Lesson 1, Topic 1

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Guidelines for Good Nutrition

The guidelines of good nutrition explain, generally, what a healthy eating pattern looks like. To have a healthy diet, most people should drink more water and eat foods that are:

lower in saturated and trans fats;
lower in sodium;
lower in sugar; and
higher in dietary fiber.

Packaged and processed foods, like fast food, microwave popcorn, candy bars, crackers, and chips do not follow these guidelines. These types of foods are high in fat, sodium, and sugar, and lack fiber and other important nutrients.

Fats

Fat is an important nutrient that gives the body energy. It helps the body absorb vitamins and supports important body functions such as the brain and immune system. Fat is also necessary for maintaining healthy skin and hair.
There are several types of fats in the foods we eat, and some are healthier than others. A diet higher in unhealthy fats can lead to high levels of LDL (bad) cholesterol and cardiovascular disease.

Healthy Fats

Unsaturated fats (both polyunsaturated and monounsaturated) do not raise blood cholesterol. These fats are normally plant oils that are liquid at room temperature. Examples include olive oil, avocado oil, and sesame oil. A healthy diet includes more foods that contain healthy unsaturated fats.

Almond butter
Avocado
Fish like salmon and tuna
Nuts like almonds, pecans, cashews, and walnuts
Olives
Seeds like pumpkin, sunflower, sesame, and chia

Unhealthy Fats

Saturated fats and trans fats are unhealthy because they can increase the risks of heart disease, diabetes, cancer, and obesity. These kinds of fats are solid at room temperature. Eat fewer foods containing saturated fat.

Butter
Cheese
Chicken Fat
Chicken Skin
Coconut Oil
Cream
Ice Cream
Meat
Milk
Palm Oil

Trans fats are harmful because they raise LDL (bad) cholesterol and lower HDL (good) cholesterol. The Food and Drug Administration banned artificial trans fats in the United States in 2018. However, some foods may still contain a small amount of trans fat as a result of food processing. In addition, trans fats may still be found in processed foods that were purchased before the ban went into effect.

Check the nutrition label on foods that might still contain trans fats.

Candy bars

Chips
Coffee creamer
Crackers
Vegetable shortenings (like Crisco)
French fries
Frozen pizza
Microwave popcorn
Refrigerated dough products
Some stick margarine

Fried fast foods can also contain high levels of trans fat because of the high cooking temperatures used during frying.

Fried chicken
Battered fish
Doughnuts
French fries
Mozzarella sticks

Tips to Reduce Unhealthy Fats

Read nutrition labels carefully to see if saturated or trans fats are listed on the label.
Look for the words “partially hydrogenated” to find trans fats in the ingredients list.
Choose lean meat or skinless chicken and trim all visible fat before cooking.
Use low-fat cooking methods such as grilling, barbecuing, steaming, stir-frying, dry roasting, or poaching.
Skim the fat off the top of cooled gravies, sauces, soups, or stews.
Cook with unsaturated fats such as olive oil.
Limit cream-based sauces and soups.

Reference the right side of page 179 for a small exercise about reading nutrition labels for unhealthy fats.

Sodium

Sodium (a mineral in salt) helps to maintain the body’s water balance, blood pressure and prevents dehydration. Too much sodium can lead to high blood pressure and heart disease.
Many people eat too much sodium. Even if salt is not added while cooking or at the table, the client could still be getting too much sodium in their diet by eating processed and/or pre-packaged foods.

Sodium Guidelines

The Dietary Guidelines for Americans recommend that healthy adults consume less than 2,300 mg of sodium per day (1 teaspoon). The American Heart Association recommends an ideal limit of no more than 1,500 mg per day for most adults. Sodium intake may be lower for the client depending on their health. Clients with congestive heart failure or high blood pressure most likely will be on a lower salt diet.

Tips to Reduce Sodium

Look for and use sodium-free, low, reduced, light in sodium, or no-salt-added processed foods.
Compare the level of salt in processed foods – the amount can vary widely between brands.
Choose fresh, frozen, or canned vegetables and meats without salt added.
Be “spicy” instead of “salty” when cooking. Flavor foods with a variety of herbs, spices, lemon, lime, or vinegar.
Avoid the salt shaker or fill it with an herb substitute instead.
Limit canned, ready-cooked, or boxed meals such as noodle casseroles or rice dishes.
Limit highly salted foods such as corned beef, bacon, luncheon meats, pickles, chips, crackers, pretzels, or preserved meats.

Look for these phrases on food labels

Sodium-free or salt-free	Each serving in this product contains less than 5 mg of sodium.
Very low sodium	Each serving contains 35 mg of sodium or less.
Low sodium	Each serving contains 140 mg of sodium or less.

Some phrases can be misleading!

Reduced or less sodium	The product contains at least 25% less sodium than the regular version.
Lite or light in sodium	The sodium content has been reduced by at least 50% from the regular version.
Unsalted or no salt added	No salt is added during the processing of a food that normally contains salt. However, some foods with these labels may still be high in sodium because some of the ingredients may be high in sodium.

Sugar

Sugar is a carbohydrate that naturally occurs in fruit, milk, and vegetables. Other carbohydrates are found in grain products like bread and pasta. Many processed foods also contain added sugar. The body uses sugar and other carbohydrates for energy. Too much sugar can lead to diabetes, obesity, tooth decay, and cardiovascular disease.

Most Americans eat too much-added sugar, and obesity and diabetes are epidemics in America today.

Guidelines for Added Sugar

Avoid or reduce added sugar as much as possible. The Dietary Guidelines for Americans recommends that most Americans eat less than 50 grams (about three tablespoons) of added sugar per day.

Tips to Reduce Sugar

Avoid or strictly limit foods that have added sugars. The most common foods that have added sugars include the following.

Sweetened coffee
Soda
Energy drinks
Fruit juice drinks
Candy bars
Cookies
Puddings
Candies
Cakes or other sweets or dessert items

Replace these items with healthier choices such as whole fruits or fruit products that have no added sugar. Look for added sugars in the ingredients list on packaged foods. In addition to the word “sugar,” the following words on a food package’s nutrition label also mean sugar.

Glucose
Fructose
Sucrose
High-fructose corn syrup (HFCS)
Evaporated cane juice
Barley malt
Corn syrup
Dextrose

Choose other carbohydrates wisely. Try whole grains (such as brown rice, bulgur, couscous, and quinoa) as side dishes. Switch from refined to whole-grain versions of bread, cereal, pasta, and rice.

See Adding More Fruits and Vegetables into the Diet in the Resource Directory on page 345 for more information. For more information about diabetes, carbohydrates, and diet, see Diabetes in Common Diseases and Conditions on page 368.

Dietary Fiber

Dietary fiber is a kind of carbohydrate from which the body gets little or no calories (energy). It naturally occurs in beans and peas, fruits, nuts, seeds, and vegetables. Dietary fiber can lower LDL (bad) cholesterol and help control blood glucose (blood sugar). It also helps make you feel full, increase the frequency of bowel movements, and reduces the risk of cardiovascular disease.

Guidelines for Dietary Fiber

Many Americans do not get enough dietary fiber. Most Americans should get about 28 grams of fiber per day. Most people can get the recommended amount of fiber by eating five servings of fruit and vegetables daily.

Clients should check with their doctor before increasing or decreasing dietary fiber. Fiber intake may need to be limited for adults with certain medical problems such as diverticulitis (inflammation or infection of the colon) or increased for clients who have chronic constipation.

Fiber should be increased in the diet slowly. Increasing fiber too fast can cause bloating and gas. Since fiber absorbs water, it is also important to drink plenty of fluids when increasing dietary fiber or taking fiber supplements.

Tips to Increase Dietary Fiber

Add beans, peas, and lentils to soups, stews, salads, and rice dishes. Substituting beans for meat will provide fiber and lower fat intake.
Choose whole-grain bread and cereals with “whole wheat flour,” “stone-ground whole wheat flour” or “100 percent whole wheat flour” as the first ingredient.
Experiment with different whole grains such as couscous, barley, bulgur, quinoa, and kasha in salads, soups, and casseroles to increase fiber.
Eat fruits such as apples, pears, bananas, berries, melons, or oranges. Peels and seeds in fruits increase fiber.
Eat vegetables such as carrots, sweet potatoes, broccoli, spinach, or green beans.
To keep the fiber content of vegetables high, eat them raw or steamed just until tender and leave the skins on.
Add dried fruits to cereal, muffins, and quick bread to increase fiber.

Look for these phrases on food labels

Good Source of Fiber, Contains Fiber, Provides Fiber	2½ grams to less than 5 grams
High Fiber, Rich in Fiber, Excellent Source of Fiber	5 grams or more

Foods Rich in Fiber

Food	Serving Size	Fiber
Bran	1/3 cup	8.5 g
Other High Fiber Cereals	1 cup	5 g
Whole-wheat spaghetti	1 cup	4 g
Corn on the cob	1 ear	6 g
Baked yam	1	7 g
Large carrot	1	2 g
Banana	1	4 g
Strawberries	1 cup	4 g
Apple with skin	1	3 g
Baked beans	1 cup	8 g
Kidney beans	1 cup	7 g
Split pea soup	1 cup	5 g
Baked potato with skin	1	3 g
Broccoli	1 cup	4 g
Dried figs	3 average	10 g
Pear	1 small	4 g
Prunes	5	4 g

Water, the Forgotten Nutrient

The human body needs water to live. Dehydration (a lack of enough water in our bodies) not only makes a person feel bad, but can also lead to heart injury, kidney failure, and death. Just a 2% water deficit can cause fatigue, confusion, short-term memory loss, and mood changes like increased irritability or depression. Dehydration can increase the risk of urinary tract infection (UTI), kidney stones, gallstones, and constipation.

The body uses water to:

digest food;
remove waste;
carry nutrients and oxygen to every cell in the body;
cool the body;
lubricate joints and tissues; and
maintain healthy skin.

Guidelines for Water Intake

Everyone’s water requirements are different. Most healthy people need between 9 and 13 cups each day, with 1 cup equaling 8 ounces.

Since fruits and vegetables are mostly water, eating at least “five a day” will also help with hydration. About 20% of a person’s total daily water intake comes from water-rich foods like lettuce, leafy greens, cucumbers, bell peppers, summer squash, celery, berries, and melons.
Coffee and tea can contribute to daily fluid intake.
Too much water can flush out electrolytes that are needed by your body and this can have a negative impact.

Some clients may be on a fluid restriction diet which limits their daily intake of water as well as foods that contain a lot of water.

Drinking More Water

Most adults in the United States do not drink
enough water, and older adults tend to drink less
water than younger adults. The thirst sensation
tends to decline as we age, making it harder for
older adults to realize they need more fluids.
Conditions such as stroke or dementia can also
impair thirst. Here are some tips to promote
drinking more water:

Encourage a client to drink before they become thirsty.
Offer fluids frequently throughout the day. It is also a good idea to keep a glass of water by a client’s chair or bed.
Fill a 20-ounce water bottle four times a day or drink a large glass of water with each meal and snack.
Add flavor to water by adding
– sliced citrus,
– crushed mint,
– peeled sliced ginger or cucumber,
– crushed berries,
– sliced melon.
Add a splash of juice to sparkling water for a bright, refreshing drink.