Adult nutrition

Definition

Nutrition describes the processes by which all of the food a person eats are taken in and the nutrients that the body needs are absorbed. Good nutrition can help prevent disease and promote health.
Vitamins and minerals are an important part of nutrition. Vitamins are organic substances present in food. They are required by the body in small amounts to regulate metabolism and to maintain normal growth and functioning. Minerals are vital because they are the building blocks that make up the muscles, tissues, and bones. They also are important to many life-supporting systems, such as hormones, transport of oxygen, and enzyme systems.
There are many nutrients the body absorbs from food and each of the food groups supplies at least one nutrient. For example, oat bran, which is a whole grain, can supply fiber and a mineral called magnesium. A good nutrition plan will ensure that a balance of food groups, and the nutrients supplied by each group, is eaten

Percentage of healthy, overweight, and obese adults in the United States

Age 20> yrs	Healthy weight BMI 18.5 to 24.9	Overweight BMI 25.0–29.9	Obese BMI 30 and above
All Adults	32.9%	34.1%	32.2%
Women	35.4%	28.6%	34.6%
Men	30.4%	39.7%	31.1%

SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, U.S. Department of Health and Human Services.

(Illustration by GGS Information Services/Thomson Gale.).

Purpose

As children, nutrition is important for normal growth and development. As adults, nutrition still promotes health and reduces risk of disease. Studies have shown that Americans have gained weight largely because they eat too much and because they choose to eat the wrong foods. Good nutrition can help prevent weight gain by focusing on consuming calories that are high in nutrients, not in sugars and fat. Nutrition also plays a role in preventing and controlling diseases. For example, poor nutrition can lead to high cholesterol, which causes coronary heart disease. Lowering salt in the diet can control high blood pressure. People with diabetes must follow special diets to control their blood glucose levels.
Examples of people with medical conditions and diseases show the effect that certain nutrients, or a lack of certain nutrients, can have on the human body. Some specific diseases linked to poor diet and physical inactivity are cardiovascular disease, type 2 diabetes, high blood pressure, osteoporosis, and certain types of cancer. Being overweight, and especially obese, also is linked to many health problems. Eating a poorly balanced diet that is low in nutrients but high in total calories can lead to weight gain.
Special diets or nutritional therapy may be used to complement other treatments subscribed by a physician to treat particular diseases and conditions. Examples include:

• High cholesterol. Eating a diet high in fiber and low in saturated fats and cholesterol can help keep cholesterol in check.
• High blood pressure. Reducing salt and certain fats, as well as reducing overall weight, helps lower blood pressure. Special diets have been developed to lower risk of high blood pressure and heart disease.

KEY TERMS

Monounsaturated fat—Fats that contain one double or triple bond per molecule. Though these fats still have lots of calories, they can help lower blood cholesterol if used in place of saturated fats. Examples of monounsaturated fats are canola oil and olive oil.
Polyunsaturated fat—Fats that contain two or more double or triple bonds per molecule. Examples include fish, safflower, sunflower, corn, and soybean oils.

• Diabetes. Nutrition is critical to adults with type 2 diabetes. They will have to control portions, eat regularly and eat nutrient-rich foods, along with other dietary guidelines.
• Anemia. People with anemia need to get more iron from their diets and will be encouraged to eat more foods such as soybeans, spinach, and others.

Sometimes, people who are ill need artificial nutrition to help them receive the proper nutrients. The nutrition may come in the form of special drinks that supplement their diets or even be provided through intravenous (IV) injections in a hospital or other facility.
Nutrition is important throughout adults’ lives. As younger adults, good nutrition helps keep people strong as they need energy for active lives that may involve athletic pursuits and busy days filled with work and raising children. Pregnant women will need to pay particular attention to nutrition. In the middle years, proper nutrition helps prevent disease and weight gain that normally is associated with aging and lives that may become more sedentary. And as people reach their mature years, nutrition becomes critical, as many people in their later years fail to eat properly due to medical conditions and medications or social factors.

Description

The United States Department of Agriculture (USDA) and the United States Department of Health and Human Services revised the Dietary Guidelinesfor Americans in 2005. The guidelines are science-based and outline advice for choosing a nutritious diet and maintaining a healthy weight. The 2005 guidelines also address physical activity and food safety and make recommendations for special population groups.
Finally, calorie requirements and servings are based more on gender, age, and level of physical activity, while in 2000, the servings were more uniform for all adults. The USDA also revised the traditional food pyramid to make it customized for individuals.

Basic food groups

The following are the basic food groups included in the pyramid provided by the USDA:

• Grains. The guidelines recommend eating at least three ounces of whole grain bread, cereal, crackers, rice, or pasta every day. At least one-half of all grains should be whole grains, which can be determined by looking for the word “whole” before the grain name on the list of ingredients.
• Vegetables. The pyramid recommends eating more dark green and orange vegetables, as well as more dry beans and peas.
• Fruits. A variety of fresh, frozen, or canned fruit is good, but the USDA recommends taking it easy on fruit juices.
• Milk, yogurt, and cheeses. The USDA recommends getting plenty of calcium-rich food from low-fat or fat-free milk. People who can’t drink milk should turn to lactose-free products or other sources of calcium, such as hard cheeses and yogurt.
• Meat and beans. Lean protein should come from low-fat or lean meats and poultry that is prepared by grilling, baking, or broiling. Varying choices is recommended, so that more fish, beans, peas, nuts, and seeds that provide protein are part of the diet.
• Oils and fats. Most fat sources should come from fish, nuts, and vegetable oils. Solid fats such as butter, stick margarine, shortening, and lard should be limited.

FOOD GROUPS TO ENCOURAGE. The new guidelines encourage eating enough fruits and vegetables to stay within energy needs. Two cups of fruit and about 2 and one-half cups of vegetables per day are adequate for a person consuming 2,000 calories per day. Those eating more or less than 2,000 calories can adjust their fruits and vegetables up or down.

Adopting a balanced eating pattern

The Dietary Guidelines recommend adopting a balanced eating pattern. Using the USDA’s pyramid can help customize a plan or adults can choose the DASH eating plan. DASH is a plan that was created to help prevent high blood pressure by minimizing salt in the diet, by providing a balance of nutrients, and by keeping weight down.

Recommendations for specific adult populations

Not every adult has the same nutritional needs. In addition to specific nutritional needs related to diseases or activity, the following recommendations apply to certain groups:

• People over age 50. Guidelines recommend consuming vitamin B₁₂ in fortified foods or supplements. -Women of childbearing age. If a woman many become pregnant, she should eat iron-rich plant foods or those that help absorb iron, such as vitamin-C rich foods. Women in their first trimester of pregnancy should consume adequate synthetic folic acid daily from fortified foods or supplements in addition to food forms from a varied diet.
• Older adults, people with dark skin, and people not exposed to sufficient sunlight. These individuals should consume extra vitamin D from vitamin-D fortified foods and/or from supplements.

Getting adequate nutrients

The actual amount of any nutrient a person needs, as well as the amount each individual gets from his or her diet will vary. Many adults do not receive enough calcium from their diets, which can lead to osteoporosis later in life. Other nutrients of concern are potassium, fiber, magnesium, and vitamin E. Some population groups also need to get more vitamin B₁₂, iron, folic acid, and vitamin D. These nutrients should come from food when possible, then from supplements if necessary.

Fluid

Many adults ignore the role that fluids play in nutrition. It is important to moderate drinking of high-sugar beverages and fruit juices, as well as alcoholic beverages. Most people will get adequate hydration from normal thirst and drinking behavior, especially by consuming fluids with meals.

Nutrition for strength

Adults who are physically active and who strength train or pursue athletic activities will have different nutrition needs than typical adults of the same age. For example, they will require more fluids while exercising. In general, athletes and those who are very active also require more carbohydrates in their diets than typical Americans. Carbohydrates provide energy, but they should come from whole grains and fruits, not from refined sugars.

Vegetarian diets

Vegetarians can achieve recommended nutrient intakes by carefully choosing foods from the basic food groups. They will need to pay special attention to intake of protein, iron, and other vitamins, depending on the type of vegetarian program they follow. Choosing nuts, seeds, and legumes from the meat and beans group, as well as eggs if they desire, can provide enough nutrients at the proper serving level.

Processed and prepared foods

Americans are eating out more than ever and are buying foods in the grocery store that are prepackaged. It is more difficult to judge the nutrients and calories in many of these foods and in general, fresh foods are healthier than those that are packaged. Highly processed foods do not contain significant amounts of essential minerals. They often contain high amounts of fats and sugar, as well as artificial preservatives and other additives. Many restaurants, including fast food restaurants, are trying to offer healthier selections. The USDA offers tips for eating out to help people stay within their healthy pyramid servings and portions.

Calories and weight management

The new guidelines and pyramid focus back on the basics of calorie management. It’s all about balancing energy, or the amount of calories eaten vs. the amount of calories used by the body. By managing portions, eating a balanced diet from the food groups and not using discretionary calories on high-sugar or high-fat foods, people can maintain a reasonable intake of calories. Regular physical activity can help use calories to provide better balance. Research has shown that subtracting just 100 calories a day from the diet can help manage weight, and eating 500 fewer calories a day can result in losing one pound per week in weight. But every individual is different and it is recommended to involve a physician or dietician in a weight loss plan.

Precautions

Though supplementation of nutrients sometimes is necessary, physicians and dieticians recommend that nutrients come from food, not from vitamins and supplements. Excessive use of vitamins and mineral supplements can lead to serious health problems and it is best to involve a physician to ensure that supplements are being used at appropriate and safe levels. It also is best not to change a diet without the advice of a nutritional expert or health care professional. People who are chronically ill, and women who are pregnant or breastfeeding only should change their diets under professional supervision.

Parental concerns

The recommendations in the Dietary Guidelines are for Americans over two years of age.

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Adolescent nutrition

Definition

Nutrition describes the processes by which all of the food a person eats are taken in and the nutrients that the body needs are absorbed. Good nutrition for adolescents can help prevent disease and promote proper health, growth, and development.
Adequate intakes of vitamins and minerals are an important part of nutrition. Vitamins are organic substances present in food. They are required by the body in small amounts to regulate metabolism and to maintain normal growth and functioning. Minerals are vital because they are the building blocks that make up the muscles, tissues, and bones. They also are

Healthy eating at fast food restaurants

• Skip “value-sized” or “super-sized” meals
• Choose a grilled chicken sandwich or a plain, small burger
• Use mustard instead of mayonnaise
• Limit fried foods or remove breading from fried chicken, which can cut half the fat
• Order garden or grilled chicken salads with light or reduced-calorie dressings
• Choose water or fat-free or low-fat milk instead of sweetened soda

SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, U.S. Department of Health and Human Services.

(Illustration by GGS Information Services/Thomson Gale.)
important to many life-supporting systems, such as hormones, transport of oxygen, and enzyme systems.
There are many nutrients the body absorbs from food and each of the food groups supplies at least one nutrient. For example, oat bran, which is a whole grain, can supply fiber and a mineral called magnesium. A good nutrition plan will ensure that a balance of food groups, and adequate amounts of the nutrients supplied by each group, is eaten.

Purpose

Proper nutrition is essential to keeping teens healthy and able to grow and develop properly. Eating right also helps teens participate better in school and athletic activities. The nutritional status and health of children and adolescents has declined in recent years. Government surveys have shown that at least 16% of children and adolescents age 6 to 19 years old are considered overweight and at least 11% of adolescents now are classified as obese. In 2000, more than 16% of the population under age 18 years lived in poverty, often receiving poor nutrition as a result.
Many adolescents consume more calories than they need, yet they don’t meet recommended daily intakes for a number of nutrients. Of particular concern for children and adolescents are adequate levels of calcium, potassium, fiber, magnesium, and vitamin E from the diet.
Eating disorders lead to poor nutritional status and can affect growth and development for teenagers of both sexes. They rank as the third most common form of chronic illness in adolescent girls, affecting as many as 5% of teenage girls.
Studies have shown that eating habits and nutrition in adolescence can affect not only adult weight, but other health issues later in life. For instance, not

KEY TERMS

Anorexia nervosa—A serious eating disorder characterized by a pathological fear of weight gain.
Bulimia nervosa—A serious eating disorder characterized by compulsive overeating followed by purging by self-induced vomiting or abuse of laxatives to induce diarrhea.
Osteoporosis—A condition that affects bone mass, usually later in life, making bones brittle and easily breakable.

eating enough calcium as a teenager can increase risk of osteoporosis as an older adult.
Finally, adolescent nutrition is important because some teens have health problems that require special diets. Type 1 diabetes, also called juvenile diabetes, is diagnosed in as many as 13,000 children a year, often during their teens. It requires, controlling both diet and lifestyle factors which can be particularly difficult for busy teenagers. Surprisingly, increases in obesity mean that Type 2 diabetes, which in the past has only been diagnosed in adults, now is diagnosed with increasing frequency in adolescents as well.

Description

The United States Department of Agriculture (USDA) and the United States Department of Health and Human Services revised the Dietary Guidelines for Americans in 2005. The guidelines are science-based and outline advice for choosing a nutritious diet and maintaining a healthy weight. Although the guidelines are written for adults, the nutritional elements are the same for anyone over age two years old, with key recommendations for children and adolescents. The 2005 guidelines also address physical activity and food safety. The USDA revised the traditional food pyramid to make it customized for individuals.

Basic food groups

The following are the basic food groups included in the pyramid provided by the USDA:

• Vegetables. The pyramid recommends eating more dark green and orange vegetables, as well as more dry beans and peas.
• Fruits. A variety of fresh, frozen, or canned fruit is good, but the USDA recommends limiting consumption of fruit juices.
• Milk, yogurt, and cheeses. The USDA recommends getting plenty of calcium-rich food from low-fat or fat-free milk. Adolescents should consume three c. per day of fat-free or low-fat milk or equivalent milk products. Teens who can’t drink milk should be given lactose-free products or other sources of calcium, such as hard cheeses and yogurt.
• Meat and beans. Lean protein should come from low-fat or lean meats and poultry that is prepared by grilling, baking, or broiling. Varying choices is recommended, so that more fish, beans, peas, nuts, and seeds that provide protein are part of the diet.
• Oils and fats. Most fat sources should come from fish, nuts, and vegetable oils. Solid fats such as butter, stick margarine, shortening, and lard should be limited. Adolescents should receive no more than 25% to 35% of calories from fats.

Adopting a balanced eating pattern

The Dietary Guidelines recommend adopting a balanced eating pattern. Using the USDA’s new pyramid can help customize a plan for teens that provides adequate nutrients for needed energy, growth, and development. Teenagers often report eating high levels of junk food, sweet sodas, especially when away from home. More than one-half of adolescents do not meet the Dietary Guidelines for fruit and vegetable consumption and nearly two-thirds consume more than the recommended amount of fat. Reports also show that at least two-thirds of adolescent boys and girls have tried to lose weight using unsuccessful methods. While many efforts have been made on national and local scales to improve the nutritional selections of school lunches and vending machines, the Dietary Guidelines offer a healthy way to provide a balanced diet at home and in lunch choices brought from home.

Fluid

Many adolescents ignore the role that fluids play in nutrition. It is important to moderate drinking of high-sugar beverages and fruit juices especially between meals. Caffeine from sodas and coffee drinks can interfere with sleep if consumed late at night, which already is a health and school performance issue for many teens. The Dietary Guidelines also say that adolescents should not drink alcoholic beverages. Adolescents need to drink an adequate amount of water, though they do not need to overhydrate.

Nutrition for strength

Adolescents who are physically active and play sports will have different nutrition needs than typical teenagers of the same age. For example, they will require more fluids while exercising. In general, those who are very active also require more carbohydrates in their diets than typical teens. Carbohydrates provide energy, but they should come from whole grains and fruits, not from refined sugars.

Vegetarian diets

A minority of adolescents are vegetarians, though popularity of various vegetarian diets has increased among adolescents in recent years. For the most part, teenagers can meet most nutritional requirements and achieve adequate growth with a well-planned vegetarian diet. But the trend toward vegetarianism has contributed to nutrient deficiencies in American adolescents because of restrictive eating in the formative years. Teens have been reported to suffer stunted growth, fragile bones, and stress fractures from lack of nutrients on vegetarian diets.
The Dietary Guidelines are designed so that vegetarians can achieve recommended nutrient intakes through careful selection of certain foods. However, research has shown that teenage girls often have low levels of nutrients such as zinc, iron, and calcium, which can be more difficult to obtain from a vegetarian diet. Only one in four teenage girls eat the recommended quantity of meat on a daily basis. Vegan and macrobiotic diets may require supplementation of for teens.

Processed and prepared foods

Calories and weight management

The new guidelines and pyramid focus on the basics of calorie management. It’s all about balancing energy, or the amount of calories eaten vs. the amount of calories used by the body. By managing portions, eating a balanced diet from the food groups, and not taking in too many calories on high-sugar or high-fat foods, adolescents can maintain a reasonable intake of calories. Regular physical activity can help to balance energy. Research has shown that subtracting just 100 calories a day from the diet can help manage weight. The typical soda contains 150 calories. Adults need to help teens understand that balanced eating and calorie management help manage weight, not unhealthy stretches of fasting or reliance on fad diets. Physical activity also helps manage weight. Encouraging more participation in sports or just spending time outside with family and friends vs. “screen time” in front of the television, computer, and video games, also can help manage weight safely.
Dieting is an important predictor of eating disorders among adolescents. Girls who practiced rigid dieting are about 18 times more likely to have eating. disorders such as anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified. Teen girls who have dieted moderately are five times more likely to be diagnosed with an eating disorder. If an eating disorder is diagnosed, the adolescent will receive therapy with behavioral and nutritional approaches.
Nutritional therapy for teens with eating disorders will first correct possible malnutrition caused by the eating disorder. Refeeding must be carefully planned to avoid complications brought on by sudden increased calories and weight gain. The meal plan will be based on the Dietary Guidelines with gradual increases in calories as the teen’s lean body mass increases.
Some adolescents with diabetes have been known to use doses of insulin below those recommended by their physicians to promote weight loss. Teens with Type 1 diabetes will have nutritional counseling upon diagnosis and regular checks with a registered dietician. They will have to count carbohydrates and carefully plan diet around exercise to avoid weight gain. Teens with Type 2 diabetes also will be taught how to control blood glucose levels.

Precautions

Like adults, adolescents need to understand that it is best to achieve recommended levels of nutrients through consumption of foods instead of through vitamins and supplements. Use of supplements should be done only under the supervision of a professional medical provider who understands adolescent nutrition needs. Adolescents should understand that the best way to manage weight is through a balanced approach to eating fresh foods and through remaining physically active, not through fasting, use of drugs or supplements, or through participation in fad diets.

Complications

Failing to eat a nutritious diet can cause growth and developmental problems in adolescents and cause long-term complications such as obesity or osteoporosis. Eating disorders can lead to serious complications in teens, including malnutrition, changes to heart function caused by starvation, stomach bleeding, and may cause depression leading to suicide. Improper management of diabetes can lead to loss of consciousness and seizures, and in the longer term, eye disease, kidney and heart disease, or nerve damage.

Parental concerns

Parents are up against the peer pressures and constant conflicting images that adolescents get from the media. On the one hand, teens see unrealistic images of body types on television and in magazines. On the other hand, they are bombarded with advertisements for processed, convenient, and unhealthy foods. Girls also frequently read magazine articles about dieting and weight loss, a practice that leads to unhealthy weight control behaviors. Internet Web sites even provide advice to teens on how to accomplish and hide their eating disorders and what sorts of products help people with bulimia nervosa in their purging of foods.

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