Nutrition 330 Introductory Nutrition

Study Guide: Unit 2

Dietary Reference Intakes and Diet‑Planning Guides

Various countries have established nutrient standards and dietary guidelines to promote optimal health and provide a means of surveying the nutritional status of their citizens. The standard used in Canada is the Dietary Reference Intakes (DRI), which is also used in the USA. Diet‑planning guides used in Canada and in the United States have very different designs but are similar with respect to the diets they recommend. To apply these guides correctly, one must understand their strengths and limitations, which we will discuss in this unit. This discussion is reinforced by the course assignment using Canada’s Food Guide. Finally, we look at nutrition information on food labels.

This unit consists of three sections:

2.1—Dietary Reference Intakes
2.2—Diet‑planning Guides
2.3—Nutrition Information on Food Labels

Objectives

After completing this unit, you should be able to

1. identify the four sets of standards for nutrient intake within the Dietary Reference Intakes (DRI).
2. discuss the appropriate use of the RDA and AI, and identify some of their limitations.
3. list the principles on which diet‑planning guides are formulated, and explain each principle, using examples.
4. discuss how the recommendation for energy intake is established.
5. explain how to use Canada’s Food Guide by identifying the following:
   • the four food groups,
   • the number of servings and recommended serving sizes from each of the food groups,
   • ways to optimize choices from each food group,
   • the requirement for oils and fats and examples of beneficial oils and fats,
   • the major nutrients contributed by each food group, and
   • the strengths and weaknesses of the Guide.
6. interpret the nutrition information in a standard Nutrition Facts label.

2.1 Dietary Reference Intakes

Introduction

Nutritional guidance has been provided to Canadians since 1942, starting with Canada’s Official Food Rules and continuing on to the current Eating Well with Canada’s Food Guide. During this period, many revisions have been made to the nutrient requirements and dietary recommendations. Revisions are necessary to reflect advances in the knowledge of dietary requirements, changes in educational techniques, changes in the Canadian food supply, and changes in food consumption patterns.

From the 1940s until recently, Canada used Recommended Nutrient Intakes (RNI), while the USA used Recommended Dietary Allowances (RDA). However, a new set of standards has now been established, the Dietary Reference Intakes (DRI), used in both Canada and the USA. The RDA is one of four sets of standards within the DRI. RNI is now obsolete.

Objectives

After completing this section, you should be able to

• identify the four sets of standards for nutrient intake within the Dietary Reference Intakes (DRI).
• discuss the appropriate use of the RDA and AI, and identify some of their limitations.
• discuss how the recommendations for energy intake are established.

Key Terms

After completing section 2.1, you should be able to define and use the following terms in context:

Dietary Reference Intakes (DRI)
Estimated Average Requirements (EAR)
Recommended Dietary Allowances (RDA)
Adequate Intakes (AI)
Estimated Energy Requirement (EER)
Acceptable Macronutrient Distribution Range (AMDR)
Tolerable Upper Intake Levels (UL)

Reading Assignment

• Chapter 1: “Dietary Reference Intakes,” pages 18–21 (up to “Using Nutrient Recommendations”)

Dietary Reference Intakes

The first step in setting standards and guidelines is to determine the appropriate levels of required nutrients. Researchers and nutrition experts review the available scientific literature (as described in Unit 1) and create technical recommendations for use by nutrition professionals. The foundation for all nutrition recommendations in Canada and the US is the Dietary Reference Intakes (DRI), which consist of four sets of specific standards. These standards are listed in the bullet points on page 18 and described on pages 19 and 20 of the textbook. These standards are as follows:

1. Estimated Average Requirements (EAR)

Estimated Average Requirements (EAR) are average nutrient requirements; that is, they meet the needs of half the population. EAR are used by nutrition and health professionals (e.g., daycare centres, seniors’ lodges) to plan group diets and to assess the adequacy of a diet in a specific population.

2. Recommended Dietary Allowances (RDA)

RDA are recommended intakes for vitamins, minerals, and protein that meet the needs for almost all healthy individuals with similar characteristics in a population (e.g., age, gender, body size, physiological state). The RDA are set sufficiently high to meet the body’s needs, while also reducing the risk of chronic disease. To ensure adequacy, the average requirement for a nutrient is increased by two standard deviations to cover the requirements of about 98% of the population. Thus, the RDA exceed the needs of the majority—they are generous, yet safe and adequate.

3. Adequate Intakes (AI)

AI are established when there is insufficient scientific data to determine an RDA. The text explains that AI are the average amount of a nutrient that the population actually consumes. The terms RDA and AI are used interchangeably in the text and in this course. Read pages 19 and 20 carefully to gain a clear understanding of the differences between the two.

4. Tolerable Upper Intake Levels (UL)

Tolerable Upper Intake Levels (UL) represent the level at which intakes of specific nutrients are not safe. When considering UL, the important thing to remember is that the body’s need for most nutrients falls within a range. When intakes fall below the minimum or above the maximum of the range, this may pose a danger. Figure 1–6 (p. 20) illustrates this concept.

Reading Assignment

• Chapter 1: “Using Nutrient Recommendations,” pages 21–22

Using Nutrient Recommendations

RDA are best used to evaluate the adequacy of diets of population groups. They can also be used to estimate the risks of deficiencies for an individual, but only if the person’s intakes are averaged over a sufficient period of time.

A common mistake is to interpret intakes that are less than the recommended levels as deficient rather than as a measure of a probability of inadequacy that increases as intakes fall. The RDA are only educated guesses of the exact nutrient levels people require. Consequently, adequate intakes are considered achieved when the diet provides 95% of the RDA or more. The further below the RDA of a nutrient that a person consumes, the more likely the person is to have low nutrient stores, which may lead to poor health and nutrient deficiency symptoms.

An excess of RDA obtained from ordinary foods does not typically pose a problem, because the body can either absorb less or excrete the excess without any harm. However, if nutrient intake is too high (i.e., as a result of the regular use of supplements), adverse effects may occur.

Several limitations of the RDA should be recognized:

• RDA are established for healthy people with normal rates of intestinal absorption of nutrients. People suffering from an acute or chronic illness may have different needs for nutrients. Dietitians should be consulted to modify diets for special needs.
• RDA are set for only 26 nutrients. The body also needs other trace nutrients, which must be provided by a wide selection of foods.
• RDA are established without consideration of nutrient interactions (e.g., an unusually high intake of one nutrient may affect the requirement for other nutrients). For example, excess zinc will interfere with copper absorption, or excess protein may increase calcium excretion. Such nutrient interactions are of concern, especially when mega‑vitamin and mineral or protein supplements are used.
• In spite of increased interest in the physiological changes during the aging process, only limited data are available on the nutrient requirements of the elderly. RDA for the elderly are extrapolated mainly from those of younger adults.
• Nutrient requirements vary with body size, growth rate, or both. RDA are based on the average growth rate or physiological changes according to age. RDA may be somewhat inappropriate for individuals who have different growth spurts.

Reading Assignment

• Chapter 1: “Establishing Energy Recommendations,” page 21

Recommendations for Energy Requirements

Energy requirements are compiled and expressed differently from RDA for nutrients. Firstly, there is no safety margin given in the energy (or kilocalorie) recommendation as there is for nutrients. Secondly, energy is not consumed directly, but provided by the macronutrients: carbohydrate, fat, and protein. Energy recommendations are stated in two ways:

1. Estimated Energy Requirements (EER)

EER is the average dietary energy intake that will maintain energy balance in a person with a healthy body weight and a healthy level of physical activity. The EER, stated as kilocalories per day, is an absolute amount. You can find EER for males and females of different ages in the front inside cover of the text.

2. Acceptable Macronutrient Distribution Ranges (AMDR)

Acceptable Macronutrient Distribution Ranges (AMDR) have been established for the energy‑yielding macronutrients, providing for a range of intakes of carbohydrate, fat, and protein that provide sufficient energy and nutrients while reducing risk of chronic diseases. AMDR are listed in the text on page 21. You will need to know these values.

In summary, energy requirements can be stated as an absolute value or as a distribution of kilocalories from macronutrients. For example, a 19‑year‑old female has an EER of 2403 kcals/day, and her diet should consist of 45–65% of kcals from carbohydrate, 20–35% of kcals from fat, and 10–35% of kcals from protein.

Study Questions

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2.2 Diet‑Planning Guides

Introduction

To translate the RDA values into actual foods (we eat foods, not nutrients), we must develop diet‑planning guides. Through selection of the recommended number of servings from each food group, a person can be reasonably certain of consuming all the essential nutrients the body needs. The most widely used guide in Canada is Eating Well with Canada’s Food Guide (usually referred to as Canada’s Food Guide).

Canadian and American diet‑planning guides are formulated following some basic principles: adequacy, balance, Calorie control, nutrient density, moderation, and variety.

Objectives

After completing this section, you should be able to

• list the principles on which diet‑planning guides are formulated, and explain each principle, using examples.
• explain how to use Canada’s Food Guide by identifying the following:
  • the four food groups,
  • the number of servings and recommended serving sizes from each of the food groups,
  • ways to optimize choices from each food group,
  • the requirement for oils and fats and examples of beneficial oils and fats,
  • the major nutrients contributed by each food group, and
  • the strengths and weaknesses of the Guide.

Key Terms

After completing section 2.2, you should be able to define and use the following terms in context:

Reading Assignment

• Chapter 2: Introduction and “Diet‑Planning Principles,” pages 37–39

Diet‑Planning Principles

The diet‑planning principles are well presented in the textbook. However, elaboration is needed on the principle of moderation. The textbook mentions fats and sugar as constituents to be limited to avoid excess energy.

Salt and alcohol should also be used in moderation. Moderating all of these constituents helps to reduce the risk of such health problems as obesity, cardiovascular disease, cancer, dental caries, diabetes, hypertension, and so on. Moderation means cutting down, not cutting out.

This unit states several times that the diet should be reduced in its content of fat, especially saturated fat. This is based on the viewpoint that has been strongly held for many years that saturated fat plays a major role in the causation of heart disease and that a diet with a relatively high content of fat leads to weight gain. Findings in recent years suggest that both of these relationships are actually quite weak. Accordingly, dietary recommendations now place major emphasis on the type of fat, not the total amount. As part of this, the diet should emphasize unsaturated fats rather than saturated fat.

Reading Assignment

• Eating Well with Canada’s Food Guide, pages 40–45 and pages 47–51, from “Putting the Plan into Action up to Food Labels.” Canada’s Food Guide should also be included as a brochure in your course package.

Eating Well with Canada’s Food Guide

Introduction

Canada’s Food Guide is a familiar resource to most Canadians. In the spring of 2007, Health Canada released the latest version of the food guide, Eating Well with Canada’s Food Guide. The purpose of this guide is to help Canadians make food choices that promote health and reduce the risk of chronic, nutrition‑related diseases. The 2007 Guide reflects the currently available food supply and reflects food choices made by Canadians. The Food Guide promotes a desirable pattern of eating rather than prescribing a diet. It also addresses the need for regular physical activity as part of a healthy lifestyle.

A Healthy Eating Pattern for Canadians

Eating Well with Canada’s Food Guide describes what amount of food people need and what type of food is part of a healthy eating pattern. The eating pattern in Canada’s Food Guide includes foods from each of the four food groups—Vegetables and Fruit, Grain Products, Milk and Alternatives, and Meat and Alternatives—plus a certain amount of added oils and fats.

Following the eating pattern in Canada’s Food Guide will help people

• get enough vitamins, minerals, and other nutrients.
• reduce the risk of obesity, type 2 diabetes, heart disease, certain types of cancer, and osteoporosis.
• achieve overall health and vitality (Health Canada, 2007a).

The healthy eating pattern is based on extensive scientific evidence. It was developed by looking at different combinations of amounts and types of food to find an eating pattern that meets nutrient needs. The eating pattern was also evaluated against evidence that links certain foods with reduced risk of chronic diseases. The eating pattern meets the nutrient standards called Dietary Reference Intakes (DRI). DRI summarize research findings about the amount of each nutrient and calories needed for good health and the prevention of chronic disease, while avoiding the negative effects of consuming too much of any individual nutrient. The eating pattern in Canada’s Food Guide falls within the DRI’s Acceptable Macronutrient Distribution Ranges (AMDR) for carbohydrate, protein, and fat in the diet. The table below shows the AMDR for three different age groups (Health Canada, 2007a).

Acceptable Macronutrient Distribution Ranges

(Health Canada, 2007a)

Canada’s Food Guide groups people into nine categories based on age and gender (Food Guide, p. 2). For this course, you need to remember the recommendations for adults. The recommended number of servings represents an average that should be consumed each day. People who are at a healthy weight and are very active may need more than the recommended number of servings to meet their energy needs. They simply need to choose extra servings from all four food groups. For those who are overweight, the Food Guide can serve as a basis for a weight‑loss diet.

What Type of Food Should People Choose?

The type of food that people eat is just as important as the amount. Canada’s Food Guide provides direction on specific foods to choose within each food group. Guidance to direct people’s choices includes

• Eat at least one dark green and one orange vegetable each day.
• Have vegetables and fruit more often than juice.
• Make at least half of your grain products whole grain each day.
• Drink skim, 1%, or 2% milk each day.
• Have meat alternatives such as beans, lentils, and tofu often.
• Eat at least two Food Guide servings of fish each week.
• Include a small amount of unsaturated fat each day.
• Satisfy your thirst with water (Health Canada, 2007a).

Lower in Fat

Canada’s Food Guide encourages people to choose lower fat options to reduce the total amount of fat in their diet and reduce the amount of saturated and trans fats they consume. Higher fat foods are often higher in saturated and trans fats. These kinds of fats put people at higher risk of cardiovascular disease. People should try to limit the amount of saturated and trans fats that they eat. Saturated fats are found in fatty meats, higher fat milk products, butter, lard, shortening, hard margarines, and tropical oils such as coconut and palm oil. Trans fats are found in many deep‑fried foods, fast foods, salty snacks, and baked goods made with shortening or partially hydrogenated vegetable oils. People can find the total amount of fat and the amount of saturated and trans fats in food by looking at the Nutrition Facts table on the packaging (Health Canada, 2007a).

Lower in Sugar

Canada’s Food Guide recommends eating foods lower in sugar to help limit extra calories in the diet. Baked goods and desserts, such as cakes, candies, chocolate, cookies, doughnuts, ice cream, muffins, pastries and pies, and sweetened beverages, such as energy drinks, fruit‑flavoured drinks, soft drinks, sports drinks, hot chocolate, and specialty coffees, can be high in sugar and should be limited (Heath Canada, 2007a).

Lower in Salt

Most people get more sodium than they need, especially if they eat packaged, processed foods, and meals made outside of the home. Some of the foods that can be high in sodium include snack foods such as crackers, nachos, potato chips, and pretzels; cheese, gravies, and sauces; processed luncheon meats; canned or dried soups; and frozen meals. People should compare the Nutrition Facts table on similar products and choose the one that has a lower number for the % daily value of sodium. More information on nutrition labelling is available by visiting https://www.canada.ca/en/health-canada/services/food-nutrition/food-labelling/nutrition-labelling.html (Health Canada, 2007a).

Canada’s Food Guide recommends that people prepare foods with little or no added fat, sugar, or salt. Limit the use of high‑fat spreads, sweet sauces, and salty seasonings. When cooking, try roasting, grilling, baking, stir‑frying, steaming, or poaching—all methods that require little or no added fat. The number of calories in the eating pattern in Canada’s Food Guide depends on the specific foods or beverages that a person chooses as well as on how the food is prepared. For example, a person could choose to eat a bowl of muesli served with 2% milk, which would contain more calories than a bowl of bran flakes with skim milk (Health Canada, 2007a).

Make Each Food Guide Serving Count

Eating Well with Canada’s Food Guide encourages people to choose a variety of foods from each of the four food groups—Vegetables and Fruit, Grain Products, Milk and Alternatives, and Meat and Alternatives—and to include a specific amount and type of oils and fats (Health Canada, 2007a).

Foods are classified into the groups based on the following criteria:

• foods originating from the same agricultural base,
• how foods traditionally have been classified, and
• how people use foods (e.g., legumes were placed in Meat and Alternatives because people often use them as a substitute for meat) (Health Canada, 2007a).

Because the nutrient content of foods within a food group can vary greatly, no specific nutrient criteria were established for classification of food into food groups. To accommodate different food preferences, each food group includes a wide variety of choices. Eating different foods within each group will help people get all the nutrients they need. The table that follows shows how each of the four food groups contributes a certain combination of nutrients to the healthy eating pattern (Health Canada, 2007a).

(Health Canada, 2007a)

Vegetables and Fruit

Vegetables and fruit contain important nutrients such as vitamins, minerals, and fibre. They usually are low in fat and calories. A healthy diet rich in vegetables and fruit may help reduce the risk of cardiovascular disease and some types of cancer (Health Canada, 2007a).

Nutrients provided by vegetables and fruit include carbohydrate, vitamins A and C, potassium, magnesium, and some B vitamins such as folate. The individual nutrients may explain some of the health benefits of eating vegetables and fruit. It is more likely, however, that the nutrients work together with other naturally occurring components in vegetables and fruit to provide the overall health benefit (Health Canada, 2007a).

The Vegetables and Fruit food group is the most prominent arc in the rainbow on Canada’s Food Guide, emphasizing the important role these foods play in a healthy eating pattern. This food group makes up the largest proportion of the Food Guide servings in the healthy eating pattern and includes vegetables and fruit in many forms: fresh, frozen, as juice, canned, and dried (Health Canada, 2007a).

Some products with vegetable or fruit in their names or on their packaging are composed mainly of fat or sugar or are very high in salt. Fruit candies, vegetable chips, fruit jams or spreads, ketchup, and vegetable or fruit drinks or punches do not belong in the Vegetables and Fruit food group. People should choose 100% vegetable or fruit juices. Vegetable or fruit “drinks” or “beverages” may contain only a small amount of real vegetable or fruit juice. To make informed choices, people can be encouraged to read labels on packaged foods carefully (Health Canada, 2007a).

Make Vegetables and Fruit Servings Count

Eat at least one dark green and one orange vegetable each day. Dark green and orange vegetables are mentioned specifically because they are rich in folate and vitamin A, respectively. Eating these vegetables each day will ensure that people consume adequate amounts of these nutrients (Health Canada, 2007a).

Dark green vegetables are important sources of folate. Examples include arugula, asparagus, broccoli, Brussels sprouts, collards, fresh parsley, green peas, mustard greens, romaine lettuce, and spinach. Orange vegetables are rich in carotenoids such as beta‑carotene, which the body converts to vitamin A. These include carrots, pumpkins, orange‑coloured squash, and sweet potatoes (Health Canada, 2007a).

Some orange‑coloured fruit, such as apricots, cantaloupe, mango, and papaya, are also important sources of carotenoids. People can eat them in place of an orange vegetable. Oranges, though a good source of nutrients such as folate and vitamin C, are not a good source of carotenoids (Health Canada, 2007a).

Choose vegetables and fruit prepared with little or no added fat, sugar, or salt. Most vegetables and fruit are naturally low in fat. Vegetables and fruit become high sources of fat when they are breaded, fried, or served with cream‑based sauces, whipped cream, or butter. French fries, onion rings, salads with large amounts of dressing, and fruit served with cream are just a few examples of higher fat choices. People can cook vegetables or enhance the flavours of a salad using a small amount of unsaturated oil, such as canola or olive oil (Health Canada, 2007a).

Frozen and canned vegetables and fruit are a healthy and convenient option. Fruit in heavy syrup, however, has more sugar and extra calories. Choose unsweetened frozen fruit or fruit packed in juice. Canned vegetables usually contain added salt. People can rinse and drain canned vegetables to lower the sodium content. Some frozen vegetables come with added seasonings and sauces. Find the amount of fat and salt (sodium) in prepared vegetables by looking at the Nutrition Facts table on the packaging (Health Canada, 2007a).

Have vegetables and fruit more often than juice. Canada’s Food Guide recommends that people choose vegetables and fruit more often than juice to get more fibre. It can help people feel full and satisfied, which may help reduce the risk of obesity (Health Canada, 2007a).

Food Guide Servings for Vegetables and Fruit.

What is one Food Guide Serving? In general, one medium fresh vegetable or fruit or 125 mL (1/2 cup) cut up is equivalent to one Food Guide serving. One Food Guide serving of salad or raw leafy greens is 250 mL (1 cup) and 125 mL (1/2 cup) of cooked leafy green vegetables. A Food Guide serving of dried fruit is 60 mL (1/4 cup). A Food Guide serving of juice is equivalent to 125 mL (1/2 cup) (Health Canada, 2007a).

Grain Products

Grain products, particularly whole grains, are a source of fibre and typically low in fat. Fibre‑rich foods can help people feel full and satisfied. A diet rich in whole grains may also help reduce the risk of cardiovascular disease (Health Canada, 2007a).

Nutrients provided by grain products include carbohydrate, B vitamins (e.g., thiamin, riboflavin, niacin, and folate), iron, zinc, magnesium, and other components such as fibre. The health benefits associated with grain products cannot be attributed to any one nutrient. It is more likely that the nutrients work together with other naturally occurring components to provide an overall health benefit (Health Canada, 2007a).

The Grain Products food group is represented by a prominent arc in the rainbow on Canada’s Food Guide. This means that, relative to some other food groups, a large number of Food Guide servings is recommended. Grain Products include all grains, cereals, pasta, rice, and products made with grain flour (including corn flour) (Health Canada, 2007a).

Make Grain Products Servings Count

Make at least half of your grain products whole grain each day. Whole grains and whole-grain foods are composed of all three edible layers of the grain seed or kernel. Each layer provides a unique combination of nutrients. The outer bran layer provides all of the fibre as well as B vitamins; minerals such as magnesium, iron, and zinc; phytochemicals; and some protein. The middle endosperm layer accounts for the majority of the weight of the grain and is composed mostly of carbohydrate and protein. The inner germ layer provides B vitamins, unsaturated fats, vitamin E, minerals, and phytochemicals (Health Canada, 2007a).

Examples of whole grains include amaranth, brown rice, buckwheat, bulgur, millet, pot barley, quinoa, spelt, triticale, whole oats or oatmeal, whole rye, whole-grain wheat, and wild rice. Whole grains can be eaten on their own or used as ingredients in products or recipes such as buckwheat in pancakes, oats in cereal, quinoa in a pilaf, or whole-grain wheat in bread (Health Canada, 2007a).

People can find out if a product is made with whole grain by reading the ingredient list on the food label. Whole-grain foods will have the words whole or whole grain followed by the name of the grain as one of the first ingredients. The beginning of the list could say “whole-grain wheat” or “whole-grain oats” (Health Canada, 2007a).

What about refined grains? When whole grains are refined, both the bran and germ layers are removed. This results in a loss of fibre, vitamins, minerals, and phytochemicals. When wheat is milled to make white flour, for example, only the grain’s endosperm layer remains in the flour. In Canada, non‑whole-grain breads and pasta are made partly or entirely with white flour that has been “enriched.” The enrichment process restores some of the minerals and vitamins such as iron and certain B vitamins to levels that approximate those in the original whole-grain wheat (Health Canada, 2007a).

Imported white‑flour‑based grain products, such as some types of pasta, may not be enriched. To find out if the pasta product has been enriched, people can look for these nutrients in the ingredients list: folic acid, iron, riboflavin, niacin, and thiamin. Note that most rice is not enriched with these nutrients (Health Canada, 2007a).

Choose grain products that are lower in fat, sugar, or salt. Grain products typically are low in fat. People should limit the amount of fat added to these foods. They can use a small amount of oil or a soft margarine low in saturated and trans fats, on grain products such as breads or pasta, or when they cook or bake (Health Canada, 2007a).

Baked goods such as cakes, croissants, doughnuts, pastries, pies, and most cookies and muffins will add extra calories, fat, sugar, or salt (sodium) to the diet and should be limited. These foods are typically low in c and are not usually made with whole grains. People can use the ingredient list and Nutrition Facts table on food labels to compare products and make informed choices. Nutrition information for food purchased in coffee shops or restaurants is sometimes available on request from the vendors or on their websites (Health Canada, 2007a).

Food Guide Servings for Grain Products

What is one Food Guide Serving? In general, one Food Guide serving of Grain Products is a slice of bread (35 g), half a bagel (45 g), half a flatbread (35 g) such as tortilla, pita, 125 mL (1/2 cup) of cooked rice or pasta, or 30 grams of cold cereal. Because the volume (mL) of cereal that is equivalent to 30 grams varies depending on the type of cereal, people should refer to the Nutrition Facts table on the packaging. It will state the equivalent volume for 30 grams of the cereal in millilitres (mL) or cups (Health Canada, 2007a).

People need to become familiar with the amount of food that makes up one Food Guide serving of Grain Products. A pasta meal in a restaurant or at home can easily add up to four Food Guide servings or more of Grain Products, depending on the portion size and whether bread is part of the meal. People can use a measuring cup to see what one or two Food Guide servings of grains such as rice and pasta look like when served on a plate or in a bowl (Health Canada, 2007a).

Milk and Alternatives

The Milk and Alternatives food group provides calcium, vitamins A, D, and B12, riboflavin, zinc, magnesium, potassium, protein, and fat. Many of these nutrients are important for developing strong bones and reducing the risk of osteoporosis. The Milk and Alternatives food group includes milk, fortified soy beverage, canned (evaporated) milk, powdered milk, cheese, and yogourt (Health Canada, 2007a).

Make Milk and Alternatives Servings Count

Drink skim, 1%, or 2% milk each day. Canada’s Food Guide recommends that people drink low fat milk (skim, 1% MF, or 2% MF) each day. The fat content of other milk products varies widely. Drinking low fat milk is an effective way to consume protein, calcium, magnesium, riboflavin, vitamin A, vitamin B12, vitamin D, and zinc while minimizing the amount of saturated fat and calories (Health Canada, 2007a).

Fortified soy beverages can be used as an alternative to milk. They contain added vitamins and minerals to make them a nutritionally adequate alternative. People should look for the word fortified on the label when buying soy beverages (Health Canada, 2007a).

People should drink 500 mL (2 cups) of milk every day because it is the main food source of vitamin D. Fluid, evaporated, and powdered milk sold in Canada are fortified with vitamin D. Soy beverages with the word fortified on their packaging also contain vitamin D. This nutrient is also found in some other foods such as fatty fish, fish oils, margarine, and egg yolks. Milk used in the production of other dairy products such as yogourt and cheese is not required to be fortified with vitamin D. For this reason, yogourt and cheese may or may not be sources of vitamin D (Health Canada, 2007a).

Some rice, potato, and almond beverages are fortified with calcium, vitamin D, and other nutrients. Even when they are fortified, however, these types of beverages do not contain the level of protein found in milk or fortified soy beverages. Although some orange juices are sold with added calcium, with or without added vitamin D, they also do not provide protein and other important vitamins and minerals found in either milk or fortified soy beverages (Health Canada, 2007a).

Select lower fat milk alternatives. Milk products with a high milk fat content (% M. F.) such as cheese and some yogourt will provide high amounts of fat, saturated fat, and calories. Lower fat yogourt, with 2% MF or less, and lower fat cheese, with 15% to 20% MF or less, can help to reduce calories and saturated fat intake. People should note, however, that most lower fat cheeses still contain a significant amount of saturated fat (Health Canada, 2007a).

Ice cream, regular sour cream, and table or coffee cream are higher fat choices. They contribute extra saturated fat and calories to the diet and should be limited (Health Canada, 2007a).

Food Guide Servings for Milk and Alternatives

What is one Food Guide Serving? One cup (250 mL) of either milk, fortified soy beverage, or reconstituted powdered milk counts as one Food Guide serving. For canned (evaporated) milk, 125 mL (1/2 cup) is considered a serving. A Food Guide serving of Milk and Alternatives also includes 175 grams (3/4 cup) of yogourt or kefir (another type of cultured milk product) and 50 grams (1 1/2 oz.) of cheese (Health Canada, 2007a).

Meat and Alternatives

The Meat and Alternatives group provides important nutrients such as iron, zinc, magnesium, B vitamins (thiamin, riboflavin, niacin, vitamin B6, and vitamin B12), protein, and fat. Foods belonging to this food group include eggs, fish, legumes such as chick peas, kidney beans and lentils, meat, nuts and seeds, poultry, shellfish, and tofu (Health Canada, 2007a).

Make Meat and Alternatives Servings Count

Have meat alternatives such as beans, lentils, and tofu often. To minimize the amount of saturated fat in the diet, Canada’s Food Guide suggests that people regularly choose beans and other meat alternatives such as lentils and tofu. Legumes (beans, peas, and lentils) are also sources of folate and fibre. Nuts and seeds are other types of meat alternatives and are relatively high in calories, but contain monounsaturated fats and essential polyunsaturated fats, which are beneficial for cardiovascular health (Health Canada, 2007a).

Eat at least two Food Guide servings of fish each week. Eating fish helps reduce the risk of cardiovascular disease. People are encouraged to eat at least 150 grams of fish each week (Health Canada, 2007a).

All fish contain at least some omega‑3 fats called EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). People should get these fats through food because very little is produced by our bodies. Char, herring, mackerel, rainbow trout, salmon, and sardines have very high amounts of these omega‑3 fats. By themselves, EPA and DHA do not account for all the health benefits associated with regularly eating fish. It is likely that the omega‑3 fats, the other nutrients found in fish, and the displacement of high‑fat foods contribute to cardiovascular benefits. Deep‑fried fish or fast‑food fish sandwiches do not offer the same cardiovascular benefits. To get the greatest health benefits, people should cook fish using lower fat preparation methods (Health Canada, 2007a).

For high‑risk groups such as pregnant women and young children, refer to Health Canada’s most recent advisory on safe fish consumption. Eating predator‑type fish such as fresh tuna, shark, and swordfish can lead to over‑exposure to mercury. Refer to https://www.hc-sc.gc.ca/index-eng.php for the latest information (Health Canada, 2007a).

Select lean meat and alternatives prepared with little or no added fat or salt. To minimize the amount of saturated fat in the diet, Canada’s Food Guide emphasizes lean cuts of meat and skinless poultry. Lean or extra lean cuts of meat include inside round roast, outside round roast, eye of round steak or roast, strip loin steak, sirloin steak, rump roast, and lean and extra lean ground meat or ground poultry. Tenderloin cuts of meat can be lean if the visible fat is trimmed. Game meat such as bison, caribou, deer, elk, and moose also tend to be lean (Health Canada, 2007a).

Lean meat, poultry, and fish become higher fat choices once they are fried or served with gravy or other high fat sauces. Instead of frying or deep‑frying meats, Canada’s Food Guide recommends baking, broiling, poaching, or roasting them and allowing the fat to drip off. Luncheon meats, processed meats, and sausages add fat and sodium to the diet. Canada’s Food Guide recommends that people who eat these products choose lower fat and lower salt (sodium) varieties (Health Canada, 2007a).

Shellfish such as clams, crab, lobster, mussels, oysters, scallops, and shrimp are all generally low in fat and provide essential nutrients. Deep‑frying or dipping them in butter sauce, however, adds fat and calories (Health Canada, 2007a).

Food Guide Servings for Meat and Alternatives

What is one Food Guide serving? For beans or tofu, 175 mL (3/4 cup) counts as one Food Guide serving. A Food Guide serving of Meat and Alternatives also includes 75 grams (2-1/2 ounces) of cooked fish, chicken, beef, pork, or game meat. For general reference, a Food Guide serving of cooked meat, fish, or poultry is also about 125 mL (1/2 cup). Two eggs, 60 mL (1/4 cup) of nuts or seeds, and 30 mL (2 Tbsp) of peanut butter or nut butters are all equivalent to one Food Guide serving (Health Canada, 2007a).

A full Food Guide serving of Meat and Alternatives does not have to be eaten at every meal. In fact, having smaller amounts will allow people to enjoy a greater variety of foods from this food group (Health Canada, 2007a).

The healthy eating pattern and guidance of Canada’s Food Guide are suitable for vegetarians. To ensure adequate nutrient intakes of iron, zinc, and vitamin B12, vegetarians can choose a variety of meat alternatives such as beans, lentils, eggs, tofu, soy‑based meat substitutes, nuts, nut butters, and seeds. Milk and fortified soy beverages also provide calcium, vitamin B12, vitamin D, and protein (Health Canada, 2007a).

Oils and Fats

The 2007 Canada’s Food Guide, for the first time in its history, recognizes that a small amount of certain types of oil or fat is essential and desirable in the daily diet. These supply calories and essential fatty acids, and they help the body absorb fat‑soluble vitamins. Beneficial fats come primarily from unsaturated fat sources such as vegetable oils (canola, olive, and soybean); soft, non‑hydrogenated margarines; and nuts, seeds, and fatty fish. The Nutrition Facts label, now found on the majority of processed foods in Canada, is a valuable tool in helping to choose margarine with no trans fat and low saturated fat. Thus, the new recommendation for oils and fats is to include a small amount of unsaturated fat each day (Health Canada, 2007a).

Oils and fats supply calories and essential fats and help our bodies absorb fat‑soluble vitamins A, D, E, and K. The type of fat consumed is as important for health as the total amount consumed (Health Canada, 2007a).

Fats are composed of smaller units called fatty acids. These fatty acids can be saturated, trans, or unsaturated (polyunsaturated and monounsaturated). The main type of fatty acids that a fat or oil contains is used in its description. Canola and olive oils, for example, are described as monounsaturated fats (Health Canada, 2007a).

A number of foods contribute to the total amount of fat in a person’s diet. Fat is naturally present in many foods, such as meat, fish, cheese, nuts, and avocados. A significant amount, however, comes from oils and fats that are added to foods. Often these fats are added during cooking such as oil used for stir‑frying vegetables. Other fats are added at the table, including most salad dressings and sauces, mayonnaise, or margarine (Health Canada, 2007a).

A diet low in saturated fat and trans fat can help reduce the risk of cardiovascular disease. People should consume mostly unsaturated fats (polyunsaturated and monounsaturated fats) such as vegetable oils, soft non‑hydrogenated margarines, and the type of fat found in nuts, seeds, and fatty fish. These foods are important sources of essential fats (omega‑3 and omega‑6 fats) that cannot be synthesized by the body and must be obtained from the diet (Health Canada, 2007a).

Include a small amount—30 to 45 mL (2 to 3 tablespoons)—of unsaturated fat each day. This includes oil used for cooking, salad dressings, margarine, and mayonnaise. People should include a small amount of unsaturated fat as part of the healthy eating pattern that includes mostly lower fat foods. This will ensure people have enough essential fats. Consuming a larger amount of added fat is not recommended, as it will increase the total calories in the diet (Health Canada, 2007a).

Use vegetable oils such as canola, olive, and soybean. Vegetable oils such as canola, olive, and soybean contain mainly monounsaturated and polyunsaturated fats. These types of oils are emphasized in the diet for good health (Health Canada, 2007a).

Choose soft margarines that are low in saturated and trans fats. Limit butter, hard margarine, lard, and shortening. Fats that are solid at room temperature such as butter, lard, and shortening contain more saturated fats or trans fats than oils. Because saturated and trans fats are associated with an increased risk of cardiovascular disease, these types of added fats should be limited. A few tropical plant oils such as coconut oil, palm kernel oil, and palm oil are also high in saturated fats and should also be limited (Health Canada, 2007a).

Beverages

Canada’s Food Guide suggests that people drink water regularly. It can satisfy thirst and promote hydration without adding calories to the diet (Health Canada, 2007a).

The body naturally loses water throughout the day. These fluids must be replaced. Without adequate fluid intake, people can become dehydrated. This can lead to fatigue, weakness, headache, irritability, dizziness, and even impaired physical performance (Health Canada, 2007a).

People need more fluids when they are physically active. For most very active people, water is all they need to stay hydrated (Health Canada, 2007a).

In hot weather, people also need more fluids. Those most at risk of becoming dehydrated are young children and older adults (Health Canada, 2007a).

Soft drinks, sports drinks, energy drinks, and alcoholic beverages can add a significant number of calories to the diet. These drinks may also contain caffeine or sodium. The ingredients list and Nutrition Facts label will indicate if they contain sugar, fat, sodium, or caffeine (Health Canada, 2007a).

Fruit‑flavoured drinks are not nutritionally equivalent to 100% juices. If the name of the beverage includes words such as punch, drink, ‑ade, or cocktail, it is not 100% juice (Health Canada, 2007a).

In addition to sugar or syrups, sweetened hot or cold beverages may contain cream, whipped cream, or other high fat ingredients. These ingredients increase the amount of calories provided by the beverage. Hot chocolate and specialty coffee drinks are examples of beverages that can contribute additional sugar, fat, saturated fat, caffeine, and calories. The portion sizes for some of these beverages are very large, which can also increase their calorie content. The number of calories in beverages can add up quickly. To make informed choices, people can check the nutrition information, which is often available where these beverages are sold (Health Canada, 2007a).

Limited Foods

Limited foods are those that are high in calories, fat, sugar, and/or salt. These foods should be used only when adequate servings in all other food groups have been consumed and there is room for additional calories. Ideally, these foods should be consumed in limited amounts and infrequently. See the back page of the guide under the heading Eat Well for examples of “limited foods.”

Classifying Foods

The following foods are often classified incorrectly:

One method to determine whether a convenience or processed food belongs to a particular food group is to read the list of ingredients. Ingredients are listed by weight, in descending order of predominance. If two of the first four ingredients fit into a specific food group, the food likely contains the nutrient in a significant amount. If sugar or fats are listed as the predominant ingredients, the product should be chosen only occasionally. The same is generally true if water is the predominant ingredient.

How to Count Food Guide Servings in a Meal

From beef lo mein to shepherd’s pie to vegetable curry, meals typically consist of different foods from each food group. Counting the number of Food Guide servings in a meal requires that people know what foods are in a meal, as well as how much of each food was used to prepare the meal (Health Canada, 2007a).

The first step is to think about all the ingredients used to make that meal and then identify in which food groups they belong. Next, compare the amounts of the main ingredients in a portion of the meal to the amounts that make up a Food Guide serving in Canada’s Food Guide. This will provide an estimate of the number of Food Guide servings in a portion of the meal (Health Canada, 2007a).

Physical Activity

Previous food guides in Canada have included statements to encourage regular physical activity, but the present guide has quantified this general recommendation by suggesting a target duration. Many daily activities count toward the recommended 30 to 60 minutes of physical activity. Examples include yard work, golf (walking), and housework (such as mopping floors and carrying groceries).

Summary of Canada’s Food Guide

• Eat the recommended amount and type of food each day.
• Eat at least one dark green and one orange vegetable each day.
• Choose vegetables and fruit prepared with little or no added fat, sugar, or salt.
• Have vegetables and fruit more often than juice.
• Make at least half of your grain products whole grain each day.
• Choose grain products that are lower in fat, sugar, or salt.
• Drink skim, 1%, or 2% milk each day.
• Select lower fat milk alternatives.
• Have meat alternatives such as beans, lentils, and tofu often.
• Eat at least two Food Guide servings of fish each week.
• Select lean meat and alternatives prepared with little or no added fat or salt.
• Include a small amount of unsaturated fat each day.
• Satisfy your thirst with water.
• Limit foods and beverages high in calories, fat, sugar, or salt.
• Be active every day (Health Canada, 2007a).

When the recommended numbers of servings from each of the foods groups and a small amount of oil is consumed regularly and the key nutritional messages above have been adhered to, there is high probability of achieving overall good nutritional and physical health.

Canada’s Food Guide: Strengths and Weaknesses

Strengths of the Food Guide include the following:

1. It is a simple, yet comprehensive guide that is easy to teach, learn, and remember.
2. The Guide is designed to help plan and assess the diets of all healthy Canadians over two years of age. It provides specific guidance for various age groups and recognizes the different needs of females and males.
3. It provides a total diet approach that helps Canadians meet their nutritional requirements and achieve overall health and vitality.
4. It has incorporated current scientific evidence relating intake of certain beneficial foods to reducing risk of chronic diseases.
5. It has been updated to reflect current eating patterns of Canadians and the changing food supply.
6. It can accommodate ethnic foods and special dietary needs such as low salt, low fat, and low calories.
7. It has included a recommendation for daily moderate physical activity as a step towards better health and a healthy body weight.

The new Guide has corrected many of the weaknesses of the previous guides. There is much more clarity about serving sizes and serving ranges. The new Guide can be used for children as young as two years. There is much more emphasis on choosing whole grains and lower fat, sugar, and salt options. Small quantities of oils and fats are now included as part of a healthy diet. More multicultural food choices have been included. The website www.healthcanada.gc.ca/foodguide provides a wealth of information on examples of servings and sizes as well as preparation methods to limit fat, sugar, and salt.

Weaknesses still inherent in the guide include the following:

1. Based on the considerable variation in nutrient values of foods, it may be possible to consume the recommended numbers of servings, yet have inadequate nutrient intake (below DRI values) if less nutrient‑dense foods are consistently chosen.
2. Combination foods like casseroles continue to be difficult to break down into individual components.
3. Eating out and using prepared foods may make estimating serving sizes difficult.

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2.3 Nutrition Information on Food Labels

Introduction

Nutrition information on food labels allows consumers to make informed food choices. Nutrition labelling includes Nutrition Facts, nutrition or health claims, and ingredient lists. In Canada, nutrition labelling is mandatory for most food products. Nutrition Facts tables provide useful and sometimes surprising information for both consumers and nutrition students.

Objective

After completing this section, you should be able to interpret the nutrition information in a standard Nutrition Facts label.

Key Term

After completing section 2.3, you should be able to define and use the following term in context:

Percent Daily Value (DV)

Reading Assignment

• Chapter 2: “Food Labels,” pages 51–55

  Note: You will not be tested on the Glossary (p. 55).

Nutrition Facts Tables

The Nutrition Facts table is designed to look the same on most prepackaged products. Alternative formatting may be used on small packaging.

Almost all prepackaged food products must display the Nutrition Facts. Nutrition Facts labels are not required for fresh fruit and vegetables; fresh meat, poultry, and fish (but ground meat and poultry must have the Nutrition Facts); foods prepared or packaged at the grocery store and sold on site (e.g., bakery items, bulk sausages); products with insignificant amounts of all 13 core nutrients in a normal serving (e.g., coffee beans, tea leaves, herbs, and spices); and alcoholic beverages. Foods that are not prepackaged will not have a Nutrition Facts table. This includes foods that are served or sold in restaurants and cafeterias, take‑out meals, and meats and cheeses sold at deli counters.

Nutrition Facts labels present standard information in a consistent order, including

• serving sizes,
• number of calories,
• 13 core nutrients, and
• percent Daily Value (DV).

All of the information in Nutrition Facts is based on specific portion sizes that may vary between similar foods, and, as mentioned earlier, are not always consistent with Canada’s Food Guide. The information on serving size in a Nutrition Facts table is important.

The nutrition values for energy‑providing nutrients, fibre, and sodium are presented for the actual quantity of the nutrient in the specified serving size. Even if the nutrient amount is zero, it is listed.

The DV is based on the set of nutrition recommendations and Recommended Daily Allowances (RDAs) that address the population group with the highest needs, which is often 19–24‑year‑old males. However, women have higher iron needs than men, so the DV for iron is based on the needs of an adult woman (i.e., for women aged 19–50). The percent Daily Value indicates, at a glance, whether there is a lot or a little of a nutrient per serving of food. The percent DV can be used to compare foods. For example, if you were looking for high‑calcium foods, then a food with 25% DV of calcium would be a better choice than one with only 5%.

The DVs for fat and carbohydrates are based on appropriate levels for a 2000‑kcal diet, which is not suitable for many people. For energy intake, the DVs end up being appropriate for a “composite” person, providing only a crude estimate for most adults. Percent DV for fat and carbohydrate cannot be interpreted as percent of kcal or percent of the weight of the food. For example, the Nutrition Facts table presented in the text has 20% DV for fat. Some interpret this to mean that the food is 20% by weight. It should be interpreted as a food that is high in fat.

There are many more nutrients than the 13 mandatory ones found in most Nutrition Facts. Manufacturers may list other nutrients from a defined group, including other vitamins, minerals, types of fat, sugar, alcohols, and starch.

Nutrient labels often include nutrient content claims, which make relative claims about nutrients in foods, such as “reduced in fat,” “very high source of fibre,” or “source of omega‑3 polyunsaturated fatty acids.” Nutrient content claims usually appear on the front of food packages. Nutrition claims may also include authorized diet‑related health claims, which highlight a relationship between diet and a disease or condition that is supported by sound scientific evidence. One example of a diet‑related health claim is: “A healthy diet rich in a variety of fruits and vegetables may help reduce the risk of some types of cancer.” Government regulations require specific wording of a claim to ensure that the claim is applied consistently and is not misleading. The government also determines the criteria needed to qualify for a nutritional claim. See Table 2.7 on page 56.

Nutrition and diet‑related health claims usually highlight one nutrient of a food and are optional. Some evidence suggests that food products with nutrition and diet‑related health claims may cost more than products of comparable nutritional value that do not include a claim (Riciutto & Tarasuk, 2005). To assess the overall value of a food, read the Nutrition Facts and the ingredient list, and check comparable foods. For example, a product that is low in sodium or high in fibre may still be high in fat and calories.

More information on the Nutrition Facts label is available online at https://www.canada.ca/en/health-canada/services/food-nutrition/food-labelling/nutrition-labelling.html.

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References