{\rtf1\adeflang1025\ansi\ansicpg1252\uc1\adeff0\deff0\stshfdbch0\stshfloch0\stshfhich0\stshfbi0\deflang1033\deflangfe1033{\fonttbl{\f0\froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\f37\froman\fcharset238\fprq2 Times New Roman CE;}{\f38\froman\fcharset204\fprq2 Times New Roman Cyr;} {\f40\froman\fcharset161\fprq2 Times New Roman Greek;}{\f41\froman\fcharset162\fprq2 Times New Roman Tur;}{\f42\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\f43\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);} {\f44\froman\fcharset186\fprq2 Times New Roman Baltic;}{\f45\froman\fcharset163\fprq2 Times New Roman (Vietnamese);}}{\colortbl;\red0\green0\blue0;\red0\green0\blue255;\red0\green255\blue255;\red0\green255\blue0;\red255\green0\blue255; \red255\green0\blue0;\red255\green255\blue0;\red255\green255\blue255;\red0\green0\blue128;\red0\green128\blue128;\red0\green128\blue0;\red128\green0\blue128;\red128\green0\blue0;\red128\green128\blue0;\red128\green128\blue128;\red192\green192\blue192;} {\stylesheet{\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \snext0 \styrsid8934555 Normal;}{\*\cs10 \additive \ssemihidden Default Paragraph Font;}{\* \ts11\tsrowd\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\trcbpat1\trcfpat1\tblind0\tblindtype3\tscellwidthfts0\tsvertalt\tsbrdrt\tsbrdrl\tsbrdrb\tsbrdrr\tsbrdrdgl\tsbrdrdgr\tsbrdrh\tsbrdrv \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang1024\langfe1024\cgrid\langnp1024\langfenp1024 \snext11 \ssemihidden Normal Table;}{\s15\ql \li0\ri0\widctlpar \tqc\tx4320\tqr\tx8640\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext15 \styrsid806713 header;}{ \s16\ql \li0\ri0\widctlpar\tqc\tx4320\tqr\tx8640\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext16 \styrsid806713 footer;}}{\*\latentstyles\lsdstimax156\lsdlockeddef0}{\*\pgptbl {\pgp\ipgp0\itap0\li0\ri0\sb0\sa0}{\pgp\ipgp1\itap0\li0\ri0\sb0\sa0}}{\*\rsidtbl \rsid806713\rsid1451464\rsid4266201\rsid8934555\rsid10039176\rsid11015151\rsid11479072\rsid12062112 \rsid14504713\rsid16200556}{\*\generator Microsoft Word 11.0.0000;}{\info{\title Effective consumer label education requires active, not passive learning}{\author }{\operator }{\creatim\yr2009\mo8\dy4\hr15\min15}{\revtim\yr2009\mo8\dy13\hr19\min9} {\version5}{\edmins16}{\nofpages5}{\nofwords2224}{\nofchars12683}{\*\company Taunton Siding Co., Inc.}{\nofcharsws14878}{\vern24615}{\*\password 00000000}}{\*\xmlnstbl {\xmlns1 http://schemas.microsoft.com/office/word/2003/wordml}{\xmlns2 urn:schemas-micr osoft-com:office:smarttags}}\paperw12240\paperh15840\margl1440\margr1440\margt1440\margb1440\gutter0\ltrsect \widowctrl\ftnbj\aenddoc\donotembedsysfont1\donotembedlingdata0\grfdocevents0\validatexml1\showplaceholdtext0\ignoremixedcontent0\saveinvalidxml0\showxmlerrors1\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\formshade\horzdoc\dgmargin\dghspace120 \dgvspace180\dghorigin1440\dgvorigin1440\dghshow2\dgvshow2 \jexpand\viewkind1\viewscale100\pgbrdrhead\pgbrdrfoot\splytwnine\ftnlytwnine\htmautsp\nolnhtadjtbl\useltbaln\alntblind\lytcalctblwd\lyttblrtgr\lnbrkrule\nobrkwrptbl\snaptogridincell\allowfieldendsel\wrppunct \asianbrkrule\rsidroot8934555\newtblstyruls\nogrowautofit \fet0{\*\wgrffmtfilter 013f}\ilfomacatclnup0{\*\ftnsep \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10039176 \chftnsep \par }}{\*\ftnsepc \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10039176 \chftnsepc \par }}{\*\aftnsep \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10039176 \chftnsep \par }}{\*\aftnsepc \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10039176 \chftnsepc \par }}\ltrpar \sectd \ltrsect\linex0\sectdefaultcl\sectrsid806713\sftnbj {\headerr \ltrpar \pard\plain \ltrpar\s15\qc \li0\ri0\widctlpar\tqc\tx4320\tqr\tx8640\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid806713 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10039176 {\*\xmlopen\xmlns2{\factoidname PlaceName}}{\*\xmlopen\xmlns2{\factoidname place}}Bristol{\*\xmlclose} {\*\xmlopen\xmlns2{\factoidname PlaceName}}{\*\xmlopen\xmlns2{\factoidname PlaceType}}Plymouth{\*\xmlclose}{\*\xmlclose} {\*\xmlopen\xmlns2{\factoidname PlaceName}}{\*\xmlopen\xmlns2{\factoidname PlaceType}}Regional{\*\xmlclose}{\*\xmlclose} {\*\xmlopen\xmlns2{\factoidname PlaceName}}{\*\xmlopen\xmlns2{\factoidname PlaceType}}Technical{\*\xmlclose}{\*\xmlclose} {\*\xmlopen\xmlns2{\factoidname PlaceType}}School{\*\xmlclose}{\*\xmlclose} \par Practical Nurse Program \par }}{\footerr \ltrpar \pard\plain \ltrpar\s16\ql \li0\ri0\widctlpar\tqc\tx4320\tqr\tx8640\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 { \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10039176 Class Lecture \endash Unit 1 Hour 3 NutrLecUnit1Hour3.rtf \par }}{\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang {\pntxta )}} {\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl8 \pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11015151 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11015151 Introduct}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid806713 ion to Nutriton \endash Unit I, Hour 3}{ \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555 \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid806713 \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11015151 Review }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12062112 Food Pyramid}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11015151 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid8934555 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11015151\charrsid8934555 \par }\pard \ltrpar\ql \fi720\li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid806713 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14504713 The FDA requires certain labeling on prepared foods.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555\charrsid8934555 Health care professionals must be able to interpret the Food Label a little more critically than the average consumer if they are to become reliable health care educators. \par The FDA has put a great deal of time, effort, and money into providing food label s designed for helping consumers make healthier food choices. The label can give guidelines for managing weight, making better food choices, finding nutritional information about a product, comparing one product with other similar products and identif ying critical food allergens. \par First, look at the ingredients. The ingredients are listed in descending order, starting with the primary ingredient of the product. Remember back to what was said about Whole Wheat products. In this label, even though whe at flour is listed, this particular product would not be a source of whole wheat. \par The allergy information contains only the most common, critical food allergies and/or food intolerances. Even foods that don\rquote t necessarily contain a certain ingredient, b ut are prepared in the same processing plant that prepares food with allergens must be listed. This product doesn\rquote t contain egg, but is made in a plant that produces products made with egg. Because of this FDA rule, you might see a warning on peanut butter \endash Warning! This product may contain peanuts. \par Allergens are those particules that cause an allergic reaction. Pollen is the allergen that triggers the allergic reaction known as hay fever. The common, critical food allergens are milk products, eg gs, peanuts, fish, shellfish, soy, wheat, and tree nuts. There are many other food allergens out there \endash bananas, strawberries, chocolate to name a few, but the FDA has only identified the 8 that are known to cause severe, life threatening allergic reactions. \par The other label on each food item is the nutrients label. The nutrients label shows the amounts of macronutrients by weight, usually grams, and the percentage of the macronutrients and some micronutrients in relation to the daily needs. This per centage is based upon a 2,000 kcalorie diet. \par There are some terms you need to know to be able to interpret these amounts and percentages. \par The Dietary Reference Intakes (DRI) is a group of nutritional recommendations and standards. \par Up until recently, the recommended amounts of specific nutrients was referred to as the Recommended Dietary Allowance (RDA). This was a one-size-fits-all list and served as the standard from 1941 to 1989. The RDA's were revised and are now part of th e DRI's (Dietary Reference Intakes). The DRI\rquote s define specific guidelines for special populations, in particular lactating and pregnant women, as opposed to just the one general population addressed by RDA\rquote s. \par Most of you have probably heard of the Recommended Dietary Allowance, maybe even called it the Recommended Daily Allowance, but that is just one set of guidelines to help plan a healthy diet. \par The RDA\rquote s define the daily amount needed of specific nutrients required by most people to maintain optimum health. These amounts are based upon scientific research. \par The Estimated Average Requirements (EAR) is also based upon scientific research. These are the amounts required by half the group within a specific population (child, adult, pregnant woman, etc.) to maintain health. \par The EAR forms the basis for the RDA. \par The science of nutrition is based upon scientific fact and proven research. Sometimes a nutrient, usually a micronutrient like a vitamin or mineral, is known to be beneficial, but the exact amount needed daily hasn\rquote t been determined by scientific research. In this case, the term \lquote Adequate Intake\rquote is used. A person needs an \lquote Adequate Intake\rquote of magnesium each day. \par Not all nutrients follow the rule \endash \lquote More is Better\rquote Some nutrients should be avoid, like trans fats. Others are quite necessary, but only in restricted amounts, like cholesterol and sodium. \par In these cases, restrictions are set upon the maximum allowable daily amounts. These numbers are the Tolerable Upper Intake Levels or UL. \par So, the Dietary Reference Intakes contain guidelines for including 3 \lquote at least\rquote amounts of nutrients and 1 \lquote at most\rquote amount of nutrients. \par The Percent Daily Value is the percent of each nutrient needed each day based upon a 2,000 kcalorie diet. For instanc e, the RDA of Calcium is 1000 mg - 1300 mg per day. If a food contains 250 mg calcium, then that food would contain approximately 20% of the daily calcium requirement. If that same food contains 18 mcg/d Vitamin C, then that food contains approximate ly 2% of the total amount of Vitamin C needed for that day. \par The goal of the Nutrition Facts label is to provide information, but not to teach people how to interpret them; they need more guidance and context to make informed decisions . \par The label doesn\rquote t teach nutrition but is a valuable nutrition education tool. \par The Nutrition Facts label. It identifies the 6 basic messages/skills we seek to communicate to health professionals, educators and consumers. \par (1) Serving Size and Servings per Container \endash often people eat more than 1 serving \par (2) Calories per serving and how many of those calories come from fat (rather than protein or carbohydrates) \par (3) Nutrients to be limited - %DV should be No More Than 100% per day. These change from product to product. \par (4) Nutrients to be enjoyed - %DV should be At Least 100% per day. These also change from product to product. \par (5) The footnote at the bottom of the label contains the Daily Values for the nutrients listed and dietary advice generally consistent with the DGA. The footnote, which is not found on smaller product labels, never changes from product to product. \par Question: How Many Calories Am I actually Eating? \par Answer: Number of Servings per Container, Serving Size, Number of Calories per Serving Size \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid806713 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555\charrsid8934555 \par }\pard \ltrpar\ql \fi720\li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid806713 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555\charrsid8934555 The calories come directly from the macronutrients: Fats, Carbohydrates, and Proteins \par Fats = 9 kcal per gram for a total of 108 kcal \par Carbohydrates = 4 kcal per gram for a total of 124 kcal \par Proteins = 4 kcal per gram for a total of 20 kcal \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid806713 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555\charrsid8934555 \par }\pard \ltrpar\ql \fi720\li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid806713 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555\charrsid8934555 108 + 124 + 20 = 252 which is approximately equal to the 250 Calories stated \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid806713 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555\charrsid8934555 \par }\pard \ltrpar\ql \fi720\li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid806713 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555\charrsid8934555 In this example, one serving of macaroni and cheese equals one cup. If you ate the whole package, you would eat two cups, which doubles the calories and other nutrient numbers, including the % DVs. \par As you can see-The number of servings you consume will determine the number of calories and nutrients you actually eat. \par Bottom line: You need to compare how much you actually eat - not only to the serving size on the label but also to the number of servings you eat, to figure out how many calories (and nutrients) you are consuming. \par In terms of calories, what amount is Low, Moderate, or High? \par Here\rquote s our GENERAL GUIDE TO CALORIES. Notice how it gives consumers a context for determining calorie amounts based on 2000 calories. \par \tab 40 calories is low-- is actually a nutrient content claim. \par \tab 100 calories is moderate is--5% of 2000 calories \par \tab 400 calories is high-- is 20% of 2000 calories. \par Eating too much fat, saturated fat, trans fat, and cholesterol, or sodium may increase your risk of certain chronic diseases, like heart disease, some cancers, or high blood pressure. \par So when we say, \'93Limit These Nutrients,\'94 the goal is to stay BELOW 100% of the DV for each one of these nutrients per day. \par Note: Trans fat doesn\rquote t have a %DV: message: Health experts recommend that you keep your intake of saturated fat, trans fat, and cholesterol as low as possible as part of a nutritionally balanced diet. \par So, which nutrients are needed in 'adequate amounts'? \par Americans often don't get enough dietary fiber, vitamin A, vitamin}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid806713 C, calcium, and iron in their }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555\charrsid8934555 diets. \par Eating enough of these nutrients can benefit your health and help reduce the risk of some diseases and conditions. \par For example, getting enough calcium may reduce the ris k of osteoporosis, a condition that results in brittle bones as one ages. You can also address the benefits of a high-fiber diet: for example, improved laxation, increased satiety, and the possibility of reduced risk of heart disease, particularly when the fiber is soluble and the diet is low in saturated fat and cholesterol. \par Daily Values represent expert advice for upper daily limits (for total fat, sat fat, cholesterol, and sodium), based on a a 2,000 calorie diet.\emdash But for Total Carbohydrates and dietary fiber, they represent lower daily limits\emdash Public health experts advise us to stay within these limits, ie dietary recommendations, per day for a 2,000 calorie. \par The %DV tells you if a serving of food is high or low in a nutrient. The %DV column does not add up vertically to total 100%. \par Instead, each nutrient with a % DV (e.g., fat, cholesterol, sodium, vitamin c, calcium, etc.) is based on a 100% of the daily requirements (or the DV) for that nutrient based upon a 2,000 calorie diet. \par How can you tell if the %DV is high or low? \par On this sample label: 12g fat equals 18% DV \par Is 18% DV for Total fat or 20% DV for Sodium high or low? Do these nutrient amounts contribute a lot or a little to the daily limit of 100% DV? \par Here\rquote s an easy way to know: Check the Quick Guide to % DV for context. \par 5% DV or less is low and 20% DV or more is high for all nutrients, including those you want to limit (e.g., fat, saturated fat, cholesterol, and sodium) or those you want to get enough of, like fiber and calcium. \par Critical Thinking Question: Which nutrients have no %DV? \par There are three nutrients that have no % DV (for TRANS FATS & SUGARS, THERE ARE NO DAILY VALUES RECOMMENDATIONS FOR THEM.) \par For Protein: Unless a claim is made, or the food is meant for use by inf ants and children under 4 years old, there is no requirement for a % DV for protein. Current scientific evidence indicates that protein intake is not a public health concern for adults and children over four years old. \par Trans fat: Scientific reports link trans fat (saturated fat and cholesterol) with raising LDL (\'93bad\'94) blood cholesterol, which increases your risk of coronary heart disease, a leading cause of death in the {\*\xmlopen\xmlns2{\factoidname country-region}}{\*\xmlopen\xmlns2{\factoidname place}}US{\*\xmlclose}{\*\xmlclose}. However, experts could not provide a reference value for trans fat nor any other information that FDA believes is sufficient to establish a DV or % DV. \par Although sugars have no % DV, you can know how to limit your intake by comparing two products and choosing t}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid806713 he one with the lowest amount.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555\charrsid8934555 \par To compare, look at the Nutrition Facts label to determine the TOTAL amount of sugars in a food. The total amount of sugar includes both naturally occurring sugars and those sugars added to the food. \par In this case, the plain yogurt on the left has 10g of sugar in one serving; the fruit yogurt on the right has 44g of sugars, 2-3 times the amount of sugar found in most candy bars. \par So how can you tell if either of these yogurts has added sugars? \par Check the ingredients to see if the sugars are natural sugars or added sugars. \par The %DV of macronutrients are given as well as the weights (in grams) of each. For the micronutrients, only the %DV are given, no weights. Remember that some %DV are meant to be the maximum and some %DV are meant to be the minimum. \par Some common diseases and disorders associated with too little or too much nutrients. As you progress through this course, you\rquote ll discover many more nutrition associated disorders. \par What can you tell from reading this label? \par If the consumer\rquote s g oal is to reduce fat, then the reduced fat product is a better choice. If the goal is to reduce carbohydrates, then the regular peanut butter is better. If the consumer should avoid sodium, then the regular peanut butter is better. What can you tell about peanut butter as a source of vitamins and minerals? \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11479072 What about shopping? What are some good shopping tactics? How can you save money when buying food without compromising nutritional value?}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8934555 \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11479072 [Open discussion \endash use slides for pointers] \par }\pard \ltrpar\ql \fi720\li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid11479072 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11479072 \par }\pard \ltrpar\ql \fi720\li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1451464 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1451464 It\rquote s not feasible for people who are following a diet to mathematically count calories with every meal. Instead, they use an \lquote exchange list.\rquote Exchange lists are very commonly used by people with health related dietary restrictions. \par \par The most commonly use d exchange list is published jointly by the American Dietetics Association and the American Diabetes Association. While designed primarily for people who have diabetes and others who must follow special diets, the exchange lists are based on principles of good nutrition that apply to everyone. \par \par The diabetic exchanges are six different lists of foods grouped according to similar calorie, carbohydrate, protein, and fat content; these are starch/bread, meat, vegetables, fruit, milk, and fat. A person is allowe d a certain number of exchange choices from each food list per day. \par \par Foods can be selected from within the same list, but not from other lists. A slice of bread cannot be substituted for a vegetable serving even if both items contain the same amount of calories. \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1451464 \par }\pard \ltrpar\ql \fi720\li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid11479072 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11479072 Here is a partial listing of the Starches. There is a full ADA Exchange List in your Nutricalc software that came with your textbook. You\rquote ll need to go to Preferences to find it.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11479072 \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1451464\charrsid1451464 Persons who are on a special diet , also called a therapeutic diet, are generally guided by the physician and the registered dietitian in determining how many servings of each group should be included in each meal. \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1451464 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11479072 \par }\pard \ltrpar\ql \fi720\li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid11479072 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11479072 What happens when people don\rquote t get the required nutrients? It\rquote s important to recognize that it \rquote s not just the quantity of food eaten that\rquote s important as it is the quality of food eaten. It is possible to receive enough calories, yet lack one or more nutrients. \par People who are seriously malnourished don\rquote t look healthy. In fact, people who are malnourished aren\rquote t healthy. Malnourished people will display some, but not all, of these qualities. \par \par Even if a person receives enough calories for energy, they may be lacking in one or more essential nutrients like protein, or vitamins, or minerals, or a combination of all. \par \par \lquote Essential\rquote is a term used to indicate a nutrient the body can\rquote t manufacture on its own. The liver is capable of producing cholesterol from non-cholesterol fat and Vitamin D absorbed from the sun. Cholesterol is not an essential nutrient. The body has no way of producing Vitamin C. Vitamin C must come from a dietary source. Vitamin C is an essential nutrient. \par \par Serious signs of malnutrition don\rquote t always emerge in the early stages. The nutritional reserves are depleted over time. \par Malnourished people lack energy even when they have enough fuel. They also lack the necessary nutrients to regain and maintain health. \par \par Poor nutrition will always have serious consequences eventually. It is up to you, the nurse, to promote optimum nutrition in the community and in the health care facility.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11479072 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid11479072 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11479072\charrsid8934555 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4266201\charrsid8934555 \par }}