# TEMA 4 RECOMMENDED INTAKES.pptx

23 de Mar de 2023

### TEMA 4 RECOMMENDED INTAKES.pptx

1. UNIT 4: RECOMMENDED INTAKES CLARAGOMISCOLOMA UCV.CURSO2022-2023
2. 4.1.- ENERGY UNITS "ENERGY IS NEITHER CREATED NOR DESTROYED, IT JUST TRANSFORMS" Principle of conservation of energy or First law of the thermodynamics. This principle governs all energy transformations and is applicable to all systems, whether physical, chemical or biological.
3. The initial chemical energy contained in the nutrients that make up the food that is ingested, is released by combustion with O2 through respiration-oxidation reactions in the cells. This energy thus released: It is partly lost as HEAT In part, used or stored in ATP form Later it is used for re-synthesis of macromolecules, transport, heart function, lung function, intestinal movements, physical activity ...
4. ENERGYUNITS 1 Kcal = 4,2 Kj 1 Kj= 0,24 Kcal Nutrients provide energy that will manifest itself in the form of heat, but this energy will be used to perform a work. Food (g) Kcal/100 g Kcal/portion Kj/ portion 75 gwhite bread 240 75 gwhole wheat bread 251 75 gsandwich bread 249
5. 4.2. ENERGY NEEDS On the nutritional labels the “percent daily values” are based on a 2000 calorie diet. The number of calories the body consumes in a day is different for every person. Your body might need more or less than 2000 Kcals.
6. 4.2. ENERGY NEEDS A person's ENERGY NEEDS are determined by: - Basal metabolism: which varies based on age, sex, weight/height, pathological processes (metabolic stress) and body composition -Physical exercise: represents about a third of total energy expenditure. The RECOMMENDATIONS are based on an intake adapted to the age, physiological state and physical activity of the individual. In adults, the recommended intake decreases with age
7. 4.3.- ENERGY BALANCE CALCULATION The EB is determined by the difference between income and energy expenditure. EB = INCOME – EXPENSES IF INCOME < EXPENSES..... IF INCOME > EXPENSES...... This equation remains in equilibrium in the adult who maintains a stable weight.
8. - The balance between energy ingested and consumed is the determining factor of body weight in adults and affects the size of fatty deposits in adipose tissue. - If an energy intake greater than necessary is maintained for a sufficient period of time, changes in weight and body composition will appear. - This balance is controlled by: . Hypothalamic center of hunger and satiety . Efficiency of energy production and heat release . Endocrine balance: some hormones can induce changes in appetite and energy utilization.
9. ENERGY INCOME The raw energy of ingested food depends on its energy nutrient content. The 3 macronutrients components of the diet, once digested and absorbed, are oxidized to provide energy. HC and LIPIDS are completely oxidized in the body, but PROTEINS are not. That is why nitrogenous substances derived from them appear in urine: UREA, URIC ACID and CREATININE.
10. The estimate of the energy value of nutrients and alcohol is: 4 Kcal / g PROTEINS and CARBOHYDRATES 9 Kcal / g LIPIDS 7 Kcal / g ALCOHOL** (not considered a nutrient, but provides Kcal that are metabolized) ENERGY INCOME
11. ENERGY EXPENDITURE TOTAL ENERGY EXPENDITURE (TEE) is determined by basal metabolic rate and by physical activity. TEE HEALTHY ADULT= BMR × PAEE In people with some oxidative stress factor, energy expenditure is higher (Metabolic stress factor).
12. BMR: BASAL METABOLIC RATE - It is the BASAL METABOLISM - In most adults, it represents 50-70% of total energy expenditure and is expressed in kcal / 24h. - Sex and age influence BMR because of the difference in body composition between the sexes and the changes that this composition undergoes over the years. In women 10%< men From the age of 40, the basal metabolic rate begins to decrease
13. Internationally, it is accepted that the baseline energetic needs are 24 Kcal/kg/ day What are your baseline energy needs according to this quick formula? To know the total energy expenditure of the person, it is necessary to correct the baseline calculation, with reduction by AGE, the physical activity factor and the metabolic stress factor.
14. CALCULATION OF BASAL METABOLIC RATE (BMR) (HARRIS- BENEDICT) Women: BMR=655+(9’6 x W)+(1’85 x H)-(4’6 x A) Men: BMR=66’5+(13’7 x W)+(5 x H)-(6’8 x A) (W = weight in Kg; H = Height cm.; A = age in years) To obtain the total energetic expenditure, we need to correct the basal calculation with the factor for physical activity and the factor for metabolic stress.
15. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE It is the most variable component of total energy expenditure and therefore the easiest to change.
16. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE
17. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE
18. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE What counts as light activity? Light activity is moving rather than sitting or lying down. Examples of light activity include: - getting up to make a cup of tea - moving around your home - walking at a slow pace - cleaning and dusting - vacuuming - making the bed - standing up
19. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE What counts as moderate intensity activity? Moderate intensity activity will raise your heart rate, and make you breathe faster and feel warmer. One way to tell if you're working at a moderate intensity level is if you can still talk, but not sing. Examples of moderate intensity activities include: - walking for health - water aerobics - riding a bike - dance for fitness - doubles tennis - hiking
20. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE What counts as vigorous intensity activity? Vigorous intensity activity makes you breathe hard and fast. If you're working at this level, you will not be able to say more than a few words without pausing for breath. Most moderate intensity activities can become vigorous if you increase your effort. Examples of vigorous activities include: - running - aerobics - swimming - riding a bike fast or on hills - singles tennis - football - hiking uphill - dance for fitness - martial arts
21. MS: METABOLIC STRESS SURGERY MINOR- MAJOR POLY TRAUMATISM INFECTION BURNED CANCER 1,1 - 1,2 1,4 1,2 – 1,6 2,1 2 Total Energy Expenditure (TEE)=BMR X AF X MS
22. ADJUSTMENTS FOR SPECIAL SITUATIONS AND WEIGHT PREGNANCY 2ND AND 3RD TRIMESTER +350 Kcal/day LACTATION +500 Kcal/day OVERWEIGHT -10-20% TEE OBESITY -30-40 % TEE
23. 4.4.- DISTRIBUTION OF ENERGY NEEDS IN IMMEDIATE PRINCIPLES PROTEINS- 10-15% daily kcal (0,8-1,5 g/kg of bodyweight) At least half of them with a high biological value LIPIDS- aprox. 30% daily kcal Saturated fats: aprox < 10% Polyunsaturated fats: aprox 7% Monounsaturated fats : aprox 15 – 20% CARBOHYDRATES - 55-60% daily kcal Simple CH (rapid absorption) < 10% FIBER: 25-30 gr/day
24. DISTRIBUTION THROUGHOUT THE DAY - It depends on the habits of the person. - Depends on where the period of more energy expenditure for work or physical activity is located. MODEL OF 5 INTAKES BREAKFAST: 25% PRE-LUNCH SNACK: 10% LUNCH: 30% PRE-DINNER SNACK: 10% DINNER: 25%
25. 4.5.- NUTRIENT NEEDS AND RECOMMENDATIONS - Delivering a list of prohibited foods can lead to serious food imbalances, since the patient (who does not always know what a balanced or healthy diet is) can fall into the error of abusing some allowed foods. - We must know the amounts of nutrients and energy that the body needs: INDIVIDUAL NEEDS GENERAL NEEDS
26. DIETARY REFERENCE INTAKES (DRIs) - The Dietary Reference Intakes (DRIs) are a set of scientifically based nutrient reference values for healthy populations. - DRIs are used by nutrition practitioners, governments, and non-governmental organizations to assess and plan the nutrient intakes of individuals and population groups. - 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
27. DIETARY REFERENCE INTAKES (DRIs) - The Dietary Reference Intakes (DRIs) is an umbrella term that describes four types of reference values ESTIMATED AVERAGE REQUIREMENT (EAR) RECOMMENDED DIETARY ALLOWANCE (RDA) ADEQUATE INTAKE (AI) TOLERABLE UPPER INTAKE LEVEL (UL)
28. DIETARY REFERENCE INTAKES (DRIs) ESTIMATED AVERAGE REQUIREMENT (EAR) - EAR is the amount of a nutrient that is estimated to meet the requirements for a specific criterion of adequacy of half of the healthy individuals of a specific age, sex, and life-stage. - At the EAR, 50% of the individuals in a group are below their requirement, and 50% are above it. Thus, a person whose usual intake is at the EAR has a 50% risk of an inadequate intake during the reporting period. - The EAR is used to calculate the RDA.
29. DIETARY REFERENCE INTAKES (DRIs) RECOMMENDED DIETARY ALLOWANCE (RDA) - 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. - The RDA is used as a goal for usual intake of individuals. - RDA can only be set for a particular nutrient if there is sufficient scientific evidence to establish an EAR for that nutrient.
30. DIETARY REFERENCE INTAKES (DRIs) 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. - 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.
31. DIETARY REFERENCE INTAKES (DRIs) TOLERABLE UPPER INTAKE LEVEL (UL) -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. - As intake increases above the UL, the potential risk of adverse effects increases - 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.
32. DIETARY REFERENCE INTAKES (DRIs) TOLERABLE UPPER INTAKE LEVEL (UL) 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.
33. DIETARY REFERENCE INTAKES (DRIs) HOW TO USE NUTRIENT RECOMMENDATIONS 1. They apply to healthy people. Need to be adjusted for malnourished people or with medical problems. 2. Recommendations are not minimum requirements. They target most of the people and do not account for individual variation in nutrient needs (registered dietitian can help determine if recommendations should be adjusted. 3. Variety of food (mixtures of nutriens) : excess intakes are unlikely. 4. Recommendations apply to average daily intakes. Depending on the nutrient, deficiency develops more rapidly ( Ex. Thiamin and vit C : days or weeks) or more slowly (vit. A and Vt B12 : months or years) 5. Each DRI category serves a unique purpose - EAR: develop and evaluate nutrition programs for certain groups - RDA: goals for individuals - UIL: serve as reminder specially upon supplements
34. DIETARY REFERENCE INTAKES (DRIs)
35. DIETARY REFERENCE INTAKES (DRIs)
36. https://www.nal.usda.gov/human- nutrition-and-food-safety/dri-calculator
37. ACTIVITIES 1. Energy expenditure exercise: Calculate how much energy you consume a day, taking into account the time you use for each physical activity. 2. Calculate your daily nutrient recommendations by using the mentioned site and make a table such as this one: 3. Calculate your daily energy income taking as a reference one normal day from your weekly intake report. Use the following food composition database: www.bedca.net/bdpub/index_en.php