pressure, 36%
prehypertension
**1&2 account for 48% of all deaths**
Deaths: Preliminary Data for 2009
by Kenneth D. Kochanek, M.A.; Jiaquan Xu, M.D.; Sherry L. Murphy, B.S.; Arialdi M. Miniño M.P.H.; and Hsiang-Ching Kung, Ph.D., Division of Vital Statistics March 16, 2011
Functional Status
Ability to do activities of daily living. Basic activities include:
Personal hygiene
and grooming

Bowel and
bladder
management

Self feeding

Functional
transfers: getting
from bed to wheel
chair, getting onto
or off of toilet, etc.

Dressing and
undressing

Ambulation:
walking without
use of an assistive
device (walker,
cane, or crutches)
or using a
wheelchair
Functional Status and Quality of Life
Caloric and Nutrient Intake
As we age, does our need for
calories increase or decrease?

As we age, does our nutrient
need increase or decrease?

• An average sized elderly male
needs 600 calories less than in his
prime.
• An average sized elderly woman
needs 300 calories less than in
her prime.

• Nutrient need stays the same.
• Because our calorie need
decreases as we age, but our
nutrient needs to not, nutrient
dense food becomes essential to
maintain functional status.
Lipids
• Three kinds of fats are part of the lipid group
– Saturated Fats
• Trans Fats

– Monounsaturated Fats
– Polyunsaturated Fats
Saturated Fats
• Fats that have no double bonds
• Are solid at room temperature
• Contribute significantly to heart disease and other health
problems
• Sources are:
– Coconut and Palm Oil
– Animal products
• Meats
• Poultry
• Dairy Products

Trans Fats – are manufactured or hydrogenated fats. These are
fats changed from liquid to solid by adding hydrogen atoms
Monounsaturated Fats
• Fats that contain one double bond.
• Sources are:
–
–
–
–
–
–
–

olive oil
canola oil
peanut oil
peanuts
pecans
almonds
avocados

• MUFA actually lower the amount of cholesterol in the
body. However too much fat of any kind is bad for the
health.
Polyunsaturated Fats
• Fats that contain two or more double bonds
• Sources are:
– vegetable oils
•
•
•
•

corn
safflower
sunflower
cottonseed
Cholesterol
• Another kind of lipid found in the body
• Is closely linked with heart disease because it
collects on the walls of the arteries and blocks
flow of the blood to the heart

Only found in animal
products butterfat, egg yolks,
organ meats (liver and brain)
Lean Proteins
Fatty Proteins
Carbohydrates

Foe?

Friend?
or
There’s Been A Misunderstanding…

…all carbohydrates are not bad for you
Foe
Friend
Functional Foods
• Foods that provide health benefits
beyond basic nutrition. They have
identified benefit in disease
prevention, reduced risk of disease,
and possibly in treating diseases.
Functional Foods
So What Are “Carbs”?
• Organic compounds that consist of carbon, hydrogen, and
oxygen
• The bodies most important source of energy

Simple Carbohydrates: Glucose & Fructose
Complex Carbohydrates
Oligosaccharides and Polysaccharides
Refined Carbohydrates
Whole plants stripped of the germ and/or bran from the
grain leaving highly digestible and easily preserved starch
or sugar

Endosperm

Endosperm

Bran
Germ
Whole Grain

“White” Grain
Glycemic Index (GI)
Is a measure of the effects of carbohydrates (CHO) on blood sugar levels

• CHO that break down
quickly during digestions
and release glucose rapidly
into the bloodstream have a
high GI

• CHO that break down slowly
with a gradual glucose
release have a low GI
How do you figure GI?
The glycemic index of a food is defined as the
area under the two-hour blood glucose
response curve following after eating a 50
gram portion of a “carbohydrate” food.
GI Classifications

2.5 g fiber, which is considered a good source, will lower glycemic index

5 g fiber is an excellent source, and will lower GI even more
Higher Fiber = Lower GI
Limitations of GI
• GI doesn’t account for what is eaten with other foods –
protein offsets quick elevations
• GI is significantly altered by the type of food, ripeness,
processing, storage length, cooking methods, and
variety. Example – potatoes
• Glycemic response different from one person to
another, and even in the same person from day to day
• Most values on the GI do not show the impact of
glucose levels after two hours
• Glycemic response is strongly influenced by the
composition of the previous meal and when it was
consumed
Fiber
Soluble Fibers
• Regulate colonic transit
time
• Increase:
– Satiety
– Fecal bulk
– Frequency of BM

• Decreases
– Gastric emptying
– Glucose absorption from
small intestine
– Postprandial glucose level

Insoluble Fibers
• Regulate colonic transit
time
• Binds minerals
• Increase:
– Fecal bulk
– Frequency of BM
Soluble Fibers
Food Sources
•
•
•
•
•
•
•
•
•
•

Green beans
Carrots
Bananas
Oranges
Apples
Citrus Fruits
Berries
Oatmeal
Legumes/dried beans
Vegetable gums

Health Benefits
• Promotes healthy gut
environment
• Decreases:
–
–
–
–

Risk of Cardiovascular Disease
Risk of Diabetes
Risk of Obesity
Cholesterol
Insoluble Fibers
Food Sources
•
•
•
•
•
•
•
•
•
•
•
•

Wheat bran
Whole wheat and rye
Apple peeling
Pear
Cabbage family
Fresh tomatoes
Root veggies
Whole grain cereals
Potatoes
Strawberries
Peaches
Plums

Health Benefits
• Decreases:
–
–
–
–

Constipation
Diverticular disease
Hemorrhoids
Hiatal hernia
Health Benefits of Whole Grain
• Reduced Risk of Cardiovascular Disease
• Protection from Insulin Insensitivity/Resistance and Diabetes
• Body Weight Regulation –
– increased satiety
– delays how quickly the stomach empties

• Reduced Cancer Risk
Major Types of Whole Grain
• Corn – Ground; dried cornmeal
• Barley- Whole Grain Form – Hulled. Refined
Form - Pearled
• Oats – Contain Soluble and Insoluble Fiber.
• Rye
• Rice
• Wheat
What About Pasta?
• Pasta is not a naturally occurring grain but can
be made from whole grains. However, most
pasta on grocery store shelves is made from
Semolina flour, which is made from refined
wheat grains. Thus it is not whole grain.

??

??
Whole Grains and Cereals

At least half of all grains should be whole grains
Fruits and Vegetables
Antioxidants

Phytochemicals
Properly Packaged
• 200 epidemiological studies demonstrate a 50% lower cancer risk.
• Antioxidants & Phytochemicals are complementary and synergistic in:
–
–
–
–
–
–
–

Stimulating the immune system
Antibacterial and antiviral activity
Detoxification
Enzymes
Decreasing platelet aggregation
Reducing blood pressure
Altering cholesterol metabolism
Fruits and Vegetables
• Phytochemicals
• Antioxidants
• Serve 5 fruits/vegetables daily
Antioxidants
• Title: A.C.E. Selenium

• Job Description:
The Body’s Bouncer
Antioxidants
• Free radicals are unstable
molecules which are short one
electron and it needs one more
electron to become stable. The
body tries to borrow one from
a stable molecule, so the
previously stable molecule is
now a free radical - this chain
reaction continues until broken
by an antioxidant.
Oxidative Stress
• Is the imbalance between free radicals and
antioxidants .
– Stimulation of immune system due to infection or
disease.
– Exposure to Exogenous ROS

• Inadequate Supply
– Low or inadequate dietary intake for an extended
period of time.
Oxidative Stress
Phytochemicals Are Unique

• Phytochemicals are not necessary for growth,
development, maintenance or repair – they
protect against disease.
• Fruits and vegetables are excellent sources of
phytochemicals and antioxidants and appear
to have a synergistic effect.
Phytochemical Categories
Phytochemicals are organized according to their protective
physical, and chemical properties. Sometimes that groups
them by color.
•Terpenoids
•Organosulfurs
•Polyphenols
Rainbow of Colors
Phytochemicals are widely found in the rainbow of colors:
•Red
•Orange and Yellow
•Green
•Blue and Purple
The More the Merrier
• Sneak vegetables into:
– Recipes
– Entrees
– Snacks
– Ask for two times the
serving when eating out

“You are what you eat!”
Colorful Beans
• Just like with fruits and vegetables, you want a
variety of colors.
• Beans contain the most fiber of all.
• ½ c beans daily will decrease cholesterol 5-10% in
6 weeks.
• Beans:
–
–
–
–

Decrease cholesterol
Decrease blood pressure
Stabilizes blood sugars
Helps weight loss (satiety)
Legumes
• Just like with fruits and vegetables, you want a
variety of colors.
• Beans contain the most fiber of all.
• ½ c beans daily will decrease cholesterol 5-10% in
6 weeks.
• Beans:
–
–
–
–

Decrease cholesterol
Decrease blood pressure
Stabilizes blood sugars
Helps weight loss (satiety)
The Right Balance
20-30% Fat
For A 2000 Calorie Diet
900 – 1300 calories
Carbohydrates

300 – 500 calories Protein
400 – 600 calories Fat
Application
Go Functional For All the Right
Ingredients

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Nutrition's Role in Quality of Life

  • 1. • How Nutrition Affects Quality of Life By Diane G Fager, LRD admin@grovemenus.com 208-528-0690
  • 2. What Are the Right Ingredients In a Great Menu?
  • 3. Aging is Experienced by Everyone Factors in Aging In your Control: •Weight •What you eat •Exercise •Smoking Not in your Control: •Disease •Food Supply •Disasters •Environment
  • 4. Adult Disease Statistics How are these diseases affected by diet? How do these disease affect functional status? 1. 2. 3. 4. 598,607 died from Diseases of the Heart. 568,668 died from Malignant Neoplasms (cancer) 128,603 died from Cerebrovascular Diseases (stroke) – Diabetes Mellitus – 68,504. 1 in 13 people has diabetes (1 in 4 pre-diabetes) Every 10 seconds a person dies from diabetes-related causes 5. 34 % Americans have high blood pressure, 36% prehypertension **1&2 account for 48% of all deaths** Deaths: Preliminary Data for 2009 by Kenneth D. Kochanek, M.A.; Jiaquan Xu, M.D.; Sherry L. Murphy, B.S.; Arialdi M. Miniño M.P.H.; and Hsiang-Ching Kung, Ph.D., Division of Vital Statistics March 16, 2011
  • 5. Functional Status Ability to do activities of daily living. Basic activities include: Personal hygiene and grooming Bowel and bladder management Self feeding Functional transfers: getting from bed to wheel chair, getting onto or off of toilet, etc. Dressing and undressing Ambulation: walking without use of an assistive device (walker, cane, or crutches) or using a wheelchair
  • 6. Functional Status and Quality of Life
  • 7. Caloric and Nutrient Intake As we age, does our need for calories increase or decrease? As we age, does our nutrient need increase or decrease? • An average sized elderly male needs 600 calories less than in his prime. • An average sized elderly woman needs 300 calories less than in her prime. • Nutrient need stays the same. • Because our calorie need decreases as we age, but our nutrient needs to not, nutrient dense food becomes essential to maintain functional status.
  • 8. Lipids • Three kinds of fats are part of the lipid group – Saturated Fats • Trans Fats – Monounsaturated Fats – Polyunsaturated Fats
  • 9. Saturated Fats • Fats that have no double bonds • Are solid at room temperature • Contribute significantly to heart disease and other health problems • Sources are: – Coconut and Palm Oil – Animal products • Meats • Poultry • Dairy Products Trans Fats – are manufactured or hydrogenated fats. These are fats changed from liquid to solid by adding hydrogen atoms
  • 10. Monounsaturated Fats • Fats that contain one double bond. • Sources are: – – – – – – – olive oil canola oil peanut oil peanuts pecans almonds avocados • MUFA actually lower the amount of cholesterol in the body. However too much fat of any kind is bad for the health.
  • 11. Polyunsaturated Fats • Fats that contain two or more double bonds • Sources are: – vegetable oils • • • • corn safflower sunflower cottonseed
  • 12. Cholesterol • Another kind of lipid found in the body • Is closely linked with heart disease because it collects on the walls of the arteries and blocks flow of the blood to the heart Only found in animal products butterfat, egg yolks, organ meats (liver and brain)
  • 13.
  • 17. There’s Been A Misunderstanding… …all carbohydrates are not bad for you
  • 18. Foe
  • 20. Functional Foods • Foods that provide health benefits beyond basic nutrition. They have identified benefit in disease prevention, reduced risk of disease, and possibly in treating diseases.
  • 22. So What Are “Carbs”? • Organic compounds that consist of carbon, hydrogen, and oxygen • The bodies most important source of energy Simple Carbohydrates: Glucose & Fructose
  • 24. Refined Carbohydrates Whole plants stripped of the germ and/or bran from the grain leaving highly digestible and easily preserved starch or sugar Endosperm Endosperm Bran Germ Whole Grain “White” Grain
  • 25. Glycemic Index (GI) Is a measure of the effects of carbohydrates (CHO) on blood sugar levels • CHO that break down quickly during digestions and release glucose rapidly into the bloodstream have a high GI • CHO that break down slowly with a gradual glucose release have a low GI
  • 26. How do you figure GI? The glycemic index of a food is defined as the area under the two-hour blood glucose response curve following after eating a 50 gram portion of a “carbohydrate” food.
  • 27. GI Classifications 2.5 g fiber, which is considered a good source, will lower glycemic index 5 g fiber is an excellent source, and will lower GI even more Higher Fiber = Lower GI
  • 28. Limitations of GI • GI doesn’t account for what is eaten with other foods – protein offsets quick elevations • GI is significantly altered by the type of food, ripeness, processing, storage length, cooking methods, and variety. Example – potatoes • Glycemic response different from one person to another, and even in the same person from day to day • Most values on the GI do not show the impact of glucose levels after two hours • Glycemic response is strongly influenced by the composition of the previous meal and when it was consumed
  • 29. Fiber Soluble Fibers • Regulate colonic transit time • Increase: – Satiety – Fecal bulk – Frequency of BM • Decreases – Gastric emptying – Glucose absorption from small intestine – Postprandial glucose level Insoluble Fibers • Regulate colonic transit time • Binds minerals • Increase: – Fecal bulk – Frequency of BM
  • 30. Soluble Fibers Food Sources • • • • • • • • • • Green beans Carrots Bananas Oranges Apples Citrus Fruits Berries Oatmeal Legumes/dried beans Vegetable gums Health Benefits • Promotes healthy gut environment • Decreases: – – – – Risk of Cardiovascular Disease Risk of Diabetes Risk of Obesity Cholesterol
  • 31. Insoluble Fibers Food Sources • • • • • • • • • • • • Wheat bran Whole wheat and rye Apple peeling Pear Cabbage family Fresh tomatoes Root veggies Whole grain cereals Potatoes Strawberries Peaches Plums Health Benefits • Decreases: – – – – Constipation Diverticular disease Hemorrhoids Hiatal hernia
  • 32. Health Benefits of Whole Grain • Reduced Risk of Cardiovascular Disease • Protection from Insulin Insensitivity/Resistance and Diabetes • Body Weight Regulation – – increased satiety – delays how quickly the stomach empties • Reduced Cancer Risk
  • 33. Major Types of Whole Grain • Corn – Ground; dried cornmeal • Barley- Whole Grain Form – Hulled. Refined Form - Pearled • Oats – Contain Soluble and Insoluble Fiber. • Rye • Rice • Wheat
  • 34. What About Pasta? • Pasta is not a naturally occurring grain but can be made from whole grains. However, most pasta on grocery store shelves is made from Semolina flour, which is made from refined wheat grains. Thus it is not whole grain. ?? ??
  • 35. Whole Grains and Cereals At least half of all grains should be whole grains
  • 37. Properly Packaged • 200 epidemiological studies demonstrate a 50% lower cancer risk. • Antioxidants & Phytochemicals are complementary and synergistic in: – – – – – – – Stimulating the immune system Antibacterial and antiviral activity Detoxification Enzymes Decreasing platelet aggregation Reducing blood pressure Altering cholesterol metabolism
  • 38. Fruits and Vegetables • Phytochemicals • Antioxidants • Serve 5 fruits/vegetables daily
  • 39. Antioxidants • Title: A.C.E. Selenium • Job Description: The Body’s Bouncer
  • 40. Antioxidants • Free radicals are unstable molecules which are short one electron and it needs one more electron to become stable. The body tries to borrow one from a stable molecule, so the previously stable molecule is now a free radical - this chain reaction continues until broken by an antioxidant.
  • 41. Oxidative Stress • Is the imbalance between free radicals and antioxidants . – Stimulation of immune system due to infection or disease. – Exposure to Exogenous ROS • Inadequate Supply – Low or inadequate dietary intake for an extended period of time. Oxidative Stress
  • 42. Phytochemicals Are Unique • Phytochemicals are not necessary for growth, development, maintenance or repair – they protect against disease. • Fruits and vegetables are excellent sources of phytochemicals and antioxidants and appear to have a synergistic effect.
  • 43. Phytochemical Categories Phytochemicals are organized according to their protective physical, and chemical properties. Sometimes that groups them by color. •Terpenoids •Organosulfurs •Polyphenols
  • 44. Rainbow of Colors Phytochemicals are widely found in the rainbow of colors: •Red •Orange and Yellow •Green •Blue and Purple
  • 45. The More the Merrier • Sneak vegetables into: – Recipes – Entrees – Snacks – Ask for two times the serving when eating out “You are what you eat!”
  • 46. Colorful Beans • Just like with fruits and vegetables, you want a variety of colors. • Beans contain the most fiber of all. • ½ c beans daily will decrease cholesterol 5-10% in 6 weeks. • Beans: – – – – Decrease cholesterol Decrease blood pressure Stabilizes blood sugars Helps weight loss (satiety)
  • 47. Legumes • Just like with fruits and vegetables, you want a variety of colors. • Beans contain the most fiber of all. • ½ c beans daily will decrease cholesterol 5-10% in 6 weeks. • Beans: – – – – Decrease cholesterol Decrease blood pressure Stabilizes blood sugars Helps weight loss (satiety)
  • 49. For A 2000 Calorie Diet 900 – 1300 calories Carbohydrates 300 – 500 calories Protein 400 – 600 calories Fat
  • 51. Go Functional For All the Right Ingredients

Notas del editor

  1. Menus that improve the residents quality of lifeMenus that control costsMenus that meet state regulations
  2. lean beef and pork cuts, chicken without skin, seafood, nonfat milk and yogurt, low fat cheese (mozzarella)
  3. ideas: pictures of fatty beef and pork cuts, sausage, bacon, salami, hot dog, pepperoni, cheese, breaded chicken, seafood, any things fried, breaded, Vit D milk
  4. 2. Friend or Foe
  5. 4. FoePictures of cake, soda pop, ooey gooey sweet items, and refine bread, rice, and so forth
  6. 3. Friend not only your friend, but absolutely essential too your health and well beingScatter pictures of functions foods, use individual pictures of things like oatmeal, whole grain bread, brown rice, specific fruits, specific vegetables – you can use pictures you already have
  7. 7. Fruits and Vegetables slide – pictures of fruits and vegetables a. add to that picture - bullet points antioxidants and phytochemicals
  8. 9. Packaged just rights amounts 200 epidemiological studies demonstrate a 50% lower cancer riskAntioxidant, PhytochemicalsTheir modes of action are complementary and synergistic in stimulating the immune system, antibacterial and antiviral activity, detoxification enzymes, decreasing plately aggregation, reducing blood pressure, altering cholesterol metabolism -  to name a few
  9. 15. Antioxidants – Vitamins A, C, E, and Mineral Selenium – a picture of ACE Selenium again, your body’s bouncer
  10. 12. Antioxidants – picture of antioxidant neutralizing a free radical - Free radicals are unstable moleculeswhich are short one electron and it needs one more electron to become stable. The body tries to borrow one from a stable molecule, so the previously stable molecule is now a free radical this chain reaction continues untilbroken by an antioxidant. Take out other bullet point on this slide, I’m going to restate it differently.
  11. 14. Antioxidants – oxidative stress Oxidative stress - imbalance between free radicals and antioxidants   *increased need1. Stimulation of immune system due to infection or disease2. Exposure to Exogenous ROS* inadequate supply1. Low or inadequate dietary intake for an extended period of time
  12. 20. Phytochemicals – are unique because they are not necessary for growth, development, maintenance or repair – they protect against disease; F&V are excellent sources of phytochemicals and antioxidants and appear to have a synergistic effect
  13. 21. Phytochemical Categories
  14. 35. Sneak in vegetables into recipes, entrees, snacks, personally when eating out, ask for 2 times the vegetables. Melanie – any ideas you have here woul be good
  15. 34. Legumes - just like F&V you want a variety of colorsMore fiber in beans than anything else, it decreases chol, blood pressure (K, MG), and stabilizes blood sugars, lose weight (satiety), ½ c beans daily will decress chol 5 to 10 % in 6 weeks have Zn Mn, Cu , K Mg, B VitaminesGround bean powderTry different kinds of beans like lentils, black bean, lima, butter beans, navy beans, bean dip
  16. 35. Can you find pictures of good meals that use ¾ the plate with colorful vegetables, fruits, and starches and then 1/4th the plate lean meat (pork, fish, chicken, lean beef) or soups, fun breakfasts, whole grain sandwiches with veggies and fruit. Look for color and pictures that apply the principles.
  17. 36. Go functional! Carbs can be good for you and are essential to good health.