Dietary Intake and Nutritional Assessment Methods

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Introduction

The recommended dietary intakes were developed in 1991 for use in Australia. These are values used to define the levels of various nutrients that should be adhered to in order to meet the nutritional needs of healthy people. Nutritious foods and an active lifestyle are very important factors that govern the achievement of good health. Nutritious foods are foods that promote the health and wellbeing of an individual and do not expose them to nutrition-related diseases such as diabetes, heart diseases, and cancer.

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This is a report on the suitability of an adult male’s diet and it gives recommendations on how the diet should be modified in accordance with the current nutritional status of the subject. The suitability of this subject’s diet will be determined by comparing it with the Australian dietary guidelines, which mainly comprise of core food groups that reflect the RDIs and the composition of foods in Australia. The diet has been recorded in two forms: a 24hr recall and a 3 days recall.

The objective of this paper, therefore, is to determine the appropriateness of a selected type recorded using a 24hr recall, and 3 days approach from a selected individual by comparing it to Australian dietary guidelines.

Discussion of the subject’s nutrients in the 3 days Food Record in comparison with RDI value

Good nutrition is an imperative marker for good health. Individual factors such as level of physical activity, sex, developmental stage, and age determine one’s nutritional requirements (English & Lewis 1991). There is nutrient variance in the subject’s diet since the nutrient intake is not commensurate with the RDIs. The intake of both the macro- and micro-nutrients is either lower or higher than recommended.

The total caloric intake is less than the RDI value. In addition, the RDIs of the different macronutrients that provide energy in the body show discrepancies in comparison to the intake. This is because carbohydrates, which should form the largest proportion of the total calories, are lesser in amount compared with the other two macro-nutrients.

The protein foods and especially the red meats, selected by the subject are not ideal sources since apart from the tuna sandwich and the egg, others like the kebab and kibbi do not have the same nutrient composition as fried natural mutton or beef. This is because kebab meat, or kibbi, is relatively artificial and does not contain some of the very essential nutrients.

This statement is justified by the variance in zinc levels given the high intake of protein animal foods, which are believed to have high levels of zinc compared with plant foods. The subject’s diet is a typical example of poor feeding habits that are associated with chronic diseases since the inadequacies in energy and total caloric are not commensurate with inadequacies of the three main types of energy-giving foods.

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A large proportion of the micro-nutrients on the other hand are not in accordance with the RDIs. Lack of adequate calcium intake as is the case from the diet leads to lowered bone density and exposure to bone fractures (National Health and Medical Research Council et al. 2006). Excessive intakes of phosphorus and sodium excessive are of concern since these levels have disastrous effects on individuals’ health as far as the heart is concerned.

According to Smirnov, Volkov, Dobronravov & Rafrafi (2010), high intakes of phosphorus than normal predispose people to heart diseases. An excessive intake of sodium beyond the normal levels interferes with calcium availability in the body and results in high blood pressure. High blood pressure eventually leads to cardiovascular diseases and renal diseases (Graudal, Galløe, Garred 1998). The imbalance of these nutrients is attributed to consumption of artificially processed meats that mainly contain high amounts of sodium and phosphorus compared with natural meats, more so the white meats.

An excessive intake of iron results in atherosclerosis and ischemic heart disease (Obikoya 2010). Zinc is a very important nutrient for men with regard to reproduction (National Health and Medical Research Council 1992b). However, the diet under analysis only includes half of its requirement. Another important nutrient whose level is low in the diet is potassium. Potassium is effective in counteracting the effects of sodium but in the subject’s diet, the low levels of potassium and excessive intakes of sodium distorts electrolyte balance and the adverse effects of sodium prevail (Greenfield & Southgate 2003).

The consumption of thiamine, and riboflavin, is below the recommended while the intakes of vitamin C and niacin equivalents are above the recommended intakes. Consumption of excessive vitamin C is deemed wasteful since excess vitamin C beyond what the body requires is excreted from the body as waste.

The same with applies for niacin equivalents. Total retinol is very high compared with the RDI value. Upper RDI value for total has been established because excessive intake of total is toxic and is associated with liver abnormalities. The recommended intake for water is 3400g but the subject only managed to take in only managed to take in 1731.8g of water. This is too little water given the high consumption of sodium. The intake of fibre is also quite low compared with the recommended.

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Fibre plays a very essential role in peristalsis and digestion. Studies have indicated that low intakes of fibre are associated with cancer (Karen et al. 1992). Therefore, it is very important to ensure that one meets his or her daily recommendations for fibre. The subject ostensibly did not consume any alcohol, and this is very healthy since alcohol interferes with nutrient absorption and utilization.

Comparing the subject record in 3 days and 24 hour with the recommendation of the dietary guidelines

Australian dietary guidelines advocate for the daily consumption of adequate food from each of the five food groups. Variety within a food group should be observed and individuals should consume a lot of plant foods. Water is life and it is recommended that adults should drink at least 8 glasses of per day (Kellet, Smith & Schmerlaib 1998).

According to the three day intake, the ingestion of 12.39 servings is too high compared with the acceptable normal quantities of 4-9 servings. A 3 days dietary recording is more representative than a 24 hour recall and gives a more typical picture of the food intake of an individual. Therefore, in this case, the 3 days dietary intake will act as the typical representation of the subject’s usual dietary intake as demonstrated by Marr (1971).

The majority of consumed cereals are refined, commercialized, and not considered to be healthy choices like the cakes and biscuits compared with what the dietary guidelines recommend. These types of cereals only provide empty calories that do not nourish the body. Cakes, biscuits, chocolate, and cheese are grouped as extra foods whose consumption should be spared by people who are inactive and aim at reducing weight. The consumption of such kinds of cereals therefore should be limited (Sherman & Mehta, 2009).

The amount of total calories consumed by an individual determines the healthy wellbeing of the individual in relation to chronic diseases (Jelliffe, 1966). The type also is an attributing factor since carbohydrates as opposed to fats, are better sources for energy metabolism (National Health and Medical Research Council, et al. 2006).

Compared with the 3 days record, the 24hour recall is biased to one day, which does not ideally indicate an individual’s usual food intake. The 24 hour recall shows a similar variance with regard to total calories and the macro-nutrients. The variance is greater for the 24hr recall as compared with the 3 days record. Just like in the 3 days record, the subject’s choice of cereals is not appropriate and this affects the suitability of the diet.

The selection of what are considered as extra foods is associated with caloric intakes that cause greater harm compared with caloric intakes from recommended foods such as rice, nuts and oats.

During the 24hour recall, there was no intake of vegetables, which are a major source of minerals. This is one of the reasons why most of the micro-nutrients are insufficient. Under the minerals’ section, it is only iron whose intake is commensurate with the recommended intake. This is explained by the mere fact that most of the servings of meat were more than the recommended. Worth noting is the variance between excessive intakes of meat from the 24hr recall, and just enough amounts of iron.

One would expect high intake levels of iron as well but it all narrows down to poor food choices. There are variances in all the other nutrients indicated. The consumption of calcium, potassium, magnesium, and zinc is below the RDIs while the consumption of phosphorus and sodium is above the RDIs. As explained earlier on, the consumption of excessive sodium is associated with heart diseases as well as the consumption of excessive phosphorus (Smirnov, Volkov, Dobronravov & Rafrafi 2010).

Comparing between two methods of nutritional assessment and core food groups

The core food groups were developed by the NHMRC with continued efforts by the National Food Authority. They are useful in determining the adequacy of people’s diets as well as in informing consumers on healthy eating habits (Cashel & Jefferson, 1994). As stated earlier, a 3 day food record is more representative than a 24 hour recall.

This is because the 3 day food record captures diet variety compared with the 24 hour recall (Crawford, Obarzanek, Morrison, & Sabry 1994). In addition, the 3 day food record is more accurate due to the same reasons explained above. Irrespective of this difference, the two methods of determining food intake differ from the core food groups.

The food records compared with the core food groups indicate that the intake of cereals was greater compared with the recommended of 270g. In both food records, the intake of vegetables, fruits, and milk was higher compared with the recommendations from the core food groups. In addition, in both food records, the intake of meat was higher compared with the core food groups. This shows that in as far as the core food groups are concerned; the two types of food records give similar results.

Comparing 24 hour and three days record with NHMRC report

As stated earlier on, fats are not the best sources of energy due to intermediary by-products like ketone bodies that distorts the internal body environment. Intake of fat beyond the recommended normal levels is associated with chronic diseases like type 2 diabetes, kidney diseases, hypertension and cardiovascular diseases.

Most of the fats should be from the poly unsaturated fats and especially the omega 3 and omega six, which are considered to be essential fatty acids (National Health and Medical Research Council 1992b). The essential fatty acids mentioned are important since they help to lower the levels of cholesterol in the body.

According to the food records, the intake of fat was above that recommended by the NHMRC. In addition, the proportion of saturated to unsaturated fatty acids was higher. These two characteristics of the diet create a lot of concern since they act as risk factors for ill health. It is important for individuals to be cautious in choosing foods that are healthy enough in terms of the nutrients.

Diet Modification

The subject’s BMI of 42 is above the recommended, which is a range between 18.5 and 24.9. This therefore means that the subject should either engage in physical activity to burn out the excess weight or make modification in the diet based on various parameters. In the three days food recording, it was obvious that the selection of cereals for consumption was not ideal, that is, was based on cakes, biscuits, hamburgers and chocolates.

These types of cereals are not nutrient-dense and for foods like hamburgers, they contain a lot of salt in them. This could explain why the diet of this individual has a high salt content. Therefore, these kinds of cereals should be replaced with grains like corn, rice, wheat, barley, millet, and rye. The types of food consumed by the subject are not nutrient dense hence the reason why the diet is deficient in most of the nutrients found in natural foods.

If individuals select their cereals healthily, it is almost impossible to have deficiencies in some of these nutrients, specifically thiamine. In addition, the protein sources of food should be changed to include legumes and nuts, whose nutrient composition is much better than the processed meats. In any meal, carbohydrates ought to make up for the largest proportion of the kilocalories. However, in this particular example of a diet, most of the energy is from proteins and fats due to poor selection of foods.

The biochemical processes involved so that these two types of nutrients are able to provide energy to the body disrupts the internal environment. In addition, it has been indicated that protein interferes with the absorption and bioavailability of calcium therefore excessive intakes might yield more adverse effects. When the diet has too much proteins and fat as opposed to one’s requirements, this leads to obesity and if one was already obese, this is associated with increased risk to heart diseases. This is the typical case of the subject at hand.

According to Australian dietary guidelines, out of the 20-35% of fats that should make up the total calories, no more than 10% should be from the trans-fats and saturated fatty acids (National Health and Medical Research Council et al. 2006). Therefore, with reference to the diet being analyzed, poor food choices is the reason why the ratio of saturated fats to unsaturated fats is high. Once again, the meat types should be reduced.

The subject could opt for stewed instead of fried meat since the former has less amounts of saturated fats compared with the unsaturated fats. In addition, most of the foods, even rice which could otherwise be boiled, have been fried. This adds onto the amount of unhealthy saturated fats that cause illnesses such as type 2 diabetes, dementia, cancer and elevated blood pressure (Crawford, Bazinet & Sinclair 2009; National Heart Foundation of Australia 2008).

Conclusion

A range is very essential, or a confidence interval because it becomes near impossible to consume the exact amount of recommended nutrients. During the analysis, using a single RDI value becomes tricky. The core food groups give room for extra nutrients that apparently are attributed to food preparation.

However, this assumption is wrong since the same process of food preparation leads to a loss of nutrients. Extensive research should be conducted to develop lower and upper limits for all nutrients in Australia. Fish and poultry, which are white meats, are categorised as meats yet the nutrient content between white meats and red meats is very different.

For example while fish contains essential fatty acids, red meat contains invisible fat that is deemed hazardous to health. Therefore, there is need to broaden the scope of the Australian core food groups in a manner that caters for nutrient composition. It is recommendable therefore that the subject adopts a healthy eating style that will be achieved through healthy food choices.

Reference List

Cashel, K & Jefferson, S 1994, The core food groups: The scientific basis for developing nutrition education tools, NHMRC, Canberra.

Crawford, M, Bazinet, R & Sinclair, A 2009, “Fat intake and CNS functioning: ageing and disease”, Ann Nutr Metab, vol. 55, no.1-3, pp. 202-28.

Crawford, PB, Obarzanek, E, Morrison, J & Sabry ZI 1994, “Comparative advantage of 3-day food records over 24-hour recall and 5-day food frequency validated by observation of 9- and 10-year-old girls”, Journal of the American Dietetic Association, vol. 94, no. 6, pp. 626-630.

English, R & Lewis, J 1991, Nutritional values of Australian foods, AGPS, Canberra.

Graudal, NA, Galløe, AM, & Garred, P 1998, “Renin, Aldosterone, Catecholamines, Cholesterols, and Triglyceride”, JAMA, vol. 17, pp. 1383-1391.

Greenfield, H & Southgate, DAT 2003, Food composition data: Production, management and use, 2nd edn, FAO, Rome.

Jelliffe, DB 1966, The assessment of the nutritional status of the community, WHO, Geneva.

Karen, C, English, R, Lewis, J, Holt, R, Dobson, R, Greenfield, H & Jayashree, A 1992, Composition of foods, Australia (COFA), National Food Authority, Canberra.

Kellet, E, Smith, A & Schmerlaib, Y 1998, The Australian Guide to Healthy Eating, Commonwealth of Australia, Victoria.

Marr, JW 1971, “Individual dietary surveys: purposes and methods”, World Rev. Nut. Diet, vol. 13, pp. 105-164.

National Health and Medical Research Council, Australian Government Department of Health and Ageing, & New Zealand Ministry of Health 2006, Nutrient reference values for Australia and New Zealand including recommended dietary intakes, Commonwealth of Australia, Canberra.

National Health and Medical Research Council 1992b, The role of polyunsaturated fats in the Australian diet, AGPS, Canberra.

National Heart Foundation of Australia (National Blood Pressure and Vascular Disease Advisory Committee) 2008, Guide to management of hypertension, National Heart Foundation of Australia.

Obikoya, G 2010, “Too Much Iron: Iron Overdose”, The Vitamins & Nutrition Center. Web.

Sherman, RA & Mehta, O 2009, “Dietary phosphorus restriction in dialysis patients: potential impact of processed meat, poultry, and fish products as protein sources”. Am J Kidney Dis., vol. 54, no. 1, pp. 18-23.

Smirnov, AV, Volkov, MM, Dobronravov, VA & Rafrafi, H 2010, “Phosphorus and calcium metabolism and the cardiovascular system status in patients with early stage chronic renal disease”, Ter Arkh, vol. 82, no. 6, pp. 25-8.

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